Drug Side Effects (Cardio)

Question 1

Ivabradine.

Answer 1

Arrhythmias (AF, bradycardia, AV block), hypotension, plasma conc increased when co-administered with verapamil.

Question 2

B-agonists.

Answer 2

Tissue necrosis due to peripheral vasoconstriction, acute pulmonary oedema, tremor, arrhythmias (tachycardia esp), chest pain/angina, anxiety/panic attacks, adrenaline also causes bronchodilation.

Question 3

B-blockers.

Answer 3

Fatigue/malaise, cold peripheries (with maybe paraesthesia [pins and needles]), peripheral vasoconstriction, heart failure (when sympathetic drive needed to maintain CO), bradycardia, AV block, hypoglycaemia (cardioselective have less risk).

Question 4

Muscarinic antagonists (atropine).

Answer 4

Dilation of pupils, dry mouth, transient tachycardia, reduced bronchial secretions.

Question 5

Calcium sensitiser (levosimendan).

Answer 5

Arrhythmias, hypokalaemia.

Question 6

Digoxin.

Answer 6

Blurry or yellow vision, AV block, thrombocytopenia, arrhythmias (SV origin particularly).

Question 7

Class Ia antiarrhythmics.

Answer 7

Blurred vision, dry mouth, constipation, urinary retention.

Question 8

Class Ib antiarrhythmics.

Answer 8

Local anaesthetic, drowsiness and confusion, hepatitis and liver failure.

Question 9

Class Ic antiarrhythmics.

Answer 9

Sudden cardiac death associated with VF after MI.

Question 10

Class III antiarrhythmics.

Answer 10

Hypokalaemia (may precipitate torsades de pointes), phlebitis if given in peripheral vein, photosensitive rash, hypo/hyperthyroidism, pulmonary fibrosis, long QT.

Question 11

Adenosine.

Answer 11

Chest pain, dyspnoea, dizziness, nausea, AV block, sinus pause, bradycardia/asystole.

Question 12

Organic nitrates.

Answer 12

Throbbing headache (initially), hypotension esp postural, tolerance common for prolonged ISMN use.

Question 13

ACEIs.

Answer 13

Hypotension (first dose esp), dry cough, hyperkalaemia, renal dysfunction, angioneurotic oedema, peripheral oedema.

Question 14

ARBs.

Answer 14

Same as ACEIs but without angioneurotic oedema.

Question 15

Calcium channel blockers (dihydropyridines).

Answer 15

Peripheral oedema, postural hypotension, thrombocytopenia.

Question 16

Verapamil.

Answer 16

Constipation, AV block, bradycardia/asystole, peripheral oedema, CCF with pulmonary oedema, increased risk of myopathy when used with atorvastatin and simvastatin. Increases plasma conc of ivabradine, digoxin and dabigatran.

Question 17

Diltiazem.

Answer 17

AV block, peripheral oedema, bradycardia/SA block, increases plasma conc of digoxin and ivabradine.

Question 18

A-blockers.

Answer 18

Hypotension (first dose and postural), peripheral oedema, headache (initially).

Question 19

Potassium channel openers.

Answer 19

Rectal bleeding, hypotension, angioneurotic oedema, cutaneous dilation with flushing, reflex tachycardia at high doses.

Question 20

Loop diuretics.

Answer 20

Hypokalaemia, electrolyte imbalance, postural and first dose hypotension, exacerbate diabetes, induced hypokalaemia can precipitate hepatic encephalopathy.

Question 21

Thiazide diuretics and thiazide-like diuretics.

Answer 21

Hypokalaemia, electrolyte imbalance, postural and first dose hypotension, hypercalcaemia, impotence, gout and gouty arthritis, exacerbate diabetes, induced hypokalaemia can precipitate hepatic encephalopathy

Question 22

Spironolactone.

Answer 22

Hyperkalaemia, gynaecomastia, electrolyte imbalance, hypertrichosis (excessive hair growth).

Question 23

HMG CoA reductase inhibitors (statins).

Answer 23

Hyperglycaemia and diabetes mellitus, myalgia, myopathy, arthralgia, rhabdomyolysis, renal failure.

Question 24

Fibrates.

Answer 24

Myalgia, myopathy, arthralgia, rhabdomyolysis, renal failure, hepatitis and liver failure (due to hepatotoxicity).

Question 25

Bile acid binding resins.

Answer 25

GI discomfort, bad tasting mouth, deficiency of fat-soluble vitamins, coagulopathy due to vit K deficiency.

Question 26

Cholesterol absorption inhibitors.

Answer 26

GI discomfort, hepatitis and liver failure, myalgia, myopathy, arthralgia.

Question 27

Warfarin.

Answer 27

Haemorrhage, skin necrosis (protein C or S deficiency), (higher risk of haemorrhage in liver disease, high metabolic rate or drugs),

Question 28

Heparin and LMWH.

Answer 28

Haemorrhage, osteoporosis, hyperkalaemia (due to hyperaldosteronism), hypersensitivity reactions, hepatin-induced thrombocytopenia, LMWH not suitable for patients with renal impairment.

Question 29

DOACs.

Answer 29

Haemorrhage, thrombocytopenia.

Question 30

Antiplatelets.

Answer 30

Haemorrhage, peptic ulcer, bronchospasm (asthma), GI disturbance (PPI usually given with aspirin).

Question 31

Fibrinolytics.

Answer 31

Haemorrhage.