Side effects of common drugs Flashcards
Common side effects with beta-blockers
- Fatigue
- Coldness of extremities
- Sleep disturbance with nightmares
- May exacerbate asthma so should be avoided in asthma or bronchospasm
- Bradycardia
- Hypotension
- Sexual dysfunction
Which beta-blockers are less likely to cause sleep disturbances with nightmares?
Water soluble ones:
- Atenolol
- Celiprolol
- Nadolol
- Sotalol
Which beta-blockers can be given in asthma is there is no alternative?
Cardioselective beta-blockers:
- Atenolol
- Bisoprolol
- Metoprolol
- Nebivolol
- Acebutolol
Beta-blockers and diabetes
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
ACEinhibitor common side effects
- Dry cough (change to ARB)
- Rash
- Hyperkalaemia
- Hypotension
- Renal impairment
- Altered LFT
- Angioedema
When do statins have an increased incidence of myopathy?
- 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
Statins and LFT’s
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
Statins common side effects
- Abdominal pain
- Flatulence
- Rash
Simvastatin is contraindicated with which drugs?
- Ciclosporin
- Danazol
- Gemfibrozil
Simvastatin should be given at 20mg max with which drugs?
- Amiodarone
- Verapamil
- Diltiazem
- Amlodipine
When should simvastatin 80mg be given?
- Severe hypercholesterolemia
- High risk of cardiovascular complications who have not achieved benefits at lower doses
What is first line statin and dose in primary and secondary CVD prevention?
Primary prevention = Atorvastatin 20mg
Secondary prevention = Atorvastatin 80mg
Common side effects of anti-muscarinic
- Dry mouth
- Blurred vision
- Urinary retention
- Drowsiness
- Constipation
- Increased risk of fall
- Confusion and memory loss
What drugs cause anti-muscarinic side effects?
- Antihistamines
- Antispasmodics
- Narcotic analgesics
- Anti depressants
Common side effects of SSRI’s
- 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