Adverse Effects

Question 1

Adrenaline : Adverse

Answer 1

1. Tachycardia
2. Dysrhythmias including ventricular fibrillation
3. Hypertension
4. Pupillary dilation
5. Anxiety
6. Nausea & vomiting

Question 2

Amiodarone : Adverse

Answer 2

1. Hypotension
2. Bradycardia
3. Dysrythmias

Question 3

Aspirin : Adverse

Answer 3

1. Allergic reactions (e.g. asthma, angioneurotic oedema, rhinitus, urticaria, laryngeal oedema and shock - check for Hx of previous reaction)
2. Aggravation of any bleeding tendency
3. Gastric irritation (unlikely to be significant with one tablet)
4. Bleeding may take longer to stop.

Question 4

Atropine : Adverse

Answer 4

1. Dry mouth
2. Blurred vision
3. Tachycardia
4. Nausea & vomiting
5. Hyperthermia
6. Dysrhythmias
7. Agitation, delirium, hallucinations, seizure and coma may occur in high doses
8. Urinary retention

Question 5

Benzyl Penicillin : Adverse

Answer 5

Hypersensitivity reactions may occur (e.g. urticaria, angio-oedema, convulsions and anaphylaxis)

Question 6

Calcium Gluconate : Adverse

Answer 6

1. May [+] myocardial and cerebral damage by increasing intracellular calcium levels
2. Tissue necrosis if extravasation from vein occurs
3. Dysrhythmias

Question 7

Clopidogrel : Adverse

Answer 7

1. Allergic reactions (e.g. asthma, angioneurotic oedema, rhinitus, urticaria, laryngeal oedema and shock - check for Hx of previous reaction)
2. Aggravation of any bleeding tendency
3. Gastric irritation (unlikely to occur with the current dose)
4. Bleeding may take longer to stop

Question 8

Compound Sodium Lactate : Adverse

Answer 8

1. Pulmonary Oedema
2. Hypothermia
3. When given in excess can contribute to coagulopathy (hypothermic & dilutional) and exacerbate acidosis.

Question 9

Droperidol : Adverse

Answer 9

1. Extrapyramidal reactions
2. Rarely, neuroleptic malignant syndrome (characterised by muscular rigidity, fever, hyperthermia, altered consciousness and autonomic instability)

Question 10

Enoxaparin Sodium : Adverse

Answer 10

1. Aggravation of any bleeding tendency
2. Allergic reactions (e.g. asthma, angioneurotic oedema, rhinitus, urticaria, laryngeal oedema and shock)
3. Bleeding may take longer to stop.

Question 11

Fentanyl : Adverse

Answer 11

1. Respiratory depression
2. Hypotension
3. Nausea & vomiting

Question 12

Fexofenadine : Adverse

Answer 12

1. Headache
2. Drowsiness
3. Nausea
4. Dry mouth

Question 13

Frusemide : Adverse

Answer 13

1. Excessive diuresis can lead to hypovolaemic shock

2. Potassium loss can precipitate dysrhythmias

Question 14

Glucagon : Adverse

Answer 14

1. Nausea & vomiting

2. Allergic reactions rarely occur

Question 15

Glucose 10% : Adverse

Answer 15

1. Tissue necrosis if extravasation from vein occurs
2. May aggravate brain damage in head injuries and strokes
3. May precipitate Wernicke’s Encephalopathy in alcoholics with thiamine deficiency.

Question 16

Glucose Gel : Adverse

Answer 16

May precipitate Wernicke’s Encephalopathy in alcoholics with thiamine deficiency.

Question 17

Glyceryl Trinitrate : Adverse

Answer 17

1. Hypotension
2. Flushing
3. Headache

Question 18

Hydrocortisone : Adverse

Answer 18

Nil

Question 19

Ibuprofen : Adverse

Answer 19

1. Nausea & vomiting
2. GI irritation
3. Diarrhoea
4. Renal impairment
5. Uncommon : hypersensitivity reactions with urticaria and pruritus

Question 20

Influenza Vaccine : Adverse

Answer 20

1. Feeling weak (Asthenia)
2. Diaphoresis
3. Malaise
4. Headache
5. Arthralgia
6. Fever
7. Rigors
8. Myalgia
9. Localised reactions (e.g. inflammation)

Question 21

Ipratropium Bromide : Adverse

Answer 21

Mild anticholinergic effects (e.g. urinary retention)

Question 22

Ketamine : Adverse

Answer 22

1. Distressing psychological reactions (e.g. agitation, hallucinations and / or dysphoria)
2. Nausea & vomiting
3. Muscle effects including increased tone, random purposeless movements

Question 23

Lignocaine : Adverse

Answer 23

1. May cause or exacerbate ventricular dysrhythmias
2. In high doses, it may cause:
   - Neurological side effects (drowsiness, disorientation, agitation, muscle twitching, fits and coma)
   - Cardiac effects (hypotension, bradycardia, heart block(s) and asystole)

Question 24

Methoxyflurane : Adverse

Answer 24

1. [-] LOC

2. Renal damage in high doses

Question 25

Metoclopramide : Adverse

Answer 25

1. Restlessness, drowsiness and fatigue 2. Extrapyramidal / acute dystonic reactions including spasm of the facial muscles, trismus, rhythmic protrusion of the tongue, abnormal speech, spasm of the extra occular muscles and unnatural positioning.

Question 26

Midazolam : Adverse

Answer 26

1. [-] LOC resulting in upper airway obstruction 2. Respiratory and cardiovascular depression which may be exacerbated in patients with limited physiological reserves and/or under the influence of alcohol or drugs.

Question 27

Morphine : Adverse

Answer 27

1. [-] LOC 2. Respiratory depression 3. Hypotension 4. Nausea & vomiting

Question 28

Naloxone : Adverse

Answer 28

1. Opioid withdrawal (nausea, vomiting, sweating, tachycardia, hypertension & combative behaviour) 2. Pulmonary oedema in patients with pre-existing cardiac disease. 3. Dysrhythmias (VF, VT)

Question 29

Ondansetron : Adverse

Answer 29

1. Headache and/or flushing 2. Seizures and movement disorders 3. Visual disturbance 4. Hypersensitivity reactions (including anaphylaxis)

Question 30

Oxygen : Adverse

Answer 30

1. [+] fire and explosion risk

Question 31

Oxytocin : Adverse

Answer 31

``` Common: - headache - tachycardia - bradycardia - nausea - vomiting Rare: - Anaphylactoid reaction with dyspnoea, hypotension, shock, rash and arrythmias ```

Question 32

Paracetamol : Adverse

Answer 32

1. Nausea | 2. Liver failure in overdose situations

Question 33

Pralidoxime Chloride / Atropine : Adverse

Answer 33

1. Dry mouth 2. Blurred vision 3. Tachycardia 4. Nausea & vomiting 5. Hyperthermia 6. Dysrhythmias 7. Urinary retention 8. Agitation, delirium, hallucinations, seizure and coma may occur in high doses 9. Muscle tightness and pain at injection site.

Question 34

Salbutamol : Adverse

Answer 34

1. Dysrhythmias in high doses | 2. Shakes and tremors

Question 35

Sodium Bicarbonate : Adverse

Answer 35

1. Metabolic acidosis (may cause dysrhythmias) 2. Heart failure 3. Hypokalaemia (may cause dysrhythmias)

Question 36

Tenecteplase : Adverse

Answer 36

1. Intracranial haemorrhage 2. Reperfusion arrythmias (usually self limiting) 3. Aggravation of any bleeding tendency.