Objective: Retrieve the information of drugs and their adverse effects using online tools
1. Metformin HCL
Brand Name: Fortamet, Glumetza
Metformin is used to control high blood sugar. It is used with a proper diet and exercise program and possibly with other medications. It is used in patients with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metformin works by helping to restore your body’s proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb.
- Nausea, vomiting, stomach upset, or a metallic taste in the mouth may occur.
- physical weakness (asthenia), diarrhea, gas (flatulence)
- symptoms of weakness, muscle pain (myalgia)
- upper respiratory tract infection
- low blood sugar (hypoglycemia)
- abdominal pain (GI complaints), lactic acidosis (rare)
- low blood levels of vitamin B-12
- chest discomfort
- chills, dizziness, bloating/abdominal distention, constipation, heartburn
- stomach symptoms return later (after taking the same dose for several days or weeks).
- Stomach symptoms that occur after the first days of your treatment may be signs of lactic acidosis
- Low blood sugar may occur if this drug is prescribed with other diabetesmedications. (Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet.)
- allergic reaction (such as rash, itching/swelling -especially of the face/tongue/throat; severe dizziness, trouble breathing) to this drug is rare.
Brand Name: Cytotec, Arthrotec
Used to prevent stomach ulcers while someone take NSAIDs ( e.g., aspirin, ibuprofen, naproxen) , especially if you are at risk for developing ulcers or have a history of ulcers. Misoprostol helps to decrease the risk of serious ulcer complications such as bleeding. This medication protects your stomach lining by lowering the amount of acid that comes in contact with it. This medication is also used in combination with another drug (mifepristone) to end a pregnancy (abortion).
- Nausea or stomach cramps may occur
- Diarrhea is common with misoprostol and usually occurs about two weeks after start taking it, and lasts for about a week. Persistent diarrhea may sometimes lead to a large loss of body’s water and minerals.
- severe dizziness, decreased urination, mental/mood changes, muscle weakness, slow/irregular heartbeat.
- menstrual problems or irregularities, unusual/heavy vaginal bleeding may occur.
3. Azithromycin Tablet
Brand Name: Zithromax Used to prevent and treat a very serious type of infection (mycobacteria). It is a macrolide-type antibiotic. It works by stopping the growth of bacteria. This medication will not work for viral infections (such as common cold, flu). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness. Zithromax Z-PAK (azithromycin) is a semi-synthetic macrolide antibiotic used for treating: otitis media (middle ear infection), tonsillitis, laryngitis, bronchitis, pneumonia, and sinusitis caused by susceptible bacteria.
- diarrhea or loose stools,
- abdominal pain,
- stomach upset,
- vaginal itching or discharge,
- sleep problems (insomnia),
- skin rash or itching,
- ringing in the ears,
- hearing problems,
- or decreased sense of taste or smell.
- Cardiovascular: Palpitations and chest pain.
- Gastrointestinal: Dyspepsia, flatulence, vomiting, melena, and cholestatic jaundice.
- Genitourinary: Monilia, vaginitis, and nephritis.
- Nervous System: Dizziness, headache, vertigo, and somnolence.
- General: Fatigue.
- Allergic: Rash, photosensitivity, and angioedema.
4. Doxycycline Calcium Oral
Brand Name: Vibramycin
Doxycycline Calcium Oral is a tetracycline antibiotic used to treat many different bacterial infections, such as urinary tract infections, acne, gonorrhea, and chlamydia, periodontitis (gum disease), and others. It is also used to treat blemishes, bumps, and acne-like lesions caused by rosacea. Vibramycin Oral is available in generic form.
- stomach upset,
- skin rash,
- itching, or
- vaginal itching or discharge
- Gastrointestinal: anorexia, nausea, vomiting, diarrhea, glossitis, dysphagia, enterocolitis, inflammatory lesions (with monilial overgrowth) in the anogenital region, and pancreatitis. Hepatotoxicity has been reported rarely. These reactions have been caused by both the oral and parenteral administration of tetracyclines. Superficial discoloration of the adult permanent dentition, reversible upon drug discontinuation and professional dental cleaning has been reported. Permanent tooth discoloration and enamel hypoplasia may occur with drugs of the tetracyclineclass when used during tooth development. (See WARNINGS)
- Skin: maculopapular and erythematous rashes. Exfoliative dermatitis has been reported but is uncommon. Photosensitivity is discussed above. (See WARNINGS)
- Renal toxicity: Rise in BUN has been reported and is apparently dose related. (See WARNINGS)
- Immune: Hypersensitivity reactions including urticaria, angioneurotic edema, anaphylaxis, anaphylactoid purpura, pericarditis, exacerbation of systemic lupus erythematosus, and drug reaction with eosinophilia and systemic symptoms (DRESS).
- Other: Bulging fontanels in infants and intracranial hypertension in adults. (See WARNINGS)
- Blood: Hemolytic anemia, thrombocytopenia, neutropenia and eosinophilia have been reported.
- When given over prolonged periods, tetracyclines have been reported to produce brown-black microscopic discoloration of thyroid glands. No abnormalities of thyroid function studies are known to occur.
5. Anthrax Vaccine Adsorbed Emergent Biosolutions
Brand Name: BioThrax
It is an immunization used to help prevent anthrax disease in people exposed to the bacteria through the skin or lungs. BioThrax vaccine works by exposing you to an antigen protein that causes your body to develop immunity to the disease. BioThrax does not contain live or killed forms of the bacteria that cause anthrax. BioThrax vaccine will not treat an active infection. Common side effects of BioThrax include injection site reactions (pain, redness, swelling, warmth, itching, or tenderness), limited arm movement or stiffness in the injected arm, joint or muscle ache or pain, headache, dizziness, tiredness, weakness, low fever, swelling in your hands or feet, or skin rash.
- mild redness, swelling, or tenderness where the shot was given;
- trouble moving the injected arm;
- muscle pain;
- tired feeling; or
- The most common ( ≥ 10%) local (injection-site) adverse reactions observed in clinical studies were tenderness, pain, erythema, edema, and arm motion limitation. The most common ( ≥ 5%) systemic adverse reactions were muscle aches, headache, and fatigue.
Brand Name: Cipro
This drug is a quinolone antibiotic. Cipro is available as a generic drug and is prescribed to treat infections of the skin, lungs, airways, bones, joints, and urinary tract infections caused by susceptible bacteria.
- stomach pain/stomach upset
- vaginal itching or discharge
- abnormal liver function tests
- abdominal pain
- blurred vision
- sleep problems (insomnia or nightmares), and
- Ciprofloxacin can cause serious side effects, including tendon problems, side effects on your nerves (which may cause permanent nerve damage), serious mood or behavior changes (after just one dose), or low blood sugar (which can lead to coma).
Some other effects are:
- Disabling and Potentially Irreversible Serious Adverse Reactions
- Tenditits and Tendon Rupture
- Peripheral Neuropathy
- Central Nervous System Effects
- Exacerbation of Myasthenia Gravis
- Other Serious and Sometimes Fatal Adverse Reactions
- Hypersensitivity Reactions
- Serious Adverse Reactions with Concomitant Theophylline
- Clostridium difficile-Associated Diarrhea
- Prolongation of the QT Interval
- Musculoskeletal Disorders in Pediatric Patients
- Development of Drug Resistant Bacteria
Brand Name: Noroxin
Noroxin (norfloxacin) is a fluoroquinolone antibiotic used to treat bacterial infections of the prostateand urinary tract. Noroxin also treats gonorrhea.
- abdominal cramping
- stomach cramps,
- rectal pain,
- muscle and joint aches,
- back pain,
- vaginal itching or discharge, or
- abdominal pain, back pain, constipation, diarrhea, dry mouth, dyspepsia/heartburn, fever, flatulence, hyperhidrosis, loose stools, pruritus, rash, somnolence, and vomiting.
Brand Name: Amoxil
Amoxil (amoxicillin) is a penicillin-type antibiotic used to treat infections caused by bacteria that are B-lactamase negative (B-lactamase positive bacteria are usually resistant to Amoxil); these infections usually occur in the skin, lungs, urinary tract and eye, ears, nose, and throat. Amoxil is available as a generic drug termed amoxicillin. Amoxil may be combined with other drugs (for example, clavulanic acid [Augmentin]), to make the antibiotic more effective.
- stomach pain
- vaginal itching or discharge
- rash, and
- swollen, black, or “hairy” tongue.
Other serious side effects of Amoxil include:
- colitis caused by overgrowth of Clostridium spp in the intestines
- jaundice, and
- Hemic and Lymphatic Systems: Anemia, including hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis have been reported. These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena.
- Central Nervous System: Reversible hyperactivity, agitation, anxiety, insomnia, confusion, convulsions, behavioral changes, and/or dizziness have been reported
- Tooth discoloration (brown, yellow, or gray staining) has been reported. Most reports occurred in pediatric patients. Discoloration was reduced or eliminated with brushing or dental cleaning in most cases.
Brand Name: Trobicin
Trobicin (spectinomycin) For Injectable Suspension is an antibiotic used to treat gonorrhea. Common side effects of Trobicin include nausea, dizziness, soreness at the injection site, hives, insomnia, chills, and fever.
- soreness at the injection site
- During multiple dose subchronic tolerance studies in normal human volunteers, the following were noted: a decrease in hemoglobin, hematocrit and creatinine clearance; elevation of alkaline phosphatase, BUN and SGPT. In single and multiple dose studies in normal volunteers, a reduction in urine output was noted. Extensive renal function studies demonstrated no consistent changes indicative of renal toxicity.
- A few cases of anaphylaxis or anaphylactoid reactions have been reported. If serious allergic reactions occur, the usual agents (epinephrine, corticosteroids, and/or antihistamines) should be available for emergency use. In cases of severe anaphylaxis, airway support and oxygen may also be required.
Brand Name: Retrovir
Retrovir (zidovudine) is an antiviral medication used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Retrovir is also given during pregnancy to prevent an HIV-infected woman from passing the virus to her baby. Retrovir is not a cure for HIV or AIDS. Retrovir is available in generic form.
- trouble sleeping (insomnia),
- loss of appetite,
- joint pain, and
- changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk).
Some other serious side effects of Retrovir may occur including:
- unexplained weight loss,
- persistent muscle aches or weakness,
- joint pain,
- numbness or tingling of the hands/feet/arms/legs,
- severe tiredness,
- vision changes,
- severe or persistent headaches,
- signs of infection (such as fever, chills, trouble breathing, cough, non-healing skin sores),
- signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter), or
- signs of a certain nerve problem known as Guillain-Barre Syndrome (such as difficulty breathing/swallowing/moving your eyes, drooping face, paralysis, slurred speech).
- Hematologic toxicity, including neutropenia and anemia
Lactic acidosis and severe hepatomegaly with steatosis
Hepatic decompensation in patients co-infected with HIV-1 and hepatitis C
- Nervous : Anxiety, confusion, depression, dizziness, loss of mental acuity, mania, paresthesia, seizures, somnolence, vertigo.
- Hematologic:Aplastic anemia, hemolytic anemia, leukopenia, lymphadenopathy, pancytopenia with marrow hypoplasia, pure red cell aplasia.
- Hepatobiliary: Hepatitis, hepatomegaly with steatosis, jaundice, lactic acidosis, pancreatitis.
- Musculoskeletal : Increased CPK, increased LDH, muscle spasm, myopathy and myositis with pathological changes (similar to that produced by HIV-1 disease), rhabdomyolysis, tremor.
11. Emtricitabine and tenofovir alafenamide tablets
Brand Name: Descovy
Descovy (emtricitabine and tenofovir alafenamide) is a two-drug combination of two HIV nucleoside analog reverse transcriptase inhibitors (NRTIs), and is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection in adults and pediatric patients 12 years of age and older.
- changes in body fat distribution
- changes in your immune system
- new or worse kidney problems, including kidney failure,
- bone problems such as bone pain, softening, or thinning and fractures, or
- increased cholesterol.
- Severe Acute Exacerbations of Hepatitis B
- Immune Reconstitution Syndrome
- New Onset or Worsening Renal Impairment
- Lactic Acidosis/Severe Hepatomegaly with Steatosis
12. darunavir, cobicistat, emtricitabine, and tenofovir alafenamide tablets
Brand Name: Symtuza
Symtuza (darunavir, cobicistat, emtricitabine, and tenofovir alafenamide) is a four-drug combination of a human immunodeficiency virus (HIV-1) protease inhibitor, a CYP3A inhibitor, and two HIV-1 nucleoside analog reverse transcriptase inhibitors, and is indicated as a complete regimen for the treatment of HIV-1 infection in adults who have no prior antiretroviral treatment history or who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable antiretroviral regimen for at least 6 months and have no known substitutions associated with resistance to darunavir or tenofovir.
- abdominal discomfort, and
- Severe acute exacerbations of hepatitis B
- Severe skin reactions
- Immune reconstitution syndrome
- New onset or worsening renal impairment
- Lactic acidosis/severe hepatomegaly with steatosis
- Gastrointestinal Disorders: dyspepsia, pancreatitis (acute), vomiting
- Skin and Subcutaneous Tissue Disorders: angioedema, pruritus, Stevens-Johnson syndrome
- Metabolism and Nutrition Disorders: anorexia, diabetes mellitus, lipodystrophy
- Reproductive System and Breast Disorders: gynecomastia
- Musculoskeletal and Connective Tissue Disorders: myalgia, osteonecrosis
- Psychiatric Disorders: abnormal dreams
- Immune System Disorders: (drug) hypersensitivity, immune reconstitution inflammatory syndrome
- Hepatobiliary Disorders: acute hepatitis
13. benzhydrocodone and acetaminophen
Brand Name: Apadaz, Xodol
Apadaz (benzhydrocodone and acetaminophen tablets) is a combination of a prodrug of the opioidagonist hydrocodone and a non-narcotic pain reliever and fever reducer indicated for the short-term (no more than 14 days) management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.
- dizziness, and
- Addiction, Abuse, and Misuse
- Life-Threatening Respiratory Depression
- Neonatal Opioid Withdrawal Syndrome
- Interactions with Benzodiazepines and other CNS Depressants
- Adrenal Insufficiency
- Severe Hypotension
- Serious Skin Reactions
- Anaphylaxis and Other Hypersensitivity Reactions
- Gastrointestinal Adverse Reactions
- Gastrointestinal disorder: abdominal distension, abdominal pain, flatulence
- General disorders and administration site conditions: asthenia
- Nervous system disorders: presyncope, tremor
- Respiratory, thoracic and mediastinal disorders: dyspnea
- Vascular disorders: hot flush, hypotension
- Adverse reactions occurring at less than 1%: the following lists clinically relevant adverse reactions that occurred with an incidence of less than 1% in APADAZ clinical trials.
- Eye disorders: eye pruritus
- Gastrointestinal disorders: diarrhea, gastroesophageal reflux disease, haematemesis
- General disorders and administration site conditions: chest discomfort
- Infections and infestations: rhinitis
- Nervous system disorders: hypoesthesia, syncope
- Psychiatric disorders: agitation, euphoric mood, nightmare
Brand Name: Zestril
Zestril (lisinopril) is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a heart attack.
- upset stomach, and
- mild skin itching or rash.
- Body as a whole: Fatigue, asthenia, orthostatic effects.
- Digestive: Pancreatitis, constipation, flatulence, dry mouth, diarrhea.
- Hematologic: Rare cases of bone marrow depression, hemolytic anemia, leukopenia/neutropeniaand thrombocytopenia.
- Endocrine: Diabetes mellitus, inappropriate antidiuretic hormone secretion.
- Metabolic: Gout.
- Skin: Urticaria, alopecia, photosensitivity, erythema, flushing, diaphoresis, cutaneouspseudolymphoma, toxic epidermal necrolysis, Stevens – Johnson syndrome, and pruritus.
- Special Senses: Visual loss, diplopia, blurred vision, tinnitus, photophobia, taste disturbances, olfactory disturbance.
- Urogenital: Impotence.
- Miscellaneous: A symptom complex has been reported which may include a positive ANA, an elevated erythrocyte sedimentation rate, arthralgia/arthritis, myalgia, fever, vasculitis, eosinophilia, leukocytosis, paresthesia and vertigo. Rash, photosensitivity or other dermatological manifestations may occur alone or in combination with these symptoms.
- Metabolism and Nutrition Disorders
- Hyponatremia, cases of hypoglycemia in diabetic patients on oral antidiabetic agents or insulin
- Nervous System and Psychiatric Disorders
- Mood alterations (including depressive symptoms), mental confusion, hallucinations
- Skin and Subcutaneous Tissue Disorders
15. Sildenafil Tablet
Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice “safe sex” such as using latex condoms. Consult your doctor or pharmacist for more details.
- Dizziness, headache, flushing, or stomach upset may occur.
- Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur
- Rarely, sudden decreased vision, including permanent blindness, in one or both eyes (NAION) may occur.
- Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur.
- allergic reaction such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing to this drug is rare.
16. Spinal anaesthesia
Spinal anaesthesia is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long. It is a safe and effective form of anesthesia performed by nurse anesthetists and anesthesiologists which can be used as an alternative to general anesthesia commonly in surgeries involving the lower extremities and surgeries below the umbilicus. The local anesthetic or opioid injected into the cerebrospinal fluid provides anesthesia, analgesia, and motor and sensory blockade. The tip of the spinal needle has a point or small bevel. Recently, pencil point needles have been made available (Whitacre, Sprotte, Gertie Marx and others).
Complications of spinal anesthesia can result from the physiologic effects on the nervous system and can also be related to placement technique. Most of the common side effects are minor and are self-resolving or easily treatable while major complications can result in more serious and permanent neurological damage and rarely death. These symptoms can occur immediately after administration of the anesthetic or arise up to 48 hours after surgery.
- Mild hypotension
- Nausea and vomiting
- Transient neurological symptoms (lower back pain with pain in the legs)
- Urinary retention
- Post-dural-puncture headache or post-spinal headache – Associated with the size and type of spinal needle used
- Serious and permanent complications are rare but are usually related to physiologic effects on the cardiovascular system and neurological system or when the injection has been unintentionally at the wrong site. The following are some major complications:
- Nerve injuries: Cauda equina syndrome, radiculopathy
- Cardiac arrest
- Severe hypotension
- Spinal epidural hematoma, with or without subsequent neurological sequelae due to compression of the spinal nerves.
- Epidural abscess
- Infection (e.g. meningitis)
17. levothyroxine sodium
Brand Name: Levothroid
Levothroid (levothyroxine sodium) is a replacement for a hormone that is normally produced by your thyroid gland to regulate the body’s energy and metabolism used to treat hypothyroidism (low thyroid hormone). Levothroid is also used to treat or prevent goiter (enlarged thyroid gland), which can be caused by hormone imbalances, radiation treatment, surgery, or cancer.
- hair loss during the first few months of treatment.
- muscle weakness;
- headache, leg cramps;
- nervousness, trouble sleeping;
- diarrhea; or
- skin rash, partial hair loss.
Adverse reactions associated with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage They include the following:
- General: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating;
- Central nervous system: headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia;
- Musculoskeletal: tremors, muscle weakness;
- Cardiovascular: palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest;
- Respiratory: dyspnea;
- Gastrointestinal: diarrhea, vomiting, abdominal cramps and elevations in liver function tests;
- Dermatologic: hair loss, flushing;
- Endocrine: decreased bone mineral density; Reproductive: menstrual irregularities, impaired fertility.
- Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height.
- Seizures have been reported rarely with the institution of levothyroxine therapy.
- Inadequate levothyroxine dosage will produce or fail to ameliorate the signs and symptoms of hypothyroidism.
- Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur.
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