Adverse Drug Reactions

Question 1

Name 5 drugs that cause urinary retenion?

Answer 1

DON’T A

• Disopyramide
• Opioids
• NSAIDs
• Tricyclic antidepressants e.g. amitriptyline
• Anticholinergics e.g. antipsychotics, antihistamines

Question 2

Name 6 drugs that can cause drug-induced impaired glucose tolerance

Answer 2

TITANS

• Thiazides, furosemide (less common)
• Interferon-alpha
• Tacrolimus, ciclosporin
• Antipsychotics
• Nicotinic acid
• Steroids
• Beta-blockers (slight impairment)

Beta-blockers cause a slight impairment of glucose tolerance. They should also be used with caution in diabetics as they can interfere with the metabolic and autonomic responses to hypoglycaemia

Question 3

Name 5 drugs that can cause lung fibrosis

Answer 3

• amiodarone
• cytotoxic agents: busulphan, bleomycin
• anti-rheumatoid drugs: methotrexate, sulfasalazine
• nitrofurantoin
• ergot-derived dopamine receptor agonists (bromocriptine, cabergoline, pergolide)

Question 4

What are the 4 drugs for tuberculosis?

Answer 4

RIPE
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Question 5

Mechanism of action of rifampicin

Answer 5

Inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA

Question 6

Side effects of rifampicin

Answer 6

• Hepatitis
• Orange secretions
• Flu-like symptoms

Rifampicin = potent liver enzyme inducer

Question 7

Side effects of isoniazid

Answer 7

• Peripheral neuropathy: prevent with pyridoxine (vitamin B6)
• Hepatitis
• Agranulocytosis

Isoniazid = liver enzyme inhibitor

Question 8

What are the side effects of pyrazinamide?

Answer 8

• Hyperurucaemia - causing gout
• Arthralgia, myalgia
• Hepatitis

Question 9

What are the side effects of ethambutol?

Answer 9

• Optic neuritis - check visual acuity before + during treatment
• Dose needs adjusting in patients with renal impairment