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105 Cards in this Set
- Front
- Back
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Side effects of Thiazides
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Hypokalemia
1. Incr. Na+ reaching collecting tubules leads to higher exchange of Na+/K+. 2. Decr. fluid volume leads to aldosterone secr. 3. Incr. diuresis in general, incl. that for K+. Hyponatremia (The drugs MOA) Hypercalcemia (?) Hyperglycemia (decr. plasma K+ leads to decr. insulin secr.) Elevated plasma lipids (?) Hyperuricemia (Thiazides compete with uric acid for secr. into tubular fluid) Fluid depletion with hypotension and light-headedness Hypersensitivity reactions (bone marrow suppression, dermatitis, necrotizing vasculitis and interstitial nephritis are very rare) 25% decr. in Lithium secretion due to thiazides. |
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Loop diuretics side effects
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Hyponatremia (MOA)
Hypomagnessemia (Incr. secr. of Mg+) Ototoxicity, esp. when used together with Aminoglycosides. Ethacrynic acid is worst. Tinnitus, hearing loss (Accumulation in ear fluids and disturbance of function) Hyperuricemia (competition of diuretics with uric acid for organic acid secretory system) Hypocalcemia (Incr. Ca++ secr.) Hypokalemia (Incr. K+ excr. as with thiazides) Metabolic alkalosis Rash Dyslipidemia Acute hypovolemia with hypotension, shock and cardiac arrhythmias |
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Loop diuretics interactions
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Loop diuretics displace warfarin and clofibrate from plasma proteins.
They cause decr. clearance of Li+. Loop diuretics incr. renal toxicity of cehalosporins. They show additive toxicity with other oototoxic drugs (aminoglycosides) Probenecid and other inhibitors of organic acid secr. system shifts the dose response curve of LoopDs to the right. |
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Spironolactone side effects
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Hyperkalemia (Inhib. K+ excr.)
Gynecomastia, decr. libido, menstural irregularities, impotence (Inhib. of steroid metabolism) Androgenic effects in females Gi tract disturbances. Frequent, and can cause peptic ulceration. |
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Triamterene and amiloride side effects
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Hyperkalemia
Use cautiously with ACE inhibitors, avoid with spironolactone/eplerenone. Azotemia (reversible) |
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Acetazolamide side effects
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Hyperchloremic metabolic acidosis (mild)
Nephrolithiasis Hypokalemia Drowsiness and paresthesias. |
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Osmotic diuretics side effects
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Incr. extracellular fluid volume
Hypersensitivity reactions Glycerin metabolism can lead to hyperglycemia and glycosuria Headache, nausea and vomiting. |
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ACE inhibitors side effects
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Cough and angioedema (because of incr. bradykinin levels, leading to incr. secretions in resp. airways and vasodilation and incr. vessel permeability)
Rash, fever, altered taste Postural Hypotension (in hypovolemic states) with first dose syncope. Hyperkalemia (Decr. aldosterone) so that K+ must be monitored. Renal failure (reversible) in patients with renal artery stenosis. Fetotoxicity, therefore CI in pregnancy. |
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Beta blockers side effects
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Orthostatic hypotension
Bradycardia (less so the ones with ISA) Bronchoconstriction (less so the cardioselective ones, selective Beta1 antagonists) CNS effects such as fatigue, lethargy, insomnia and hallucinations. Sexual dysfunction, decr. libido and impotence. Disturbed lipid metabolism, incr. TAG and decr. HDL. Withdrawal tachycardia, arrhythmias, angina, infarction or even sudden cardiac death. (supersensitivity of the receptors due to prolonged blockade) Hypoglycemia |
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ARBs side effects
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The angiotensin receptor blockers have the same side effect profile as that of ACE inhibitors but do not cause cough or angioedema.
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Nitrates side effects
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Headache in most patients.
High doses cause postural hypotension, facial flushing and reflex tachycardia. Severe hypotension together with sildenafil. Methemoglobinemia (this side effect may be used in the treatment of cyanide poisoning) Tolerance |
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Calcium channel blockers side effects
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The incidence and type of side effects depend very much on what type of CCB is being used. Diltiazem has the lowest freq. of side effects of the CCBs.
Hypotension (with the dihydropyridines, such as nifedipine) Reflex tachycardia Worsened heart failure (due to negative inotropism) Flushing, headache, peripheral edema (ankle edema 10-15%). CONSTIPATION Gingival hyperplasia Incr. digoxin toxicity. |
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Digitalis side effects
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Digitalis toxicity is one of the most commonly encountered adverse drug reactions.
Ventricular tachycardia. Digoxin toxicity is managed with discontinuing the treatment and addition of antiarrhythmic agent. If this is not sufficient we add antibodies to digoxin which binds to and inactivates digoxin. Atrial arrhythmias. GI effects: Anorexia, nausea, and vomiting. CNS effects: Headache, fatigue, confusion, blurred vision, alteration of color perception and halos on dark objects. |
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What predisposes a patient to digoxin toxicity?
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Hypokalemia is the main factor.
Hypomagnesemia Hypercalcemia Drugs: Quinidine, verapamil and amiodarone by competing with digoxin for excretion and binding sites on proteins. Corticosteroids, diuretics (potassium depleting) and a variety of other drugs may also predispose to digoxin toxicity. Hypoxia, hypothyroidism, renal failure, and myocarditis are also predisposing factors. |
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Quinidine side effects
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Arrhythmia (torsades de pointes due to QT elongation)
SA and AV node blockade or asystole. Nausea, vomiting and diarrhea are common. Cinchonism (due to anticholinergic effects) incl. blurred vision, tinnitus, headache, disorientation and psychosis. Atropine like effects and mild alpha adrenergic blockade. |
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Procainamide side effects
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High incidence of side effects.
Reversible lupus erythrematosus. Asystole or induction of ventricular arrhythmias. CNS: depression, hallucinations and psychosis. |
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Disopyramide side effects
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Disopyramide has anticholinergic side effects such as blurred vision, dry mouth and mucosas, urinary retention and constipation.
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Lidocaine side effects
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Lidocaine has a fairly broad therapuetic index.
It shows only little impairment of left ventricular function and no negative inotropism. CNS: Drowsiness, slurred speech, paresthesia, agitation, confusion, and convulsions. Cardiac arrhythmia may occur as with all antiarrhythmics. |
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Tocainide side effects
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Can cause pulmonary fibrosis.
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Flecainide side effects
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Dizziness, blurred vision, headache, and nausea.
Aggravation of preexisting arrhythmias or induce life-threatening ventricular tachycardias that are resistant to treatment. The Class IC antiarrhythmics are considered rather unsafe agents. |
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Levodopa side effects
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Nausea, anorexia and vomiting due to stimulatoin of chemoreceptor trigger zone by dopamine.
Tachycardia, extrasystoles due to stim. of the heart. Hypotension. Mydriasis. Brown saliva and urine due to melanin pigment from catecholamine oxidation. Visual and auditory HALLUCINATIONS and abnormal involuntary movements (dyskinesias). They are due to overstimulation of dopamine in the brain. Mood changes, depression, psychosis and anxiety. Blood dyscrasias and positive Coombs test. |
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Levodopa interactions
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Vitamin B6 pyridoxine increases the peripheral breakdown of levodopa and diminishes its effectiveness.
MAO inhibitors such as phenelzine can together with levodopa cause a hypertensive crisis. In psychotic patients, levodopa increases symptoms. In patients with glaucoma, an increase in intraocular pressure may occur. Cardiac patients should be carefully monitored. |
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Selegiline side effects
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In high doses it loses its MAO type B selectivity and may cause hypertensive crisis.
Insomnia (metabolic products of deprenyl are amphetamine and methamphetamine) |
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Entecapone
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Diarrhea, postural hypotension, nausea, anorexia, dyskinesia, hallucinations, and sleep disorders. (Like with levodopa-carbidopa)
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Tolcapone
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Same as Entecapone plus it can cause severe fulminating hepatic necrosis which has led to entecapone replacing tolcapone.
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Bromocriptine side effects
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Similar to those of levodopa except that hallucinations, confusion and delirium, nausea and orthostatic hypotension are more common.
Dyskinesia is less pronounced. Serious cardiac problems may develop. Worsening of vasospasms in patients with peripheral vascular disease. Worsening of peptic ulcers. Since it is an ergot derivative, it can cause pulmonary and retroperitoneal fibrosis. Inhibits prolactin secretion. |
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Pramipexole, ropinirole and rotigotine side effects
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Nausea, hallucinations, insomnia, dizziness, constipation, and orthostatic hypotension.
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Amantadine side effects
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Restlessness, agitation, confusion, hallucinations and at high doses it may induce an acute toxic psychosis.
Orthostatic hypotension, urinary retention, peripheral edema and dry mouth may also occur. |
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Benzodiazepine side effects
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Drowsiness and confusion (the two most common side effects of BZDs)
Cognitive impairment and anterograde amnesia Development of tolerance Early morning insomnia Avoid BZDs in liver damage, glaucoma, and in combination with alcohol and other CNS depressants. The most severe side effect is respiratory depression, which can be counteracted with flumazenil. |
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Flumazenil side effects
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Precipitation of withdrawal from BZDs.
Flumazenil + TCAs can cause seizuring Dizziness, nausea, vomiting and agitation. |
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Buspirone side effects
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Nausea, headache, dizziness, nervousness, and light-headedness.
Hypothermia, prolactin and GH increase. |
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Barbiturates side effects
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CNS depression of any degree. Drowsiness, impaired concentration, and mental and physical sluggishness. Synergistic with alcohol.
Drug hangover, meaning drowsiness well after the patient awakes. Induction of liver enzymes with resultant decreased effect of many drugs. Physical dependence is common with barbiturates. Withdrawal is more severe than with opioids and may lead to death. It is characterized by tremors, anxiety, restlessness, nausea and vomiting and may progress to seizures, cardiac arrest and death. Barbiturate poisoning has been a leading cause of overdoses for many decades. No antidote. Causes severe resp. depression with central cardiovascular depression. |
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Ramelteon side effects
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Dizziness, fatigue and somnolence
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Caffeine side effects
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Very much dependant on dose:<br /><br />1.5 gram (15 cups of coffee):<br />Anxiety and tremors<br /><br />2-5g spinal cord stimulation<br /><br />high doses causes positive inotropism and chronotropism with tachycardia and worsening of angina.<br /><br />Diuresis<br /><br />Insomnia, agitation. Lethal dose is 10g which induces cardiac arrhythmias and seizures.<br><br>Deterioration of peptic ulcer
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Nicotine side effects
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Besides the long term cardiovascular and respiratory side effects of nicotine usage, there are some instant adverse effects:
High doses cause ganglionic blockade and respiratory paralysis and severe hypotension caused by medullary paralysis. Irritability, tremors. Intestinal cramps, diarrhea, tachycardia, hypertension. Physical dependence with withdrawal symptoms. |
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Varenicline
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Suicidal thoughts, mood changes and vivid dreams.
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Inhalation anesthetics in general - side effects
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Liver and kidney damage (oxid. met. produces flouride and bromide ions which are tissuetoxic, especially in females)
Respiratory system depression Atropine-sensitive bradycardia. Hypotension (often desired), ischemic tissue injury could ensue. If we need to counter this we may adm. phenylephrine. Arrhythmias, due to sensitization of the heart to catecholamines. Especially in the prescence of hypocapnia. Malignant hyperthermia (mostly halothane) Fetal damage (aplastic anemia, oral clefts etc.) |
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Isoflurane side effects
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Less effects on the heart than halothane and other anesthetics
Respiratory depression like the rest. Concentration dependent hypotension Possible cognitive decline |
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Desflurane side effects
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Irritation of the airways -> Laryngospams, cough and excessive secretions.
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Sevoflurane
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Nephrotoxicity
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Nitrous oxide side effects
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Retarded oxygen uptake
Concentration of other anesthetics in alveoli |
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Enflurane side effects
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Less arrhythmogenic than halothane.
Less sensitization of heart to catecholamines. Causes CNS excitation at twice the MAC and also at lower doses if hyperventilation reduces the partial pressure of CO2. Therefore Enflurane is contraindicated in patients with seizures. |
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Halothane side effects
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Bradycardia (atropine sensitive)
Cardiac arrhythmias, esp. serious if hypercapnia or incr. catecholamines. Hypotension (concentration-dependent like other inhaled anesthetics). Countered with alpha agonists (phenylephrine) Malignant hyperthermia (countered with dantrolene) Liver and kidney damage (can lead to severe hepatic necrosis in 1 in 10 000 individuals, esp. females) |
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Typical neuroleptics - side effects
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EPS
Reversible Parkinsonism, Akathisias (motor restlessness) and Dystonias. Improves with musc. blockers. Tardive dyskinesias: Involuntary movements of the tounge, neck, lips, trunk and limbs. Develops late (6-12 months) Can be irrevesible. Probably due to dopamine rec. supersensitivity. Worsens with musc. blockers. Ach. block: Dry mouth, Blurred vision, Constipation and Urinary retention. Alpha block: Hypotension, ejaculation problems. Hyperprolactinemia (due to block of inhibitory dopamine rec on pituitary) in turn causes amenorrhea, galactorrhea, gynecomastia, weight gain, infertility Neuroleptic malignant syndrome Muscle rigidity, hyperthermia, tremors, mood changes. Possibly life threatening (treated with Dantrolene) |
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Clonidine side effects
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Xerostomia and sedation are prominent.
Depression and fatigue due to reduced centrally acting catecholamines. Sudden discontinuation may have serious side effects due to supersensitivity to catecholamines. |
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Methyldopa side effects
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Sedation, dry mouth, and impotence.
Hemolytic anemia, Inflammatory disorders of various organs, most commonly liver. |
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Phenytoin side effects
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Ataxia and nystagmus (cerebellar depression)
Cognitive impairment (CNS depression) Hirsutism (and other endocrine abnorms.) Gingival hyperplasia Coarsening of facial features Dose dependent zero order kinetics. Exacerbation of abscence seizures. Fetal hydantoin syndrome High I.V rate: Cardiac arrhythmias, hypotension, CNS depression GI disturbance Injection site inflammation, tissue damage, pain (reduced with Fosphenytoin) Folate deficiency -> megaloblastic anemia Hypersensitivity reactions (could also lead to Steven Johnson's syndrome) Pseudolymphoma syndrome Many interactions since it is a enzyme inducer. Mnemonic for some of them: PHENYTOIN: P-450 interactions Hirsutism Enlarged gums Nystagmus Yellow-browning of skin Teratogenicity Osteomalacia Interference with B12 metabolism (hence anemia) Neuropathies: vertigo, ataxia, headache |
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Carbamazepine side effects
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Autoinduction of metabolism
Nausea and visual disturbances Granulocyte suppression (could lead to aplastic anemia) Exacerbated abscence seizures. Hyonatremia A characteristic rash |
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NSAIDs side effect
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Gastrointestinal ulceration and bleeding
Inhibition of uterine motility and thus prolongation of delivery. Inhibition of prostaglandin mediate renal blood flow, esp. during CHF. Blockade of platelet aggregation -> prolonged bleeding time. Hypersensitivity reactions. Displacement of plasma protein binding drugs such as warfarin due to high pp binding. Worsening of some allergies, especially asthma, because alot of arachidonic acid is redirected to lipoxygenation to leukotrienes. Interaction with ACE inhibitors to decrease their efficacy by eliminating the actions of bradykinin. |
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Aspirin side effects
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As previously mentioned for the NSAIDs plus Salicylism (aspirin intoxication)
Salicylism: Tinnitus, high frequency hearing loss, headache, nausea and dimness of vision. Three phases of respiratory changes: 1. At high aspirin doses, it causes uncoupling of oxidative phosphorylation and increases in CO2 which leads to increased respiration. 2. At higher doses aspirin directly stimulates respiration and thus leads to diminished CO2 and respiratory alkalosis. 3. At even higher doses aspirin directly inhibits the cardiovascular center and respiration leading to respiratory acidosis uncompensated by the kidneys. Salicylism is usually reversible after 3 days of discontinuation of the drug. Reye's syndrome. |
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Acetaminophen side effects
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Very low side effect profile.
Overdose however leads to hepatocellular necrosis. Early features of acetaminophen overdosage are: 1. Nasea and vomiting. 2.Lethargy and sweating 3. Abdominal pain (after 24-48 hours) 4. Liver damage is usually at a maximum 72 hours after ingestion. |
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Who is at especially high risk of hepatocellular damage with acetaminophen?
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People who have induced their CYP450 enzymes through ingestion of:
Phenytoin Phenobarbital Carbamazepine Rifampin Alcohol |
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Amiodarone side effects
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More than half of patients require to discontinue treatment due to toxicity.
Pulmonary fibrosis Liver toxicity Blue discoloration of skin due to iodine Hypo/Hyperthyroidism Photosensitivity GI tract intolerance Tremor, ataxia, dizziness Neuropathy Muscle weakness |
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SSRIs side effects
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Dizziness, sedation and headache, sweating, anxiety, nausea and other GI tract effects and changes in weight.
Sleep disturbances (some, such as fluvoxamine and paroxetine are more sedating, flouxetine and sertraline are more activating) Serotonin syndrome in overdosage (esp. if combined with MAOIs) (Hyperthermia, tremors, mood changes, myoglobinemia, myoclonus and rigidity) Increased suicidality (esp. in children) Sexual dysfunction. Discontinuation syndrome (headache, malaise, flu-like symptoms, agitation and irritability, nervousness and changes in sleep pattern) |
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SNRIs side effects
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Venlafaxine:
Nausea, headache, sexual dysfunction, dizziness, insomnia, sedation and constipation. High doses may cause incr. BP and heart rate. Duloxetine: Nausea and dry mouth and constipation. Insomnia, dizziness, somnolence, and sweating. Sexual dysfunction occurs and possible risk for incr. in HR and BP. |
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Bupropion side effects
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Dry mouth, sedation, insomnia, anxiety and agitation.
Incr. freq of seizures in epileptic patients. Low incidence of sexual dysfunction. |
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Mirtazapine side effects
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Sedative due to potent antihistaminergic activity.
No sexual side effects. Increased appeptite and weight gain are frequent. |
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Nefazodone and Trazodone side effects
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Nefazodone and Trazodone are markedly sedating due to histaminergic blockade.
Trazodone also may cause priapism. Nefazodone may cause liver toxicity. |
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TCAs side effects
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Musc. block:
Dry mouth, blurred vision, mydriasis, sweating, constipation and urinary retention. Hist. block: Sedation Alpha-adrenergic block: Hypotension and ejaculatory problems. TCA decrease the seizure treshold. Incr. suicidality. Low incidence of sexual dysfunction. Slowing of cardiac conduction like quinidine (QT prolongation) Weight gain is common. Inducement of manic episodes in bipolar patients. Exacerbation of angina, BPH, epilepsy, arrhythmic patients. Many drug interactions. |
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TCA drug interactions.
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MAOI:
Mutual enhacement, tachycardia, hypertension, hypertensive crisis and arrhythmias, convulsions and coma. Adrenergics: Potentiated effect due to TCA Ethanol and other depressants: Toxic sedation Narcotics: Increased sedation Indirect adrenergics: Blockade of action of indirect adrenergics |
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MAO inhibitors side effects
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Tranylcypromine and selegiline have amphetamine-like effects leading to insomnia and agitation.
Severe and often unpredictable side effects due to drug-drug and food-drug interactions. (Tyramine) Serotonin syndrome and hypertensive crisis are examples. Increaced suicidality (like with all antidepressants) Drowsiness Orthostatic hypotension Blurred vision Dry mouth Dysuria Constipation. |
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Lithium salts side effects
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Extremely low therapeutic index, like that of digitalis.
Headache, dry mouth, polydipsia, polyphagia, polyuria, gastrointestinal distress (give lithium with food), fine hand tremor, dizziness, fatigue, dermatologic reactions and sedation. High plasma levels can cause ataxia, slurred speech, coarse tremors, confusion and convulsions. Thyroid function may be depressed. Lithium should not be combined with thiazides as they decrease lithium clearance by 25%. |
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Morphine (most opioids) side effects
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Severe respiratory depression
Overdose of morphine could also cause convulsions. Constipation Vomiting (direct stimulation of chemoreceptor trigger zone) and dysphoria Allergy-enhanced hypotensive effects (histamine release) Elevation of intracranial pressure (because depr. respiration leads to incr CO2 which dilates cerebral vessels) Urinary retention in BPH. Increased biliary pressure due to contraction of sphincter of Oddi and gallbladder. Use morphine cautiously in patients with bronchial asthma or liver failure. Tolerance and dependance with withdrawal: Autonomic, motor and psychological symptoms which are rather serious, almost unbearable. It is not, however fatal. |
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Morphine interactions
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The depressant action of morphine is enhanced by phenothiazines, MAOIs, TCAs.
Amphetamine inexplicably enhances the analgesia of morphine. |
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Meperidine side effects
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Even more resp. depression than that of morphine.
Large doses of meperidine causes accumulation of a toxic metabolite, normeperidine, which can cause: Anxiety, tremors, muscle twitches and rarely convulsions. It dilates pupils unlike the other opioids and causes hyperreactive reflexes. Severe hypotension can occur. Blurred vision and dry mouth due to some antimuscarinic action. Dependence. |
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Pentazocine side effects
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Respiratory depression in high doses.
Constipation. Incr. blood pressure. Hallucinations, nightmares, dysphoria, tachycardia ad dizziness. Worsening of angina. Decreased renal plasma flow. Precipitation of withdrawal in morphine addict. |
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Buprenorphine side effects
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Respiratory depression which cannot easily be oversome with naloxone.
Decr./Incr. BP. Nausea and dizziness. |
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Tramadol side effects
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Anaphylactoid reactions.
Incr. seizures in pat. taking SSRIs, TCAs or MAOIs. |
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Naloxone side effects
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Precipitations of opioid withdrawal.
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Opioid withdrawal acute phase
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Yawning
Sweating Chills Gooseflesh Anxiety, irritability Lacrimation Rhinorrhea Craving Pupillary dilation Stomach cramps, diarrhea and vomiting. |
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Opioid withdrawal prolonged phase
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Decreased BP and bradycardia.
Depression, anhedonia Deep muscle aches and pains. Insomnia, disturbed sleep. Poor appetite. Reduced libido, impotence, anorgasmia. Craving and obsessing. |
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Short acting Beta2 agonists side effects
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Tachycardia
Hyperglycemia Hypokalemia Hypomagnesemia However, they are minimized due to inhalation. |
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Long acting Beta2 agonists side effects
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Similar to quick-relief.
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Inhaled corticosteroids side effects
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Have rather few side effects particularly if used with a spacer.
Oral candidiasis and hoarseness of voice. |
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Leukotriene antagonists side effects
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Elevations in hepatic enzymes, requiring periodic monitoring. 3-5 times normal req. discontinuation.
Eosinophilic vasculitis. (Churg Strauss) Headache and dyspepsia. Zileuton and zafirlukast are P450 inhibitors, and can increase warfarin levels, because they are 90% pp bound. |
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Cromolyn and nedocromil side effects
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Bitter taste and irritation of the larynx.
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Antiepileptics general side effects.
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Sedation and dizziness and drowsiness.
Ataxia and nystagmus. Rash. Nausea and vomiting. Osteoporosis Teratogenicity Weight gain or weight loss. Hyponatremia. |
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Etomidate side effects
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Decrease in plasma cortisol and aldosterone, which can persists up to 8 hours. (due to inhib. of 11-beta-hydroxylase)
Venous pain Skeletal muscle movements are not uncommon. |
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Ketamine side effects
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Increased cerebral blood flow and induction of postoperative hallucinations, not seldom of sexual nature.
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Propofol
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Sometimes excitation phenomena, such as muscle twitching, spontaneous movement, or hiccups.
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Anticholinesterases side effects in general
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Side effects due to incr. Ach:
Diarrhea, vomiting. Possible bradycardia, hypotension. Possible bronchoconstriction especially in asthmatics. |
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Donepezil
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Incr. bowel movements, nausea and vomiting.
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Rivastigmine
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Like that of Donepezil
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Tacrine side effects
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Liver toxicity
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Galantamine
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Same as rivastigmine and donepezil.
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Groups of drugs used for Alzheimer's dementia.
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Anticholinesterases
Anti-NMDA receptor (NSAIDs may be beneficial) (Statins are being checked for efficacy) (Estrogens may be protective) However the above do not show conclusive results. Current focus lies on development of drugs that target the amyloid plaques directly. |
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Theophylline side effects
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Very narrow therapeutic index and big variations in plasma conc.
Adverse drug interactions with many drugs. Potentially life threatening cardiac arrhythmias. Seizures and convulsions. |
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Ticlopidine side effects (+MOA)
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MOA: Blocks ADP binding on platelet leading to less GP IIb/IIIa activation.
Severe hematologic reactions, including agranulocytosis, thrombocytopenic purpura, aplastic anemia. So only used when other treatments fail. (Black box warning) Inhibition of P450 causes many drug interactions. |
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Clopidogrel sife effects (+MOA)
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MOA: Same as ticlopidine
Much more safe, although TTP may also occur. Inhibition of P450 causes many drug interactions. |
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Abciximab side effects (+MOA)
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MOA: Abciximab blocks GP IIb/IIIa receptor.
Potential for bleeding. Expensive. |
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Eptifibatide & Tirofiban side effects (+MOA)
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MOA: Direct block of GP IIb/IIIa receptor.
Only I.V formulations are available because oral formulations are too toxic. Bleeding is the most common adverse effect. |
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Dipyridamole side effects (+MOA)
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MOA: Dipyridamole inhib. phosphodiesterase -> incr. cAMP -> decr. Ca++ -> decr mediator release. Additionally it reduces uptake of ADP.
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Felbamate specific side effects
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Same as other anticonvulsants plus:
Aplastic anemia Hepatic failure Therefore only used in refractory epilepsies. |
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Levetiracetam side effects
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Rather well tolerated.
Can cause dizziness, sleep disturbances, headache and weakness. |
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Pregabalin side effects
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Drowsiness, blurred vision, weight gain, and peripheral edema.
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Tiagabine side effects
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Seizures can occur in patients taking tiagabine who do not have epilepsy.
Tiredness, dizziness, Gi upset. |
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Topiramate side effects
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Somnolence, weight loss, paresthesias, and renal stones.
Glaucoma, oligohydrosis and hyperthermia have also been reported. |
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Zonisamide side effects
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CNS side effects
Renal stones Oligohydrosis and hyperthermia and decr. sweating. |
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Cocaine side effects
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Rapidly fatal due to arrhythmias, hypertensive crises, respiratory depression, seizures, myocardial infarcts and strokes. Treat with diazepam, propranolol and CCBs.
Hyperthermia may also cause death due to cocaine and is not dose dependent. Psychoses |
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Cocaine withdrawal
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Depression, dysphoria
Sleepiness, fatigue Bradycardia |
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Amphetamine side effects
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Rarely fatal, could however lead to arrhythmias and hypertension.
Psychosis is more common with amphetamine, and this can be treated with haloperidol. |
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Beta blockers contraindications
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Bradycardia
Hypotension Acute heart failure Peripheral vascular disease Use cautiously in patients with: Asthma Diabetes |
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Amphetamine withdrawal
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Ravenous appetite
Lethargy, somnolence Depression Drug craving Bradycardia Necrotizing arteritis could lead to fatal brain hemorrhage or renal failure. |
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Hallucinogens adverse reactions
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Panic reactions - best managed by sedation with benzodiazepines or barbiturates.
Acute psychotic reactions - best managed with neuroleptics such as chlorpromazine, occurs only in people with strong predispositions. |
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Tetrahydrocannabinol side effects
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Lower serum testosterone
Airway narrowing and similar problems to cigarette smoking. Aggraveted angina pectoris due to incr. HR, orthostatic hypotension and increased carboxyhemoglobin Amotivational syndrome Acute panic reaction, toxic delirium, paranoid states, and rare acute psychoses. Recurrence of schizophrenia. |
