4Th Year - Pharm - Important Side Effects

Front 1

Methyldopa

Back 1

1. Lactation (MEN also !)
2. Positive Coombs test

Front 2

Clonidine

Back 2

1. Sedation
2. Quick withdrawal-->Hypertensive crisis

Front 3

Guanethidine

Back 3

1. Effector supersensitivity
2. Postural hypotensoin
3. Diarrhea

Front 4

Reserpine

Back 4

1. Postural hypotension
2. Nightmares, sedation
3. Parkinosonism
4. Increased gastric acid

Front 5

Selective alpha1 blockers (prazosin, terazosin...)

Back 5

1. 1st dose postural hypotension
2. Water/salt retention

Front 6

Hydralazine

Back 6

SLE like syndrome

Front 7

Minoxidil

Back 7

1. Reflex sympathetic
2. Salt/water retention
3. Hirsutism

Front 8

Sodium nitroprusside

Back 8

1.Cyanide toxicity (treat with B12 or thiosulfate)
2. Methemoglobinemia

Front 9

Diazoxide

Back 9

1. Strong reflex tachycardia

Front 10

Fenoldopam

Back 10

1. Increased Intraocular pressure

Front 11

ACE inhibitors

Back 11

1. Hyperkalemia
2. Cough
3. Anigoedema
4. Contraindicated in pregnancy
5. Decreased by NSAIDs

Front 12

AT-II antagonists

Back 12

1. Contraindicated in pregnancy

Front 13

CCBs

Back 13

1. Cardiac arrest, AV block
2. Heart failure
3. Hypotensoin
4. Nifedipine contraindicated in ACS (increased risk for MI)

Front 14

Procainamide

Back 14

1. SLE like syndrome
2. QT prolong --> Torsades de pointes
3. Hypotension due to some ganglion-blocking effects

Front 15

Quinidine

Back 15

1. Cinchonism (tinnitus, vertigo...)
2. GI problems

Front 16

Disopyramide

Back 16

1. Atropine like
2. Strong negative inotropic - contraindicated in HF

Front 17

Lidocaine

Back 17

1. Adverse effects of anhesthetics - tremors, parasthesias, nausea...

Front 18

Flecainide

Back 18

1. CAST trial showed increased mortality when treating post-MI patients. use ONLY for SVT in patients with normal hearts

Front 19

Propafenone

Back 19

1. Metallic taste.
2. Constipation

Front 20

Amiodarone

Back 20

1. AV block
2. Pulmonary fibrosis.
3. Hepatotoxic
4. Photodermatitis
5. Halos in vision
6. Hypo/Hyper thyroid
NOTE - metabolised by 3A4

Front 21

Bretylium

Back 21

1. Postural hypotensoin due to sympathoplegic effects

Front 22

Sotalol

Back 22

1. Torsade de pointes
2. Exacerbation of HF

Front 23

Adenosine

Back 23

1. Flushing
2. Chest pain
3. Short AV block

Front 24

Statins

Back 24

1. Hepatotoxicity
2. Myopathy --> Rhabdomyolysis if combined with fibrates and such
3. Increased levels with Verapamil/Amiodarone (3A4 inducers)

Front 25

Niacin

Back 25

1. Cutaneous flushing (take aspirin prior)
2. Acanthosis nigricans (insulin resistance)
3. Hepatotoxicity
4. Hyperuricemia

Front 26

Fibrates

Back 26

1. Rashes
2. Myopathy
3. Hypokalemia
4. Gallstones

Front 27

Resins

Back 27

1. Constipation, bloating
2. ADEK malabsorption (hypoPT)
3. Impaired absorption of gitialis, warfarin...
4. VLDL levels may increase

Front 28

Statins+fibrates / Statins+niacin

Back 28

Rhabdomyolysis

Front 29

Insulin

Back 29

1. Hypoglycemia
2. Lipodystrophy
3. Insulin allergy

Front 30

Sulfonylureas

Back 30

1. Hypoglycemia
2. Hyponatremia (mostly in 1st generation)

Front 31

Biguanides (Metformin)

Back 31

1. GI discomfort
2. Reduced B12 absorption
3. LACTIC ACIDOSIS (impairs hepatic metabolism of lactic acid)

Front 32

TZDs (Rosiglitazone)

Back 32

1. Decreased contraceptive levels due to 3A4 metabolism
2. Contraindicated in pregnancy
3. Weight gain
4. Reovulation
5. Hepatotoxicity

Front 33

Alpha-glucosidase inhibitors

Back 33

1. Abdominal pain, gas, diarrhea
2. Hepatotoxicity

Front 34

Nitrites

Back 34

1. Tachycardia
2. Orthostatic hypotension
3. Throbbing headache from meningeal artery dilation
4. Methemoglobinemia

Front 35

Acetozolamide

Back 35

1.Metabolic acidosis
2.Renal stones
3.Hypokalemia
4. Decreased ammonia excretion and risk of hepatic encephalopathy !

Front 36

Furosemide

Back 36

1.Metabolic alkalosis
2.Ototoxicity
3.Hyperuricemia
4. Hypomagnesemia
5.Hypocalcemia if hyper before
6. Allergic reactions to sulfa part

Front 37

Thiazides

Back 37

1. Hypokalemic Alkalosis
2. Impaired carbohydrate tolerance
3. Hyperlipidemia {LDL)
4. Hyponatremia (!)
5. Allergy

Front 38

Spironolactones (and other K sparing diuretics)

Back 38

1. Hypekalemia
2. Metabolic acidosis
3. Gynecomastia
4.

Front 39

Mannitol

Back 39

1. Extracellular volume expansion prior to diuresis leads to hyponatremia
2. Later dehydration can lead to hyperkalemia and hypernatremia

Front 40

Iron toxicity

Back 40

1. Necrotizing gastroentritis
2. Metabolic acidosis, shock

Front 41

Heparin

Back 41

1. Bleeding
2. Hair loss
3. Osteoporosis
4.HIT
CI in active bleeding, hemophilia, intracranial hemorrhage, post surgery

Front 42

Warfarin

Back 42

1.Crosses placenta, teratognic, hemorrhage in fetus
2.Hemorrhagic infarction due to depression of Protein C

Front 43

Ticlopidine

Back 43

Nausea, dyspepsia, diarrhea, hemorrhage
2. TTP

Front 44

steroids treatment for Asthma

Back 44

1. Cataracts
2. Osteoporosis
3. Reversible growth delay in children

Front 45

Methylxantines

Back 45

1. GI distress
2. Insomina
3. Arrhythmias

Front 46

Sodium bicarbonate

Back 46

1. Distension, belching
2. Metabolic alkalosis

Front 47

Calcium carbonate

Back 47

1. Distension, belching
2.Metabolic alkalosis
3. Hypercalcemia

Front 48

Magnesium hydroxe

Back 48

Diarrhea

Front 49

Aluminum hydroxide

Back 49

Constipation

Front 50

H2 blockers (Cimetidine...:)

Back 50

1. Gynecomastia
2. Galactorrhea
3. Impotence
Crosses placenta and into breast milk. Do not use in pregnancy!

Front 51

Omeprazole (PPIs)

Back 51

1. Diarrhea
2. B12 malabsorption
3. Carcinoids
4. Increased risk for infections with C.Difficle
5. Decreased absorption of drugs that need an acid environment -- Digoxin !

Front 52

Sucralfate

Back 52

1. Constipation due to aluminum hydroxide
2. May bind to other drugs and alter their absorption

Front 53

Misoprostol (PGE analog)

Back 53

1. Causes uterine contractions. DO NOT give during pregnancy.

Front 54

Bismuth

Back 54

1. Blackening of stool & tongue

Front 55

Domperidone, Metocloperamide

Back 55

1. Galactorrhea, Gynecomastia, menstural disorders
2. Metoclopramide also insomina, anixety, other CNS stuff
3. Parkinsonism

Front 56

Apprepitant (NK1 antagoinst)

Back 56

1. Diarrhea
2. Fatigue
3. Decreases INR

Front 57

Doperidol (Anti psychotic, anti-emetic)

Back 57

1. Prolonged QT

Front 58

Docusate, Mineral oil (stool softeners)

Back 58

long term use can lead to ADEK malabosrption

Front 59

Phenolphtalaein

Back 59

A cathartic (irritant) that leads to cardiac toxicity. Removed from market.

Front 60

1. Pectin
2. Bile salt binding resin
(both used as anti diarrhea)

Back 60

1. May bind other drugs
2. Fat malbasorption

Front 61

Octreotide (somatostatin)

Back 61

1. Fat malabsorption
2. Gallstones
3. Hypo/hyperglycemia
4. Bradycardia

Front 62

5-ASA

Back 62

1. GI upset
2. BM suppression
3. Arthralgias
4. Hypersensitivity to sulfapyridine
5. Folic acid deficiency (give 1mg/day !)

Front 63

Purine analogs

Back 63

1. BM suppression
2. Hepatotoxicity
3. HS reactions
4. Lymphoma
5. Crosses placenta

Front 64

MTX

Back 64

1. BM suppression
2. Megaloblastic anemia

Front 65

Infliximab (anti TNF alpha)

Back 65

1. Chest pain / Dyspnea
2. Serum sickness
3. Lymphoma

Front 66

Pancrealipase

Back 66

Hyperuricosurea
renal stones

Front 67

Treatment for hepatitis

Back 67

IFN-alpha
Lamivudine
Adefovir
Entecavir
Ribavirin

Front 68

MOA of Lamivudine , MOA of Adefovir

Back 68

Lamivudine -> HBV DNA pol inhibitor, by chain termination.
Adefovir -> Adenine analog, causes chain termination

Front 69

MOA of Entecavir, MOA of Ribavirin

Back 69

Entecavir - Guanosine nucleoside analog, inhibts HBV DNA pol
Ribavirin - Guanosine analog that inhiits HCV mRNA capping and RNA-dependent DNA pol

Front 70

Droperidol

Back 70

Strong sedation, prolonged QT --> Torsade de pointes (rare)