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Common Side effects, Adverse effects, and highlights

Famous Medications and their common side effects, adverse effects or highlights

  1. It’s the antidote for tylenol
  2. Smells like rotten eggs.  No, it is not expired if it smells bad.
  3. Also used in cystic fibrosis to loosen thick and sticky mucus.
  1. Family: ACE inhibitors
  2. Famous side effect is COUGH
  3.  Adverse effect (of all ACE inhibitors) ANGIOEDEMA.  Scary especially is edema of the airway. Can’t breathe
  4. Can cause hyperkalemia.
  5. End in -pril (Captopril is another example)
  6. What if cough and angioedema are both in the choices. Think: Are they asking for a common side effect or an adverse effect: ADVERSE: angioedema
  7. Common: cough
  1. If having a procedure with contrast must be stopped 48 hours prior to prevent METABOLIC ACIDOSIS
  1. Ok, it bad on the kidneys. Nephrotoxic. Check levels, check urine output, check BUN/Creatinine.
  2. But mostly, usually if given too fast, RED MAN SYNDROME. Yes, erythema of face, neck, & upper torso.
  3. Treatment of red man syndrome: stop infusion, given benadryl.
  1. Do you know that this medication can cause Neuroleptic Malignant Syndrome and Extrapyramidal Symptoms…crazy, I know!
  2. Extrapyramidal symptoms (EPS): Parkinson-like symptoms, tardive dyskinesia, Dystonia, tremor, slurred speech, restlesness and anxiety.
  3. Watch out for lip smacking (it’s a sign of EPS). NCLEX would likely say: client is lip smacking and you should think EPS from Reglan.
  4. Neuroleptic Malignant Syndrome: Potentially fatal, high fever, diaphoresis, & unstable blood pressure.
  1. Ototoxicity (tinnitus, ringing i the ears)
  2. Nephrotoxicity
  3. But is the NCLEX going to say “check for nephrotoxicity.” No way, it will say “monitor BUN/Creatinine, check urine output, check potassium”
  1. You will see a lot of nausea, vomiting, and diarrhea, but never forget VISUAL DISTURBANCES such as yellow halos.
  1. Contraindicated in patients with SICKLE CELL ANEMIA. Renal impairment makes them at risk for seizures.
  2. Even with healthy people, too much demerol in a day can cause seizures. Low dose is usually ok.
  1. Number 1 in myocardial infarctions
  2. But do NOT given in pancreatitis due to Sphincter of Oddi dysfunction (not the dog).
  3. Ok, Iam sure you know that Narcan is the antidote and that it causes respiratory depression.
  1. Irreversible teeth staining
  2. Do not given to pregnant or lactating women and children under 8.
  1. They cause Serotonin syndrome: tachycardia, hyperreflexia, sweating, mydriasis, myoclonus.
  2. Who are these criminals: Prozac, Celexa, Lexapro, Paxil. 
  3. Never forget the increased risk of suicide in children and adolescents.
  1. Hepatotoxic
  2. Antidote: mucomyst (acetylcysteine), but you knew that already.
  3. Bet you did not know that another name is acetominophen.
  1. Major side effect: Gastritis.
  2. Also kidney injury
  3. Trust me, that Ibuprophen can be dangerous to the kidneys.
  1. Side effect: constipation, metallic taste, nausea, temporary staining of teeth.
  2. Take it with orange juice or vitamin C to increase absorption
  3. Milk, coffee, and tea DECREASE absorption
  4. Remain upright for 30 minutes to prevent esophageal irritation.
  1. No nitrates
  2. You always think of nitroglycerin, but Isosorbide mononitrate is also a nitrate. Duh
  1. Stevens-Johnson Syndrome (rare but fatal severe skin rash).
  2. Other famous meds that cause Steven-Johnson Syndrome: Dilantin, Tegretol, allopurinol, tylenol and NSAIDS (crazy, I know).
  3. Focus on remembering sulfa drugs and dilantin  can cause Steven Johnson syndrome.

 

  1. Birth defects
  2. Pregnancy test before prescribing
  3. Must be on BIRTH CONTROL.
  4. Other side effects I have seen in questions: suicide ideation and depression.
  5. Common side effect: dry skin
  1. As with all antihypertensive: Orthostatic hypotension. Change position slowly.
  2. You will be suprised how often changing position slowly with antihypertensives comes up.
  3. Other side effects of Beta blockers: Impotence and bradycardia. 
  4. Hold for HR < 60
  5. Remember beta receptors in the lungs. Beta 2 receptors cause dilation in the lungs so if you block them it can make asthma worse. 
  6. Non-selective beta blockers are contraindicated in asthma (labetalol, Carvedilol)
  7. But there are selective beta blockers that are ok in asthma (do not block beta in lungs) (Metropolol, atenolol, esmolol).
  1. Thorazine (antipsychotic)
  2. Compazine (antiemetic)
  3. Phenergan (for allergy symptoms, nausea, or insomnia sometimes)
  4. mmmm…various uses for phenothiazines.
  5. Dangerous side effects Extrapyramidal symptoms, Neuroleptic Malignant Syndrome, and agranulocytosis.
  6. Agranulocytosis: decrease of a type of WBCs. Think Infection.
  7. Neuroleptic Malignant Syndrome: Think hyperthermia, autonomic dysregulation
  8. EPS (repetitive, involuntary facial movements, such as tongue twisting, chewing motions and lip smacking, cheek puffing, and grimacing)
  1. Prednisone, methyprednisolone. Plain steroids.
  2. Check blood sugar (cause hyperglycemia)
  3. Check blood pressure (cause hypertension)
  4. Leukocytosis. Monitor for infection.
  5. Cause poor wound healing.
  6. Cause bruising and petechiae
  7. Cushing’s symptoms (moon face, buffalo hump, edema, weight gain).
  8. Mood changes.
  1. atorvastatin (Lipitor)
  2. Big side effect I have seen a lot: Rhabdomyolysis- coca cola urine and muscle weakness
  3. liver dysfunction: check liver functions tests.
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