Adverse Effects Flashcards
(95 cards)
5α reductase inhibitors
finasteride
Antiandrogen action:
Impotence
Reduced libido
Hair growth
Breast cancer (men)
α-blockers
doxazosin, tamsulosin, alfuzosin
Postural hypotension
Dizziness
Syncope
(Particularly present after first dose)
Acetylcholinesterase inhibitors
donepezil, rivastigmine
Nausea, diarrhoea and vomiting
Exacerbation of asthma/COPD
Peptic ulcers, bleeding, bradycardia, heart block
Hallucinations
Altered/aggressive behaviour
Extrapyramidal symptoms & neuroleptic malignant syndrome
Acetylcysteine (N-acetylcysteine)
IV administration:
Anaphylactoid reaction
Nebulised administration:
Bronchospasm
Activated charcoal
Black stools, vomiting
Aspiration → pneumonitis, bronchospasm, airway obstruction
Intestinal obstruction
Adenosine
Bradycardia
Asystole
Sinking feeling, breathlessness
Sense of impending doom
Adrenaline
epinephrine
After Cardiac arrest:
Adrenaline induced hypertension
Use in conscious patients:
Anxiety, tremor, headaches, palpitations
In those with existing heart disease:
Angina, MI, arrhythmias
Aldosterone antagonists
spironolactone, eplerenone
Hyperkalaemia
Gynaecomastia
Liver impairment + jaundice
Alginates and antacids
gaviscon, peptac
Magnesium salts → diarrhoea
Aluminium salts→ constipation
Allopurinol
Can trigger/worsen acute attack of gout
Skin rash (Stevens-Johnson syndrome, toxic epidermal necrolysis)
Allopurinol hypersensitivity syndrome (fever, eosinophilia, lymphadenopathy)
Aminoglycosides
gentamicin, amikacin, neomycin
Nephrotoxicity (reduce urine output, rising serum creatinine + urea)
Ototoxicity (hearing loss, tinnitus, vertigo)
Aminosalicylates
mesalazine, sulfasalazine
GI upset
Headache
Leucopenia, thrombocytopenia
Renal impairment
Sulfasalazine:
Oligospermia (reversible)
Serious hypersensitivity reaction
Amiodarone
Hypotension
Lungs (pneumonitis)
Heart (bradycardia, AV block)
Liver (hepatitis)
Skin (photosensitivity, grey discolouration)
Thyroid abnormalities
ACE inhibitors
ramipril, lisinopril, perindopril
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
Angiotensin receptor blockers
losartan, candesartan, irbesartan
Hypotension (particularly after first dose)
Persistent, dry cough (increased bradykinin)
Hyperkalaemia (low aldosterone promotes K retention)
Antidepressants
tricyclics; amitriptyline, lofepramine
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
Antidepressants
venlafaxine, mirtazapine
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
Antiemetics - dopamine D2-receptor antagonists
metoclopramide, domperidone
Diarrhoea
Metoclopramide:
Extrapyramidal symptoms (movement abnormalities)
Acute dystonic reaction
Domperidone:
QT-prolongations
Arrhythmias
Antiemetics - histamine H1-receptor antagonists
cyclizine, cinanrizine, promethazine
Drowsiness
Dry throat + mouth
Tachycardia, palpitations
Antiemetics - serotonin 5-HT3-receptor antagonists
ondansetron, granisetron
Rare
Constipation, diarrhoea and headaches can occur
Antifungal drugs
nystatin, clotrimazole, fluconazole
Topical nystatin and clotrimazole:
Local irritation
Oral fluconazole: GI upset Headache Hepatitis Hypersensitivity
Rare: Severe hepatic toxicity Prolonged QT interval, arrhythmias Cutaneous reactions Anaphylaxis
Antihistamines - H1-receptor antagonists)
cetirizine, loratadine, fexofenadine, chlorphenamine
Chorphenamine can cause sedation
Antimotility drugs
loperamide, codeine phosphate
GI effects
Indirectly, risk of opioid toxicity and dependence with codeine
Antimuscarinics - bronchodilators
ipratropium, tiotropoium, glycopyrronium, aclidinium
Irritation to respiratory tract (nasopharyngitis, sinusitis, cough)
GI disturbance (dry mouth, constipation, urinary retention, blurred vision, headaches)