Science Quiz / Side Effects of EBSE drugs

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Can you name the EBSE drugs?

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

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