ADR exam q notes Flashcards
Antacids interactions
- Quinolones (cipro, levo, oflo) – 2 hrs before or 4 hrs after
- Tetracyclines – 2-3 hrs gap
- Itraconazole – 2 hrs before, 1 hr after
- Digoxin – separate by 2 hrs
- Rosuvastatin – separate by 2 hrs
- Ibandronic – avoid for at least 6 hrs before or 1 hr after
- Alendronate – separate by 2 hrs
- Levothyroxine – separate by 4 hrs
- Iron – 1 hr before or 2 hrs after
Iron drug interactions
1) antacids - iron 1 hours before or 2 hours after. iron absorption reduced.
2) calcium - iron 1 hours before or 2 hours after - iron absorption reduced
3) clozapine: risk of intestinal obstruction - caution
4) quinolones (ciprofloxacin, levofloxacin, ofloxacin) - separate by 2 hours at least
5) tetracyclines (doxycycline) Abx 2-3 hours AFTER iron
6) bisphosphonates e.g., residronate, alendronic acid - separate by at least 2 hours
7) carbidopa - may reduce effectiveness of carbidopa
8) levothyroxine - space admin by at least FOUR HOURS - thyroxine reduced absorption 9) methyldopa - may reduce effectiveness of methyldopa
Which drug causes colour vision changes?
Tranexamic acid
serious side effect - report
Tranexamic acid and warfarin
reduce effect of drugs
Which drug causes halitosis?
Disulfiram
Reacts with gram - bacteria
Sildenfafil + doxazosin
Hypotensive effect
Antiemetics to avoid in PD
- metoclopramide and prochloperazine
- can worsen symptoms
- can induce acute dystonic reactions involving facial and skeletal muscle spasms
What electrolyte imbalance does lithium cause?
Hyponatraemia
Drugs to avoid in peanut allergy
o Arachis oil,
o Estriol cream
o Utrogesten
o Cortiment
o Abidec multivitamin drop
o Desogestrel brands (e.g., feanolla, lovima, moonia)
o Naseptin cream
CYP enzyme inducers
CRAP GPS
Carbemazepines
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas
CYP enzyme inhibitors
SICKFACES.COM
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol & Grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
Drugs that cause folate deficiency
MAT
- Methotrexate
- Anticonvulsants
- Trimethoprim
Which drug causes binge eating disorder
Bromocriptine
Apomorphine
Lacosamide SE
dizziness, false or unusual sense of well being shakiness and unsteady walk
Are mirtazipine sedative effects greater at higher or lower doses?
Lower
ANAESTHESIA + ACEI/ARB
- severe hypotension
- Induction of anaesthesia
- May need to be discontinued 24 hrs before surgery
Drugs that cause B12 deficiency
- metformin
- PPI
- Colchicine
Amiodarone SE
Pulmonary toxicity
Diuretic with risk of non melanoma skin cancer
Hydrochlorothiazide
Which drug causes tendonitis
Ciprofloxacin
Which DPP4i is preferred in renal impairment?
Linagliptin
Which DPP4i is preferred in liver impairment?
Linagliptin and sitagliptin
Which drug causes dark yellow,and occasionally brown urine?
Nitrofurantoin
What colour does nitrofurantoin turn urine?
dark yellow, and occasionally brown urine
What colour does rifampicin turn urine?
reddish-orange
Which drugs are likely to cause hyperthyroidism
Levothyroxine
Liothyronine
Lithium
Amiodarone
Olanzapine + methotrexate
Agranulocytosis
Drugs that can cause gout
ACEi
BB
Diuretics
Domperidone + fluconazole =
QT interval
Spironolactone + furosemide =
hyponatraemia
Which drug can be continued before surgery and would not require any peri operative advice
Levetiracetam
Levothyroxine
Which antidiabetic drug can cause pancreatitis?
GLP1 agonists
What electrolyte imbalance occurs in SBS?
hypomagnesemia
Which treatment is not appropriate in SBS?
Metoclopramide
Simvastatin + amlodipine
- increased risk of rhabdomyolsis
- ensure simvastatin max dose 20mg
Nitrate therapy ADR
- Headache, flushing
- Palps, syncope
Lithium monitoring
- BMI
- eGFR
- thyroid function
- U&Es
olanzapine and smoking
Reduce the dose of olanzapine in quitting smoking, as olanzapine levels can increase
Epilepsy and EHC
Refer - IUD fitted
Zolendronic acid main SE
Reduced dental mobility
osteonecrosis of the jaw
Which drugs are likely to cause Lichen Planus?
rash
TLD
What is the most important monitoring req for mirabegron?
BP
What drugs increase the anticoagulant effect of warfarin?
- Clarithromycin
- Doxycycline
- Erythromycin
- Metronidazole
What drugs decrease the anticoagulant effect of warfarin?
Rifampicin
Testosterone exposure in children
Premature puberty and genital enlargement in children in close physical contact with adult using topical testosterone
Nitrofurantoin main ADR
pulmonary and hep
Which gout treatment is cautioned in CVD?
Febuxostat
rivaroxaban + dipyrimadole
increased risk of bleeding
cytotoxic drugs which formulations are not interchangeable
paclitaxel
Which drugs are CI in acute porphyrias?
clindamycin, pizotifen, tamoxifen, verapamil
sildenafil is OK
Levonorgestrel + phenobarbital
decreases the conc of levonorgestrel, so need to increase the dose
What is the antidote for anticholinergic poisioning/overdose? →
physostigmine
What choice of anaphylaxis is appropriate for a child from age 12 years to 17 years old in case of an emergency in the pharmacy? →
adrenaline injection 1mg/mL IM 500mcg (300mcg if small or prepubertal) - repeat after 5 minutes if necessary
What choice of anaphylaxis is appropriate for a child up to 6 months in case of an emergency in the pharmacy? →
adrenaline injection 1mg/mL IM child up to 6m: 100-150mcg (repeated after 5 minutes if necessary)
What drugs cause gynaecomastia
REMEMBER ‘BOOBS TF’ -
- Bicalutamide
- Omeprazole (PPIs is very rare),
- Oestrogen (diethylstillbesterol indicated for prostate cancer),
- Blockers H2 receptors (cimetidine/famotidine)
- Spironolactone
- Testosterone
- Finesteride
What choice of anaphylaxis is appropriate for a child from age 6 months to 5 years old in case of an emergency in the pharmacy? →
adrenaline injection 1mg/mL IM 150mcg (repeated after 5 minutes if necessary)
