Side Effects Flashcards
penicillins
HYPERSENSITIVITY RX (anaphylaxis in 0.05%) -neurotoxicisty, hematologic side effects
PCN + CEPH ASSOC W/ NEPHTOTOXICITY (INTERSTITIAL NEPHRITIS)
ampicillin + amox
MACULOPAPULAR RASH IN PT W/ INFECTIONS MONO
>90% diarrhea
cephalosporins
10% CROSS-REACTIVITY TO PT ALLERGIC TO PCN
DISULFIRAM RX (2ND/3RD)
diarrhea, less common: inc LFTs, neutropenia, thrombocytopenia
aztreonam
beta lactam that has no cross-reactivity w/ PCN or cephalosporins
vancomycin
RED MAN SYNDROME (histamine release occurs when infused too quickly)
- avoid w/ slow infusion over 1-2 hours
- ototoxic (reversible), nephrotoxic
macrolides
GI UPSET (less w/ newer ones)
CYTOCHROME P450 INHIBITOR
PROLONGED QT INTERVAL
CAUTION IF PT ON NIACIN OR STATINS (inc risk muscle toxicity)
fluoroquinolones
TENDON RUPTURE, growth plate arrest, damage to articular cartilage
- don’t give if <18yo or pregnant
- MAY EXACERBATE MYASTHENIA GRAVIS
- QT PROLONGATION
- photosensitivity
clindamycin
MAY CAUSE C.DIFF
-not good CSF penetration
tetracyclines
DEPOSIT IN TEETH / DISCOLORATION hepatotoxic DON'T GIVE TO CHILDREN <8 OR PREGNANCY PHOTOSENSITIVITY don't give simultaneously w/ dairy, Ca, Al, Mg or Fe
sulfonamides (ie bactrim)
rash in 3-5%
don’t give after 2nd tri –> may devo KERNICTERUS
SULFA ALLERGY
HEMOLYSIS IF G6PD DEFICIENCY
metronidazole
AVOID ETOH DURING AND 48H AFTER --> DISULFIRAM-LIKE REACTION NEUROTOXICITY metallic taste possible carcinogenic potential pancreatitis
augmentin
pcn w/ highest occurrence of DIARRHEA
photosensitivity
tetracyclines fluoroquinolones sulfonamides trimethoprim-sulfamethoxazole pyrazinamide
orange tears / secretions
rifampin
QT prolongation
antiemetics (think zofran) typical and atypical antipsychotics TCAs benzisoxazoles (antipsychotic) quinolones (levo, moxi) macrolides (erythro, clarithro) antimalarials antifungals methadone
ethanol and benzodiazepines
bx/mood effects:
- disinhibition
- DEPRESSION
- labile mood - erratic bx, aggression
physio effects:
- prolonged rx time, muscular incoordination, facial flush
- WERNICKE’S ENCEPHALOPATHY (ataxia, confusion, oculomotor palsy - b1/thiamine deficiency)
- KORSAKOFF SYNDROME amnesia
- hepatomegaly, palmar erythema, cirrhosis, dupuytrens contractures, gynecomastia, testicular atrophy
- increased MCV
withdrawal onset/sx: 6-24h -INCREASED CNS ACTIVITY: tremor, insomnia, n/v, anxiety, tachycardia, htn, inc RR 6-48h -seizures, hyperreflexia 2-5 days -DELIRIUM TREMENS: ALTERED SENSORIUM hallucinations, "something crawling on them", ams, seizures --> often happens when hospitalized for another reason
stimulants: cocaine and amphetamines
bx/mood effects:
- elevated/euphoric mood, restlessness, pressured speech
- PSYCHOSIS: anxiety, paranoia, AGGRESSION, AGITATION, hallucinations
physio effects:
- neuro: inc motor activity, ha, tremor, flushing, hyperthermia, cold sweats, n/v, seizures
- SYMPATHETIC STIMULATION: sweat, tachy, HTN, PUPIL DILATION, peripheral vasoconstriction, myocardial infarction
- picking at skin, rhabdomyolysis
withdrawal onset/sx:
-varied: craving w/ resultant dysphoria, agitation, anxiety, sweating, HYPERSOMNIA, INCREASED APPETITE, nightmares, SUICIDE IDEATION, ha, irritable, fatigue, cramps
opioids and narcotics
bx/mood effects:
-EUPHORIA AND SEDATION, drowsy, impaired social fx, impaired memory, slowed speech
physio effects:
- PUPILLARY CONSTRICTION
- RESPIRATORY DEPRESSION, BRADYCARDIA, HYPOTN, coma, n/v, hypothermia
- chronic: pruritus and constipation
withdrawal onset/sx:
6-24h
-psychomotor agitation, anxiety, irritable, twitch, ywaning, dysphoria, insomnia, sweating
-hyperthermia, htn, tachy
-flu-like sx: RHINORRHEA, myalgias, chills, PILOERECTIONS
-n/v/d
-PUPILLARY DILATION, TEARING
nicotine
bx/mood effects:
-n/v/d, abd pain, ha
physio effects:
-tremor, tachycardia, salivation
withdrawal onset/sx:
- usually begin w/in 24h:
- anxiety, restlessness, bradycardia, increased appetite and craving
cannabis
bx/mood effects:
-euphoria, giddiness, psychosis in some cases
physio effects:
-dry mouth, conjunctival erythema, tachycardia, hypotn
withdrawal onset/sx:
-irritable, insomnia, restlessness, diaphoresis, diarrhea, twitches
PCP
bx/mood effects:
-impulsiveness, homicidality, psychosis, delirium, seizures, NYSTAGMUS
withdrawal onset/sx:
-depression, irritable, anxiety, sleep problems
LSD
-visual hallucinations and synesthesias (seeing sound as color), delusions, pupillary dilation
levodopa/carbidopa
n/v, hypoTN, somnolence, dyskinesia, “wearing off bradykinesia” w/ long term use
phenytoin / dilantin
Ind: tonic-clonic seizures, prophylaxis, status epilepticus
SE: rash (erythema multiforme / SJS), GINGIVAL HYPERPLASIA, HIRSUTISM, teratogenic, arrhythmias
