Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

emergency drugs and doses > Side effects and contraindications > Flashcards

Side effects and contraindications Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

Aspirin, warfarin and heparin

A

Do not give to patients with bleeding risk (e.g. prolonged prothrombin time due to liver disease).
Remember prophylactic heparin is contraindicated in acute ischaemic stroke due to bleeding risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Steroid side effects?

A 
Stomach ulcers
Thin skin
Oedema
Right and left heart failure
Osteoporosis
Infection (including candida)
Diabetes (more often hyperglycaemia)
Cushing's syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

NSAID side effects and contraindications?

A 
NSAID
No urine (renal failure)
Systolic dysfunction (heart failure)
Asthma
Indigestion (any cause)
Dyscrasia (clotting abnormality)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Antihypertensives side-effect

A

Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Beta blockers

A

Bradycardia, wheeze in asthmatics, worsening of acute heart failure (but effective in chronic heart failure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Calcium channel blockers

A

Bradycardia, peripheral oedema, flushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ACE inhibitors

A

Electrolyte disturbance (hyperkalaemia) and dry cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diuretics - loop and K sparing

A

Electrolyte disturbance, renal failure.

Loop (e.g. furosemide) can cause gout. K sparing (e.g. spironolactone) can cause gynaecomastia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thiazide diuretics

A

Cause hypokalaemia by increasing potassium excretion by the kidneys.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Metoclopramide

A

Passes blood brain barrier and can exacerbate parkinsonian symptoms. Domperidone does not pass the BBB and is therefore safer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Methotrexate

A

Withhold in potential sepsis!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Trimethoprim and methotrexate

A

Both are folate antagonists and cannot be taken together. This can lead to pancytopenia and neutropenic sepsis, due to bone marrow toxicity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prophylactic enoxoparin

A

Contraindicated following acute stroke (approximately for 2 months but varies by trust)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clozapine

A

Agranulocytosis resulting in neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Digoxin toxicity effects

A

Confusion, nausea, visual halos, arrythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lithium toxicity effects

A

Early - tremour
Intermediate - tiredness
Late - arrythmias, seizures, coma, renal failure, diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Phenytoin toxicity side effects

A

Gum hypertrophy, atazia, nystagmus, peripheral neuropathy, teratogenicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Gentamicin and vancomycin toxicity side effects

A

Ototoxicity and nephrotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Side effect of carbamazapine

A

Can lead to SIADH and therefore hyponatraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Slow AF

A

Withold digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SIADH as a side effect

A 
sulfonylureas*
    SSRIs, tricyclics
    carbamazepine
    vincristine
    cyclophosphamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Drugs to be avoided during breastfeeding

A 
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
    psychiatric drugs: lithium, benzodiazepines
    aspirin
    carbimazole
    methotrexate
    sulfonylureas
    cytotoxic drugs
    amiodarone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Drugs which can be given for women who are breastfeeding

A

antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is tramadol notorious for?

A

Confusion in the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does cyclizine cause as a side effect?

A

Drowsiness and confusion can occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When is methotrexate contraindicated?

A

In active infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the rules surrounding use of NSAIDS and methotrexate

A

Use with caution as there is a risk of nephrotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What do loop diuretics and thiazide diuretics cause?

A

Hyponatramia and hypokalcaemia

29
Q

When should heparin prophylaxis not be taken?

A

Following acute stroke

30
Q

Why should beta blockers and verapamil not be mixed?

A

This causes severe bradycardia

31
Q

What are the causes of hypernatreamia?

A

Dehydration
Drips
Drugs
Diabetes insipidus

32
Q

Side-effects of lamotrigine?

A

Rash,

Rarely stephens-johnson syndrome

33
Q

Carbamazepine side-effects?

A 
Hyponatraemia
Rash
Dysarthria
Ataxia
Nystagmus
34
Q

Phenytoin side-effects?

A

Ataxia, peripheral neuropathy, gum hyperplasia, hepatotoxicity

35
Q

Side effects of sodium valproate?

A

Tremour, teratogenicity, weight gain

36
Q

Levetiracetam side-effects

A

Fatigue, mood disorders, and agitation

37
Q

When should a laxative never be given?

A

Obstruction

38
Q

Gentamicin and vancomycin side effects

A

Nephrotoxicity, ototoxicity

39
Q

Any antibiotics, but particularly broad spectrum like cephalosporins or ciprofloxacin ADR

A

C. diff colitis

40
Q

ACE inhibitor ADR

A

Hypotension, electrolyte abnormalities, acute kidney injury, dry cough

41
Q

Beta-blockers

A

Hypotension, bradycardia, wheeze in asthmatics, worsens acute heart failure (but helps chronic heart failure)

42
Q

Calcium channel blockers (e.g. diltiazem)

A

Hypotension, bradycardia, peripheral oedema, flushing

43
Q

Diuretics

A

Hypotension, electrolyte abnormalities, acute kidney injury, subclass-dependent effects, e.g. spironolactone causes gynaecomastia

44
Q

Heparin

A

Haemorrhage (particularly renal failure or <50 kg)

Heparin induced thrombocytopaenia

45
Q

Warfarin

A

Haemorrhage (through has a procoagulant effect initially and takes a few days to work, thus need to prescribe heparin initially alongside until INR is 2)

46
Q

Aspirin

A

Haemorrhage, peptic ulcers, gastritis, tinnitus in large doses

47
Q

Digoxin

A

Nausea, vomiting, diarrhoea,
Blurred vision, confusion, drowsiness,
Xanthopsia (disturbed yellow/green visual perception, including ‘halo’ vision)

48
Q

How does low potassium affect digoxin?

A

Augments the effect

49
Q

How does high potassium affect digoxin?

A

Reduces the effect

50
Q

Amiodarone

A

Interstitial lung disease (pulmonary fibrosis)
Thyroid disease (both hypo and hyperthyrodism are reported, it is structurally related to iodine, hence its name amIODarone)
Skin graying
Corneal deposits

51
Q

Lithium

A

Early - tremour

Intermediate - tiredness

Late - arrythmias, seizures, coma, renal failure, diabetes insipidus

52
Q

Haloperidol

A

Dyskinesias, e.g. acute dystonic reactions, drowsiness

53
Q

Clozapine

A

Agranulocytosis (requires intensitve monitoring of FBC)

54
Q

Dexamethasone and prednisolone

A

STEROIDS

Stomach ulcers
Thin skin
Oedema
Right and left heart failure
Osteoporosis
Infection (including candida)
Diabetes (commonly causes hyperglycaemia, rarely progresses to diabetes)
Cushing's syndrome
55
Q

Fludrocortisone

A

Hypertension/ sodium and water retention

56
Q

Ibuprofen

A

NSAID

No urine (renal failure)
Systolic dysfunction (heart failure)
Ashma
Indigestion (any cause)
Dyscrasia (clotting abnormality)
57
Q

Simvastatin

A

Myalgia, abdominal pain, increase ALT/AST (can be mild), rhabdomyolysis (can be just mildly increased creatinine kinase though)

Management of statin-induced myalgia - exclude rhabdomyoltsis with creatinine kinase and urine dip. Otherwise, if symptoms unacceptable or CK very high (>2000), 1. ensure needs statin 2. reduce the dose 3. switch to other statin with lower risk of myalgia (risk of myalgias: simvastain > atorvastatin > pravastatin ?(fluvastatin) or a fibrate.

58
Q

If the scenario refers to low GCS or acidotic behaviour ,look for metformin in the question

A
59
Q

What can iodinated contrast media cause?

A

Renal failure

This may then be associated with increased risk of metformin induced lactic acidosis or ACE inhibitor associated kidney injury

60
Q

What are the most common enzyme inhibitors?

A

Ketoconazole, ciprofloxacin, erythromcyin, grapefruit juice

61
Q

What do beta blockers and verapamil cause?

A

Profound hypotension and asystole

62
Q

What happens if alcohol is drunk with metronidazole

A

Nausea and vomiting

63
Q

Metformin causes

A

lactic acidosis

64
Q

NSAIDS cause

A

GI bleeding

65
Q

Monoamine inhibitors cause

A

hypertensive crisis

66
Q

Warfarin and acute alcohol causes

A

Increased anticoagulation

67
Q

Warfarin and chronic alcohol causes

A

decreased anticoagulation

68
Q

Metronidazole and disulfiram cause

A

Sweating, nausea, flushing, vomiting

69
Q

Barbituates, opioids and benzodiazepines cause

A

Sedation

emergency drugs and doses (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions