Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paeds, MEP, OTC & Misc. > Common drug interactions & SE's & important facts! > Flashcards

Common drug interactions & SE's & important facts! Flashcards

1
Q

What are the CYP450 enzyme substrates?

A
  1. Warfarin
  2. Oral contraceptives
  3. TCAs
  4. Statins
  5. Methadone
  6. Amlodipine
  7. LTRA
  8. Theophylline
  9. ?Corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the CYP450 inducers? (BTS CRAP GPSS)

A

B - Barbiturates
T - topiramate
S - St John’s Wort

C - Carbamazepine or oxcarbazepine
R - Rifampicin or Rifabutin
A - Alcohol (chronic)
P - Phenytoin

G - Griseofulvin
P - Phenobarbital
S - Sulphonylureus - gliclazide
S - Smoking!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the CYP450 inhibitors? (SICKFACES.COM GAVID)

A

S - Sodium valproate
I - Isoniazid
C - Cimetidine
K - Ketoconazole
F - Fluconazole
A - Alcohol (binge)
C - Chloramphenicol
E - Erythromycin or Clarithromycin
S - Sulfonamides - Trimethoprim
.
C - Ciprofloxacin
O - Omeprazole
M - Metronidazole

G - Grapefruit
A - Amiodarone
V - Verapamil
I - Itraconazole
D - Diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does grapefruit juice do to some drugs?

A

It’s an enzyme inhibitor => increase plasma concentration!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which CVS drugs do grapefruit juice increase their plasma concentrations?

A
  • amiodarone
  • statins
  • dihydropyridine CCBs - amlodipine
  • verapamil
  • dronedarone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which CNS drugs do grapefruit juice increase their plasma concentrations?

A
  • Sertraline
  • quetiapine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which immunosuppressants do grapefruit juice increase their plasma concentrations?

A
  • tacrolimus
  • ciclosporin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which OTHER DRUGS do grapefruit juice increase their plasma concentrations?

A
  • phosphodiesterase type-5 inhibitors = sildenafil
  • colchicine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which common drugs are hepatotoxic?

A
  • antipsychotics
  • amiodarone
  • carbamazepine
  • co-amoxiclav
  • fluconazole
  • fluclox
  • isoniazid
  • ketoconazole
  • labetalol
  • methotrexate
  • paracetamol
  • phenothiazine
  • pioglitazone
  • rifampicin
  • statins
  • tetracycline
  • valproate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which common drugs are nephrotoxic?

A
  • ACEi
  • aminoglycosides
  • aciclovir
  • ciclosporin
  • cephalosporins
  • Li
  • methotrexate
  • NSAIDs
  • quinolones
  • tacrolimus
  • tetracyclines
  • vancomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which “sick day rules” meds need to be stopped temporarily due to a risk of an AKI. This is because it can result in dehydration, V, diarrhoea, fever or sweats?

A
  • ACEi/ARB - nephrotoxic and reduces eGFr
  • diuretics - exacerbates dehydration and electrolyte disturbance
  • Metformin - increased risk of lactic acidosis in renal impairment
  • NSAIDs - nephrotoxic and reduces eGFR, Na, and water retention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Regarding oral SE’s of drugs, which drugs can cause ORAL ULCERS?

A

1st: ACEi
1st: NSAID
1st: Cytotoxic = methotrexate
Nicorandil
Pancreatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Regarding oral SE’s of drugs, which drugs can cause ORAL CANDIDIASIS?

A

corticosteroid inhalers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Regarding oral SE’s of drugs, which drugs can cause STAINING OF TEETH

A

Chlorhexidine = brown
Liquid iron = black
1st: Tetracyclines = yellow-grey

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Regarding oral SE’s of drugs, which drugs can cause OSTEONECROSIS OF THE JAW?

A

bisphosphonates - esp IV route for treatment of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Regarding oral SE’s of drugs, which drugs can cause GINGIVAL HYPERTROPHY?

A

Phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Regarding oral SE’s of drugs, which drugs can cause XEROSTOMIA (DRY MOUTH)?

A

1st: antimuscarinics
antipsychotics
1st: opioids
1st: antihistamines
1st: antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Regarding oral SE’s of drugs, which drugs can cause TASTE DISTURBANCE?

A

1st: ACEi
1st: amiodarone
1st: clarithromycin
1st: metformin
1st: metronidazole
1st: zopiclone
carbimazole
Li

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which type of drugs cause MYELOSUPPRESSION?

A
  • DMARDS - methotrexate
  • antiepileptics - carbamazepine, lamotrigine, phenytoin
  • Abx = chloramphenicol, co-trimoxazole
  • Immunosuppressants - azathioprine, cytotoxics (except vincristine and bleomycin)
  • anti-folates = phenytoin, methotrexate, trimethoprim
  • OTHERS = aminosalicylates, carbimazole, clozapine, mirtazepine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which antimicrobials cause PHOTOSENSITISATION?

A
  • antifungals = voriconazole (skin cancer)
  • tetracyclines = doxycycline, demeclocycline
  • other Abx = co-trimoxazole, quinolones
  • anti-malarials = hydroxychloroquine, chloroquine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which other drugs can cause PHOTOSENSITISATION?

A
  • amiodarone
  • tacrolimus
  • vit A
  • isotretinoin
  • benzoyl peroxide
  • topical NSAID
  • phenothiazine antipsychotics = prochlorperazine, chlorpromazine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which drugs can cause CONTACT SENSITISATION?

A
  • 1st: methotrexate
  • `1st: cytotoxic drugs
  • chlorpromazine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which drugs cause QT PROLONGATION (increased risk of ventricular arrhythmias)?

A
  • antipsychotic drugs = pimozide
  • antidepressants = citalopram, escitalopram, TCAs, venlafaxine
  • sotalolol, amiodarone
  • Li, 5HTa agonists (sumatriptant), 5-HT3 antagonists (ondansetron), domperidone, metoclopramide, quinine
  • macrolides, chloroquine, quinolones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which drugs cause HYPOKALAEMIA?

A
  • loop and thiazide diuretics
  • corticosteroids
  • beta2 agonists
  • stimulant laxative overuse
  • theophylline
  • amphoteracin B
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which drugs can increase the RISK OF BLEEDS?

A
  • antiplatelets - NSAIDs, SSRIs, venlafaxine, clopidogel
  • Anticoagulants - warfarin, heparins, NOACs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which drugs can cause THROMBOEMBOLISM?

A
  • cytotoxics - vinca alkaloids, tamoxifen
  • Other drugs - oestrogen, tranexamic acid, HRT, COCs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which drugs can cause BRADYCARDIA?

A
  • CVS = BB, amiodarone, digoxin, rate-limiting CCBs (diltiazem, verapamil)
  • CNS = antimuscarinic
28
Q

Which drugs can cause FIRST-DOSE HYPOTENSION?

A
  • Alpha-blockers
  • ACEi/ARBs
  • Nitrates
29
Q

Which drugs can cause HYPOTENSION?

A
  • BB, CCB, ACEi/ARBs, alpha blockers
  • alcohol, nitrates, diuretics, sildenafil, dopamine receptor agonists
30
Q

Which drugs can cause ANTIMUSCARINIC EFFECTS?

A
  • antimuscarinic
  • TCA
  • antihistamine
  • antipsychotic
  • clozapine
31
Q

Which drugs can cause CNS DEPRESSANT EFFECTS?

A
  • alcohol
  • antiepileptics
  • antihistamines
  • antipsychotis
  • benzodiazepines
  • opioids
  • Z-drugs
32
Q

Which drugs can cause PERIPHERAL NEUROPATHY?

A
  • amiodarone
  • phenytoin
  • isoniazid
  • metronidazole
33
Q

Which drugs can cause SEROTONIN SYNDROME?

A
  • 5HT1A agonists = sumatriptan
  • antidepressants = TCAs, MAOI, SSRI, MAO-Bi (selegiline)
  • 5HT3 antagonists = St John’s Wort
34
Q

Which drugs can cause OTOTOXICITY?

A
  • aminoglycosides = gentamicin, cisplatin
  • glycopeptides = vancomycin
  • loop diuretics
  • vinca alkaloids
35
Q

Which drugs can LOWER THE SEIZURE THRESHOLD?

A
  • quinolones
  • SSRIs
  • antipsychotics
  • tramadol
  • theophylline
  • Li
36
Q

Which drugs can INCREASE SERUM K+?

A
  • ACEi/ARB
  • aldosterone antagonists - e.g. spironolactone
37
Q

Which drugs can REDUCE K+?

A
  • theophylline
  • B2 agonists - salbutamol
  • corticosteroids
  • diuretics
  • stimulant laxative (excessive use)
38
Q

Which drugs can cause HYPONATRAEMIA?

A
  • carbamazepine
  • diuretics
  • antidepressants
39
Q

Which drugs are TERATOGENIC?

A
  • anti-folate = methotrexate, trimethoprim
  • statins
  • tetracyclines = dental hypoplasia, teeth staining
  • prostaglandin analogues: misoprostol = miscarriage, induces labour
  • ACEi/ARBs
  • isotretinoin
  • Li
  • Na valproate
  • Warfarin = congenital malformations, foetal and neonatal haemorrhage
  • chloramphenicol = grey baby syndrome
  • Aspirin/NSAIDs = early closure of ductus arteriosus
  • Topiramate = cleft palate
  • Finasteride = feminisation of male foetus
  • quinolones = arthropathy
  • aminoglycosides = auditory and vestibular damage in 2nd and 3rd trimester
40
Q

Which drugs can affect BREAST-FEEDING?

A
  • ethosuximide, lamotrigine = high amounts present in breast milk
  • fluvastatin = high amounts present in breast milk
  • phenobarbital = inhibits infant’s sucking-reflex
  • bromocriptine = inhibits lactation
41
Q

Which BB’s are water soluble?

A

This means they are a lot less likely to cross the BBB and cause SE’s such as nightmares and insomnia:
- Atenolol
- Celiprolol
- Nadolol
- Sotalol
(CANS)

Water soluble BB’s

42
Q

Which BB’s are cardioselective?

A

These BB’s are the type to predominately select the B1-adrenoceptors found in the heart, so they are good for asthmatics or a history of asthma.
- Atenolol
- Acebutolol
- Bisoprolol
- Metoprolol
- Nebivolol

(BAtMAN)

43
Q

Which BB’s are OD dosing?

A
  • Atenolol
  • Bisoprolol
  • Celiprolol
  • Nadolol

(BANC)

44
Q

Which BB’s are less likely to cause coldness of extremities, fatigue and bradycardia?

A
  • Pindolol
  • Oxprenolol
  • Acebutaolol
  • Celiprolol

(A POC)

Intrinsic sympathomimetic

45
Q

What is the vitamin D (colecalciferol) conversion?

A

400 units = 10 mcg

46
Q

Regarding NSAIDs and GI events, which type of NSAIDs have the lower risk?

A

Selective COX-2 inhibitors

47
Q

Regarding NSAIDs and GI events, which NSAIDs have the highest risk?

A
  • Piroxicam
  • Ketoprofen
  • Ketorolac trometamol
48
Q

Regarding NSAIDs and GI events, which NSAIDs have the intermediate risk?

A
  • Diclofenac,
  • Naproxen
  • Indomethacin
49
Q

Regarding NSAIDs and GI events, which NSAIDs have the lowest risk?

A

Ibuprofen

50
Q

Regarding NSAIDs and CVS events, which NSAIDs have the highest risk?

A

Selective COX-2 inhibitors:
- Diclofenac 150mg/day + ibuprofen 2.4g/day have the highest risk (HOWEVER, low-dose ibuprofen 1.2g/day has not been associated with an increased risk)

  • Naproxen 1g/day has a lower risk
51
Q

What nutritional deficiencies are found in short bowel syndrome?

A

Vitamins A, B12, D, E and K, essential fatty acids, zinc, and selenium

52
Q

Which drugs can induce dyspepsia?

A
  • Bisphosphonates
  • NSAIDs, Aspirin
  • Corticosteroids
  • CCB
  • BB
  • Nitrates
  • Benzodiazepines
  • Antimuscarinics
  • Theophylline
  • Tricyclic AEDs
53
Q

Neonatal drugs

A
  • Caffeine citrate => increase breathing rate
  • Vitamin K => thickens blood
  • Labinic => probiotic
  • Folic acid => give to breastfeeding mothers
  • Sytron (sodium feredetate) => give after 28 days as they cannot absorb the iron
  • Sucrose 24% solution => helps decrease their pain threshold
  • Pseudoephedrine eye drops => dilate eyes for the drs to see if there is any form of detachment of the eye
  • Curosurf => surfactant for lungs
  • Sodium phosphate (PO/NG) => rickets
54
Q

Drug induced DM?

A
  • thiazides
  • glucocorticoids
  • BB - mask hypoglycaemia
  • atypical antipsychotics = clozapine, olanzapine, quetiapine
  • ciclosporin
  • nicotinic acid
  • protease inhibitors
  • tacrolimus
55
Q

Corticosteroids SE’s (ACHING BOSOM)

A

A = Adrenal suppression, increased appetite, abrupt withdrawal reactions
C = Cushing’s syndrome, cataracts
H = Hyperglycaemia (DM), hyperlipidaemia
I = Infections, insomnia
N = NS: psychiatric reactions
G = Glaucoma, GI ulcers

B = Increase BP
O = Osteoporosis
S = Skin thinning
O = Obesity
M = Muscle wasting

56
Q

Antipsychotics - Best to treat negative symptoms of schizophrenia?

A

2nd gen antipsychotics = amisulpride, aripiprazole, quetiapine

57
Q

Antipsychotics - best to treat extrapyramidal SE’s?

A

2nd gen antipsychotics = aripiprazole, quetiapine, olanzapine least likely to cause this

58
Q

Antipsychotics - the least effect on the QT interval?

A

Aripiprazole

59
Q

Antipsychotics - Worst effect for QT intervals?

A

haloperidol + pimozide

60
Q

Antipsychotics - the drugs that have a small chance of causing QT prolongation?

A

risperidone prochlorperazine, olanzapine, amisulpride

61
Q

Antipsychotics - Pts with schizophrenia are more likely to develop insulin resistance and DM. Which antipsychotics are less likely to cause this?

A

1st gen typically have the lowest risk with haloperidol being the best!
2nd gen - amisulpride + aripiprazole have the lowest risk in this gen class

62
Q

Antipsychotics - Which are least likely to cause weight gain?

A

amisulpride, sulpride, aripiprazole, haloperidol

63
Q

Antipsychotics - Which causes a sexual dysfunction effect?

A

risperidone + haloperidol commonly cause this effect!

64
Q

Antipsychotics - Which drugs commonly cause postural hypotension during initial dosage?

A

quetiapine, chlorpromazine

65
Q

Antipsychotics - which drugs cause hyperprolactinemia?

A

2nd gen antipsychotics = risperidone + amisulpride are most likely to cause this

Increase in prolactin = decreased fertility

Paeds, MEP, OTC & Misc. (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions