ADR exam q notes Flashcards

1
Q

Antacids interactions

A
  1. Quinolones (cipro, levo, oflo) – 2 hrs before or 4 hrs after
  2. Tetracyclines – 2-3 hrs gap
  3. Itraconazole – 2 hrs before, 1 hr after
  4. Digoxin – separate by 2 hrs
  5. Rosuvastatin – separate by 2 hrs
  6. Ibandronic – avoid for at least 6 hrs before or 1 hr after
  7. Alendronate – separate by 2 hrs
  8. Levothyroxine – separate by 4 hrs
  9. Iron – 1 hr before or 2 hrs after
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2
Q

Iron drug interactions

A

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

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3
Q

Which drug causes colour vision changes?

A

Tranexamic acid
serious side effect - report

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4
Q

Tranexamic acid and warfarin

A

reduce effect of drugs

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5
Q

Which drug causes halitosis?

A

Disulfiram
Reacts with gram - bacteria

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6
Q

Sildenfafil + doxazosin

A

Hypotensive effect

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7
Q

Antiemetics to avoid in PD

A
  • metoclopramide and prochloperazine
  • can worsen symptoms
  • can induce acute dystonic reactions involving facial and skeletal muscle spasms
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8
Q

What electrolyte imbalance does lithium cause?

A

Hyponatraemia

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9
Q

Drugs to avoid in peanut allergy

A

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

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10
Q

CYP enzyme inducers

CRAP GPS

A

 Carbemazepines
 Rifampicin
 Alcohol
 Phenytoin
 Griseofulvin
 Phenobarbitone
 Sulphonylureas

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11
Q

CYP enzyme inhibitors

A

SICKFACES.COM
 Sodium valproate
 Isoniazid
 Cimetidine
 Ketoconazole
 Fluconazole
 Alcohol & Grapefruit juice
 Chloramphenicol
 Erythromycin
 Sulfonamides
 Ciprofloxacin
 Omeprazole
 Metronidazole

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12
Q

Drugs that cause folate deficiency

A

MAT
- Methotrexate
- Anticonvulsants
- Trimethoprim

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13
Q

Which drug causes binge eating disorder

A

Bromocriptine
Apomorphine

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14
Q

Lacosamide SE

A

dizziness, false or unusual sense of well being shakiness and unsteady walk

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15
Q

Are mirtazipine sedative effects greater at higher or lower doses?

A

Lower

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16
Q

ANAESTHESIA + ACEI/ARB

A
  • severe hypotension
  • Induction of anaesthesia
  • May need to be discontinued 24 hrs before surgery
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17
Q

Drugs that cause B12 deficiency

A
  • metformin
  • PPI
  • Colchicine
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18
Q

Amiodarone SE

A

Pulmonary toxicity

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19
Q

Diuretic with risk of non melanoma skin cancer

A

Hydrochlorothiazide

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20
Q

Which drug causes tendonitis

A

Ciprofloxacin

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21
Q

Which DPP4i is preferred in renal impairment?

A

Linagliptin

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22
Q

Which DPP4i is preferred in liver impairment?

A

Linagliptin and sitagliptin

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23
Q

Which drug causes dark yellow,and occasionally brown urine?

A

Nitrofurantoin

24
Q

What colour does nitrofurantoin turn urine?

A

dark yellow, and occasionally brown urine

25
Q

What colour does rifampicin turn urine?

A

reddish-orange

26
Q

Which drugs are likely to cause hyperthyroidism

A

Levothyroxine
Liothyronine
Lithium
Amiodarone

27
Q

Olanzapine + methotrexate

A

Agranulocytosis

28
Q

Drugs that can cause gout

A

ACEi
BB
Diuretics

29
Q

Domperidone + fluconazole =

A

QT interval

30
Q

Spironolactone + furosemide =

A

hyponatraemia

31
Q

Which drug can be continued before surgery and would not require any peri operative advice

A

Levetiracetam
Levothyroxine

32
Q

Which antidiabetic drug can cause pancreatitis?

A

GLP1 agonists

33
Q

What electrolyte imbalance occurs in SBS?

A

hypomagnesemia

34
Q

Which treatment is not appropriate in SBS?

A

Metoclopramide

35
Q

Simvastatin + amlodipine

A
  • increased risk of rhabdomyolsis
  • ensure simvastatin max dose 20mg
36
Q

Nitrate therapy ADR

A
  • Headache, flushing
  • Palps, syncope
37
Q

Lithium monitoring

A
  • BMI
  • eGFR
  • thyroid function
  • U&Es
38
Q

olanzapine and smoking

A

Reduce the dose of olanzapine in quitting smoking, as olanzapine levels can increase

39
Q

Epilepsy and EHC

A

Refer - IUD fitted

40
Q

Zolendronic acid main SE

A

Reduced dental mobility
osteonecrosis of the jaw

41
Q

Which drugs are likely to cause Lichen Planus?

rash

A

TLD

42
Q

What is the most important monitoring req for mirabegron?

A

BP

43
Q

What drugs increase the anticoagulant effect of warfarin?

A
  • Clarithromycin
  • Doxycycline
  • Erythromycin
  • Metronidazole
44
Q

What drugs decrease the anticoagulant effect of warfarin?

A

Rifampicin

45
Q

Testosterone exposure in children

A

Premature puberty and genital enlargement in children in close physical contact with adult using topical testosterone

46
Q

Nitrofurantoin main ADR

A

pulmonary and hep

47
Q

Which gout treatment is cautioned in CVD?

A

Febuxostat

48
Q

rivaroxaban + dipyrimadole

A

increased risk of bleeding

49
Q

cytotoxic drugs which formulations are not interchangeable

A

paclitaxel

50
Q

Which drugs are CI in acute porphyrias?

A

clindamycin, pizotifen, tamoxifen, verapamil

sildenafil is OK

51
Q

Levonorgestrel + phenobarbital

A

decreases the conc of levonorgestrel, so need to increase the dose

52
Q

What is the antidote for anticholinergic poisioning/overdose? →

A

physostigmine

53
Q

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? →

A

adrenaline injection 1mg/mL IM 500mcg (300mcg if small or prepubertal) - repeat after 5 minutes if necessary

54
Q

What choice of anaphylaxis is appropriate for a child up to 6 months in case of an emergency in the pharmacy? →

A

adrenaline injection 1mg/mL IM child up to 6m: 100-150mcg (repeated after 5 minutes if necessary)

55
Q

What drugs cause gynaecomastia

A

REMEMBER ‘BOOBS TF’ -
- Bicalutamide
- Omeprazole (PPIs is very rare),
- Oestrogen (diethylstillbesterol indicated for prostate cancer),
- Blockers H2 receptors (cimetidine/famotidine)
- Spironolactone
- Testosterone
- Finesteride

56
Q

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? →

A

adrenaline injection 1mg/mL IM 150mcg (repeated after 5 minutes if necessary)