Types and mechanisms of adverse effects Flashcards

1
Q

Side effects caused by histamine H1 blockade

A

Weight gain

Sedation

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2
Q

Side effects caused by alpha 1 blockade

A

Orthostatic hypotension
Sedation
Sexual dysfunction including anorgasmia
Priapism

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3
Q

Side effects caused by muscarinic central M1 blockade

A

Agitation, delirium
Memory impairment
Seizures

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4
Q

Side effects caused by muscarinic peripheral M1 blockade

A
Dry mouth
Ataxia
Blurred vision from mydriasis
Narrow angle glaucoma
Constipation
Urinary retention
Tachycardia
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5
Q

Antipsychotic side effects which are due to their antidopaminergic effects

A
Galactorrhoea
Gynaecomastia
Menstrual disturbance
Reduced libido
Lowered sperm count
Parkinsonism
Dystonia
Akathisia
Tardive dyskinesia
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6
Q

Antipsychotic side effects which are due to their anticholinergic (antimuscarinic) effects

A

Dry mouth
Blurred vision
Urinary retention
Constipation

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7
Q

Antipsychotic side effects which are due to their antiadrenergic side effects

A

Postural hypotension

Ejaculatory failure

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8
Q

Antipsychotic side effects which are due to their histaminergic effects

A

Drowsiness

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9
Q

Tricyclic antidepressant side effects which are due to their antimuscarinic effects

A

Dry mouth

Urinary retention

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10
Q

Tricyclic antidepressant side effects which are due to their antihistaminergic efffects

A

Sedation

Weight gain

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11
Q

Tricyclic antidepressant side effects which are due to their antiadrenergic effects

A

Postural hypotension
Sexual dysfunction
Cognitive impairment

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12
Q

Tricyclic antidepressant side effects which are due to their membrane stabilisation effects

A

Cardiotoxicity

Reduced seizure threshold

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13
Q

Type of adverse drug reaction which are dose dependent and can be predicted from the pharmacology of the medication

A

Type A

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14
Q

Type of adverse drug reaction which is idiosyncratic and cannot be predicted from the pharmacology of the medication - includes allergic reactions

A

Type B

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15
Q

Percentage of adverse drug reactions which type A accounts for

A

80%

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16
Q

Type I allergic reactions

A

IgE mediated

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17
Q

Type II allergic reactions

A

Cytotoxic

18
Q

Type III allergic reactions

A

Immune complex

19
Q

Type IV allergic reactions

A

Cell mediated

20
Q

Timing of type I allergic reactions

A

Minutes to hours after exposure

21
Q

Timing of type II allergic reactions

A

Variable

22
Q

Timing of type III allergic reactions

A

1-3 weeks after exposure

23
Q

Timing of type IV allergic reactions

A

2-7 days after exposure

24
Q

Type of exposure causing type IV allergic reactions

A

Cutaneous

25
Q

Quickest type of allergic reaction

A

Type I

26
Q

Clinical features of a type I allergic reaction

A

Anaphylaxis
Urticaria
Bronchospasm

27
Q

Clinical features of a type II allergic reaction

A

Blood abnormalities - neutropaenia, thrombocytopaenia

28
Q

Clinical features of a type III allergic reaction

A

Rash
Fever
Urticaria
Vasulitis

29
Q

Clinical features of a type IV allergic reaction

A

Allergic contact dermatitis

Rash

30
Q

Proposed mechanisms of antipsychotic related weight gain

A

5HT2C antagonism
H1 antagonism
D2 antagonism
Increased serum leptin leading to leptin desensitisation

31
Q

Mechanism of sexual side effects of SSRIs

A

5HT2A stimulation

32
Q

Proposed mechanism for anxiety and agitation sometimes seen on commencing SSRIs

A

Over stimulation of 5HT2 receptors in the limbic system

33
Q

Type A adverse effects

A

Augmented reactions - an exaggeration of a drug’s normal pharmacological action when given at a therapeutic dose. Normally dose dependent

34
Q

Type B adverse effects

A

Bizarre reactions - novel responses which are not expected from the known mechanism of action of the drug

35
Q

Type C adverse effects

A

Continuing reactions - persist for a long time

36
Q

Type D adverse effects

A

Delayed reactions - become apparent after some time of use

37
Q

Type E adverse effects

A

End of use reactions - associated with withdrawal of a medication

38
Q

Mechanism of hypotensive side effects of antipsychotics

A

Alpha 1 receptor antagonism

39
Q

Mechanism of SSRI induced nausea and diarrhoea

A

5HT3 receptor activation

40
Q

Mechanism of antipsychotic induced tardive dyskinesia

A

Dopamine receptor super sensitivity

41
Q

Mechanism of antipsychotic induced akathisia and extra-pyramidal side effects in general

A

Striatum D2 blockade

42
Q

Receptor involved in serotonin syndrome

A

5HT2A