Contraindications Flashcards
Ivermectin
Loiasis
Diethylcarbamazine
Onchocerciasis (African River Blindness)
Praziquantal
Intraocular cysticercosis
Artemisinins
Children <5 kg
1st trimester pregnancy
ACT with Lumefantrine
Coartem
Cardiac arrhythmias
Cardiac dz
Chloroquine Phosphate
Safe in pregnancy
Epilepsy, myasthenia gravis
Psoriasis, porphyia
Adv liver dz or severe GI/neuro or blood d/o (G6PD)
Cardiac dysatrhmias
↓ efficacy of yellow fever vaccine if coincident
Avoid kaolin and Ca2+/Mg2+ containing antacids due to delayed GI abs
Cyp2D6 drug interactions
Quinne Sulfate
Pts w/ tinnitus/optic neuritis
Caution: pts w/ hypersnesitivity
Potentially safe in pregnancy (monitor glycose)
dose w/ renal insufficiency
Cyp3A4 drug interactions (warfarin and digoxin levels ↑)
Primaquine
Hemolysis in G6PD deficiency → screen first
Pregnancy (fetus does not have G6PD)
R/o deficiency in infant if breast-feeding
RA, lupus
Atovaquone
Risk can not be ruled out in pregnancy
Rifampin/tetracycline → ↓ plasma levels
Proguanil
Risk can not be ruled out in pregnancy
Isoniazid (INH)
Risk cannot be ruled out in pregnancy
CYP drug drug interactions
Acetaminophem → hepatoxicity
Warfaein → ↑ bleeding risk
Diazepam → sedation and reps depression
Phenytoin → neuro tox
Pyrazinamide
Risk cannot be ruled out in pregnancy
Ethambutol
Risk cannot be ruled out in pregnancy
Rifampin
Risk cannot be ruled out in pregnancy
Induces hepatic metabolism w/ CYPs → accelerates metabolism of anti-HIV cocktail (protease/rev T’ criptase inhib)
↓ HL of oral contraceptives (as well as verapamil, methadone and warfarin)
Bedaquiline
Pts w/ cardiac arrhythmias
No CYP3A4 inducers (don’t administer with rifampin → shouldn’t anyway bc its resistant)
