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37 Cards in this Set
- Front
- Back
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Hyperemesis gravidarum
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Severe form of morning sickness-excess pregnancy related nausea/vomiting, following intake food and fluid
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Thalidomide
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Drug for hyperemesis, discontinued bc teratogenic effect during pregnancy-> phocomelia (short, seal like limbs)
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serious adr
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Fatal, life threatening, results in prolonged hospitalization, birth defects
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orlistat/xenical
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Weight loss, fats in stools, fluidty of stools brings essential fluids/electrolytes w/ it out of body
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misoprostol (cytotec)
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Powerful-anti-ulcer drug, oxytoxic agent, ABORTIFICENT, post partem bleeding
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heparin
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Anticoagulant, ↑ risk bleeding, protime at 1.5-2.5x normal to prevent disorders, ↑ sensitivity to simple bruises
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rifampicin
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Antituberculous drug, reddish discoloration of urine
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isoniazid, fiampicin, pyranzinamide
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Jaundice-adverse effect of anti-Koch-anti tb, yellowing-accumulation bilirubin in skin
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Diphenhydramine (Benadryl)
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Histamine 1 receptor antagonist, 1st line r/x allergic rxn
-sedation, anti-nausea, antiemetic, antimuscarinic, antiparkinsonian, anti-cholinergic |
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minoxidil
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Hypertension-> hair growing (hirsutism)
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Sildenafil citrate
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Used HTN- vasodilating effect (-> NO) now for ED-cardiovascular effect
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diazepam
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Anxiolytic, benzodiazepine
-gives sedation |
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Important aspects of clinical practice regarding adr
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1) anticipating possible problems
2) avoiding giving drugs that may cause ADR 3) recognize ADR if happening 4) respond w/ proper management |
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penicillin
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Beta lactam antiobiotic w/ hypersentiivty rxns
ANST-skin test |
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Iostretinoin (Accutane)
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Synthetic retinoid, oral for severe cystic acne, inhibits sebaceous gland size, teratogenic
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Metronidazole
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Under nitro-imidazole grp, effective against protozoa, anerobes like bacteriodes and clostdrium
-nasuea, diarrhea, stomatitis, peripheral neuropathy -disulfiram effect w/ alchohol- nausea and vomiting |
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Anatbuse (disulfiram)
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For alcoholics, effects include-sweating, tachycardia, arrhythmias, confusion, headache, flushing, hypotension, nausea
-↑ acetaldehyde conc in blood (hangover) |
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Other drugs w/ disulfiram like effects
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Metronizadole, trimethoprim, tolbutamide, cefoperazone, cefoetan
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Chloramphenicol
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To pt w/ prolonged cough
*aplastic anemia, thrombocytopenia |
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antihypertensive drugs
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Propranolol
Nifedipine Captopril Hydrochlorothiazide Hydralazine Prazosin hcl |
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propranolol
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Beta blocker- coughing, secondary to bronchial spasm, bronchus contains beta receptor, net bronchoconstrictive effect
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nifedipine
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Calcium channel blocker-vasodilation of BV including those in CNS -> headache
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captropril
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Ace inhibnitor-halitosis-bad breath
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Hydrochlorothiazide
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Thiazide diuretic-can be inhibited by other drugs thus no frequent urination can occur
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prazosin hcl
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Alpha blockers
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Ten commandments for reducing adverse drug rxns
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1) Use as few drugs as possible
2) Know well drugs you use 3) Do not change too readily from one drug you know to another you don’t know, if change acquaint w/ pharmacology, interactions, metabolism, adverse effects 4) Don’t hesitate to use textbooks and table providing info on drug rxn, 5) Be careful when prescribe drugs that exhibit large variety of ineractions-anticoag, cns affecting 6) Look at lists patient receiving-consider wheter to discontinue 7) Be aware of interactions drugs w/ certain foods, alcohol, chemicals 8) Review w/ patient regularly-drugs taken 9) Careful when prescribe for children/elderly 10) If pt shows signs/symptoms not explained by course of illness, think adr |
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During pregnancy
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Women take >90% otc/prescription drugs/social drugs/illicit drugs
About 2-3% birth defects – drugs/alcohol Vulnerable b/w 3rd and 8th week after fertilization |
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Mechanisms drug tetratogenicity
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Direct action on fetus->damage, abnormal dvlpt. Deatj
-alter fxn placent -cause uterine ms contraction |
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type a
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Augmented/exaggerated form of drugs phar action, predictable, related to dose
-primary (extension effect)-adr related to drugs known action Atropine-dry mouth Nitroglycerin-vasodilatiation-headache Propranolol-block beta1-bronchoconstriction Nsaids=GI ulcer -secondary-adr diff from drugs known action |
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type b
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Unrelated to known pharm actions, atypical responses not expected from known action of drug
-usually severe, 1/6000 pt, unreleatd to dose, influence drug withdrawal frm market |
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Stevens johnsons syndrome
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Sulfonamides, penicillin, antibiotic, Dilantin (phenotyoin)-anticonvulsant, bextra (valdecoxib) –cox2 inhibitor
Musculocuteanos, immunologic rxn, epidermal ulceration, burning erythematous rash-spread symmetrically over body in 3-4 days, blister/snecrosis skin occurs-around mouth eyes Genital tract, blindness, urination, high death rate Dermatitis-clindamycin, amoxicillin, mixed drug to phenothiazine |
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Co-trimoxazole
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trim-offers bacteriocidal effect again bacteria causing uti, prostatitis, shigellosis
Ae: sulfonamide effect: fever, skin rash, exfoliative dermatitis, photosensitivity, urticarial, nausea, vomiting, diarrhea, sjs |
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Type c
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Continuous- effects on continuous use
Steroid – hirutism on female, buffalo hump Ehtambutol-anti tb- poor visual acuity, sign optic neuopathcy- 50% may not recover |
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type d
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Delayed, after several months/years
Diesthylstilbestrol (DES) -vaginal carcinoma in kids -ectopic pregnancy, adenosis cervix vagain t-shaped and constricted uterus alcohol/smoking-preg -FAS-metal retardation,microcephaly, short palpebral fissure, flat midace, |
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type e
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Ending of use, observe effect after discontinuation drug
Clonidine-anti hypertensive- bleeding Corticosteroids-acute adrenal insufficiency, not stopped abruptly Opiods-narcotic withdrawal symptoms |
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type f
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Failed efficacy
-inappropriate med / drug incompatiable/counterfeit/ tolerance/ poor compliance/ expired/underdosing |
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vulnerable population
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Eldery-inc freq use, lots of drugs
-inc sensitivity todrug- pharm kinetics -predisposing factors-insomia |
