Contraindications

Question 1

Sildenafil

Viagra

Answer 1

Caution w/ CV dz

Question 2

Calcium

Answer 2

Hypercalcemia

Question 3

Calcium Gluconate (IV)

Answer 3

Hypercalcemia

Ventricular fibrillation

Question 4

Vitamin D

Answer 4

Hypercalcemia

Hyper- vitaminosis D

Malabsorption syndrome

Question 5

Teriparatide

hPTH 1-34

Answer 5

Paget’s disease

Open epiphyses

Prior radiation

Bone malignancy

Hypercalcemia

Question 6

hPTH 1-84

not in US

Answer 6

Paget’s disease

Open epiphyses

Prior radiation
involving skeleton

Hypercalcemia

Question 7

Calcimimetic

Answer 7

Hypocalcemia

Question 8

Raloxifen

Answer 8

Pregnancy

Hx of presence of venous thromboembolism

Question 9

Biphosphonates

Answer 9

Hypersensitivity to drug

Hypocalcemia

Esophageal disease or unable to sit up for 30 min after taking drug orally (except IV Zoledronate)

Question 10

Denosumab

Answer 10

Hypersensitivity to drug

Hypocalcemia

Pregnancy

Question 11

Salmon Calcitonin

Answer 11

Hypersensitivity to salmon calcitonin

Question 12

Azathioprine

Answer 12

Drug interaction between azathioprine and allopurinol

Allopurinol inhibits XO metabolism of 6-MP→ life- threatening myelosuppression
pts on allopurinol for gout – ↓ dosage of azathioprine

Avoid combining with ACE
inhibitors* (exacerbates marrow suppression)

↓ dose in renal failure pts

Question 13

Mycophenolate Mofetil

Answer 13

Tacrolimus drug interaction → cause mycophenolate to accumulate → must ↓ dose
(no complications w/ cyclosporine)

↓ dose in renal insufficiency

Question 14

Calcineurin Inhibitor

Answer 14

Metabolized by Cyp3A→ drug interaction w/ meds that inhibit or induce Cyp3A activity

Inhibitors of CYP3A → toxicity

Inducers of CYP3A → ineffective

Question 15

Sirolimus

Answer 15

Metabolized by Cyp3A→ drug interaction with medications that inhibit or induce Cyp3A activity

Question 16

Abatacept

Answer 16

COPD pts → will have more adverse respiratory effects

Question 17

Adalimumab

Humira

Answer 17

Avoid in patients with recent malignancies

Question 18

Etanercept

Enbrel

Answer 18

Avoid in patients with recent malignancies

Question 19

Infliximab

Remicade

Answer 19

Avoid in patients with recent malignancies

Question 20

Rituximab

Answer 20

May harm fetus → d/c 6 mo prior to conception

Question 21

Cyclophosphamide

Answer 21

CYP450 drug interactions (can cause liver tox)

Question 22

Methotrexate

Answer 22

Penicillin, cephalosporins and NSAIDs inhibit renal excretion of MTX* monitor closely