Science Quiz / Side Effects of EBSE drugs

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QUIZ: Can you name the EBSE drugs?

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tx crohns or UC, Malaise, nausea, sulfonamide tox, reversible oliogospermia
diabetes drug: 2nd gen (glyburide, glimepiride, glipizide) -- hypoglycemia, weight gain, siADH.
Cushings, immunosuppression, *cataracts*, acne, osteoperosis, hypertension, peptic ulcers, hyperglycemia
Myelosuppression, hypersensitivity.
antidepresant : (alpha-2 antagonist, increases NE as antidepressant)sedation, increased appeitite, ***weight gain***, dry mouth
tx arrhythmia: HA, tinnitus, thrombocytopenia, torsades de pointes from increased QT interval.
diabetes drug: Lactic acidosis -- CI in renal failure
antiviral: tx CMV retinitis, Nephrotoxicity (so give with probenecid)
antiviral : Hemolytic anemia, severe teratogen ( for hep c and RSV, purine prodrug)
tx angina: Reflex tachycardia, hypotension, HA,
abx: GI upset, superinfections, rash, HA, dizziness. CI in pregnant women/children because caritlage damage. Tendonitis/rupture
tx bipolar: ( enhance GABA, block VG Na channel) GI distress, rare but fatal hepatotoxicity, tremor, weight gain, CI in pregnancy
abx: neurotoxiticy (prevent with B6), hepatotoxicity, lupus
antiviral AIDS: Hyperglycemia, GI intolerance, lipodystrophy
transplant drug: Nephrotoxic, preventable with mannitol diuresis
antiepileptic: Nystagmus, dplopia, ataxia, sedation, hirsuitism, megalobalstic anemia,(teratogen: MR and craniofacial abnl) , SLE-like syndrome, induction p-450, gingival hyperplas
antidepressant: Increase in BP, stimulant effects, sedation, nausea
anti HTN : SLE-like syndrome, compensatory tachycardia (CI in angina/CAD), fluid retention, nausea, HA, angina
tx hyperthyroid: Agranulocytosis, aplastic anemia, hepatotoxitiy, skin rash. Methimazole is the same except also a possible teratogen and no hepatotoxicity.
SE of interferons
chemo drug: toxicity that can be rescued with leucovorin (abbrv)
beta blocker that causes Dyslipidemia
anxiolytic ( bind GABA A receptor) : Dependence, additive CNS depression w/alcohol, inducer of p-450.
parkinson drug: Arrhythmias from peripheral conversion to D. long term use leads to dyskinesia with akinesia between doses. carbidopa is a peripheral decaboxylase inhibitor that li
Antacid, causes constipation
antidepresant: GI distress, sexual dysfunction. ___ syndrome with any drug that increases __ (like MAO inhibitors)-- hyperthermia, myoclonyus, CV collapse, flushing, diarrhea, seiz
anti pyretic/ pain releif- Hepatic necrosis. Metabolite depletes glutathione,
antifungal: abnormal LFT, visual disturbances
H2 blocker: Ataxia, dizziness, slurred speech
anti- osteoporosis: corrosive esophagitis (except zoledronate), nausea, diarrhea , osteonecrosis of jaw
antiepileptic: steven-johnson rash
Immonosuppressant - monoclonal ab on cd3, SE Cytokine release syndrome (binds CD3 on T cells).
K sparing diureticL Hyperkalemia (can lead to arrhythmias), aldosterone antagonist (gynecomastia).
pain blocker: Addiction, respiratory depression, miosis, additive CNS depression,
Myositis, hepatotoxicity, cholesterol gallstones (activate LPL to decr TG)
Decreased creatinine excretion
abx: hypersensitivity, hemolysis with G6PD deficiency, nephrotoxicity, photosensitivtiy, kernicterus in infants, displace warfarin from albumin
anticoagulant...teratogen, can lead to thrombosis
diuretic : Ototoxicity, hypokalemia, dehydration, allergy (sulfa), nephritis, gout (OH DANG!)
antidepressant: ( incr NE , D , 5HT) Hypertensive crisis with tyramine ingestion (wine and cheese, tyramine gets converted to NE inside nerve terminals)
Bone marrow suppression, upset GI. Used for melanoma, CML, sickel cell.
TB drug: hyperuricemia, hepatotoxicity
abx: GI distress, skin rash, seizures at high plasma levels.
antiinflammatory- Renal damage, fluid retention, aplastic anemia, GI distress, ulcers
anti migraine: (5HT 1b/1D agonist) Coronary vasospasm (CI in patients with CAD or prinzmetal's angina)
antacid ,, diarrhea
abx: Anemia, aplastic anemia, gray baby syndrome (infants lack UDP-glucuronyl transferase).
ulcers, Reye's syndrome
antifungal: GI upset, flushing
abx: hypersensitivity, vitamin K deficiency. Can cause cross-hypersensitivity with peniccilin. Increases nephrotoxicity of aminoglycosides. Disulfiram-like reaction with ethanol.
HA / constipation (used for anti nausea, anti 5-HT3a)
DUMBBELSS -- diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of muscle and CNS, lacrimation, sweating, salivation
diabetic and post-surgery gastroparesis.: ( D2 antagonist that increases tone/contractility) Parkinsonian effects, drug interaction with digoxin and diabetic agents
abx: Hepatotoxic, increases p-450, orange fluids
give example of low potency antipsychotic drug ( D antagonist antihistamin/serotonin/cholinergic also) extrapyramidal system effects (EPS -- acute dystonia -> akinesia -> akathisia
abx: pseudomembranous colitis, fever, diarrhea
diabetes drug : ( abbrev)Weight gain, edema, heart failure, hepatotoxicity
Convulsions, coma, cardiotoxicity. Also respiratory depression, hyperpyrexia. Confusion and hallucinations in elderly due to anticholinergic side effects.
abx:GI distress, discoloration of teeth, inhibition of bone growth in children, photosensitivtiy, CI in pregnancy
MAGIC RACKS -- macrolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir, acute alcohol abuse, ciprofloxacin, ketoconazole, seldane
antiviral AIDS: Bone marrow suppression (reverse with G-CSF and EPO), peripheral neuropathy,** lactic acidosis**, megloblastic anemia (ZDV). Examples of - tenofovir, emtricitabine,
abx: optic neuropathy (red/green colorblindness)
Bleeding -- treat with aminocaproic acid
tx congested nose: HTN, CNS stimulation/anxiety with pseudoephedrine.
abx: Nephrotoxicity, ototoxicity (especially with loop diuretics), teratogen
abx: red man syndrome (prevent with pretreatment with antihistamines and slow infusion rate), does NOT have many problems (actually does cause nephrotoxicity, ototoxicity, thrombop
antifungal: Hormone synthesis (gynecomastia), liver dysfunction (inhibits p-450, especially ketoconazole), fever, chills
transplant drug: Hyperlipidemia, thrombocytopenia, leukopenia. Notice it's not nephrotoxic!!!
anti malarial - Retinopathy, G6PD deficiency hemolysis ( MoA binds to parasite heme product leading to toxic build up and autodestruction of infected RBC)
Myelosuppression, hemorrhagic cystitis (remember the chemo tox man),
diabetes drug: N/V, pancreatitis
antibiotic: fever, UTI, pruritic rash, stvens-Johnson, hemolytic anemia, thrombocytopenia, agranulocytosis, urticaria.
Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter
anti arrythmic: pulmonary fibrosis, hepatotoxicity, hypothyroidism/hyperthyroidism ( think the name iodine hidden in drug). Check PFT, LFT, TFTs.
Countless SAFe Moms Take Really good Care -- Clarithromycin (embryotoxic), Sulfonamides (kernicterus), aminoglycosides (cartilage damage), fluoroquinolones (cartilage damage), metr
anti HTN and anti angina : cardiac depression, AV block, peripheral edema, flushing, dizziness, constipation
antifungal: Fever/chills, hypotension, nephrotoxicity, arhythmias, anemia, IV phlebitis.
antacids all can cause
Inhibits p-450, antiandrogenic effects, decrease creatinine excretion
alzheimers drug: (NMDA receptor antagonist) dizziness, confusion, hallucinations
MAO-B inhibitor that can enhance adverse effects of L-dopa
tx: glaucoma, mountain sickness ( CA ( carbonic anhydrase inhibitor) ( Hyperchloremic metabolic acidosis, neruopathy, NH3 toxicity, sulfa allergy
atypical antipsychotic : agranulocytosis
chemo: Nephro/acoustic nerve . Prevent nephrotoxicity with amifostine.
Nausea, cramps, steatorrhea. Used for acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors.
antiviral : leukopenia, neutropenia, thrombocytopenia, renal toxitity
anti HTN and anti CHF- (abbrv) Hyperkalemia. Cough, angioedema, taste changes, hypotension, fetal renal damage, rash, increased renin, lower AGII.
abx: Prolonged QT interval (especially erythromycin), GI discomfort, acute cholestatic hepatitis, eosinophilia, skin rashes.
order of Atypical antipsychotic that cause most___ to least ….Crazy old queens politely reach zen with antipsychotics (clozapine, olanzapine, quetiapine, paliperidone, risperidon
anxiolytic ( stimulate 5HT1a receptor) : DOESN’T interacti with alcohol
abx: hypersensitivity, interstitial nephritis
tx hypothyroid tachycardia, heat intolerance, tremors, arrhythmias
antifungal: teratogenic, carcinogenic, confusion, HA, increase p-450 and warfarin metabolism ( MoA binds to tubulin , inh mitosis…alters keratin, for dermatophite infx)
transplant drug :Nephrotoxic, peripheral neuropathy, HTN, pleural effusion, hyperglycemia
chemo: Peripheral neuropathy ,bone (myelosuppresion
antiviral AIDS: Bone marrow suppression (reverse with G-CSF and EPO), peripheral neuropathy****, rash****. Examples of -- neVIRapine, efaVIRenz, delaVIRidine.
anticoag that can cause thrombocytopenia + clotting…...platelet factor IV, stimulating antibodies that activate and clear platelets. 5-14 days after starting.
Rx incr HDL: Red, flushed face, decreased by aspirin. Hyperglycemia, hyperuricemia
tx CHF: ECG -- increased PR, decreased QT, T wave inversion, arrhythmia, hyperkalemia. Worsened by renal failure, hypokalemia (less competition for binding on Na/K ATPase), quinidi
abx: hypersensitivity, ampicillin rash, pseudomembranous colitis
antidepressant:( inh Serotonin reuptake, used for insomina and as antidepressan) .**Priapism** sedation, nausea, posutral hypotension.
tx hypercholesterol: Hepatotoxicity (increased LFT), rhabomyolysis
anti HTN, anti edema: ( abbrev) Hypokalemic metabolic alkalosis, hyponatremia ( hyperGLUC) , hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia.. Sulfa allergy.
abx: megaloblastic anemia, leukopenia, granulocytopenia (alleviate with leucovorin)
incr risk of endometrial carcinoma because it's a partial agonist,
tx kidney failure and brain swelling ( osmotic diuresis) Pulmonary edema, dehydration, CI in anuria and CHF
bipolar tx: Ebsetin's anomaly and malformation of great vessels, tremor, sedation, dema, heart blcok. hypothyroidism, polyuria (ADH antagnoist that causes nephrogenic DI). Excreted
Last resort in tachyarrhythmias (class 1C), proarrhythmic, especially post-MI (contraindicated). Prolongs refractory period in AV node.
antidepresant: ( incr NE, D, unknown MoA) no sexual SE! stimulant effect ( tachy, insomnia) HA, seizure if bulemic ***used for smoking cessation**
Diarrhea. CI in women of childbearing potential (abortifacient).
immunosuppressive: purine analogue:--Bone marrow suppression. Metabolite mercaptopurine ( 6MP) is metabolzied by xanthine oxidase... don't give allopurinol.
Nausea, HA, flushing, hypotension, AP. (PDE3 inhibitor. More cAMP in platelets inhibits response to ADP
abx: Disulfiram-like reaction wit halcohol, HA, metallic taste
anti-epileptic: ( stablizied VG Na channels) Diplopia, ataxia, agranulocytosis, aplastic anemia, liver tox, teratogenesis, induction of p-450, stevens johnson, SIADH ( bc potentiat
Rarely increases LFTs (mechanism is prevents cholesterol absorption in intestine )
PDE5 inh, aka reddys fav drug: HA, flushing, dyspepsia, risk of life-threatening hypotension with nitrates (Hot and sweaty, then HA, Heartburn, Hypotension). Impaired blue/green co
Tx endometriosis, fibrocystic breast disease, and hereditary angioedema( synthetic androgen) Weight gain, edema, acne, hirsutism, less HDL.
Neutropenia ( blocks ADP receptors, thus preventing GIIb/IIIa from being expressed and fibrinogen from binding. Used in PCI.
atypical antipsychotic :Prolongs QT interval
breast cancer drug SE Cardiotoxicity
antiHTN : Impotence, asthma exacerbation, bradycardia, AV block, CHF, sedation, sleep alterations, may mask signs of hypoglycemia.
anxiolytic: ( bind specific receptor on CABA) Dependence, additive CNS depression w/alcohol, less risk of respiratory depression and coma than barbiturates.
Foscarnet SE
p450 inducers or inhibitors Chronic CARBs, Greasy Worts, barbed-wire Phences, all rifAMP up ….. Chronic alcohol, carbamazepine, griseofulvin, st. john's wort, barbiturates, pheny
abx: hypersensitivity, hemolytic anemia
azheimer drug ( AchE Inhibitor) : Nausea, dizziness, insomnia

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