Pharmacology Quiz: Adverse Reactions & Effects

Neurological/Psychiatric Medications

• Amitriptyline:

  • Desired effect: Relieves depression, chronic pain, and insomnia
  • Adverse reactions: Sedation, dry mouth, weight gain, orthostatic hypotension, arrhythmias, suicidal ideation
  • Interactions: MAOIs (hypertensive crisis), CNS depressants (enhanced sedation), anticholinergics (increased side effects)

• Phenytoin:

  • Desired effect: Prevents and controls seizures
  • Adverse reactions: Gingival hyperplasia, ataxia, nystagmus, rash, hepatotoxicity, Stevens-Johnson syndrome
  • Interactions: Decreased efficacy of oral contraceptives and warfarin; additive CNS depression with sedatives

• Amantadine:

  • Desired effect: Relieves Parkinson's symptoms (rigidity, tremor); antiviral effects in influenza
  • Adverse reactions: Dizziness, orthostatic hypotension, insomnia, livedo reticularis (mottled skin)
  • Interactions: Increased CNS side effects with anticholinergics; reduced efficacy with antipsychotics

• Lithium:

  • Desired effect: Stabilizes mood in bipolar disorder
  • Adverse reactions: Tremor, hypothyroidism, polyuria, nephrotoxicity, toxicity signs (nausea, confusion, seizures)
  • Interactions: NSAIDs and diuretics (increased lithium levels); ACE inhibitors (toxicity risk)

• Allopurinol:

  • Desired effect: Reduces uric acid levels in gout and prevents uric acid nephropathy
  • Adverse reactions: Rash, nausea, hepatotoxicity, Stevens-Johnson syndrome, bone marrow suppression
  • Interactions: Increased toxicity of azathioprine and warfarin; decreased efficacy with aluminum hydroxide

Pain Management Medications

• Morphine:

  • Desired effect: Relief of severe pain
  • Adverse reactions: Respiratory depression, constipation, sedation, addiction risk, hypotension
  • Interactions: Additive sedation with benzodiazepines, alcohol, and CNS depressants

• Acetaminophen:

  • Desired effect: Reduction of pain and fever
  • Adverse reactions: Hepatotoxicity (in overdose), rash, renal toxicity (chronic use)
  • Interactions: Increased hepatotoxicity with alcohol; affects warfarin metabolism

• Ketorolac:

  • Desired effect: Relief of moderate to severe pain
  • Adverse reactions: GI bleeding, nephrotoxicity, prolonged bleeding time
  • Interactions: Additive GI risk with aspirin and corticosteroids; reduced efficacy with diuretics

• Sulfasalazine:

  • Desired effect: Reduction of inflammation in rheumatoid arthritis or ulcerative colitis
  • Adverse reactions: Rash, GI upset, bone marrow suppression, hepatotoxicity
  • Interactions: Reduced absorption with iron supplements; increased methotrexate toxicity

• Levodopa:

  • Desired effect: Improvement in Parkinson's motor symptoms.

Other Medications

• Prochlorperazine:

  • Desired effect: Relief of nausea and vomiting.
  • Adverse reactions: Extrapyramidal symptoms, sedation, dry mouth, hypotension
  • Interactions: Additive CNS depression with alcohol, sedatives; increased QT prolongation risk with antiarrhythmics.

• Docusate:

  • Desired effect: Relief of constipation.
  • Adverse reactions: Abdominal cramping, diarrhea
  • Interactions: Increased absorption of mineral oil (risk of toxicity).

• Omeprazole/Pantoprazole/Famotidine:

  • Desired effect: Reduction of gastric acid secretion to treat GERD, ulcers.
  • Adverse reactions: Headache, diarrhea, risk of osteoporosis (long-term use), C. difficile infection
  • Interactions: Reduced absorption of antifungals and iron; increased diazepam and warfarin levels.

• Albuterol:

  • Desired effect: Bronchodilation in asthma/COPD.
  • Adverse reactions: Tachycardia, tremors, nervousness, palpitations
  • Interactions: Increased cardiovascular effects with beta-blockers; additive stimulation with MAOIs.

• Beclomethasone:

  • Desired effect: Reduction of airway inflammation in asthma
  • Adverse reactions: Thrush, hoarseness, growth suppression (children).

• Guaifenesin:

  • Desired effect: Thinning of mucus for productive coughs
  • Adverse reactions: Nausea, dizziness, rash
  • Interactions: No significant interactions reported

• Theophylline:

  • Desired effect: Bronchodilation in chronic asthma/COPD
  • Adverse reactions: Tachycardia, seizures, GI upset
  • Interactions:Increased toxicity with ciprofloxacin; reduced levels with phenobarbital

• Cetirizine:

  • Desired effect: Relief of allergy symptoms
  • Adverse reactions: Drowsiness, dry mouth
  • Interactions: Additive sedation with alcohol and other antihistamines.

• Amphotericin B:

  • Desired effect: Treatment of severe fungal infections
  • Adverse reactions: Nephrotoxicity, infusion reactions (fever, chills), hypokalemia
  • Interactions: Increased nephrotoxicity with aminoglycosides and cyclosporine.

• Penicillin/Ceftriaxone:

  • Desired effect: Eradication of bacterial infections
  • Adverse reactions: Allergic reactions, diarrhea, superinfection (e.g., C. difficile)
  • Interactions: Reduced efficacy with tetracyclines; increased bleeding risk with anticoagulants

• Nystatin:

  • Desired effect: Treatment of candidiasis

• Prednisone:

  • Desired effect: Suppression of inflammation and immune response
  • Adverse reactions: Hyperglycemia, weight gain, hypertension, osteoporosis
  • Interactions: Increased risk of GI bleeding with NSAIDs; reduced efficacy with antidiabetic drugs.)

• Vancomycin:

  • Desired effect: Treatment of severe bacterial infections (e.g., MRSA)
  • Adverse reactions: Nephrotoxicity, ototoxicity, “red man syndrome”
  • Interactions: Increased toxicity with aminoglycosides

• Tetracycline:

  • Desired effect: Treatment of bacterial infections
  • Adverse reactions: Photosensitivity, GI upset, discoloration of teeth (children)
  • Interactions: Reduced efficacy with antacids, iron supplements; increased warfarin effect

• Timolol:

  • Desired effect: Reduction of intraocular pressure in glaucoma
  • Adverse reactions: Burning/stinging in the eye, bradycardia, hypotension (systemically)
  • Interactions: Additive bradycardia with calcium channel blockers or digoxin; antagonism with beta-adrenergic agonists (e.g., albuterol).

• Permethrin:

  • Desired effect: Kills lice and their eggs
  • Adverse reactions: Local skin irritation (itching, redness, burning), scalp irritation or temporary hair dryness.
  • Interactions: No significant drug-drug interactions

• Pyrethrin with Piperonyl Butoxide:

  • Desired effect: Disrupts nerve function in lice, leading to paralysis and death
  • Adverse reactions: Skin irritation, redness, or swelling
  • Interactions: Enhanced irritation when combined with other topical treatments.

• Benzoyl Peroxide:

  • Desired effect: Reduction of acne lesions
  • Adverse reactions: Skin irritation, dryness, redness, peeling
  • Interactions: Increased irritation with other topical retinoids or acne treatments

• Topical Glucocorticoids:

  • Desired effect: Reduction of inflammation and itching
  • Adverse effects: Not specified

• Isotretinoin:

  • Desired effect: Reduce severe acne by decreasing sebaceous gland activity
  • Adverse reactions: Dry skin, mucous membranes, teratogenic effects, depression, hepatotoxicity
  • Interactions: Increased risk of toxicity with tetracyclines (pseudotumor cerebri); additive dryness with other acne treatments.

• Isophane (NPH) Insulin

  • Desired effect: Intermediate-acting blood sugar control
  • Adverse reactions: Hypoglycemia, injection site reactions, lipodystrophy
  • Interactions: Hypoglycemia risk with beta-blockers, sulfonylureas; hyperglycemia with corticosteroids, diuretics.

• Glargine Insulin

  • Desired effect: Long-acting blood sugar control.
  • Adverse reactions: Hypoglycemia,injection site reactions
  • Interactions: Same as NPH insulin

• Metformin:

  • Desired effect: Reduction of hepatic glucose production, insulin resistance type 2 diabetes
  • Adverse Reactions: GI upset, lactic acidosis (rare) vitamin B12 deficiency
  • Interactions: Increased risk of lactic acidosis with alcohol; reduced efficacy with corticosteroids.

• Synthroid (Levothyroxine)

  • Desired effect: Replacement of thyroid hormone in hypothyroidism

• Humulin R:

  • Desired effect: Short-acting blood sugar control in diabetes.
  • Adverse reactions: Hypoglycemia, weight gain, lipodystrophy.
  • Interactions: Same as NPH insulin.

• Amiodarone:

  • Desired effect: Treatment of arrhythmias by prolonging the cardiac action potential.
  • Adverse reactions: Pulmonary toxicity, thyroid dysfunction, hepatotoxicity, photosensitivity
  • Interactions: Increased risk of bradycardia with beta-blockers or calcium channel blockers; increased warfarin and digoxin levels.

• Spironolactone:

  • Desired effect: Diuresis and potassium sparing in heart failure or hypertension
  • Adverse reactions: Hyperkalemia, gynecomastia, menstrual irregularities
  • Interactions: Increased hyperkalemia risk with ACE inhibitors, ARBs, or potassium supplements.

• Furosemide:

  • Desired effect: Diuresis and reduction of fluid overload.
  • Adverse reactions: Hypokalemia, dehydration, ototoxicity, hypotension
  • Interactions: Increased toxicity of aminoglycosides; reduced diuretic efficacy with NSAIDs.

• Digoxin:

  • Desired effect: Increased cardiac contractility and rate control in atrial fibrillation/heart failure
  • Adverse reactions: Toxicity (nausea, vomiting, bradycardia, visual disturbances), arrhythmias
  • Interactions: Increased toxicity risk with amiodarone, diuretics (hypokalemia), and verapamil.

• Lisinopril:

  • Desired effect: Reduction of blood pressure and heart failure symptoms.
  • Adverse reactions: Hyperkalemia, dry cough, angioedema.
  • Interactions: Increased hyperkalemia risk with potassium supplements or spironolactone; reduced antihypertensive effect with NSAIDs.

• Metoprolol:

  • Desired effect: Reduced heart rate and blood pressure.
  • Adverse reactions: Bradycardia, fatigue, depression, hypotension
  • Interactions: Additive bradycardia with digoxin or diltiazem; masked hypoglycemia symptoms with insulin.

• Nitroglycerin:

  • Desired effect: Relief of chest pain by dilating coronary arteries.
  • Adverse reactions: Headache, hypotension, reflex tachycardia
  • Interactions: Severe hypotension with PDE5 inhibitors.

• Warfarin:

  • Desired effect: Prevention of thromboembolism by inhibiting vitamin K-dependent clotting factors.
  • Adverse reactions: Bleeding, bruising, purple toe syndrome
  • Interactions: Increased bleeding risk with NSAIDs, antibiotics, and amiodarone; reduced efficacy with vitamin K-rich foods.

• Aspirin:

  • Desired effect: Reduction of platelet aggregation to prevent clots; pain relief.
  • Adverse reactions: GI bleeding, tinnitus (high doses), Reye's syndrome (in children).