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PSA > Common S/Es > Flashcards

Common S/Es Flashcards

1
Q

patient is in HF, do you give them either cyclizine or metoclopramide?

A

metoclopramide

cyclizine S/E fluid retention

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2
Q

S/E cyclizine?

A 
fluid retention
urinary retention
constipation
dry mouth
↑ doses: agitation
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3
Q

S/E fluoxetine?

A

rash

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4
Q

S/E COCP?

A

irritability
new headaches
weight ↑
acne

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5
Q

S/E enoxaparin?

when to adjust dose?

A

all heparins ↑K+

adjust if <50kg or GFR<30

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6
Q

S/E aspirin?

A

Fe def anaemia
(loss of protective gastric mucosa)
dyspepsia, haemorrhage

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7
Q

S/E morphine?

A

urinary retention
renally excreted so can accumulate in renal failure
beware dependence and respiratory depression

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8
Q

S/E citalopram?

A

can precipitate bleeding with dabigatran

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9
Q

S/E antihypertensives?

A

↓ BP
↓ HR
wheeze
oedema

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10
Q

major S/E of anticoagulants?

S/E warfarin?

A

haemorrhage obvss

warfarin procoagulant at 1st

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11
Q

S/E digoxin?

A

seeing “yellow, green halos” around objects (xanthopsia)
N, D, confusion, drowsiness
arrhythmias

low K+ augments digoxin effect
high levels limit the effect

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12
Q

S/E

statins?

A

↑ CK
symptomatic muscle pain (myalgia)
↑ ALT/AST (can be mild)
myopathy, myositis, rhabdomyolysis (can be just mildly ↑CK though)

abdominal pain
GI disturbances
sleep disturbance
headache

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13
Q

S/E anticholinergic drugs?

A

can cause DELIRIUM; check anticholinergic burden - still essential if catheterised?

  • blurred vision
  • tachycardia
  • dry mouth
  • urinary retention
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14
Q

how do anticholinergics basically work?

examples of anticholinergic drugs?

A

block neurotransmitter Ach

antimuscarinics: oxybutynin, tolterodine, darifenacin

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15
Q

S/E amitriptyline?

A 
anticholinergic syndrome
(dry mouth, blurred vision, tachycardia, urinary retention)
drowsiness/ delirium in elderly
QT interval ↑
toxic in OD (TCA)
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16
Q

citalopram given with clarithromycin?

A

↑ QT

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17
Q

which drugs can cause serotonin syndrome and what are its major types of Sx? (3)

A

MAOi! + SSRIs, TRAMADOL, TCAs, Li+, metoclopramide, opioids, mirtazapine, RIMA, SNRI
Sx =
1) NM ↑ (tremor, ↑ reflexes, rigidity)
2) autonomic (↑ HR, BP, ↑T, sweating, shivering, D, pupil dilation)
3) agitation, confusion, mania

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18
Q

S/E ACEi?

A

cough
renal failure
teratogen

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19
Q

S/E ARBs?

A

nephrotoxic

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20
Q

S/E NSAIDs?

A

indigestion
ulcers
↓ kidney function

21
Q

S/E carbamazepine?

A

↓ Na+

rare: agranulocytosis

22
Q

S/E tamoxifen?

A

VTE

endometrial proliferation

23
Q

S/E SSRIs?

A

serotonin syndrome obvs
sexual dysfunction
GI
initial anxiety

24
Q

S/E amiodarone?

A

ILD/pulmonary fibrosis
thyroid dysfunction
grey skin/blue rash
cornea deposits (yellow flashes whilst driving at night)

(bc 1/2 life is 42 days can get side effects well after drug is stopped)

25
Q

what does omeprazole ↑ risk of?

A

C.diff

26
Q

what drugs to beware with epilepsy?

A

alcohol, cocaine, ket
ciprofloxacin
theo/aminophylline
↑ SEIZURE RISK

27
Q

basic S/E of anticholinergic excess?

A

MAD - delirium (elderly), confusion
RED - flushing, tachycardia
DRY - dry mouth + eye, constipation, urinary retention
BLIND - blurred vision

28
Q

which drugs have anticholinergic S/Es?

A 
AMITRIPTYLINE
antimuscarinics
paroxetine
antipsychotics (clozapine)
cyclizine
29
Q

dystonia with a fixed upward gaze - what drugs are likely causing it?

A

“oculogyric crisis”

neuroleptics - (haloperidol, chlorpromazine, olanzapine, carbamazepine, levodopa, lithium, metoclopramide, domperidone)

30
Q

new D in a pt on any Abx (but most commonly the broad-spectrum antibiotics like cephalosporins or ciprofloxacin)?

A

C. diff colitis

31
Q

S/E heparins?

A

bleeding (especially If <50kg or renal impairment)

thrombocytopenia

32
Q

S/E aspirin

A

bleeding
peptic ulcers
gastritis
tinnitus in large doses

33
Q

S/E Fludrocortisone?

A

Hypertension/sodium and water retention

34
Q

if a DM pt is having Sx of ↓ GCS or has acidotic behaviour?

A

look out for metformin

35
Q

how long does it take for enzymes to be induced?

A

days - weeks

36
Q

how long does it take for enzymes to be inhibited?

A

hours - days

37
Q

example drugs with a narrow therapeutic range?

A

warfarin, digoxin, phenytoin, theophylline

38
Q

β-blockers and verapamil together?

A

may cause profound hypotension and asystole

39
Q

most common enzyme inhibitors?

A

ketoconazole, ciprofloxacin and erythromycin (and grapefruit juice!)

40
Q

main drugs to beware alcohol with?

A 
benzos etc - sedation
NSAIDS (inc aspirin) - GI bleeds
metformin - lactic acidosis
MAOis - hypertensive crisis
acute intake with warfarin - inhibition therefore ↑ bleed
metro/disulfiram - bad N and V
41
Q

S/E β-blockers?

A 
bradycardia
bronchospasm
cold extremities
fatigue
nightmares
hypotension
42
Q

what to never prescribe alongside an ACEi?

A

NSAIDs
(inhibit prostaglandins)
prostaglandins dilate afferent vessels (‘a’fferent/’a’pproaching)
NSAIDs ↓ inward flow + ↓ pressure and perfusion
↓ flow = ischaemia

43
Q

what to never prescribe alongside an NSAID?

A

ACEi
(relax efferent blood flow - ‘(e)F off’)
↓ pressure, protects vasculature from hypertension P
but also ↓ GFR

44
Q

drugs which commonly cause urinary retention?

A
  • morphine and other opioid analgesics (especially in early postoperative period)
  • anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents, detrusor relaxants)
  • GA
  • Alpha-adrenoceptor agonists (glaucoma Tx)
  • Benzodiazepines (e.g. diazepam)
  • NSAIDs (e.g. ibuprofen)
  • CCB
  • Antihistamines
  • Alcohol
45
Q

drugs that commonly cause confusion?

A
  • morphine
  • metoclopramide
  • anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents, detrusor relaxants),
  • antipsychotics,
  • antidepressants,
  • anticonvulsants.
  • less common causes (histamine H2 receptor antagonists, digoxin, beta-blockers, corticosteroids, NSAID and Abx)
46
Q

max dose citalopram for elderly/those >65?

A

20 mg

bc QT prolongation

47
Q

if ACEi and spirinolactone prescribed together?

A

raised K+ (need monitoring)

but could be legitimate prescription in HF

48
Q

ciclosporin S/E?

A
  • nephrotoxicity
  • renal function measurements are required before starting ciclosporin
  • during Tx, monitor serum creatinine every 2 weeks for the first 3 months, then monthly
49
Q

important S/E of tramadol?

A

Serotonin syndrome

PSA (29 decks)

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