Adverse Drug Reactions

Front 1

TB MEDS (INH/RIFAMPIN)

Back 1

CONFUSION; HEPATIC DISEASE

Front 2

QUINOLONES

Back 2

CONFUSION; RENAL FAILURE

Front 3

SULFA/TRIMETHOPRIM:

Back 3

CONFUSION; HYPERKALEMIA

Front 4

MYCINS

Back 4

OTOTOXICITY; RENAL DISEASE

Front 5

NSAIDS

Back 5

GI bleeds, interstitial nephritis, confusion

Front 6

Amantadine

Back 6

confusions, seizures
(parkinsons tx)

Front 7

sinemet

Back 7

confusions, seizures
(parkinsons tx)

Front 8

pergolide

Back 8

postural hypotension
(parkinsons tx)

Front 9

ropirinole

Back 9

syncope, hallucinations
(parkinsons tx)

Front 10

Thiazides

Back 10

hypokalemia, dehydration, hyperuricemia, hyperglycemia, hypercalcemia, hyponatremia, pancreatitis

Front 11

Loops

Back 11

dehydration, hypokalemia, hyponatremia - confision; OTOtoxicity

Front 12

BB - should be avoided in?

Back 12

COPD, reactive airway dz.
all are renally eliminated.
- may worsen claudication and mask hypoglycemia

Front 13

propranol

Back 13

higher blood levels; longer 1/2 life; confusion

Front 14

ACE - I

Back 14

angioedema
leukopenia
hyperkalemia

Front 15

enalapril and lisiopril

Back 15

renal excretion - prolonged action with renal dysfunction

Front 16

–NIFEDIPINE:

Back 16

PERIPHERAL EDEMA; TACHYCARDIA
(CCB)

Front 17

–DILTIAZEM

Back 17

:CONFUSION; PROLONGED HALF LIFE
(CCB)

Front 18

–VERAPAMIL

Back 18

SEVERE CONSTIPATION
(CCB)

Front 19

–CLONIDINE: ;

Back 19

DEPRESSION; CONFUSION; ANTICHOLINERGIC EFFECTS; SEDATION

Front 20

METHYLDOPA

Back 20

HEPATIC EFFECTS; CONFUSION

Front 21

RESERPINE:

Back 21

CONFUSION
-PRAZOSIN/TERAZOSIN: HYPOTENSION, CONFUSION

(centrally acting antihypertensives)

Front 22

DIGOXIN: TOXICITY COMMON AT THERAPEUTIC LEVELS
–POTENTIATED BY

Back 22

DEHYDRATION & HYPOKALEMIA

Front 23

–S/E of dig?

Back 23

DIARRHEA, CONFUSION, ANOREXIA, FATAL ARRHYTHMIA - potentiates hyperkalemia

Front 24

Drugs that cause hyperkalemia in elders?

Back 24

Na+ substitutes
K+ sparing diuretics
Spironolactone, trimaterene, amiloride
NSAID’s
ACE inhibitors; ARBS
Beta blockers
Heparin
Digoxin
Trimethoprim

Front 25

–DISOPYRAMIDE:

Back 25

URINARY RETENTION
(ANTIARRHYTHMICS)

Front 26

–LIDOCAINE:

Back 26

PROFOUND CONFUSION, AGITATION

Front 27

–QUINIDINE

Back 27

CONFUSION, HIGHLY PROTEIN BOUND SO MULTIPLE DRUG INTERACTIONS

Front 28

–AMIODARONE:

Back 28

CONFUSION, N/V, LIVER/THYROID DISEASE

Front 29

HEPARIN:

Back 29

BLEEDING; THROMBOCYTOPENIA & BONE LOSS (LONG-TERM)

Front 30

–CHLORPROPAMIDE

Back 30

LONG HALF-LIFE; ALL PROTEIN BOUND SO MAY BE DISPLACED; SIADH EFFECT! → hyponatremia → confusion
((oral hypoglycemic)

Front 31

Metformin

Back 31

lactic acidosis (esp in renal pts or w/ dehydration)

Front 32

ANTICONVULSANTS:

Back 32

–INCREASE BONE LOSS, CONFUSION, HIGHER LEVELS COMMON

Front 33

DILANTIN:

Back 33

HIGHER BLOOD LEVELS IN THE BODY - LAB DOESN’T MEASURE COMPLETE FREE DRUG

Front 34

H2 BLOCKERS:

Back 34

–CONFUSION ESPECIALLY with CIMETIDINE AS 1/2 LIFE PROLONGED/ ANTICHOLINERGIC

Front 35

–REGLAN:

Back 35

CONFUSION, PARKINSONISM

Front 36

–CISAPRIDE:

Back 36

FATAL ARRHYTHMIAS w/ MULTIPLE AGENTS
((prokinetic agent)

Front 37

OXYBUTYNIN:

Back 37

PROMINENT ANTICHOLINERGIC EFFECTS → CONFUSION

Front 38

BENZODIAZEPINES:

Back 38

–ALL HAVE LONGER HALF LIFE IN ELDERS (AVOID LONG-ACTING)
–ELDERS ARE MORE SENSITIVE TO SEDATION AND CONFUSION - ASSOCIATION WITH FALLS

Front 39

TCA's

Back 39

NEVER USED’ ANTICHOLINERGIC EFFECTS MAKE THEM LESS DESIRABLE, ESPECIALLY ELAVIL

Front 40

SSRI’S:

Back 40

ANTIDEPRESSANTS OF CHOICE. CAN CAUSE NAUSEA, AGITATION AND CONFUSION/HYPONATREMIA

Front 41

SERTRALINE

Back 41

LESS PROBLEM WITH CYTOCHROME P45O
(SSRI)

Front 42

TRAZADONE:

Back 42

BEST USED FOR SEDATIVE EFFECTS RATHER THAN AS AN ANTIDEPRESSANT
–CAUSES ORTHOSTATIC HYPOTENSION, PRIAPISM

Front 43

ANTIPSYCHOTICS:

Back 43

HIGH EXTRAPYRAMIDAL EFFECTS; CAN CAUSE NEUROLEPTIC MALIGNANT SYNDROME

Front 44

THIORIDAZINE:

Back 44

HIGH SEDATIVE
((ANTIPSYCHOTICS))

Front 45

HALOPERIDOL:

Back 45

TARDIVE DYSKINESIA; RIGIDITY; AKATHESIA (LEGS MOVING); IMPAIRED GLUCOSE TOLERANCE

Front 46

NEWER ANTIPSYCHOTICS: RISPERIDAL, OLANZEPINE, QUETIAPINE, ARIPIPRAZOLE

Back 46

LESS TARDIVE PROBLEMS; LESS RIGIDITY; INCREASED CV RISK
-- QUETIAPINE: BEST FOR PARKINSON’S &LEWY BODY

Front 47

ANALGESICS:

Back 47

ALL OPIATES CAN CAUSE SEDATION & CONFUSION AS WELL AS SEVERE CONSTIPATION

Front 48

MEPERIDINE (DEMEROL):

Back 48

METABOLITE HAS NEUROEXCITATORY EFFECT
→ CONFUSION, AGITATION, TREMORS AND SEIZURES; “DEMONAL”, NH’S DON’T CARRY IT

Front 49

TRAMADOL

Back 49

USUALLY WELL TOLERATED SEIZURES; SEDATION

Front 50

PERSANTINE

Back 50

AVOID ALWAYS-
EXCEPT 6 WKS POST CABG

Front 51

ELAVIL:

Back 51

AVOID always
ANTICHOLINERGIC

Front 52

DIAZEPAM/DALMANE:

Back 52

AVOID always
LONG HALF-LIFE

Front 53

HYDERGINE

Back 53

AVOID always
NO VALUE

Front 54

DARVOCET

Back 54

AVOID always
BAD ANALGESIC; CONFUSION

Front 55

MEPERIDINE

Back 55

AVOID always
DELIRIUM; SEIZURES; TREMORS

Front 56

Other drugs kathy said to avoid?

Back 56

METHYLDOPA
CHLORPROPAMIDE
INDOMETHACIN
RESERPINE
MUSCLE RELAXANTS
REGLAN

Front 57

Drugs kath said were underutilized in the elderly?

Back 57

ASPIRIN FOR PROPHYLAXIS
BETA BLOCKERS
CALCIUM
MULTIVITAMINS/Vitamin D
ANALGESICS
EYE LUBRICANTS
ANTI-DEPRESSANTS
ANTI-OSTEOPOROSIS MEDS