Effects and contra IDC 160 groupme

Acetylcysteine

- fever, anaphylaxis, flushing, erythema of skin, urticaria, and angioedema

- do not use in pregnancy, breastfeeding, acute bronchitis, asthma, biliary cirrhosis, children, gag reflex depression, and vomiting

Acyclovir

- local reaction at the site, HA, rash, impaired renal function

- known sensitivity to ganciclovir

- neurologic toxicity

- adequate hydration

Adenosine

- flushing, lightheadedness, dyspnea, chest pressure/discomfort, hypotension, AV block, ST segment depression, palpitation, chest pain, and paresthesia

- asystole, atrial fibrillation, bradycardia, blurred vision, hypertension, increased intracranial pressure, metallic taste, pressure in groin, seizure, ventricular fibrillation, tachycardia

- Do not use in third-degree AV block or sick sinus syndrome. atrial flutter, atrial fibrillation, and ventricular tachycardia

- Avoid use in patients with bronchoconstrictive or bronchospastic lung disease

Alteplase

- hemorrhage, hypotension, fever

- do not use in pt with active internal bleeding, history of aneurysms, cerebrovascular accident, intracranial neoplasm, or any recent history of intracranial or intraspinal surgery

Amikacin

- nephrotoxicity and ototoxicity, neuromuscular blockade, hypomagnesemia, anaphylactic shock, and blood dyscrasias

- do not use in pt with known hypersensitivity to aminoglycoside agents

- Use caution in myasthenia gravis or parkinsons

Amiodarone

- visual disturbances, hypotension, cardiogenic shock, cardiac arrest, CHF, bradycardia, liver function test abnormalities, ventricular tachycardia, fatal pulmonary toxicity, and AV block

- do not use in patients with cardiogenic shock, marked sinus bradycardia, second or third- degree AV block unless a sufncioting pacemaker is available, and in patients with idoine sensitivity or electrolyte imbalances

- Hypotension and bradycardia are related to the rate of infusion

Amphotericin B

- HA, chills, fever, hypotension, tachypnea, malaise, muscle and joint pain, anorexia, weight loss, dyspepsia, cramping, epigastric pain

- may also cause nephrotoxicity, hypokalemia, anemia, and thrombophlebitis

Ampicillin

- hypertensivity reactions, urticaria, edema, laryngospasm, bronchospasm, hypotension

- severe diarhea may be a sign of pseudomembranous colitis

- do not use in patients hypersensitive to penicillins and/or cephalosporins and renal impairment/disease

Ampicillin + Sulbactam

- do not use in patients with sensitivity to penicillins and/or cephalosporins

- pain on injection, rash, diarrhea

- itching, NV, candidiasis, fatigue, malaise, HA, chest pain, flatulence, bloating, glossitis, urine retention, dysuria, edema, erythema, chills, tightness of throat, chest pain, epistaxis, and mucosal bleeding

Atropine

- do not use in patients with narrow-angle glaucoma, adhesion between iris and lens, tachycardia, GI disease, hepatic disease, obstructive uropathy, renal disease, myasthenia gravis, asthma, thyrotoxicosis, Mobitz type II block.

- arrhythmia, flushing, hypotension, palpitations, tachycardia, ataxia, coma, delirium, disorientation, dizziness, drowsiness, fever, hallucinations, insomnia, rash, delayed gastric emptying, loss of taste, urinary retention, musculoskeletal weakness, blurred vision, dry eyes, mydriasis, increased ocular tension, dyspnea, pulmonary edema, and anaphylaxis

- ANTI-SLUD

Azithromycin

- do not use in patients with hypersensitivity to macrolides

- DIARRHEA, nv, abdominal pain

- IV may cause pain at injection and local inflammation

- rare: angioedema and anaphylaxis

Aztreonam

- do not use if they have had a hypersensitivity reaction to any beta-lactams (cross-sensitivity)

- lacks renal issues seen in aminoglycosides, but shows elevation in hepatic test

- NVD, rash, phlebitis, and blood dyscrasias

Bumetanide

- do not use in patients with anuria, past history of sulfonamide allergy, hepatic cirrhosis and ascites, and in patients with DM

- hypokalemia, hypochloremia, and hyponatremia --> muscle cramps, dizziness, hypotension, HA, nausea, and encephalopathy

- hepatic abnormalities, blood dyscrasia, dose related ototoxciity, and hyperglycemia

Buprenorphine

- Use caution in those with a history of hypersensititivty to opiate agonists, renal/hepatic function, chronic respiratory problems, and those who perform tasks that require alertness

- respiratory and/or circulatory depression (shock)

- CNS adverse effects, dizziness, sedation, coma, and dysphoria

- changes in the billiary tract pressure and urinary retention

Butorphanol

- use in caution when administering to patients with known hypersensitivity to other opiate agonists, renal/hepatic dysfunction, and in patients with respiratory problems

- Individuals who perform tasks that require mental alrtness and/or physical coordination should be warned of CNS effects

- respiratory/circulatory depression (shock)

- CNS: dizziness, sedation, coma, dysphoria

- constipation, changes in biliary tract pressure, and urinary retention

Caspofungin

- hypersensitive to caspofungin

- HA, fever, chills, hypokalemia, decreased hemoglobin, increased serum alkaline phosphatase and transminases, flushing, hypertension, hypotension, tachycardia, nvd, anorexia, increased eosinophils, decreased neutrophils, and WBC, nephrotoxicity

Cefazolin

- If a hypersensitivity reaction occurs, discontinue use and start supportive care

- severe diarhea may be a sign of pseudomembranous colitis

- contraindicated in patients with hypersensitivity to cephalosporins

- use in caution in patients with a penicillin allergy

Cefepime

- contraindicated in patients hypersensitive to cephalosporins, penicillins, or other beta-lactam antibiotics

- severe diarhea may be a sign of pseudomembranous colitis

- local reactions including phlebitis, pain, and/or inflammation

- may cause rash

Ceftriaxone

- use in caution with a previous penicillin sensitivity

- use in caution when giving IV due to thrombophlebitis

- ND, rash, blood dyscrasias, hypothrombinemia, and hepatic abnormalities, cutaneous reactions

Cefuroxime

- do not use in patients with known hypersensitivity to cephalosporins and/or penicillins

- use in caution with renal impairment and reduce the dose

- If a hypersensitivity reaction occurs, discontinue use and start supportive care

- blood dyscrasia

- use in caution when giving IV due to thrombophlebitis

- severe diarhea may be a sign of pseudomembranous colitis

Cefotaxime

- use in caution with patients with known hypersensitivity to penicillins

- use in caution when giving IV due to thrombophlebitis

- ND, rash, blood dyscrasias, hypoprothrombinemia, and hepatic abnormalities, cutaneous reactions

Chlorpromazine

- do not use in patients with bone marrow depression, angle-closure glaucoma, prostatic hypertrophy, stenosing peptic ulcer, pyloroduodenal obstruction, or bladder neck obstruction

- do not use in patients whose jobs require mental alertness or physical coordination

- Use caution in seizure disorder, severe CVD, Reye syndrome, and/or hepatic and renal impairment

- rapid adiminstration IV may cause precipitous falls in BP

- marked CNS depression

- extrapyramidal effects, tardive dyskinesia, hepatotoxicity, local dermatitis, agranulocytosis

Cidofovir

- patients hypersensitive to cidofovir, probenecid, or other sulfa drugs

- use in caution in high SCr, reduced CrCl, or elevated urine proteins

- Use caution within 7 days of other nephrotoxic agents

- may cause chills, fever, HA, alopecia, rash, nvd, anemia, neutropenia, increased intraocular pressure, increased creatinine, and proteinuria

Ciprofloxacin

- do not use in patients with known hypersensitivity to other quinolone drugs

- Proper hydration and urine output are required to prevent crystalluria

- Use caution in pt w/ history of seizures

- photosensitivity

- headache and restlessness

- arthropathies, cutaneous reactions, GI, and occasional anaphylactoid reactions

Cisplatin

- do not use in patients with known hypersensitivity to cisplatin or other platinum-containing compounds

- use in caution in the elderly, pt w/ pre-existing renal insufficiency, myelosuppression, hearing impairment, and pregancy

- may cause acute renal failure (azotemia, increased serum Cr, electrolyte abnormalities)

- Inadequate hydration and consistent aminoglycoside use are the most important risk factors for renal toxicity

- hearing loss, neurotoxicity, blurred vision, hiccups, increased LFT, and alopecia

- Anaphylaxis reactions may occur in patients with prior exposure to platinum and/ or more than 6 courses

Clindamycin

- use in caution with a history of colitis or other GI diseases

- if persistant diarrhea occurs, stop use

- GI (pseudomembranous colitis)

- leukopenia, anemia, thrombocytopenia, hepatotoxicity, and rash

Dantrolene

- do not use in patients with active hepatic disease and where spasticity is used to maintain posture or balance

- BBW for hepatotoxicity

- drowsiness, dizziness, rash, diarrhea, vomiting, muscle weakness, blurred vision, respiratory depression

Daptomycin

- contraindicated in patients with hypersensitivity to daptomycin

- Diarrhea may be a sign of pseudomembranous colitis

- may cause an increase CPK

- peripheral neuropathy

- GI (constipation, NVD), injection site reaction, headache, insomnia, rash

- less commonly: fever, dizziness, hypotension, elevated CPK, secondary infections, renal failure, anemia, dyspnea, and muscle pain

Darbepoetin

- contraindicated in patients with uncontrolled hypertension

- High hemoglobin increases risks of CV events and death

- infection, hypertension, hypotension, myalgia, headache, NVD

- most frequent severe: thrombotic events, CHF, sepsis, and cardiac arrhythmia

- theoretical risk of viral disease transmission

Dexamethasone

- use in caution with patients at risk for infectious processes

- Avoid in pt with peptic ulcer disease

- arrhythmias, premature ventricular contractions, nervousness, insomnia, irritability, hyperkinesia, psychosis, cushings hyperthyroid, hypercalcemia, peptic ulcers, GI bleed, pancreatitis, vaginitis, glaucoma, cataracts, pulmonary edema, cutaneous reactions, lipodystrophy, and osteoporosis

Diazepam

- may cause hypotension and/or respiratory depression when given too rapidly by the parenteral route

- may impair mental alertness and physical coordination

- blood dyscrasias, thrombophlebitis, sedation, hypotension, bradycardia, and respiratory depression

Digoxin

- do not use in ventricular fibrillation and certain arrhythmias

- may cause transient elevation in BP when given IV

- main risk of toxicity

- toxicity: GI, CNS (HA, visual disturbances, malaise), hyperkalemia, arrhythmias

- may cause gynecomastia, vaginal changes, and local cutaneous reactions

Diltiazem

- do not use in patients with severe left ventricular dysfunction, severe or moderate cardiac failure, severe hypotension, radiographically documented pulmonary congestion, sick sinus syndrome, or second/ third-degree AV block

- IV use may cause hypotension, heart failure (with concomitant beta-blockers), peripheral edema, and fatigue

Diphenhydramine

- do not use in patients with asthmatic attacks due to potential thickening of secretions

- Due to anticholinergic properties, it should be administered with caution in glaucoma, prostatic hypertrophy, stenosing peptic ulcer, pylorodudenal obstruction, or bladder neck obstruction

- CNS depression, sensitivity reactions, and anticholinergic effects

Dobutamine

- do not give to patients with idiopathic hypertrophic subaortic stenosis

- correct hypovolemia before use

- ectopic heartbeats, elevated heart rate, angina, chest pain, and elevation in blood pressure

- may also cause a large decrease in blood pressure, which may not be reversible

- extravasation may lead to local phlebitis and/or tissue necrosis

Dolasetron

- in patients hypersensitive to dolasetron

- HA, diarrhea, bradycardia, tachycardia, abnormal hepatic function, dizziness, fatigue, and sedation

Dopamine

- do not use in patients with pheochromocytoma and in patients with tachyarrhythmias and/ or ventricular fibrillation

- may cause angina, tachycardia, ectopic heartbeats, hypotension, angina, vasoconstriction, palpitations, dyspnea, nausea, vomiting, and headache

- if extravasation occurs immediently treat with phentolamine

Doripenem

- do not use in patients with known sensitivity to doripenem, cephalosporins, penicillins, or any beta-lactam antibiotic

- Headache and rash are the most common

- nd, anemia, renal failure, elevated LFTs, and oral candidiasis

- SJS, interstitial pneumonia, and toxic epidermal necrolysis have been reported

Doxycycline

- use in caution in patients with renal/hepatic impairment

- increased muscle weakness in myasthenia gravis

- tooth discoloration, photosensitivity, nausea, and thrombophlebitis

- nephro/ hepatic toxicity

Doperidol

- Due to severe hypotension, corrective measures should be ready to initiate

- Caution when using with other CNS depressants

- do not use in patients with a history of hypersensitivity to haloperidol or other butyrophenones

Drotrecogin

- do not use in patients with single organ dysfunction and recent surgery

- use in caution with high bleed risk

-antibody formation, ecchymosis, GI bleeding, hematoma, hematuria, petechiae, purpura, thromboembolism, and vaginal bleeding

- bleeding events are ecchymoses and GI bleeds

Enalaprilat

- should be used in cautiong with patients with sodium depletion or hypovolemia as hypotension may occur

- angioedema

- orthostatic hypotension, HA, dizziness, GI, poor taste perception, and cough

Enoxaparin

- contraindicated in patients hypersensitive to heparin, pork products, benzyl alcohol, or sulfites, and in patients with a history of heparin-induced thrombocytopenia or active major bleeding

- Epidural or spinal hematomas have been reported

- local reactions at the site of injection

- hemorrhage, edema, and anemia

Epinephrine

- contraindicated in patients with profound hypoxia, hypercapnia, and those receiving certain general anesthetics

- Use caution in patients with hypovolemia and hyperthyroidism

- edema, decreased cardiac output, and plasma volume reduction

- HA, tremor, restlessness, reduced renal blood flow, and cardiac arrhythmias

Epoetin

- contraindicated in patients with uncontrolled hypertension, known sensitivity to mammalian cell-derived products, or sensitivity to human albumin

- hypertension, venous fistula clotting, and functional iron deficiency

- rare: thrombocytosis, sweating, and bone pain

Ertapenem

- contraindicated in patients hypersensitive to other beta-lactam antibiotics

- IM administration contraindicated in patients allergic to lidocaine

- Persistent diarrhea is a sign of pseudomembranous colitis

- diarrhea, infused vein complication, nausea, headache, vaginitis, phlebitis/ thrombopheblitis, and vomiting

Erythromycin lactobionate

- Use extreme caution in patients with hepatic dysfunction or liver disease

- common: abdominal cramps, nausea, and vomiting

- less frequent: cholestatic jaundice, hepatitis, ototoxicity, and hypersensitivity reactions

Esomeprazole

- contraindicated in patients with hypersensitivity to esomeprazole or any substituted benzimidazole

- Atrophic gastritis has been experienced with long-term use

- HA, dizziness, itching, flatulence, nausea, diarrhea, xerostomia

- OD: confusion, drowsiness, blurred vision, tachycardia, nausea, and sweating

Famotidine

- Symptomatic response should not be interpreted as precluding the presence of gastric malignancy

-excreted by the kidneys and should be used in caution in those with renal impairment

- common: headache, dizziness, constipation, and diarrhea

- changes in hepatic function tests may occasionally require D/C

-

Fentanyl

- should be used in caution in patients with known hypersensitivity to other opiate agonists, bradycardia and severe renal/hepatic impairment

- use caution in COPD and other chronic respiratory conditions

- respiratory and circulatory depression

- dizziness, sedation, coma, and dysphoria

- NV, constipation, and urinary retention

- tolerance and dependence

- skeletal muscle and thoracic muscle rigidity may occur after rapid IV administration

Filgrastim

- contraindicated in patients with known sensitivity to any proteins derived from E.coli

- CBC / platelets should be done twice weekly due to the risk of leukocytosis and thrombocytopenia

- common: bone pain

- rare: fever, elevation of serum uric acid levels, local cutaneous reactions, occasionally splenomegaly

Fluconazole

- Should be used in caution in patients with known hypersensitivity to other triazole or imidazole antifungal agents

- stop use if signs of renal or hepatic impairment occur

- Patients who develop a rash should be closely monitored in case of rare exfoliative disorders

- minimal ADR, NV, and elevations in liver function tests

- Hypokalemmia has been observed in patients with myeloid leukemia

- fever, edema, pleural effusion, oliguria, and arthralgia/myalgias

Foscarnet

- contraindicated in patients with hypersensitivity to foscarnet

- discontinue if CrCl <0.4

- fever, HA, hypokalemia, hypocalcemia, hypomagnesemia, hypophatemia, NVD, anemia, and granulocytopenia

- alter creatine clearance/ renal function

Fosphenytoin

- contraindicated in patients with known hypersensitivity to other hydantoin agents and in patients with sinus bradycardia, sinoatrial block, second or third degree atrioentricular blockm adam-stokes syndrome

- may cause cardiovascular collapse and/ or central nervous system depression

- exfoliative dermatitis, SJS, lymphadenopathy, and blood dyscrasias

- hirsuitism, gingival hyperplasia, thrombophlebitis, tissue necrosis at ithe njection site, osteomalacia, and GI

Furosemide

- contraindicated in patients with anuria

- should be used with caution in patientswith hepatic cirrhosis, diabetics, or increasing azotemia, and/or oliguria

- common: fluid and electrolyte imbalance, hypotension, hyperglycemia, hyperuricemia, and hypokalemia

- thrombophlebitis at the injection site, blood dyscrasias, and ototoxicity

Ganciclovir

- contraindicated in patients with known hypersensitivity to acyclovir

- hematologic toxicity

- common: bone marrow suppression (anemia, leukopenia, neutropenia, thrombocytopenia)

- less severe: fever, edema, phlebitis, HA, disorientation, nausea, anorexia, rash, and myalgia

Gatifloxacin

- contraindicated in patients with a hypersensitivity to quinolones and in patients with diabetes

- may prolong the QT interval

- HA, dizziness, ND

- rare: SJS, seizures, hyperglycemia or hypoglycemia, tachycardia, and torsades de pointes

Gentamicin

- contraindicated in patients with known hypersensitivity to other aminoglycoside agents

- Use caution in patients receiving other nephrotoxic, ototoxic, or neurotoxic drugs.

- nephrotoxicity and ototoxicity, neuromuscular blockade

- hypomagnesemia, hypocalcemia, and rarely anaphylatic shock, blood dyscrasias

Granisetron

- contraindicated in patients with previous hypersensitivity to it or other 5HT3 receptor antagonists

- HA, constipation, musculoskeletal weakness, and hypertension

- pain, fever, dizziness, insomnia, somnolence, anxiety, agitation, rash

Haloperidol

- due to severe hypotension, corrective measures should be ready

- use caution with other CNS depressants, tardive dyskinesia, Parkinson's, and other extrapyramidal symptoms

- most common is extrapyramidal reactions (tardive dyskinesia) and other CNS reactions

- hypotension, tachycardia, respiratory depression, cogwheel reactions, akathisia, EEG changes, and an acutely dangerous reaction caused by neuroleptic malignant syndrome