8. Flashcards
What medications should be used in caution in IHD?
- NSAIDs
- oestrogens: e.g. combined oral contraceptive pill, hormone replacement therapy
- varenicline
What’s type A adverse reaction?
common, predictable and dose-related
What’s type B adverse reaction?
Type B (idiosyncratic)
bizzare and unexpected reaction related to gene/host/environmental factors
P450 system inducers
- antiepileptics: phenytoin, carbamazepine
- barbiturates: phenobarbitone
- rifampicin
- St John’s Wort
- chronic alcohol intake
- griseofulvin
- smoking (affects CYP1A2, reason why smokers require more aminophylline)
P450 inhibitors
- ntibiotics: ciprofloxacin, clarithromycine/erythromycin
- isoniazid
- cimetidine,omeprazole
- amiodarone
- allopurinol
- imidazoles: ketoconazole, fluconazole
- SSRIs: fluoxetine, sertraline
- ritonavir
- sodium valproate
- acute alcohol intake
- quinupristin
SEs of Gentamycin and Vancomycin
- ototoxicity
- nephrotoxicity
SEs of any antibiotics bit most commonly broad-spectrum e.g. Cephalosporins, ciprofloxacin
C difficile colitis
SEs of ACE0 inhibitors
- hypotension
- electrolyte imbalance
- AKI
- dry cough
Do beta-blockers help or worsen heart failure?
- Worsen ACUTE HF
- Help CHRONIC HF
SEs of beta-blockers
- hypotension
- bradycardia
- wheeze in asthmatics
- worsen acute HF (help with chronic)
SEs of Calcium-channel blockers e.g. amlodipine, diltiazem
- hypotension
- bradycardia
- peripheral oedema
- flushing
SEs of diuretics (overal)
- hypotension
- electrolyte abnormalities
- AKI
* then sub-class dependent effects e.g. gynecomastia with spironolactone
SEs of Heparin
- haemorrhage (especially if <50 kg or renal failure)
- heparin-induced thrombocytopenia
What to do when we prescribe Warfarin (at the beginning of the treatment)?
To start with Warfarin has a pro-coagulant effect and it takes few days to become anti-coagulant
Therefore heparin should be prescribed alongside Warfarin - until INR is above 2
SEs of Aspirin
- haemorrhage
- peptic ulcers
- gastritis
- tinnitus (in large doses)
