SIDE EFFECT RECOGNITION EXAM 3 PHARM

A patient has fever, sweating, tremors, diarrhea, agitation, and confusion after starting an antidepressant. Which drug/class pattern is most likely? A. SSRI serotonin syndrome B. Lithium toxicity C. Opioid respiratory depression D. Rebound congestion

Correct: A. SSRI serotonin syndrome. Why: The symptom cluster is serotonin syndrome. Know it cold: Fever + tremor + diarrhea + confusion after antidepressant = serotonin syndrome.

A patient has vomiting, diarrhea, coarse tremor, confusion, and ataxia while taking a mood stabilizer. Which medication is most likely involved? A. Lithium B. Sertraline C. Albuterol D. Fluticasone

Correct: A. Lithium. Why: This is lithium toxicity pattern. Know it cold: GI symptoms + coarse tremor + confusion/ataxia = lithium toxicity.

A patient has dry mouth, constipation, urinary retention, blurred vision, sedation, and confusion. Which medication/class is most likely? A. TCA or first-generation antihistamine B. Albuterol C. Montelukast D. Acetylcysteine

Correct: A. TCA or first-generation antihistamine. Why: This is an anticholinergic pattern. Know it cold: Dry + constipated + urinary retention + blurred vision = anticholinergic.

A patient has acute neck spasms, jaw tightness, and abnormal eye movements after an antipsychotic. Which reaction is most likely? A. Acute dystonia/EPS B. Serotonin syndrome C. Lithium toxicity D. Opioid toxicity

Correct: A. Acute dystonia/EPS. Why: Antipsychotic dopamine blockade can cause dystonia. Know it cold: Antipsychotic + spasms/abnormal movements = EPS.

A patient taking an antipsychotic has fever, severe muscle rigidity, confusion, and unstable blood pressure. Which complication is most likely? A. Neuroleptic malignant syndrome B. SSRI common side effects C. Rebound congestion D. Mucolytic effect

Correct: A. Neuroleptic malignant syndrome. Why: Fever, rigidity, mental status change, and autonomic instability suggest NMS. Know it cold: Antipsychotic + fever + rigidity + confusion = NMS.

A patient has severe sedation, slurred speech, poor coordination, and shallow respirations after taking anxiety medication. Which drug class is most likely? A. Benzodiazepine B. SSRI C. Beta-agonist D. Leukotriene blocker

Correct: A. Benzodiazepine. Why: Benzodiazepines cause CNS depression and can depress respirations. Know it cold: Benzo + sedation + shallow respirations = priority.

A patient has tremor, palpitations, nervousness, and tachycardia after using a rescue inhaler. Which medication is most likely? A. Albuterol B. Codeine C. Fluticasone D. Phenelzine

Correct: A. Albuterol. Why: Albuterol beta stimulation causes tremor and tachycardia. Know it cold: Rescue inhaler + shaky/palpitations = albuterol.

A patient has nausea, vomiting, insomnia, tremor, tachycardia, and seizure activity while on a bronchodilator requiring serum levels. Which drug is most likely? A. Theophylline B. Montelukast C. Ipratropium D. Prednisone

Correct: A. Theophylline. Why: Theophylline has a narrow therapeutic range and can cause seizures/dysrhythmias in toxicity. Know it cold: Theophylline toxicity = GI + CNS + cardiac symptoms.

A patient develops high blood glucose, mood changes, fluid retention, and infection signs while taking a systemic anti-inflammatory respiratory medication. Which medication is most likely? A. Prednisone B. Albuterol C. Ipratropium D. Codeine

Correct: A. Prednisone. Why: Systemic steroids cause hyperglycemia, mood changes, fluid retention, and infection risk. Know it cold: Prednisone = steroid systemic effects.

A patient using an inhaled steroid develops hoarseness and white patches in the mouth. Which medication is most likely? A. Fluticasone B. Albuterol C. Lithium D. Lorazepam

Correct: A. Fluticasone. Why: Inhaled corticosteroids can cause oral candidiasis. Know it cold: Fluticasone = rinse mouth to prevent thrush.

A patient has orange-red tears and urine after starting TB therapy. Which medication is most likely? A. Rifampin B. Isoniazid C. Ethambutol D. Albuterol

Correct: A. Rifampin. Why: Rifampin can discolor body fluids. Know it cold: Rifampin = orange body fluids.

A patient taking a TB medication reports blurred vision and trouble distinguishing red from green. Which drug is most likely? A. Ethambutol B. Rifampin C. Codeine D. Montelukast

Correct: A. Ethambutol. Why: Ethambutol can cause optic/visual toxicity. Know it cold: Ethambutol = vision changes.

A patient taking a TB medication reports numbness and tingling in the hands and feet. Which medication is most associated? A. Isoniazid B. Fluticasone C. Sertraline D. Oxymetazoline

Correct: A. Isoniazid. Why: Isoniazid can cause peripheral neuropathy. Know it cold: Isoniazid = neuropathy; B6 often used.

A patient has worsening nasal congestion after using a decongestant nasal spray several times daily for a week. Which medication is most likely? A. Oxymetazoline B. Albuterol C. Diphenhydramine D. Acetylcysteine

Correct: A. Oxymetazoline. Why: Overuse can cause rebound congestion. Know it cold: Oxymetazoline overuse = rebound congestion.

A patient has nightmares, depression, agitation, and suicidal thoughts after starting an asthma prevention medication. Which drug is most likely? A. Montelukast B. Albuterol C. Ipratropium D. Acetylcysteine

Correct: A. Montelukast. Why: Montelukast may cause serious neuropsychiatric effects. Know it cold: Montelukast = report mood/behavior changes.

A patient has decreased appetite, insomnia, tachycardia, and improved attention after starting an ADHD medication. Which drug is most likely? A. Methylphenidate B. Zolpidem C. Chlorpromazine D. Valproic acid

Correct: A. Methylphenidate. Why: Methylphenidate is a stimulant with appetite/sleep/HR effects. Know it cold: Stimulant + appetite loss/insomnia/↑HR = methylphenidate.

A patient has sleepwalking, preparing food while not fully awake, and no memory of the event after taking a sleep medication. Which drug is most likely? A. Zolpidem B. Sertraline C. Lithium D. Albuterol

Correct: A. Zolpidem. Why: Zolpidem can cause complex sleep behaviors. Know it cold: Zolpidem = sleep activity with no memory.

A patient has cough relief but also constipation, sedation, pinpoint pupils, and shallow breathing. Which medication is most likely? A. Codeine B. Montelukast C. Fluticasone D. Oxymetazoline

Correct: A. Codeine. Why: Codeine is an opioid antitussive with opioid adverse effects. Know it cold: Codeine = cough suppression + respiratory depression risk.

A patient has thick secretions that become easier to cough up after receiving a sulfur-smelling medication. Which medication is most likely? A. Acetylcysteine B. Lorazepam C. Lithium D. Phenelzine

Correct: A. Acetylcysteine. Why: Acetylcysteine is a mucolytic with a sulfur-like odor. Know it cold: Acetylcysteine = thins secretions.

A patient taking phenelzine eats aged cheese and develops severe headache, chest pain, and very high blood pressure. Which problem is most likely? A. Hypertensive crisis B. Serotonin syndrome C. Theophylline toxicity D. Rebound congestion

Correct: A. Hypertensive crisis. Why: MAOIs plus tyramine can cause dangerous hypertension. Know it cold: MAOI + tyramine = hypertensive crisis.