clinical states Flashcards
Name 6 drugs associated with teratogenic effects if taken when pregnant:
lithium
phenytoin
sodium valproate
warfarin
carbimazole
gentamicin
What teratogenic effect can be caused by lithium therapy during pregnancy?
cardiac abnormalities
What teratogenic effect can be caused by valproate therapy during pregnancy?
neural tube defects
What teratogenic effect can be caused by phenytoin therapy during pregnancy?
cleft lip / palate
What teratogenic effect can be caused by warfarin therapy during pregnancy?
achrondroplasia,
craniofacial abnormalities
Name 2 drugs contraindicated during breast feeding.
Amiodarone
(thyroid abnorms)
Chloramphenicol
(blood dyscrasia)
What effect can be caused by gold therapy taken whilst breast feeding?
haematological reactions,
renal impariment
What effect can be caused by lithium therapy taken whilst breast feeding?
movement disorder
What effect can be caused by oestrogen therapy taken whilst breast feeding?
virilisation of male infant
What effect can be caused by aspirin therapy taken whilst breast feeding?
reyes syndrome (encephalopathy and liver damage)
How does Reyes syndrome present?
lethargy.
sudden / prolonged vomiting.
combative behavior.
tachypnenea.
tachycardia.
Antibiotic drugs considered safe during breastfeeding
penicillin
cephalosporins
Antiepileptic drugs considered safe during breastfeeding
carbemazepine
sodium valproate
Antihypertensive drugs considered safe during breastfeeding
B Blockers
Psych drugs considered safe during breastfeeding
TCAs
Chlorpromazine
Anticoagulant drugs considered safe during breastfeeding
Heparin
Warfarin
How does obstructive jaundice affect Rifampicin?
drugs usually excreted by bile may accumulate in obstructive jaundice.
How does cirrhosis affect protein bound drugs like Phenytoin?
protein bound drugs will suffer due to low availability of binding sites secondary to low albumin in cirrhosis
why is liver failure a problem for patients taking warfarin?
reduced clotting factors -> prolonged bleed times
what are ascites?
what are they a product of?
serous peritoneal fluid buildup
- maker of decompensated liver cirrhosis
a product of portal hypertension and low albumin
name 4 drugs likely to accumulate due to severe renal failure
digoxin
erythromycin
lithium
penicillin / cephalosporins
Accumulation of digoxin leads to..
cardiac arrhythmias, heart block
Accumulation of lithium leads to..
cardiac arrhythmias, seizures
Accumulation of erythromycin leads to..
encephalopathy
Name 4 nephrotoxic drugs
aminoglycosides (~mycin)
amphotericin
NSAIDS
vancomycin
gold
penicillamine
name 4 aminoglycosides
gentamicin,
tobramycin,
neomycin,
streptomycin
which nephrotixic effect does Gold have ?
proteinuria
glomerulonephritis
what is the effect of aminoglycosides given to a patient with chronic renal failure?
ATN / AKI
