Science Quiz / Side Effects of EBSE drugs

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Can you name the EBSE drugs?

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

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