Common drugs and their SE

Question 1

NSAIDS

Answer 1

GI
-dyspepsia
-peptic ulcers, bleeds

PPI provides GI protection

Question 2

Thiazides

Answer 2

Gout exacerbation
-increase urate

Question 3

ACEi

Answer 3

Dry cough

Switch to ARBs

Question 4

CS

Answer 4

Mania, aggression, agitation

Question 5

Typical antipsychotics

Answer 5

EPSEs
-acute dystonia

Question 6

Statins

Answer 6

Myalgia, myositis, myopathy
-risk increased if high dose, given with fibrate, macrolide or CCB

Discontinue if
-CK 5x upper limit
-severe symptoms

If mild
-switch to different statin
-review dose and other meds

Best given at bed - HMG CoA reductase most active at night

Question 7

Naloxone

Answer 7

Has a shorter T1/2 than opiates so it wears off before the opiate does => continued risk of overdose

Question 8

Verapamil

Answer 8

CAN CAUSE HF - negative ionotropic effects
-diltiazem also affects peripheral smooth muscle => reduced tendency to cause HF

-for antiHTN, use DHP CCBs (nifedipine, amlodipine)

Question 9

TCAs

Answer 9

Affect ACh rec
-cardiac dysrythmias - long QT => VF
-dry mouth
-blurred vision
-constipation

Greatest OD risk

Question 10

SNRI

Answer 10

No ACh SE

Question 11

SSRIs

Answer 11

Less likely to have ACh SE

However, risk of suicidal ideation is greater during first few weeks => important to monitor

Question 12

Fusidic acid, phenytoin, peridopril caution

Answer 12

Has a variety of preparations but the dose differs

Question 13

Quinolones

Answer 13

Don’t take with indigestion remedies, Ca (milk), Fe => reduces uptake

Question 14

Antibicrobials

Answer 14

Dosing time - even distribution throughout to maintain therapeutic effect

Question 15

Insulin

Answer 15

Dosing time - avoid hyper/hypos

Question 16

Nitrates

Answer 16

Dosing time - asymmetrical dosing to prevent tolerance developing

Question 17

Parkinsons Disease meds

Answer 17

Dosing time - time sensitive to present symptoms returning if late

Question 18

MR mprphine sulfate

Answer 18

Dosing time - time sensitive to prevent pain returning

Question 19

Timolol

Answer 19

Dosing time - short half life so must be given every 12hrs, otherwise sight may be lost in glaucoma

Question 20

Levothyroxine

Answer 20

Take before breakfast to ensure max absorption