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Renal Pharm > Adverse effects > Flashcards

Adverse effects Flashcards

1
Q

Reflex tachycardia; headache, flushing & ↑Intraocular pressure

A

Fenoldopam

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2
Q

Nitrofurantoin

A

(1) Nausea, vomiting and diarrhea (take with meals to decrease adverse effects) (2) Hemolytic anemia associated with G6PD deficiency (3) Colors the urine brown

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3
Q

Hypokalemia Impaired glucose tolerance/hyperglycemia Hyperuricemia Hyperlipidemia*

A

Hydrochlorothiazide and indapamide

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4
Q

– Hyperkalemia – Renal impairment – Potential teratogen

A

Aliskiren

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5
Q

Sodium nitroprusside

A

excessive lowering of BP; accumulation of cyanide byproduct of its metabolism

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6
Q

Clonidine

A

Dry mouth; sedation; rebound hypertension (on withdrawal)

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7
Q

bradycardia & cardiac conduction problems; impotence, peripheral vascular insufficiency, hyperglycemia, diabetes, asthma Withdrawal s/s nervousness, tachycardia, increase BP

A

Propranolol

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8
Q

Calcium acetate & calcium carbonate

A

GI side effects including constipation, diarrhea, nausea, vomiting, and abdominal pain Hypercalcemia

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9
Q

(1) Nausea, vomiting and diarrhea (take with meals to decrease adverse effects) (2) Hemolytic anemia associated with G6PD deficiency (3) Colors the urine brown

A

Nitrofurantoin

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10
Q

Irreversible ototoxicity: high-pitched tinnitus; high frequency loss followed by loss of low frequency (cochlear); N/V, vertigo (vestibular) Reversible nephrotoxicity Neuromuscular blockade (inhibit ACh release; Administration of a calcium salt can overcome this effect)

A

Aminoglycosides

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11
Q

Nilutamide

A

Hot flashes, gynecomastia, GI disturbances (nausea, diarrhea or constipation), liver function test abnormalities (including hepatitis) can cause interstitial pneumonitis

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12
Q

Captopril, Lisinopril, Enalapril, Ramipril

A

– Dry cough – Angioedema – Teratogenic Hyperkalemia

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13
Q

Fosfomycin

A

Diarrhea, nausea

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14
Q

i. Hypertension ii. Thrombotic/vascular events iii. Deep vein thrombosis

A

Erythropoietic growth factors (epoetin alfa)

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15
Q

Angioedema; teratogenic

A

Losartan, Candesartan, Valsartan, Eprosartan

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16
Q

Ferrous sulfate and ferric gluconate

A

Oral admin: (a) heartburn (b) constipation or diarrhea (c) nausea (d) upper abdominal pain IV admin anaphylaxis hypotension dizziness iron overload

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17
Q

Impotence and gynecomastia Hyperkalemia Metabolic acidosis

A

Spironolactone

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18
Q

Spironolactone

A

Impotence and gynecomastia Hyperkalemia Metabolic acidosis

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19
Q

(1) Nausea, vomiting (2) Rash (3) Hepatitis (rare but fatal),  liver enzymes (4) Endocrinologic abnormalities, e.g., women, menstrual irregularities; men, gynecomastia; due to inhibition of steroid biosynthesis

A

Azoles more important for ketoconazole

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20
Q

Sedation; postural hypotension (in volume depleted patients)

A

Methyldopa (Aldomet)

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21
Q

Hypersensitivity reactions GI distress and diarrhea Neurotoxicity (myoclonus or seizures, agitation, confusion and hallucinations, or lethargy and stupor progressing to coma) Ampicillin rash

A

Penicillins - Piperacillin-tazobactam

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22
Q

Aminoglycosides

A

Irreversible ototoxicity: high-pitched tinnitus; high frequency loss followed by loss of low frequency (cochlear); N/V, vertigo (vestibular) Reversible nephrotoxicity Neuromuscular blockade (inhibit ACh release; Administration of a calcium salt can overcome this effect)

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23
Q

Hypotension Peripheral edema Headache/dizziness Cardiodepression

A

Verapamil; Diltiazem

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24
Q

Verapamil; Diltiazem

A

Hypotension Peripheral edema Headache/dizziness Cardiodepression

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25
Q

Dorzolamide; Acetazolamide

A

Metabolic acidosis

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26
Q

Metabolic acidosis

A

Dorzolamide; Acetazolamide

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27
Q

Bicalutamide & flutamide Antiandrogens

A

Hot flashes, gynecomastia, GI disturbances (nausea, diarrhea or constipation), liver function test abnormalities (including hepatitis)

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28
Q

a. GI: nausea, vomiting, abdominal discomfort b. CNS: headache, dizziness c. Have been shown to cause arthropathy in immature animals of a variety of species

A

Fluoroquinolones ciprofloxacin, levofloxacin

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29
Q

i. Hypernatremia and dehydration due to water loss in excess of sodium excretion ii. Increases plasma osmolality leading to hyponatremia manifested as headache, nausea and vomiting due to the movement of fluid into the extracellular compartments

A

Mannitol

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30
Q

Propranolol

A

bradycardia & cardiac conduction problems; impotence, peripheral vascular insufficiency, hyperglycemia, diabetes, asthma Withdrawal s/s nervousness, tachycardia, increase BP

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31
Q

Calcitriol, paricalcitol

A

i. Hypercalcemia ii. Hyperphosphatemia iii. soft-tissue and vascular calcification

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32
Q

Mannitol

A

i. Hypernatremia and dehydration due to water loss in excess of sodium excretion ii. Increases plasma osmolality leading to hyponatremia manifested as headache, nausea and vomiting due to the movement of fluid into the extracellular compartments

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33
Q

Ethacrynic acid

A

i. Hypocalcemia ii. Hypomagnesemia iii. Hypokalemia; predisposes patient to cardiac arrythmias iv. Metabolic alkalosis Decreased glucose tolerance Irreversible ototoxicity

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34
Q

Sevelamer

A

GI side effects including constipation, diarrhea, nausea, vomiting, and abdominal pain

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35
Q

Fluoroquinolones ciprofloxacin, levofloxacin

A

a. GI: nausea, vomiting, abdominal discomfort b. CNS: headache, dizziness c. Have been shown to cause arthropathy in immature animals of a variety of species

36
Q

Leuprolide; Goserelin

A

i. Disease flare-up manifested clinically as increased bone pain or increased urinary symptoms ii. Endocrine-related including hot flashes, impotence, and decreased libido

37
Q

3rd Generation Cephalosporin - Ceftriaxone

A

Hypersensitivty Local reactions at injection site Nephropathy (Risk of tubular necrosis in patients with underlying renal disease or who are taking potentially nephrotoxic drugs)

38
Q

Acute hemolytic anemia (G6P deficiency) Steven Johnson Syndrome Crystalluria Kernicterus in newborns

A

Trimethoprim-Sulfamethoxazole

39
Q

i. Hypocalcemia ii. Hypomagnesemia iii. Hypokalemia; predisposes patient to cardiac arrythmias iv. Metabolic alkalosis Decreased glucose tolerance Reversible ototoxicity

A

Furosemide

40
Q

Aliskiren

A

– Hyperkalemia – Renal impairment – Potential teratogen

41
Q

Hypotension Peripheral edema Headache/dizziness

A

Nifedipine; Amlodipine

42
Q

Nifedipine; Amlodipine

A

Hypotension Peripheral edema Headache/dizziness

43
Q

Testosterone replacement

A

Sodium retention Gynecomastia Decreased HDL cholesterol levels Polycythemia Hepatotoxicity (oral) contact dermatitis (topical)

44
Q

Hot flashes, gynecomastia, GI disturbances (nausea, diarrhea or constipation), liver function test abnormalities (including hepatitis) can cause interstitial pneumonitis

A

Nilutamide

45
Q

Oral admin: (a) heartburn (b) constipation or diarrhea (c) nausea (d) upper abdominal pain IV admin anaphylaxis hypotension dizziness iron overload

A

Ferrous sulfate and ferric gluconate

46
Q

Alfuzosin, doxazosin, tamsulosin, and terazosin

A

Cardiovascular: Orthostatic hypotension CNS: Dizziness, somnolence Genitourinary: Impotence Increased hypotensive effect when given with antihypertensive drugs such as β-blockers, diuretics, ACEIs, calcium channel blockers

47
Q

Reflex tachycardia; Postural hypotension

A

Prazosin; Doxazosin

48
Q

Losartan, Candesartan, Valsartan, Eprosartan

A

Angioedema; teratogenic

49
Q

Sildenafil, tadalafil, vardenafil

A

Hypotension i. Increased sensitivity to light ii. Blurred vision iii. Loss of blue-green color discrimination Back and muscle pain Priapism Sudden hearing loss usually on one side involving partial or complete loss of usual hearing; reversible Headache, facial flushing, rhinitis (due to vasodilation)

50
Q

Finasteride; Dutasteride

A

i. Genitourinary: ejaculation disorders (dry sex or delayed ejaculation) and erectile dysfunction (may be due to drug-induced inhibition of NO synthesis) ii. Endocrine: gynecomastia iii. Pregnancy category X - suppresses levels of DHT in male fetus inhibiting development of external genital organs and leading to feminization of a male fetus

51
Q

Hypotension i. Increased sensitivity to light ii. Blurred vision iii. Loss of blue-green color discrimination Back and muscle pain Priapism Sudden hearing loss usually on one side involving partial or complete loss of usual hearing; reversible Headache, facial flushing, rhinitis (due to vasodilation)

A

Sildenafil, tadalafil, vardenafil

52
Q

i. Hypercalcemia ii. Hyperphosphatemia iii. soft-tissue and vascular calcification

A

Calcitriol, paricalcitol

53
Q

Diarrhea, nausea

A

Fosfomycin

54
Q

Dry mouth; sedation; rebound hypertension (on withdrawal)

A

Clonidine

55
Q

Minoxidil; Pinacidil

A

(i) Reflex tachycardia; (ii) Fluid retention; (iii) Excessive hair growth; (iv) Headaches/Flushing excess cerebral/cutaneous dilation

56
Q

Sodium retention Gynecomastia Decreased HDL cholesterol levels Polycythemia Hepatotoxicity (oral) contact dermatitis (topical)

A

Testosterone replacement

57
Q

Prazosin; Doxazosin

A

Reflex tachycardia; Postural hypotension

58
Q

GI side effects including constipation, diarrhea, nausea, vomiting, and abdominal pain

A

Sevelamer

59
Q

Alprostadil

A

Intracavernosal Cavernosal plaques or areas of fibrosis at injection sites Burning discomfort or dull pain near the injection site or during the erection Priapism Intraurethral Urethra injury leading to urethral stricture and difficulty voiding Urethral pain Female sexual partners may experience vaginal burning, itching, or pain Priapism

60
Q

i. Nausea and vomiting ii. Hypocalcemia manifested as paresthesias, myalgias, cramping, tetany, and convulsions

A

Cinacalcet

61
Q

Hyperkalemia Metabolic acidosis

A

Triamterene; Amiloride

62
Q

Reflex sympathetic activation → Tachycardia; ↓Insulin release (due to Kchannel opening); Edema (salt and water retention)

A

Diazoxide

63
Q

i. Genitourinary: ejaculation disorders (dry sex or delayed ejaculation) and erectile dysfunction (may be due to drug-induced inhibition of NO synthesis) ii. Endocrine: gynecomastia iii. Pregnancy category X - suppresses levels of DHT in male fetus inhibiting development of external genital organs and leading to feminization of a male fetus

A

Finasteride; Dutasteride

64
Q

Triamterene; Amiloride

A

Hyperkalemia Metabolic acidosis

65
Q

Cardiovascular: Orthostatic hypotension CNS: Dizziness, somnolence Genitourinary: Impotence Increased hypotensive effect when given with antihypertensive drugs such as β-blockers, diuretics, ACEIs, calcium channel blockers

A

Alfuzosin, doxazosin, tamsulosin, and terazosin

66
Q

i. Disease flare-up manifested clinically as increased bone pain or increased urinary symptoms ii. Endocrine-related including hot flashes, impotence, and decreased libido

A

Leuprolide; Goserelin

67
Q

(i) Reflex tachycardia; (ii) Fluid retention; (iii) Excessive hair growth; (iv) Headaches/Flushing excess cerebral/cutaneous dilation

A

Minoxidil; Pinacidil

68
Q

GI side effects including constipation, diarrhea, nausea, vomiting, and abdominal pain Hypercalcemia

A

Calcium acetate & calcium carbonate

69
Q

Hot flashes, gynecomastia, GI disturbances (nausea, diarrhea or constipation), liver function test abnormalities (including hepatitis)

A

Bicalutamide & flutamide Antiandrogens

70
Q

Hypersensitivty Local reactions at injection site Nephropathy (Risk of tubular necrosis in patients with underlying renal disease or who are taking potentially nephrotoxic drugs)

A

3rd Generation Cephalosporin - Ceftriaxone

71
Q

Penicillins - Piperacillin-tazobactam

A

Hypersensitivity reactions GI distress and diarrhea Neurotoxicity (myoclonus or seizures, agitation, confusion and hallucinations, or lethargy and stupor progressing to coma) Ampicillin rash

72
Q

Furosemide

A

i. Hypocalcemia ii. Hypomagnesemia iii. Hypokalemia; predisposes patient to cardiac arrythmias iv. Metabolic alkalosis Decreased glucose tolerance Reversible ototoxicity

73
Q

GI disturbances (diarrhea or constipation, nausea)

A

Saw palmetto

74
Q

Erythropoietic growth factors (epoetin alfa)

A

i. Hypertension ii. Thrombotic/vascular events iii. Deep vein thrombosis

75
Q

Azoles more important for ketoconazole

A

(1) Nausea, vomiting (2) Rash (3) Hepatitis (rare but fatal),  liver enzymes (4) Endocrinologic abnormalities, e.g., women, menstrual irregularities; men, gynecomastia; due to inhibition of steroid biosynthesis

76
Q

excessive lowering of BP; accumulation of cyanide byproduct of its metabolism

A

Sodium nitroprusside

77
Q

Cinacalcet

A

i. Nausea and vomiting ii. Hypocalcemia manifested as paresthesias, myalgias, cramping, tetany, and convulsions

78
Q

Diazoxide

A

Reflex sympathetic activation → Tachycardia; ↓Insulin release (due to Kchannel opening); Edema (salt and water retention)

79
Q

Hydrochlorothiazide and indapamide

A

Hypokalemia Impaired glucose tolerance/hyperglycemia Hyperuricemia Hyperlipidemia*

80
Q

Trimethoprim-Sulfamethoxazole

A

Acute hemolytic anemia (G6P deficiency) Steven Johnson Syndrome Crystalluria Kernicterus in newborns

81
Q

Saw palmetto

A

GI disturbances (diarrhea or constipation, nausea)

82
Q

Methyldopa (Aldomet)

A

Sedation; postural hypotension (in volume depleted patients)

83
Q

Intracavernosal Cavernosal plaques or areas of fibrosis at injection sites Burning discomfort or dull pain near the injection site or during the erection Priapism Intraurethral Urethra injury leading to urethral stricture and difficulty voiding Urethral pain Female sexual partners may experience vaginal burning, itching, or pain Priapism

A

Alprostadil

84
Q

i. Hypocalcemia ii. Hypomagnesemia iii. Hypokalemia; predisposes patient to cardiac arrythmias iv. Metabolic alkalosis Decreased glucose tolerance Irreversible ototoxicity

A

Ethacrynic acid

85
Q

Fenoldopam

A

Reflex tachycardia; headache, flushing & ↑Intraocular pressure

86
Q

– Dry cough – Angioedema – Teratogenic Hyperkalemia

A

Captopril, Lisinopril, Enalapril, Ramipril

Renal Pharm (14 decks)

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