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Cardiopulm Pharm > Contraindications > Flashcards

Contraindications Flashcards

1
Q

Contraindications & Drug Interactions

A

Drug Name

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2
Q

Do not use concurrently with sildenafil

A

Isosorbide dinitrate

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3
Q

Hyperkalemia if used concurrently with spironolactone

contraindicated in 2nd/3rd trimesters of pregnancy

A

ARBs:

Valsartan

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4
Q

macrolide antibiotics (e.g., erythromycin) that ↓Eubacterium activity → ↑ toxicological potentials

A

Digoxin

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5
Q

Oral K+ or concurrent use of ACE inhibitor or ARB → ↓Hypokalemia

Patients with allergy to sulfonamide-based drugs

A

Furosemide

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6
Q

Patients with hyperkalemia or at risk of developing hyperkal;emia (e.g., patient with renal insufficiency)

A

Spironolactone

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7
Q

Patients with predisposition to asthma or severe bradycardia

A

Carvedilol

Metoprolol

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8
Q

spironolactone → Hyperkalemia

Aspirin or NSAIDs → ↓Antihypertensive effects of ACEIs

contraindicated in 2nd/3rd trimesters of pregnancy

A

ACE Inhibitors:

Captopril, Enalapril, Lisinopril

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9
Q

β-Blockers can attenuate effect

A

Dobutamine

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10
Q

– With P450 inhibitors
– With grapefruit juice

Liver disease; pregnancy & lactation

A

Statins

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11
Q
  1. Cell wall synthesis inhibitors + aminoglycosides —> synergistic
  2. Anesthetics and neuromuscular blockers
A

Aminoglycosides: Gentamicin

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12
Q
  1. Cephalosporins + aminoglycosides —> synergistic
  2. Cephalosporins + bacteriostatic agents (e.g., TCN) —> antagonistic

Patients exhibiting a hypersensitivity reaction to penicillins

A

Cephalosporins: Ceftriaxone

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13
Q
  1. Patients with liver disease
  2. Pregnancy except in extraneous conditions,
    e.g., severe hyper‐triglyceridemia (>2000 mg/dL),
    or pancreatitis
A

Fibrates

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14
Q
    • aminoglycosides —> synergistic
    • β-lactamase inhibitors —> synergistic
    • bacteriostatic agents (e.g., TCN) —> antagonistic
A 
Ampicillin
Nafcillin
Penicillin G
Penicillins
Amoxicillin + clavulanate
Penicillin G and V
Piperacillin + tazobactam
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15
Q

a. Cell wall synthesis inhibitors + aminoglycosides : synergistic
b. Anesthetics and neuromuscular blockers

A

Aminoglycosides - Gentamicin

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16
Q

a. + aminoglycosides : synergistic
b. + bacteriostatic agents (e.g., TCN) : antagonistic

Patients exhibiting a hypersensitivity reaction to penicillins

A

Ceftriaxone

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17
Q

a. Surgery within 10 days
b. Serious gastrointestinal bleeding within 3 months
c. History of hypertension (diastolic pressure >110 mm Hg)
d. Active bleeding or hemorrhagic disorder
e. Previous cerebrovascular accident or active intracranial process
f. Aortic dissection
g. Acute pericarditis

A

tPA; alteplase

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18
Q

CNS effects of are potentiated by concurrent ingestion

of alcohol or other CNS depressants

A

Chlorpheniramine

Diphenhydramine

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19
Q

Combination of β‐Blockers with organic nitrates → ↑Exercise tolerance

A

Metoprolol, atenolol (cardio-selective)

Propranolol

20
Q

CONTRAINDICATED in neonates and last month of pregnancy

Concurrent use of azathioprine, 6-mercaptopurine, methotrexate may increase risk of bone marrow suppression

A

Trimethoprim-sulfamethoxazole

21
Q

Contraindicated in patients with active pathological bleeding and
presence or history of intracranial hemorrhage

A

Ticagrelor

22
Q

CONTRAINDICATED in patients with liver disease or elevated liver
enzymes

P450 inhibitor increases warfarin, propranolol, and theophylline concentrations

A

Zileuton

23
Q

Contraindicated in patients with severe hepatic insufficiency

A

Cholesterol absorption
inhibitors

Ezetimibe

24
Q

corticosteroids enhance response

A

Albuterol (Inhaled & oral)

Salmeterol (Inhaled)

25
Q

Drugs which increase risk of bleeding; GI ulceration, and NSAIDs

A

Acetylsalicylic acid (aspirin)

26
Q 
Increase half-life
cimetidine
macrolide antibiotics
hepatic cirrhosis
premature infants
oral contraceptives

Decrease half-life
cigarette smokers
phenytoin
barbiturates

Patients with hepatic or cardiac dysfunction
Patients with seizure disorders
Patients with peptic ulcer disease

A

Theophylline

Aminophylline

27
Q

Inducers and inhibitors of P450 have corresponding effects on metabolism

A

Montelukast

28
Q

Inhibitors of P450 enzymes inhibit the conversion of drug to the active metabolite which would diminish the platelet effects of the drug

A

Clopidogrel

29
Q

inhibits P450 enzymes

A

Isoniazid

30
Q

Interfere with absorption of: Aspirin, Digoxin, Tetracycline, Thiazide diuretics, Pravastatin, Fluvastatin, and Warfarin

A

Bile acid sequestrants (resins)

Cholestyramine, Colestipol, and Colesevelam

31
Q

NOT recommended for pregnant women or children

A

Tetracyclines - Doxycycline

32
Q

Not recommended for use in patients with asthma or COPD

A

Zanamivir (inhalation)

33
Q

Other anticoagulants can increase the risk of bleeding

A 
Bivalirudin
Dabigatran
Heparin
low-molecular-weight heparin
[enoxaparin]
34
Q

P450 enzyme inhibitors increase levels, inducers decrease levels

A

Ivacaftor
Montelukast
Roflumilast

35
Q

patients with chronic liver disease, alcoholism, and older patients, and patients taking isoniazid (increased risk of hepatotoxicity)

A

Rifampin

36
Q

Patients with coronary artery disease or hypertension

Patients with an enlarged prostate

A

Phenylephrine (intranasal)

Pseudoephedrine (oral)

37
Q

Patients with glaucoma

Patients with prostatic hypertrophy

A

Ipratropium (intranasal)

38
Q

Phosphodiesterase 5 inhibitors —> increases action of nitrates and can lead to hypotension

A

Nitroglycerin

Isosorbide dinitrate; Isosorbide mononitrate

39
Q

Reduced absorption of drug caused by binding to cholestyramine in the gastrointestinal tract
Hormone replacement therapy for hypothyroid patients
Pregnancy

A

Warfain

40
Q

strong inducer of CYP3A4;
will necessitate higher
doses of ivacaftor when used in combination

A

Lumacaftor

41
Q

substrate for P-gp and CYP3A4
Other anticoagulants can increase the risk of bleeding
Anti-platelet drug can increase the risk of
bleeding

A

Rivaroxaban

42
Q

TERATOGENIC AND EMBRYOTOXIC; CONTRAINDICATED in
pregnancy. Pregnant women should not directly care for patients
receiving aerosol. Patients exposed to the drug should not conceive children during treatment or for 6 months after stopping the
drug.

A

Ribavirin

43
Q

Teratogenic-CONTRAINDICATED in pregnancy

A

Amantadine

44
Q

Teratogenic, therefore it is contraindicated in pregnancy

A

Niacin (Vit B3)

45
Q

The binding sites for macrolides, chloramphenicol, and clindamycin
overlap which may inhibit their antibacterial effects if used concurrently

A

Azithromycin, clarithromycin and erythromycin (Macrolides)

46
Q

β-blockers can attenuate the response to dobutamine

A

Dobutamine

Cardiopulm Pharm (4 decks)

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