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Top 100 Drugs > Adverse Effects > Flashcards

Adverse Effects Flashcards

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1
Q

5α reductase inhibitors

finasteride

A

Antiandrogen action:

Impotence

Reduced libido

Hair growth

Breast cancer (men)

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2
Q

α-blockers

doxazosin, tamsulosin, alfuzosin

A

Postural hypotension

Dizziness

Syncope

(Particularly present after first dose)

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3
Q

Acetylcholinesterase inhibitors

donepezil, rivastigmine

A

Nausea, diarrhoea and vomiting

Exacerbation of asthma/COPD

Peptic ulcers, bleeding, bradycardia, heart block

Hallucinations

Altered/aggressive behaviour

Extrapyramidal symptoms & neuroleptic malignant syndrome

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4
Q

Acetylcysteine (N-acetylcysteine)

A

IV administration:
Anaphylactoid reaction

Nebulised administration:
Bronchospasm

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5
Q

Activated charcoal

A

Black stools, vomiting

Aspiration → pneumonitis, bronchospasm, airway obstruction

Intestinal obstruction

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6
Q

Adenosine

A

Bradycardia

Asystole

Sinking feeling, breathlessness

Sense of impending doom

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7
Q

Adrenaline

epinephrine

A

After Cardiac arrest:
Adrenaline induced hypertension

Use in conscious patients:
Anxiety, tremor, headaches, palpitations

In those with existing heart disease:
Angina, MI, arrhythmias

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8
Q

Aldosterone antagonists

spironolactone, eplerenone

A

Hyperkalaemia

Gynaecomastia

Liver impairment + jaundice

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9
Q

Alginates and antacids

gaviscon, peptac

A

Magnesium salts → diarrhoea

Aluminium salts→ constipation

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10
Q

Allopurinol

A

Can trigger/worsen acute attack of gout

Skin rash (Stevens-Johnson syndrome, toxic epidermal necrolysis)

Allopurinol hypersensitivity syndrome (fever, eosinophilia, lymphadenopathy)

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11
Q

Aminoglycosides

gentamicin, amikacin, neomycin

A

Nephrotoxicity (reduce urine output, rising serum creatinine + urea)

Ototoxicity (hearing loss, tinnitus, vertigo)

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12
Q

Aminosalicylates

mesalazine, sulfasalazine

A

GI upset

Headache

Leucopenia, thrombocytopenia

Renal impairment

Sulfasalazine:
Oligospermia (reversible)
Serious hypersensitivity reaction

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13
Q

Amiodarone

A

Hypotension

Lungs (pneumonitis)

Heart (bradycardia, AV block)

Liver (hepatitis)

Skin (photosensitivity, grey discolouration)

Thyroid abnormalities

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14
Q

ACE inhibitors

ramipril, lisinopril, perindopril

A

Hypotension (particularly after first dose)

Persistent, dry cough (increased bradykinin)

Hyperkalaemia (low aldosterone promotes K retention)

Can cause or worsen renal failure

Angioedema

Anaphylactoid reactions

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15
Q

Angiotensin receptor blockers

losartan, candesartan, irbesartan

A

Hypotension (particularly after first dose)

Persistent, dry cough (increased bradykinin)

Hyperkalaemia (low aldosterone promotes K retention)

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16
Q

Antidepressants

tricyclics; amitriptyline, lofepramine

A

GI upset

Changes in appetite/weight loss

Hypersensitivity reactions (inc. rash)

Hyponatraemia

Suicidal thoughts and behaviour

Lower seizure threshold

Prolonged QT interval

Bleeding

Serotonin syndrome

Sudden withdrawal can cause GI upset, neurological and influenza-like symptoms and sleep disturbance

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17
Q

Antidepressants

venlafaxine, mirtazapine

A

Dry mouth

Sedation

Hypotension

Arrhythmias + ECG changes

Convulsions, hallucinations ad mania

Breast changes

Sexual dysfunction

Extrapyramidal symptoms (rarely)

Dangerous in overdose

Sudden withdrawal can cause GI upset, neurological and influenza-like symptoms and sleep disturbance

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18
Q

Antiemetics - dopamine D2-receptor antagonists

metoclopramide, domperidone

A

Diarrhoea

Metoclopramide:
Extrapyramidal symptoms (movement abnormalities)
Acute dystonic reaction

Domperidone:
QT-prolongations
Arrhythmias

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19
Q

Antiemetics - histamine H1-receptor antagonists

cyclizine, cinanrizine, promethazine

A

Drowsiness

Dry throat + mouth

Tachycardia, palpitations

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20
Q

Antiemetics - serotonin 5-HT3-receptor antagonists

ondansetron, granisetron

A

Rare

Constipation, diarrhoea and headaches can occur

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21
Q

Antifungal drugs

nystatin, clotrimazole, fluconazole

A

Topical nystatin and clotrimazole:
Local irritation

Oral fluconazole:
GI upset
Headache
Hepatitis
Hypersensitivity
Rare:
Severe hepatic toxicity
Prolonged QT interval, arrhythmias 
Cutaneous reactions 
Anaphylaxis
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22
Q

Antihistamines - H1-receptor antagonists)

cetirizine, loratadine, fexofenadine, chlorphenamine

A

Chorphenamine can cause sedation

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23
Q

Antimotility drugs

loperamide, codeine phosphate

A

GI effects

Indirectly, risk of opioid toxicity and dependence with codeine

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24
Q

Antimuscarinics - bronchodilators

ipratropium, tiotropoium, glycopyrronium, aclidinium

A

Irritation to respiratory tract (nasopharyngitis, sinusitis, cough)

GI disturbance (dry mouth, constipation, urinary retention, blurred vision, headaches)

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25
Antimuscarinics - cardiovascular and GI uses | atropine, hyoscine butylbromide, glycopyrronium
Tachycardia Dry mouth Constipation Urinary retention in patients with BPH Blurred vision Drowsiness + confusion
26
Antimuscarinics - GU uses | oxybutynin, tolterodine, solifenacin
Dry mouth Tachycardia Constipation Blurred vision
27
Antipsychotics - 1st generation (typical) | haloperidol, chlorpromazine, prochlorperazine
Extrapyramidal effects: - Acute dystonic reactions - Akathisia - Neuroleptic malignant syndrome - Tardive dyskinesia ``` Drowsiness Hypotension QT prolongation Arrythmias Hyperprolactinaemia Erectile dysfunction ```
28
Antipsychotics - 2nd generation (atypical) | quetiapine, olanzapine, risperidone, clozapine
Sedation Extrapyramidal effects Metabolic disturbance QT prolongation Arrythmias Breast symptoms Sexual dysfunction Agranulocytosis Myocarditis
29
Antiviral drugs | aciclovir
Headache Dizziness GI disturbances Rash Phlebitis at injection site Acute renal failure
30
Antiplatelet drugs - ADP-receptor antagonists | clopidogrel, ticagrelor, prasugrel
Bleeding GI upset Thrombocytopenia
31
Antiplatelet drugs | aspirin
GI irritation Peptic ulceration Haemorrhage Bronchospasm Tinnitus Life-threatening in overdose
32
Azathioprine
Bone marrow suppression Nausea Hypersensitivity reactions: - Diarrhoea + vomiting - Rash - Fever - Myalgia - Hypotension - Pancreatitis Veno-occlusive disease Hepatotoxicity Lymphoma
33
β-blockers | bisoprolol, atenolol, propanolol, metoprolol, carvedilol
Fatigue Cold extremities Headache Nausea Impotence
34
β2-agonists | salbutamol, terbutaline, salmeterol, formoterol, indacaterol
Tachycardia Palpitations Anxiety Tremor Muscle cramps
35
Benzodiazepines | diazepam, temazepam, lorazepam, chlordiazepoxide, midazolam
Drowsiness Sedation Coma Dependence Withdrawal reaction
36
Bisphosphonates | alendronic acid, disodium pamidronate, zoledronic acid
Oesophagitis Hypophosphataemia Osteonecrosis of the jaw Atypical femoral fracture
37
Calcium and vitamin D | calcium carbonate, calcium gluconate, colecalciferol, alfacalcidol
Dyspepsia Constipation Cardiovascular collapse Local tissue damage
38
Calcium channel blockers | amlodipine, nifedipine, dilitiazem, verapamil
Amlodipine + nifedipine: Ankle swelling Flushing Headache Palpitations Verapamil: Constipation Bradycardia Heart block Cardiac failure
39
Carbamazepine
GI upset Neurological effects Hypersensitivity Anti-epileptic hypersensitivity syndrome Oedema Hyponatraemia
40
Cephalosporins and carbapenems | cefalexin, cefotazime, meropenem, ertapenem
GI upset Antibiotic-associated colitis Hypersensitivity Neurological toxicity Seizures
41
Chloramphenicol
Stinging, burning + itching Dose-related bone marrow suppression Aplastic anaemia Grey baby syndrome Optic and peripheral neuritis
42
Corticosteroids (glucocorticoids) - inhaled | beclometasone, budesonide, fluticasone
Oral candidiasis Hoarse voice Pneumonia (COPD)
43
Corticosteroids (glucocorticoids) - systemic | prednisolone, hydrocortisone, dexamethasone
Immunosuppression Metabolic effects Mood + behavioural changes Adrenal atrophy Addisonian crisis Chronic glucocorticoid deficiency
44
Corticosteroids (glucocorticoids) - topical | hydrocortisone, betamethasone
Local adverse effects e.g. skin thinning, striae, telangiectasia and contact dermatitis Rebound worsening of skin condition Adrenal suppression Systemic adverse effects
45
Digoxin
Bradycardia GI disturbance Rash Dizziness Visual disturbance Digoxin toxicity
46
Dipeptidylpeptidase-4 inhibitors | sitagliptin, linagliptin, saxagliptin
Hypoglycaemia Acute pancreatitis
47
Direct oral anticoagulants (DOACs) | apixaban, dabigatran, edoxaban, rivaroxaban
Bleeding GI bleeding Anaemia GI upset Dizziness Elevated liver enzymes
48
Loop diuretics | furosemide, bumetanide
Dehydration Hypotension Low electrolyte state Hearing loss + tinnitus
49
Thiazide and thiazide-like diuretics | bendroflumethiazide, indapamide, chlortalidone
Hyponatraemia Hypokalaemia Cardiac arrhythmias Impotence
50
Dopaminergic drugs for Parkinson's disease | levodopa as co-careldopa/co-beneldopa, ropinirole, premipexol
Nausea Drowsiness Confusion Hallucinations Hypotension Dyskinesias
51
Emollients | aqueous cream, liquid paraffin
Greasy skin Exacerbation of acne Folliculitis
52
Fibrinolytic drugs | alteplase, streptokinase
Nausea + vomiting Bruising Hypotension Serious bleeding Allergic reaction Cardiogenic shock Cardiac arrest Cerebral oedema Arrythmias
53
Gabapentin and pregablin
Drowsiness Dizziness Ataxia
54
Heparins and fondaparinux | enoxaparin, dalteparin, fondaparinux, unfractioned heparin
Haemorrhage Hyperkalaemia Heparin-induced thrombocytopenia
55
Insulin | insulin aspart, insulin glargine, biphasic insulin, soluble insulin
Hypoglycaemia
56
Iron | ferrous fumarate, ferrous sulfate
Intestinal disease Atopic predisposition
57
Lamotrigine
Headache Drowsiness Irritability Blurred vision Dizziness GI symptoms Skin rash Severe hypersensitivity reaction
58
Laxatives - osmotic | lactulose, macrogol, phosphate enema
Flatulence Abdominal cramps Nausea Diarrhoea Local irritation Electrolyte disturbances
59
Leukotriene receptor antagonists | montelukast
Headache Abdominal pain Hyperactivity + reduced concentration Churg-Strauss syndrome
60
Lidocaine
Stinging on administration Drowsiness Restlessness Tremor Fits Hypotension Arrhythmias
61
Macrolides | clarithromycin, erythromycin, azithromycin
Irritant Allergy Antibiotic-associated colitis Cholestatic jaundice QT prolongation Arrythmias Ototoxicity
62
Metformin
GI upset Lactic acidosis
63
Methotrexate
Mucosal damage Bone marrow suppression Hypersensitivity reactions Hepatic cirrhosis Pulmonary fibrosis Risk of accidental overdose
64
Metronidazole
GI upset Hypersensitivity Peripheral and optic neuropathy Seizures Encephalopathy
65
Naloxone
Effect of opioid reversal may be significant in an opioid-dependent individual
66
Nitrates | isosorbide mononitrate, glyceryl trinitrate
Flushing Headaches Light-headedness Hypotension Tolerance
67
Nitrofurantoin
GI upset Hypersensitivity Chronic pulmonary reactions Hepatitis Peripheral neuropathy Haemolytic anaemia
68
NSAIDs | naproxen, ibuprofen, etoricoxib
GI toxicity Renal impairment Cardiovascular events Hypersensitivity reactions Fluid retention
69
Ocular lubricants - artificial tears | hypromellose, carbomers, liquid and white soft paraffin
Stinging on application Blurring of vision
70
Oestrogens and progestogens | combined ethinylestradiol products, desogestrel
Irregular bleeding Mood changes Cardiovascular disease Stroke Breast/cervical cancer risk
71
Opioids - strong | morphine, oxycodone
Respiratory depression Neurological depression Nausea + vomiting Pupillary constriction Constipation Itching Tolerence + dependence Withdrawal reaction
72
Opioids - weak/moderate | tramadol, codeine, dihydrocodeine
Nausea Constipation Dizziness Drowsiness Neurological + respiratory depression Codeine + dihydrocodeine must never be given IV - causes reaction similar to anaphylaxis
73
Oxygen
Discomfort from mask e.g. dry throat
74
Paracetamol
Few side effects Causes liver failure in overdose
75
Penicillins | benzylpenicilin, phenoxymethylpenicillin
Allergy occurs in 1-10% if people Skin rash Anaphylactic reaction Neurological toxicity
76
Penicillins - antipseudomonal | piperacilllin with tazobactam - tazocin
GI upset Antibiotic-associated colitis Hypersensitivity
77
Penicillins - broad-spectrum | amoxicillin, co-amoxiclav
GI upset Antibiotic-associated colitis Allergy Acute liver injury e.g. jaundice, hepatitis
78
Penicillins - penicillinase-resistant | flucloxacillin
GI upset Allergy Skin rash Anaphylactic reaction Liver toxicity
79
Phosphodiesterase (type 5) inhibitors | sildenafil
Flushing Headache Dizziness Nasal congestion Hypotension Tachycardia Palpitations
80
Prostaglandin analogue of eye drops | latanoprost, bimatoprost
Blurred vision Conjunctival reddening (hyperaemia) Occular irritation + pain Permanent change in eye colour
81
Protein pump inhibitors | lansoprazole, omeprazole, pantoprazole
GI disturbances Headache Hypomagnesaemia
82
Quinine | quinine sulfate
Tinnitus Deafness Blindness GI upset Hypersensitivity reactions QT prolongation Hypoglycaemia
83
Quinolones | ciprofloxacin, moxifloxacin, levofloxacin
GI upset Hypersensitivity reactions Neurological effects Rupture of muscle tendons QT prolongation Arrhythmias
84
Serotonin 5HT1-receptor agonists | sumatriptan
Pain/discomfort in chest + throat MI
85
Sex hormone antagonists for breast cancer | tamoxifen, anastrozole, letrozole
Vaginal dryness Hot flushes Loss of bone density VTE Endometrial cancer Agranulocytosis Liver failure
86
Statins | simvastatin, atorvastatin, pravastatin, rosuvastatin
Headache GI disturbances Aches Myopathy Rhabdomyolysis Rise in liver enzymes
87
Sulphonylureas | glicazide
GI upset Hypoglycaemia Rare hypersensitivity reactions
88
Tetracyclines | doxycycline, lymecycline
Nausea, vomiting + diarrhoea Hypersensitivity reactions Oesophageal irritation Photosensitivity Discolouration and/or hypoplasia of tooth enamel Hepatotoxicity Intracranial hypertension
89
Thyroid hormones | levothyroxine, liothyronine
Similar to symptoms of hyperthyroidism GI - diarrhoea, vomiting, weight loss Cardiac - palpitations, arrhythmias, angina Neurological - tremors, restlessness, insomnia
90
Trimethoprim | trimethoprim, co-trimoxazole
GI upset Skin rash Hypersensitivity reactions Haematological disorders Hyperkalaemia
91
Valproate (valproic acid) | sodium valproate, valproic acid
GI upset Neurological and psychiatric effects Thromobcytopenia Increased liver enzymes Hair loss
92
Vancomycin
Thrombophlebitis Red man syndromem Immediate/delayed hypersensitivity reaction Nephrotoxicity Ototoxicity Neutropenia Thrombocytopenia
93
Vitamins | folic acid, thiamine, hydroxocobalamin, phytomenadione
Anaphylaxis (rarely)
94
Warfarin
Bleeding
95
Z-drugs | zopiclone, zolpidem
Daytime sleepiness Rebound insomnia when stopped Neurological effects Dependence Withdrawal symptoms Drowsiness, coma and respiratory depression in overdose Zopiclone: Taste disturbance Zolpidiem: GI upset

Top 100 Drugs (4 decks)

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