Drug adverse reactions

Question 1

gentamycin

Answer 1

ototoxicity, nephrotoxicity

Question 2

vancomycin

Answer 2

ototoxicity, nephrotoxicity

Question 3

ACE-i

Answer 3

hypotension, hyperkalaemia, cough, AKI

Question 4

Beta blockers

Answer 4

hypotension, bradycardia, Wheeze (asthmatics), worsens acute HF (but helps chronic)

Question 5

CCB’s

Answer 5

hypotension, bradycardia, peripheral oedema, flushing

Question 6

Diuretics

Answer 6

hypotension, electrolyte abnormalities, AKI, Spironolactone only: Gynaecomastia

Question 7

Heparins

Answer 7

Haemorrhage, Heparin induced thrombocytopenia (pro-thrombotic state!)

Question 8

Warfarin

Answer 8

Haemorrhage (initially pro-coagulant and takes a few days to work so prescribe heparin as a bridge)

Question 9

Aspirin

Answer 9

haemorrhage, peptic ulcer/gastritis, tinnitus at large doses

Question 10

digoxin

Answer 10

N&V&D, Confusion, blurred vision, yellow-green vision (xanthopsia) and halos in vision, drowsiness

LOW K+ augments digoxin’s effect! and HIGH K+ limit the effect!

Question 11

Amiodarone

Answer 11

Lung fibrosis (upper?), hypothyroidism (and HYPER may also occur), skin greying, corneal deposits

Question 12

Lithium

Answer 12

Early-Tremor
intermediate-tiredness
Late-arrythmias, seizures, coma, renal failure, diabetes insipidus

Question 13

Haloperidol

Answer 13

dyskinesias (acute dystonic reactions), drowsiness

Question 14

Clozapine

Answer 14

agranulocytosis

Question 15

Dexamethasone and prednisolone

Answer 15

STEROIDS:
Stomach ulcers
Thin skin
(o)Edema
Right and left heart failure
Osteoporosis (and avascular necrosis)
Infection (including candida)
Diabetes(commonly causes hyperglycaemia, doesn’t often cause full diabetes)
Cushing’s syndrome

Note abrupt withdrawal/illness may precipitate addisonian crisis (remember sick day rules)

Question 16

Fludrocortisone

Answer 16

hypertension, sodium and water retention

Question 17

Ibuprofen and NSAIDS

Answer 17

NSAID:
No-urine (AKI)
Systolic dysfunction (Heart failure)
Asthma
Indigestion (stomach ulcers)
Dyscrasia (clotting abnormality)

Question 18

Statins

Answer 18

Myalgia (most common, note Check CK! if myalgia occurs can reduce dose, then try diff statin, then try diff lipid lowering drug)

Also causes: abdominal pain, Rhabdomyolysis, increased ALT/AST (can be mild)

Question 19

PPI’s

Answer 19

Hyponataemia, hypomagnesaemia