PHARM Exam 4 - Side & Adverse Effects
Fluorouracil - ANS-(Antineoplastic med)
1) bone marrow suppression (neutropenia)
2) oral and GI ulceration
3) cerebellar dysfunction (dizziness, weakness, ataxia)
Methotrexate - ANS-(Antineoplastic med)
1) Alopecia,
2) stomatitis
3) hyperuricemia,
4) photosensitivity,
5) hepatotoxicity,
6) hematological and GI toxicity
Vincristine - ANS-(Antineoplastic med)
1) Neurotoxocity (numbness, tingling fingers and toes, constipation, and paralytic ileus)
Tamoxifen - ANS-(Antineoplastic med)
1) Hypercalcemia,
2) elevated cholesterol and triglyceride levels
3) edema
4) Decreases the effects of estrogen
Cephalosporins - ANS-a. Allergy - assess and monitor
b. GI Disturbances
c. Pseudomembranous colitis (C. diff)
i. If diarrhea occurs, do not take OTC drugs; alert health care provider.
ii. For mild to moderate C.diff infection, doctors usually prescribe metronidazole (Flagyl)
iii. For more severe and recurrent cases, vancomycin (Vancomycin)
d. Nephrotoxicity
e. Risk of bleeding
i. (monitor PT)
f. Avoid alcohol
i. Disulfiram-like reaction
Penicillin Drug Interaction - ANS-Inactivates Aminoglycoside (infuse separately)
, Aminoglycosides - ANS-a. Nephrotoxicity
i. elevations in serum creatinine and blood urea nitrogen (BUN)...Monitor both
b. Ototoxicity
i. first sign of impending cochlear damage is high-pitched tinnitus (ringing in the ears)
c. Dysrhythmia
Gentamicin toxicity - ANS-(Aminoglycoside)
Gentamicin toxicity is the most common cause of bilateral vestibulopathy (damage to
both inner ears).
Macrolides - ANS-¬ Pseudomembranous colitis
a. (C. difficile - 10-15 watery stools) - notify HCP
¬ QT prolongation and sudden cardiac death
¬ Risk of superinfection
a. (loose, malodorous stools; fuzzy, black tongue growth; vaginal discomfort and
discharge)
¬ Hepatotoxicity in some patients
a. Increases with preexisting hepatic disorder
(Erythromycin or clarithomycin + calcium channel blocker = hypotension or shock)
Sulfonamides - ANS-i. Hepatotoxicity
ii. Nephrotoxicity
iii. Bone marrow suppression
iv. GI effects
v. Dermatologic
1. Photosensitivity
2. Stevens Johnson Syndrome
a. Purple or red blisters appear all over the body that leads to shedding of skin on the
affected area, and makes the skin susceptible to bacterial infections.
Thrombocytopenia -> Avoid in third trimester of pregnancy
(Intensify the effects of warfarin, phenytoin, and sulfonylurea-type oral hypoglycemics
(eg, glipizide, glyburide). May need decreased dosages)
Tetracyclines - ANS-a. Hepatotoxicity
b. Nephrotoxicity
c. Teeth (staining)
d. Dermatologic
i. (rash, photosensitivity)
Ciprofloxacin - ANS-i. GI: Nausea/vomiting, diarrhea, abdominal pain
Fluorouracil - ANS-(Antineoplastic med)
1) bone marrow suppression (neutropenia)
2) oral and GI ulceration
3) cerebellar dysfunction (dizziness, weakness, ataxia)
Methotrexate - ANS-(Antineoplastic med)
1) Alopecia,
2) stomatitis
3) hyperuricemia,
4) photosensitivity,
5) hepatotoxicity,
6) hematological and GI toxicity
Vincristine - ANS-(Antineoplastic med)
1) Neurotoxocity (numbness, tingling fingers and toes, constipation, and paralytic ileus)
Tamoxifen - ANS-(Antineoplastic med)
1) Hypercalcemia,
2) elevated cholesterol and triglyceride levels
3) edema
4) Decreases the effects of estrogen
Cephalosporins - ANS-a. Allergy - assess and monitor
b. GI Disturbances
c. Pseudomembranous colitis (C. diff)
i. If diarrhea occurs, do not take OTC drugs; alert health care provider.
ii. For mild to moderate C.diff infection, doctors usually prescribe metronidazole (Flagyl)
iii. For more severe and recurrent cases, vancomycin (Vancomycin)
d. Nephrotoxicity
e. Risk of bleeding
i. (monitor PT)
f. Avoid alcohol
i. Disulfiram-like reaction
Penicillin Drug Interaction - ANS-Inactivates Aminoglycoside (infuse separately)
, Aminoglycosides - ANS-a. Nephrotoxicity
i. elevations in serum creatinine and blood urea nitrogen (BUN)...Monitor both
b. Ototoxicity
i. first sign of impending cochlear damage is high-pitched tinnitus (ringing in the ears)
c. Dysrhythmia
Gentamicin toxicity - ANS-(Aminoglycoside)
Gentamicin toxicity is the most common cause of bilateral vestibulopathy (damage to
both inner ears).
Macrolides - ANS-¬ Pseudomembranous colitis
a. (C. difficile - 10-15 watery stools) - notify HCP
¬ QT prolongation and sudden cardiac death
¬ Risk of superinfection
a. (loose, malodorous stools; fuzzy, black tongue growth; vaginal discomfort and
discharge)
¬ Hepatotoxicity in some patients
a. Increases with preexisting hepatic disorder
(Erythromycin or clarithomycin + calcium channel blocker = hypotension or shock)
Sulfonamides - ANS-i. Hepatotoxicity
ii. Nephrotoxicity
iii. Bone marrow suppression
iv. GI effects
v. Dermatologic
1. Photosensitivity
2. Stevens Johnson Syndrome
a. Purple or red blisters appear all over the body that leads to shedding of skin on the
affected area, and makes the skin susceptible to bacterial infections.
Thrombocytopenia -> Avoid in third trimester of pregnancy
(Intensify the effects of warfarin, phenytoin, and sulfonylurea-type oral hypoglycemics
(eg, glipizide, glyburide). May need decreased dosages)
Tetracyclines - ANS-a. Hepatotoxicity
b. Nephrotoxicity
c. Teeth (staining)
d. Dermatologic
i. (rash, photosensitivity)
Ciprofloxacin - ANS-i. GI: Nausea/vomiting, diarrhea, abdominal pain
