Opioid (narcotics)-Morphine

• Most common adverse effect:  light-headedness, dizziness, sedation, nausea, and vomiting, constipation, orthostatic hypotension, urinary retention, incresaed intracranial pressure, euphoria,  miosis
  

• Most serious adverse effect: respiratory depression

Opioid antagonists

*Narcan*

Adverse effects rarely seen

Salicylates-Aspirin

• Most common adverse effect:  GI distress

• Most serious adverse effect: renal impairment, gastric ulceration and GI bleeding

• Salicylism - tinnitus, headache, GI distress, paresthesias, respiratory stimulation,
  

Nonsteroidal anti-inflammatory medications

Ibuprofen

• Most common adverse effect:  GI related

• Most serious adverse effect: hepatic and renal toxicity

• Also, can cause hematologic problems, nephrotoxicity, hearing loss and tinnitus.
  

Acetaminophen

Adverse effects occur usually only at toxic levels

Most serious adverse effect:

acetaminophen may cause hepatic or renal toxicity in susceptible patients.

Other: hematologic and GI problems

Beta Blockers-“olol” medications-atenolol

• Most common adverse effect;  postural hypotension, bronchospasm/bronchoconstriction
• Most serious AE:       MI
  

Other effects:

• Cardiac: Bradycardia, AV heart block, heart failure
• hypoglycemia symptoms blocked
• decreased libido
• lethargy, weakness, dizziness, depression, insomnia, nightmares, hallucinations
  

ACE Inhibitors-“pril” medications

• chronic cough
• rash
• hypotension
• hyperkalemia, hyponatremia
• angioedema
• renal failure
• fetal injury
• neutropenia
  

Cardiac Glycosides (Digoxin)

• Most frequent adverse effect: cardiac toxicity, (hypokalemia, hypomagnesaemia, and hypercalcemia increase the risk of toxicity

• Most serious adverse effect:  ventricular fibrillation

• Also, anorexia, N/V, fatigue, visual disturbances (yellow-green halos)
  

Nitrates

Most common adverse effect: 

headache, followed by hypotension (b/c of vasodilation)

also, flushing, blurred vision, dry mouth and peripheral edema

Anticoagulant-Heparin

• Most common adverse effect:  bleeding (antidote for heparin overdose is protamine sulfate)

• Most serious adverse effect: thrombocytopenia

• Other: easily bruised, nose bleeds, bleeding stools, bleeding peptic ulcers, and bleeding hemorrhoids
  

Coumadin (Warfarin)

bleeding (vitamin K is the antidote for Warfarin)

easily bruised, nose bleeds, bleeding stools, bleeding peptic ulcers, bleeding hemorrhoids, many drug to drug interactions

Lipid-Lowering medications-(Statin Drugs)

• Most common adverse effects: headache and elevated liver enzyme levels (hepatotoxicity)
  

• Most serious adverse effect: rhadbomyolysis (breakdown of skeletal muscle) and myopathy (weakenss)

• Also, diarrhea, constipation, dyspepsia, abdominal pain, nausea

Diarrhea, nausea, constipation, adbominal pain, dypepsia, headache, hepatotoxicity, rbadbomyolysis and myopathy

Mucolytics

• Most common adverse effects:  N/V, rhinorrhea

• Most serious adverse effects:  bronchospasm and bronchoconstriction

• Also, chest tightness and "burning" feeling in upper airway
  

Bronchodilators-Albuterol

• Most common adverse effects:  throat irritation, palpitations, tachycardia, anxiety, tremors, increased BP

• Most serious adverse effects:  bronchospasm

• Also: headache, insomnia, muscle cramps, dyspepsia, and N/V
  

Anti-Inflammatory Agents-Inhaled Glucocorticoids (AeroBid)

Most common adverse effects:  dry mouth, dysphonia, Oral Candidiasis

Hydrochlorothiazide HTCZ- Thiazide Diuretics

Most common adverse effect:  from fluid and electrolyte loss (dizziness, light-headedness, vertigo, nausea, and vomiting)

Also: aplastic anemia, thrombocytopenia, dehydration

Loop Diuretics - High Ceiling Diuretics- Furosemide (Lasix)

• Most common adverse effect:  related to fluid and electrolyte loss, especially potassium loss

• Most serious adverse effect: significant hypokalemia, permanent deafness, and activation or exacerbation of lupus.

• Also - dehydration, ototoxicity
  

Potassium-Sparing Diurectics-Aldactone

• Most common adverse effect: nausea, vomiting, anorexia, dry mouth and headache

• Most serious adverse effect:  hyperkalemia (electrolyte imbalance)

• Also - Endocrine effects
  

Peptic Ulcer medications-Proton Pump Inhibitors

headache and diarrhea

Thyroid medications

Most common adverse effect:  symptoms of hyperthyroidism

Can also worsen MI

Diabetic medications-Regular Insulin

hypoglycemia

anaphylaxis and hypersensitivity

Oral hypoglycemic-sulfonylureas-Glyburide

• Most common adverse effect:  nausea, epigastric fullness, heartburn

• Most serious adverse effect: hypoglycemia

Oral hypoglycemic-non-sulfonylureas-Metformin

Most common adverse effect: 

• nausea,
• diarrhea,
• abdominal bloating,
• flatulence, and
• anorexia: GI adverse effects appear to be dose related.
• Also: dyspepsia and sometimes hypoglycemia when combined with other diabetic drugs
  

Glucose-Elevating Agents - glucagon

Hypokalemia

Also: N/V, generalized alleric reactions, urticaria, respiratory distress and hypotension

Glucocorticoids

• Most common adverse effect: CNS complaints of euphoria, headache, and vertigo; GI complaints of nausea, vomiting, increased appetite, weight gain, and dyspepsia

• Most serious adverse effect:  acute adrenal insufficiency

Benzodiazepines

• Most common adverse effect: mild drowsiness, ataxia, confusion

• Most serious adverse effect:  paradoxical reactions

Selective Serotonin Reuptake Inhibitors-(SSRI’s) sertraline (Zoloft)

• Most common adverse effect: GI distress (Nausea), headache, sleep disturbance, and abnormal ejaculation/decreased libido, weight gain
  

• Most serious adverse effect:  may possibly increase the risk for suicide, especially in pediatric populations

• Life threatening effects: Seizures, tachycardia, bradycardia, and AV block
  

Antiseizure medications- Phenytoin (Dilantin)

Most common adverse effects:  CNS: (dizziness, ataxia, blurred vision)  Nausea and gingival hyperplasia.

Other more serious problems are: liver damage, a blood disease (blood dyscrasias), and cardiovascular collapse

Antibiotic medications-Penicillin

• Most common adverse effect:  nausea, vomiting, diarrhea

• Most serious adverse effect: allergy to PCN

Cephalosporin- Cefazolin

Most common adverse effect:        nausea, vomiting, diarrhea 

-pseudomembranous colitis

-pain at IM

-abdominal pain

-anorexia

Antibiotic medications-Vancomycin

• Most common adverse effect: histamine release resulting in “red-man” syndrome

• Most serious adverse effects:  ototoxicity and nephrotoxicity

• Also: permanent hearing loss and Leukopenia,
  

Aminoglycosides-Gentamicin

• Most common adverse effect: nausea, vomiting, diarrhea, and weight loss

• Most serious adverse effects:  ototoxicity and nephrotoxicity, neuromuscular blockade
  

Tetracyclines

Most common adverse effect:

discoloration of teeth, nausea, vomiting, and photosensitivity

Most adverse effects:   azotemia

Also: suprainfection, hepato and renal toxicitiy

Ciprofloxacin (Cipro)

• Most common adverse effect: GI distress (nausea, vomiting, diarrhea, and abdominal pain), dizziness, drowsiness, and headache
  

• Most serious adverse effect:  tendon rupture

Antiviral medications-Acyclovir

• Most common adverse effect: nausea, vomiting, anorexia, light-headedness, abdominal pain, and headache.

• Most serious adverse effects:  seizures and renal dysfunction