Adverse drug reactions

Question 1

Medications that can exacerbate heart failure?

Answer 1

Thiazolidinediones- pioglitazone is contraindicated as it causes fluid retention

Verapamil- negative inotropic effect

NSAIDs/glucocorticoids- should be used with caution as they cause fluid retention. low-dose aspirin is an exception

Class I antiarrhythmics- flecainide (negative inotropic and proarrhythmic effect)

Question 2

Drugs that worsen seizure control?

Answer 2

alcohol, cocaine, amphetamines
ciprofloxacin, levofloxacin
aminophylline, theophylline
bupropion
methylphenidate (used in ADHD)
mefenamic acid

Question 3

Drugs to avoid in asthma?

Answer 3

NSAIDs
beta-blockers
adenosine- use verapamil instead

Question 4

drugs to avoid in pregnancy?

Answer 4

Antibiotics;
tetracyclines
aminoglycosides
sulphonamides and trimethoprim
quinolones: the BNF advises to avoid due to arthropathy in some animal studies

Other drugs;
ACE inhibitors, angiotensin II receptor antagonists
statins
warfarin
sulfonylureas
retinoids (including topical)
cytotoxic agents

Question 5

Drugs that exacerbate psoriasis?

Answer 5

trauma
alcohol
drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids

Question 6

How often do you monitor agranulocytosis risk with clozapine use?

Answer 6

Every week for the first 18 weeks and every second week up to 1 yea