PHARM: adverse effects by class

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parasympathomimetics
increased salivation, sweating, muscle cramping, abdominal cramping, hypotension (orthostatic), diarrhea, difficulty breathing, blurred vision, muscle weakness
anticholinergics
tachycardia, tendency to cause urinary retention in men with prostate disorders, drowsiness, blurred vision, dry mouth, dry mucous membranes, urinary hesitancy, decreased sweating, (SOB, cough, dysphagia, syncope, fever, anxiety, RUQ pain, extreme lethargy, dizziness signs of anticholinergic crisis)
sympathomimetics
SOB, palpitations, dizziness, chest/arm pain or pressure, tachycardia, urinary retention in men with prostate disorder, drowsiness, blurred vision, dry mouth, dry mucous membranes, urinary hesitancy, decreased sweating
adrenergic blockers
syncope, urinary hestiancy in those with bph, dizziness, drowsiness, lightheadedness, blurred vision, tinnitus, epistaxis, edema, possible nasal congestion
TCAs
anticholinergic effects. tachycardia, tendency to cause urinary retention in men with prostate disorders, drowsiness, blurred vision, dry mouth, dry mucous membranes, urinary hesitancy, decreased sweating, orthostatic hypotension, sedation, constipation
MAOIs
orthostatic hypotenstion, headache, insomnia, diarrhea. avoid foods containing tyramine and caffeine
SSRis and SNRIs
weight gain, sexual dysfunction, excessive doses can cause confusion, anxiety, restlessness, HTN, tremors, sweating, fever
atypical antidepressants
generally similar to SSRIs and SNRIs. headache, insomnia, nervousness, dry mouth, dizziness, weight loss, sexual dysfunction, chills, confusion, anxiety, restlessness, HTN, termors, sweating, fever, blurred vision, constipation, and muscle incoordination
benzodiazepines
drowsiness, sedation, amnesia, weakness, disorientation, ataxia, sleep disturbance, BP changes, blurred vision, double vision, nausea, and vomiting.
barbiturates
depress CNS function, drowsiness, withdrawal syndrome is extremely severe and can be fatal. overdose results in profound respiratory depression, hypotension, and shock. at high doses some can produce anesthesia
nonbenzodiazepine, nonbarbiturate CNS depressants
daytime sedation, confusion, amnesia, dizziness, depression, nausea, vomiting, headache, drowsiness, sweating, palpitations, shaking, rebound insomnia when discontinued
mood stabilizers
excessive sweating or dehydration can cause lithium toxicity. dizziness, fatigue, short-term memory loss, increased urination, nausea, vomiting, loss of appetite, abdominal pain, diarrhea, dry mouth, muscular weakness, and slight tremors
CNS stimulants for ADHD
insomnia, nervousness, anorexia, weight loss, irregular heartbeat, high blood pressure, liver toxicity.
Nonstimulants for ADHD
headache, insomnia, upper abdominal pain, decreased appetite, and cough
opioids
respiratory depression, sedation, nausea, vomiting, dysphoria, hallucinations, constipation, dizziness, itching
NSAIDs
heartburn. uncommon unless given in high doses. at high doses, can cause GI discomfort and bleeding
statins
GI disturbances such as indigestion, flatulence, cramping, and constipation. can cause muscle injury resulting in symptoms such as weakness, soreness, and pain. atorvastatin and rosuvastatin are effective regardless the time of day taken. taking other statin drugs in the evening makes them available to work on the higher amount of cholesterol that the body makes at night.
bile acid resins
GI disturbances. constipation, bloating, nausea, indigestion. self-medication with niacin can cause gout and liver damage from high doses. it will not lower cholesterol at low doses. take 1 hour before or 4 hours after other meds. dissolving it in water and keeping fluid intake high helps to avoid irritation of the mouth and constipation
fibric acid agents
few serious adverse effects. Rashes and Gi complaints are the most common. increased risk of gallstones
Diuretics
dehydration is one of most common. electrolyte imbalances most common. hypokalemia (loss of Potassium) or hyperkalemia (high levels of potassium; occurs when taking potassium supplements with potassium-sparing diuretics)
Calcium Channel Blockers
headache, dizziness, and flushing. reflex tachycardia, rebound hypotension if suddenly stopped.
ACE inhibitors
PERSISTENT COUGH. hypotension, headache, dizziness
cardiac glycoside
initial ones are GI related and include loss of appetite, vomiting, and diarrhea. Headache, drowsiness, confusion, and blurred vision may occur. excessive slowing of the HR and other cardiac abnormalities can be fatal if not corrected.
Sodium Channel Blockers
have potential to cause new dysrhythmias or worsen existing ones. hypotension, dizziness, fainting, dry mouth, constipation, urinary retention can occur, nausea, vomiting, abdominal pain, and headache.
Beta Blockers
bradycardia, hypotension, dizziness, fainting, risk for bronchospasm, diminished sex drive and impotence
Potassium Channel Blockers
bradycardia, possibly hypotension, can worsen dyrshythmias. most serious is a pneumonia-like syndrome. blurred vision, rashes, photosensitivity, nausea, vomiting, anorexia, fatigue, dizziness
anticoagulants
BLEEDING.
antiplatelets
flulike syndrome, headache, diarrhea, dizziness, bruising, upper respiratory tract infection, and rash or pruritus. GI bleeding can occur. Excessive bleeding is a potential adverse effect
thrombolytics
like anticoagulants, bleeding is major adverse effect.
organic nitrates
headache most common, dizziness, reflex tachycardia
immunosuppressants
infections common. reduction in urine output, tremor, HTN, elevated hepatic enzyme values.
penicillins
ALLERGY most common. (s/s allergy: rash, fever, and anaphylaxis) diarrhea, nausea, and vomiting. Anaphylaxis is most serious.
Cephalosporins
like penicillins, ALLERGY most common. GI complaints common, kidney toxicity in older drugs.
tetracylcines
GI distress relatively common, photosensitivity, decrease effectiveness of oral contraceptives
macrolides
no serious adverse effects. Mild GI upset, diarrhea, and abdominal pain are most common.
aminoglycosides
ototoxicity is possible and may become permanent with continued use. Ringing in the ears, dizziness, and persistent headaches are early signs. monitor for nephrotoxicity
fluoroquinolones
nausea, vomiting, and diarrhea most frequent. most serious are DYSRHYTHMIAS and potential HEPATOTOXICITY.
sulfonamides
nausea and vomiting most frequent. More serious are formation of crystals in urine, allergic reactions, nausea, and vomiting. not common, but potentially fatal blood abnormalities can occur.
antifungal drugs
fever and chills at the beginning of therapy, phlebitis is common during IV therapy, nephrotoxicity, nausea, vomiting, diarrhea
antiretrovirals
severe toxicity to blood cells at high doses. anemia and leukopenia are common, headache, generalized weakness, anorexia, nausea, diarrhea, lactic acidosis.
drugs for helminth and protozoan infections
anorexia, nausea, diarrhea, dizziness, and headache. Dryness of mouth and metallic tast can occur with Flagyl
alkylating agents
bone marrow suppression is primary dose-limiting adverse effect. red blood cells, white blood cells, and platelets begin to decline quickly. nausea, vomiting, diarrhea. alopecia is expected
antimetabolites
fatal bone marrow toxicity at high doses. hemorrhage and bruising due to low platelet counts are often observed. Nausea, vomiting, and anorexia are common.
cytotoxic antibiotics
major dose-limiting adverse effect is bone marrow suppression. adverse effects are similar to those of the alkylating agents
hormone and hormone antagonists
nausea and vomiting, hot flashes, fluid retention, venous blood clots, and abnormal vaginal bleeding relatively common
biologic response modifiers
flulike syndrome of fever, chills, dizziness, and fatigue, headache, nausea, vomiting, diarrhea, and anorexia. depression and suicidal ideation have been reported. with prolonged therapy, immunosuppression, serious toxicity such as hepatotoxicity and neurotoxicity may be observed
H1 receptor blockers (antihistamines)
1st gen cause significant drowsiness. dry mouth, tachycardia, and mild hypotension
intranasal corticosteroids
most common are intense buring sensation in the nose immediately after spraying and drying of the nasal mucosa. nasal irritation and bleeding occur in a few pts.
decongestants
most serious, limiting adverse effect is rebound congestion when used for longer than 3-5 days. minor stinging nad dryness in nasal mucosa. HTN and CNS stimulation that may lead to insomnia or anxiety
insulins
most serious is hypoglycemia: (s/s: tachycardia, confusion, sweating, and drowsiness)
oral hypoglycemics
rashes and photosensitivity are possible. mild, GI-related effects such as nausea, vomiting, or loss of appetite