Side effects of common drugs Flashcards

1
Q

Common side effects with beta-blockers

A
  • Fatigue
  • Coldness of extremities
  • Sleep disturbance with nightmares
  • May exacerbate asthma so should be avoided in asthma or bronchospasm
  • Bradycardia
  • Hypotension
  • Sexual dysfunction
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2
Q

Which beta-blockers are less likely to cause sleep disturbances with nightmares?

A

Water soluble ones:
- Atenolol
- Celiprolol
- Nadolol
- Sotalol

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3
Q

Which beta-blockers can be given in asthma is there is no alternative?

A

Cardioselective beta-blockers:
- Atenolol
- Bisoprolol
- Metoprolol
- Nebivolol
- Acebutolol

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4
Q

Beta-blockers and diabetes

A

Beta-blockers are not contraindicated in diabetes but can cause a small deterioration of glucose tolerance.
- Cardioselective beta-blockers are prefered or avoided altogether in those with frequent episodes of hypoglycaemia

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5
Q

ACEinhibitor common side effects

A
  • Dry cough (change to ARB)
  • Rash
  • Hyperkalaemia
  • Hypotension
  • Renal impairment
  • Altered LFT
  • Angioedema
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6
Q

When do statins have an increased incidence of myopathy?

A
  • Statins given at high doses
  • Statins given with a fibrate with lipid lowering doses of nicotinic acid or with immunosuppressants such as ciclosporin
  • Family history of muscular disorders
  • Previous history of muscular toxicity
  • High alcohol intake
  • Hypothyroidism
  • Females
  • Elderly
  • Renal impairment
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7
Q

Statins and LFT’s

A

They alter LFTs
- Use in caution in those with history of liver disease or with high alcohol intake
- AST and ALT
- LFT carried out before and within 3 months of starting and at 1 year if normal

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8
Q

Statins common side effects

A
  • Abdominal pain
  • Flatulence
  • Rash
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9
Q

Simvastatin is contraindicated with which drugs?

A
  • Ciclosporin
  • Danazol
  • Gemfibrozil
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10
Q

Simvastatin should be given at 20mg max with which drugs?

A
  • Amiodarone
  • Verapamil
  • Diltiazem
  • Amlodipine
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11
Q

When should simvastatin 80mg be given?

A
  • Severe hypercholesterolemia
  • High risk of cardiovascular complications who have not achieved benefits at lower doses
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12
Q

What is first line statin and dose in primary and secondary CVD prevention?

A

Primary prevention = Atorvastatin 20mg
Secondary prevention = Atorvastatin 80mg

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13
Q

Common side effects of anti-muscarinic

A
  • Dry mouth
  • Blurred vision
  • Urinary retention
  • Drowsiness
  • Constipation
  • Increased risk of fall
  • Confusion and memory loss
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14
Q

What drugs cause anti-muscarinic side effects?

A
  • Antihistamines
  • Antispasmodics
  • Narcotic analgesics
  • Anti depressants
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15
Q

Common side effects of SSRI’s

A
  • Agitated, shaky or anxious
  • Nausea and vomiting
  • Indigestion, diarrhoea or constipation
  • Loss of appetite and weight loss
  • Dizziness
  • Blurred vision
  • Dry mouth
  • Low sex drive
  • Erectile dysfunction in men
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16
Q

First choice of SSRI in younger people or those with CVD?

A
  • Sertraline
  • Fluoxetine
  • Paroxetine
17
Q

Common side effects of quinolone antibiotics

A
  • Caution in patients with epilepsy
  • Tendon damage
  • Tendon rupture may occur within 48 hours of starting treatment
  • Not recommended in children or growing adolescents as it can cause arthropathy (Lyme’s disease)
18
Q

What other drug class is not used in children?

A
  • Tetracyclines
  • Can cause yellowing of teeth
  • Has interaction with milk and antacids
19
Q

Common antibiotic side effects/interactions

A
  • Aminoglycosides - ototoxicity and nephrotoxicity
  • Metronidazole and alcohol can worsen side effects
  • Clindamycin and diarrhoea
  • Isoniazid and peripheral neuropathy
20
Q

Tuberculosis treatment regime

A
  • Rifampicin, ethambutol hydrochloride, pyrazinamide and isoniazid (with pyridoxine hydrochloride) in the initial phase continued for 2 months.
  • After initial phase, offer standard continuation treatment with rifampicin and isoniazid (with pyridoxine hydrochloride) for a further 4 months
21
Q

Common side effects of hypoglycaemia

A
  • Sweating
  • Shaking
  • Anxiety
  • Palpitations
  • Feeling weak
  • Nauseated
  • Confusion
  • Poor concentration
    In severe cases, convulsions and coma
22
Q

Metformin common side effects

A

Metformin is first line in obese diabetic patients as it does not increase appetite
- Anorexia
- Nausea and vomiting
- Diarrhoea
- Metallic taste
- Decreases vitamin B12 absorption

23
Q

When is metformin contraindicated

A
  • Severe hepatic or renal disease as it can cause lactic acidoses
  • Stop if renal function is below 30mL/min
24
Q

Pioglitazone common side effects

A

Risk of heart failure and bladder cancer

25
Q

Gliptins common side effects

A

Pancreatitis risk

26
Q

Flozins comon side effects

A

UTIs
Diabetic ketoacidosis
Fourniers gangrenes
Amputations with canagliflozin

27
Q

Medicine sick leave rule

A

If patient experiences fever, sweats, shakes, vomiting, diarrhoea then consider temporarily stopping the medicines and restart after 24-48 hours of eating and drinking normally.
- ARBs
- ACE inhibitors
- NSAIDs
- Diuretics
- Metformin

28
Q

Which drugs cause AKI?

A
  • Aminoglycosides
  • NSAIDs
  • ACE inhibitors
29
Q

Who is at risk of AKI?

A
  • Aged 65 years or over
  • Kidney problems
  • Heart failure
  • Liver disease
  • Diabetes
30
Q

In CKD, what is there a disruption in the regulation of?

A
  • Phosphate- increased phosphorus in blood
  • Calcium - phosphate binds to calcium in the blood causing lower levels of calcium
  • Vitamin D - low levels found
  • Parathyroid hormone - increased
31
Q

Which antipsychotics cause erectile dysfunction?

A

Risperidone and other typical antipsychotics

32
Q

First generation antipyschotics

A

Chlorpromazine, Levomepromazine, Flupentixol, Haloperidol

33
Q

Second generation antipsychotics

A

Clozapine, quetiapine, olanzapine, Risperidone, Amisulpride, Aripiprazole

34
Q

Which antipsychotics cause tardive dyskinesias?

A

First generation

35
Q

Which antipsychotics cause hyperprolactinaemia?

A

Risperidone