Side-Effects of Common Drugs

Question 1

CCBs

Answer 1

• Headache
• Flushing
• Ankle oedema

NB - Verapamil also causes constipation.

Question 2

BBs

Answer 2

• Bronchospasm (especially in asthmatics)
• Fatigue
• Cold peripheries
• Sleep disturbances

Question 3

Nitrates

Answer 3

• Headache
• Postural hypotension
• Tachycardia

Question 4

Nicorandil

Answer 4

• Headache
• Flushing
• Anal ulceration

Question 5

Amoxicillin

Answer 5

• Rash with infectious mononucleosis

Question 6

Co-amoxiclav

Answer 6

• Cholestasis

Question 7

Flucloxacillin

Answer 7

• Cholestasis (usually develops after several weeks of use)

Question 8

Erythromycin

Answer 8

• GI upsret
• Prolongs QT interval

Question 9

Ciprofloxacin

Answer 9

• Lowers seizure threshold
• Tendonitis
• Increases risk of tendon rupture

Question 10

Metronidazole

Answer 10

• Reaction following alcohol ingestion

Question 11

Doxycycline

Answer 11

• Photosensitivity

Question 12

Trimethoprim

Answer 12

• Rashes, including photosensitivity
• Pruritis
• Suppression of haematopoiesis

Question 13

Metformin

Answer 13

• GI side-effects
• Lactic acidosis

Question 14

Sulphonylureas (i.e. glimeprimide, chlorpropamide, glipizide)

Answer 14

• Hypoglycaemic episodes
• Increased appetite and weight gain
• SIADH
• Liver dysfunction (cholestatic)

Question 15

Glitazones (i.e. pioglitazone, rosiglitazone)

Answer 15

• Weight gain
• Fluid retention
• Liver dysfunction
• Fractures

Question 16

Gliptins (i.e. sitagliptin, vildagliptin, linagliptin)

Answer 16

• Pancreatitis

Question 17

Glucocorticoids (i.e. prednisolone, dexamethasone, betamethasone)

Answer 17

• Endocrine: impaired glucose regulation, increased appetite/weight gain, hirsutism, hyperlipidaemia
• Cushing’s syndrome: moon face, buffalo hump, striae
• Dermatological: thinning of skin, easy bruising
• Musculoskeletal: osteoporosis, proximal myopathy, avascular necrosis of the femoral head, muscle weakness
• Immunosuppression: increased susceptibility to severe infection, reactivation of tuberculosis
• Psychiatric: insomnia, mania, depression, psychosis
• Gastrointestinal: peptic ulceration, acute pancreatitis
• Ophthalmic: glaucoma, cataracts
• Suppression of growth in children
• Intracranial hypertension
• Neutrophilia

Question 18

Mineralocorticoids (i.e. fludrocortisone)

Answer 18

• Fluid retention
• Hypertension

Question 19

Important information about steroids

Answer 19

• DON’T – Don’t stop taking steroids abruptly. There is a risk of adrenal crisis.
• S – Sick Day Rules. (double dose for 2 days when ill)
• T – Treatment Card.
• O – Osteoporosis prevention with bisphosphonates and supplemental calcium and vitamin D.
• P – Proton pump inhibitor for gastric protection.