Side effects

Question 1

Penicillins

Answer 1

GI upset, C-diff due to broad action

10% have allergic reaction

Question 2

Cephalosporins

Answer 2

GI upset, C-diff risk + risk of CNS toxicity and seizures

Question 3

Trimethoprim

Answer 3

GI upset, rare hypersensitivity reactions
Can impair haematopoiesis - haematological disorders
Hyperkalaemia and raised plasma creatinine

Question 4

Nitrofurantoin

Answer 4

GI upset, rare hypersensitivity reactions
Turns urine dark yellow/brown
Rare chronic pulmonary reactions, hepatitis and peripheral neuropathy
Neonates - haemolytic anaemia

Question 5

Tetracyclines

Answer 5

GI upset, but amongst lowest risk for C-diff

Oesophageal irritation, ulceration, dysphagia, photosensitivity, tooth enamel discolouration

Question 6

Aminoglycosides

Answer 6

Nephrotoxicity and Ototoxicity as they accumulate in renal tubular epithelial cells and cochlear/vestibular hari cells

Question 7

Macrolides

Answer 7

GI upset when oral and thrombophlebitis when IV

Allergy, C-diff, QT prolongation and ototxicity

Question 8

Quinolones

Answer 8

Generally well tolerated - GI upset and some delayed hypersensitivity reactions
Can have neurological effects, rupture muscle tendons, and prolong QT interval

Question 9

Metronidazole

Answer 9

GI upset, hypersensitivity

At high doses - neuro effects, peripheral and optic neuropathy, seizures and encephalopathy

Question 10

Glycopeptides

Answer 10

Thrombophlebitis, severe anaphylactoid reactions (Red man syndrome - due to non-specific degranulation of mast cells)

Question 11

NSAIDs

Answer 11

GI toxicity, Renal Impairment, CV events, hypersensitivity and fluid retention

Question 12

Codiene

Answer 12

Nausea, Constipation, dizziness, drowsiness, neurological and respiratory depression in overdose

Question 13

Morphine

Answer 13

High dose = Resp and neuro depression, euphoria and detachment
Pupillary restriction, constipation,
Itching, urticaria, vasodilation and sweating - histamine release

Question 14

Paracetamol

Answer 14

Generally very safe - lack of COX1 inhibition means no ulcers, RI or CV events

Question 15

Xanthine Oxidase Inhibitors

Answer 15

Generally well tolerated but a skin rash could indicate a hypersensitivity reaction such as Stevens-Johnson syndrome

Question 16

Alpha-Blockers

Answer 16

Postural Hypotension, dizziness and syncope

Question 17

5-alpha-reductase Inhibitors

Answer 17

Anti-androgen effect can cause impotence, reduced libido, breast tenderness, hair growth - breast cancer reported

Question 18

L-dopa

Answer 18

Any dopaminergic drug can cause drowsiness, nausea, confusion, hallucinations and hypotension

Question 19

Phenytoin

Answer 19

Long term - skin coarsening, acne, hirsutism and gum hypertrophy
Dose related cerebellar toxicity and impaired cognition

Question 20

Carbemazepine

Answer 20

GI upset, neurological effects, oedema and hyponatraemia

Antiepileptic hypersensitivity syndrome - Stevens Johnson syndrome

Question 21

Sodium Valproate

Answer 21

GI upset, neurological/psychiatric effects, thrombocytopenia and increase in liver enzymes

Question 22

Lamotrigine

Answer 22

Antiepileptic hypersensitivity syndrome

Question 23

Levetiracetam

Answer 23

Nasopharyngitis, somnolence (Sleepiness), headache, fatigue and dizziness

Question 24

Tricyclics

Answer 24

Dry mouth, constipation, urinary retention, blurred vision - muscarinic
Sedation and hypotension - H1 and a1 receptors
Arrythmias and ECG changes

Question 25

SSRI's

Answer 25

GI upset, appetite and weight disturbance, hypersensitivity and hyponatraemia Can increase suicidal thoughts and behaviours Serotonin syndrome - triad of autonomic hyperactivity, altered mental state and neuromuscular excitation

Question 26

Benzodiazepines

Answer 26

Drowsiness, sedation and coma Loss of airway reflexes Withdrawal symptoms when stopped

Question 27

Acetylcholinesterase inhibitors

Answer 27

Diarrhoea, muscle cramps, fatigue, nausea, vomiting and insomnia

Question 28

Antacids

Answer 28

Diarrhoea + Constipation

Question 29

H2 antagonists

Answer 29

Bowel disturbance, headaches and dizziness

Question 30

PPI

Answer 30

GI disturbance and headaches, can reduce barrier against C-diff

Question 31

Loperamide

Answer 31

Constipation

Question 32

Laxatives

Answer 32

Abdo pain/cramps and diarrhoea

Question 33

Aminosalicylates

Answer 33

GI upset and headache, can cause rare but serious blood disorders - leukopenia, thrombocytopenia and renal impairment

Question 34

Antiemetics

Answer 34

Diarrhoea and can be extra-pyramidal symptoms

Question 35

Loop diuretics

Answer 35

Dehydration, hypotension, loss of Na, K, Cl, Mg, Ca

Question 36

Thiazide Diuretics

Answer 36

Hyponatraemia, hypokalaemia

Question 37

Potassium Sparing Diuretics

Answer 37

Hyperkalaemia - muscle weakness, cardiac dysrhythmias | Gynaecomastia, liver impairent, jaundice and Stevens Johnson Syndrome

Question 38

Beta-blockers

Answer 38

Fatigue, cold extremities, headache and GI disturbance | Bronchoconstriction

Question 39

Calcium Blockers

Answer 39

Ankle swelling, flushing, headache, palpitations

Question 40

ACE Inhibitors

Answer 40

Hypotension, cough, hyperkalaemia

Question 41

AT1 Blockers

Answer 41

Hypotension, hyperkalaemia, renal failure

Question 42

Nitrates

Answer 42

Flushing, headaches, light-headedness and hypotension

Question 43

Cardiac Glycosides

Answer 43

Bradycardia, GI disturbance, rash, dizziness, visual disturbance Low Therapeutic Range

Question 44

Amiodarone

Answer 44

Few side effects acutely - hypotension during infusion | Chronically - Pneumonitis, bradycardia, AV block, hepatitis, photosensitivity and greying of skin

Question 45

Aspirin

Answer 45

GI irritation, hypersensitivity reactions (bronchospasm), tinnitus

Question 46

Clopidogrel

Answer 46

Bleeding, GI upset, rare = thrombocytopenia

Question 47

Heparin

Answer 47

Bleeding and rarely thrombocytopenia

Question 48

NOACs

Answer 48

Bleeding, back pain, dizziness, headache, menorrhagia,

Question 49

Warfarin

Answer 49

Bleeding

Question 50

Statins

Answer 50

Generally safe - headaches, GI upset or myopathy/ rhabdomyolosis

Question 51

Beta-2-agonists

Answer 51

Tachycardia, palpitations, anxiety, tremor | Promote glycogenolysis - hyperglycaemia

Question 52

Anticholinergics

Answer 52

Dry mouth

Question 53

Corticosteroids

Answer 53

Increased catabolism can lead to proximal muscle wasting and skin thinning Mood and behaivour changes, hypertension, hypokalaemia, oedema

Question 54

Mucolytics

Answer 54

Anaphylaxis, allergic rashes and GI bleeding

Question 55

Theophylline

Answer 55

Nausea, GI upset, Palpitations, Tachycardia, Arrythmias, Convulsions and headaches

Question 56

Insulin

Answer 56

Hypoglycaemia - coma and death

Question 57

Sulfonylureas

Answer 57

Weight gain due to anabolic nature of insulin which can lead to greater resistance GI upset, hypoglycaemia, rare hypersensitivity reactions

Question 58

Biguanides

Answer 58

Reduces weight gain | GI upset, lactic acidosis is rare,

Question 59

Thyroxine

Answer 59

Similar effects to hyperthyroidism | Can precipitate cardiac ischaemia in those with coronary artery disease as increases HR and metabolism

Question 60

Carbimazole

Answer 60

Nausea, headache arthralgia, GI upset, skin rashes, taste disturbance, fever, malaise

Question 61

Bisphosphonates

Answer 61

Oesophagitis, hypophosphataemia, rare - osteonecrosis of the jaw

Question 62

Calcium and Vit D

Answer 62

Oral calcium - dyspepsia and constipation | IV - Cardiovascular collapse if given too fast

Question 63

Mineralicorticoids

Answer 63

Water retention, hypertension, hypokalaemia, weak bones, stomach ulcers, slow wound healing, thin skin, headaches and trouble sleeping