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100 Drugs > Drug 75-100 > Flashcards

Drug 75-100 Flashcards

Indications MoA SEs Warnings Interactions

1
Q

Sodium Chloride: Indications (3)

A
  1. NaCl 0.9% and 0.45% used to PROV SODIUM + WATER IV in pts unable to take enough orally
  2. NaCl 0.9% used to EXPAND CIRCULATING VOL in states of circulatory compromise (incl shock)
  3. NaCl 0.9% used for RECONSTITUTION + DILUTION OF DRUGS for adm by injection or infusion
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2
Q

Sodium Chloride: MoA

A
  • Na+ is the main cation in ECF so it determines osmolality which body tries to keep constant
  • Increasing body Na+ with NaCl –> increase in extracellular water volume = expands ECF volume
  • Extracellular sodium concentrations = 140mmol/L
  • NaCl 0.9% has 154mmol/L so is roughly isotonic with ECF, so ECF expands by roughly the same amount of NaCl 0.90% administered
  • normal Na requirements for adults = 1mmol/kg/day (incr in disease states eg diarrhoea)
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3
Q

Sodium Chloride: SEs

A
  1. FALL IN CO –> precipitate HF, by incr LV filling beyond point of maximal contractility on Starling Curve
  2. OEDEMA - by providing Na more rapidly than pt can excrete it
  3. HYPERCHLORAEMIA –> ACIDOSIS, due to incr urinary losses of bicarbonate. As NaCl 0.9% has 154mmol/L of chloride vs 100mmol/L in ECF
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4
Q

Sodium Chloride: Warnings

A
  1. HF: Fluid challenge volume should be reduced in pts with HF due to risk of worsening cardiac contractility
  2. RENAL IMPAIRMENT: vital to monitor fluid balance closely to avoid overload
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5
Q

Potassium IV: Indications (2)

A
  1. PREVENT POTASSIUM DEPLETION - in pts who can’t take adequate amounts orally
  2. Tx of established potassium depletion and HYPOKALAEMIA - that is severe (<2.5mmol/L), symptomatic or causing arrhythmias
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6
Q

Potassium IV: MoA

A
  • Normal K+ req = 1mmol/kg/day in adults, to prevent K+ depletion
  • Established K+ depletion and hypokalaemia may be caused by D, V, or 2’ hyperaldosteronism
  • in severe cases, hypokalaemia may result in arrhythmias, muscle weakness and paralysis (extreme)
  • for best effect, IV Potassium is given with NaCl rather than glucose, as negatively charged chloride ions promote retention of K+ in serum for longer, whereas glucose may promote insulin release with resultant stimulation of Na+/K+ ATPase, shifting K+ into cells
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7
Q

Potassium IV: SEs

A
  1. HYPERKALAEMIA –> arrhythmias - from overcorrection
  2. IRRITANT TO VEINS - if infused rapidly or in too high conc, so infusion rate in peripheral vein should not exceed 20mmol/hr
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8
Q

Potassium IV: Warnings

A
  1. RENAL IMPAIRMENT
  2. OLIGURIA
    - as they have minimal potassium losses and are v susceptible to hyperkalemia
    - replace with extreme caution
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9
Q

Potassium IV: Interactions

A
  1. Potassium elevating drugs
    - additive effect
    - eg oral potassium supplements, aldosterone antagonists, potassium-sparing diuretics, ACE i and ARBs
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10
Q

Glucose (dextrose): Indications (4)

A
  1. PROV WATER IV - Glucose 5% - if can’t take orally
  2. Tx HYPOGLYCAEMIA - Glucose 10,20 + 50% - severe or cannot be tx orally
  3. HYPERKALAEMIA - Glucose 10, 20 + 50% used with insulin - calcium gluconate may also be given
  4. RECONSTITUION + DILUTION OF DRUGS - Glucose 5%
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11
Q

Glucose (dextrose): MoA

A
  • When given in 5% solution, glucose is adm simply as a means of prov water IV
  • glucose makes solution initially isotonic and prevents it from inducing osmolysis
  • glucose rapidly taken up by cells and metabolised, leaving free (hypotonic) water that diffuses throughout all body water compartments
  • only 7% of the adm volume remains in the intravascular space, glucose not suitable for expanding circulating volume
  • higher conc glucose solutiosn are used to tx hypoglycaemia
  • hyperkalaemia, insulin (usu actrapid) stimulates Na+/K+-ATPase and shifts potassium into cells, glucose prevents hypoglycaemia
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12
Q

Glucose (dextrose): SEs

A
  1. Glucose 50% highly IRRITANT to VEINS –> local pain, phlebitis and thrombosis
  2. HYPERGLYCAEMIA - if glucose administration exceeds its utilisation (likely in pts with DM)
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13
Q

Glucose (dextrose): Warnings

A
  1. THIAMINE DEFICIENCY - IV glucose can –> Wernicke’s encephalopathy , so give thiamine (as pabrinex)
  2. RENAL FAILURE - monitor fluid bal to avoid overload
  3. HYPONATRAEMIC pt (or children) -administering hypotonic fluid may –> hyponatraemic encephalopathy
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14
Q

Glucose (dextrose): Interactions

A

-Glucose + insulin have antagonistic effects but concurrent adm may be appropriate eg IV insulin infusions BUT rate of glucose infusion should be kept constant unless tx for hypoglycaemia is req

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15
Q

Compound sodium lactate (Hartmann’s solution): Indications (2)

A
  1. PROV SODIUM + WATER IV - in pts unable to take orally
  2. EXPAND CIRCULATING VOL in states of circulatory compromise (incl shock) - can be done as fluid challenge, where selected vol of fluid (eg 500ml) is infused rapidly
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16
Q

Compound sodium lactate (Hartmann’s solution): MoA

A

=balanced salt solution - designed to mimic serum in terms of electrolytes

  • 1L contains Na+ 131mmol, Cl- 111mmol, K+ 5mmol, Ca2+ 2mmol, lactate 29mmol
  • with adeq liver ftn, lactate metabolised to pyruvate + then either glucose or CO2 + H20, with the release of bicarb in both cases
  • Na+ content means it may be used to provide Na and water IV, + for expansion of circ volume
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17
Q

Compound sodium lactate (Hartmann’s solution): SEs

A
  1. SEVERE HF- if xs adm due to fall in CO as LV filling incr beyond maximal contractility on Starling curve
  2. OEDEMA - by prov sodium more rapidly than pt can excrete it -esp relevant in pts who have received multiple fluid challenges
    - advantage of sodium lactate over sodium chloride is its lower chloride content SO less likely to cause hyperchloraemiac acidosis
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18
Q

Compound sodium lactate (Hartmann’s solution): Warnings

A
  1. HF - risk of worsening myocardial contractility
  2. RENAL IMPAIRMENT - vital to monitor fluid balance closely to avoid overload
    - also monitor serum K+ conc
  3. SEVERE LIVER DISEASE
    - may not be sufficient capacity to metabolise lactate
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19
Q

Colloids (plasma substitutes): Indications (2)

A
  1. Used to EXPAND CIRCULATING VOL in states of circulatory compromise (incl shock)
  2. CIRRHOTIC LIVER DISEASE
    - albumin used to prevent effective hypovolaemia in large-volume paracentesis (ascitis fluid drainage)
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20
Q

Colloids (plasma substitutes): MoA

A

Colloid= solution containing a large, osmotically active molecule eg albumin or modified gelatin

  • large mol’s can’t readily diffuse out of vessels, and their osmotic effect holds the infused fluid in the plasma
  • the effect in expanding circ vol is therefore greater than that of a crystalloid eg soidum chloride
  • but little evidence that colloids have better clinical outcomes as most pts needing vol expansion eg severe sepsis have leaky capillaries
  • large volume paracentesis (defined as >5l) in cirrhotic liver disease can produce adverse haemdoynamic effects - can adm human albumin solution (HAS) in an attempt to prevent this
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21
Q

Colloids (plasma substitutes): SEs

A
  1. HF
  2. OEDEMA - as has significant amount of Na
  3. HYPERSENSITIVITY rtns - incl anaphylaxis, caused by Gelatins (may prefer crystalloids which are non-allergic)
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22
Q

Colloids (plasma substitutes): Warnings

A
  1. HF - worsening contractility

2. RENAL IMPAIRMENT - monitor fluid balance to avoid overload

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23
Q

5α-reductase inhibitors: Indications (1)

A
  1. BPH - 2nd line medical Mx after α blockers
    - improve LUTS, such as difficulty passing urine, urinary retention + poor urinary flow + reduce need for prostate-related surgery
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24
Q

5alpha-reductase inhibitors: MoA

A

5α-reductase inh reduce size of prostate gland by inhibiting intracellular enzyme 5α-redcutase

  • enzyme converts testosterone to its more active metabolite dihydrotestosterone
  • As dihydrotestosterone stim prostatic growth, inhibition of its production by 5α-reductase inh redcues prostatic enlargement + impr urinary flow
  • BUT it can take several months for this effect to become evident clinically
  • SO α-blocker usu prefferred for initial therapy
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25
Q

5alpha-reductase inhibitors: SEs

A
  1. ANTI-ANDROGEN ACTION –> impotence, reduced libido, breast tenderness + gynaecomastia, affects pt adherence
  2. HAIR GROWTH - due to androgen inhibition (exploited to treat male pattern baldness)
  3. BREAST C - reported in M taking Finasteride
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26
Q

5alpha-reductase inhibitors: Warnings

A
  1. PREGNANT WOMEN - exposure of male foetus to 5α-reductase inh –> abn dev of external genitalia
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27
Q

Z drugs: Indications (1)

A
  1. INSOMNIA - debilitating or distressing - short term tx
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28
Q

Z drugs: MoA

A
  • Similar action to benzos but chemically distinct
  • target is GABA A receptor
  • GABA A receptor is a chloride channels that opens in resp to GABA, the main inhibitory neurotransmitter in the brain
  • opening the channel allows chlordie to flow in, making cell resistant to depolarisation
  • like benzos, Z drugs facilitate and enhance bidning of GABA to GABA A receptor
  • widespread depressant effect on synaptic transmission
  • clinical manifestation of this incl reduced anxiety, sleepiness and sedation
  • shorter duration of action than benzos
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29
Q

Z drugs: SEs

A
  1. DAYTIME SLEEPINESS - can’t drive or perform complex tasks
  2. REBOUND INSOMNIA - when drugs stopped
  3. CNS EFFECTS - headaches, confusion, nightmares and (rarely) amnesia
  4. TASTE DISTURBANCE - with zopiclone
  5. GI UPSET - with Zolpidem
  6. DEPENDANCE + WITHDRAWL SYMPT’S eg headachces, muscle pains and anxiety on stopping - use >4weeks
  7. OD –> drowsy, coma and respiratory depression
30
Q

Z drugs: Warnings

A
  1. ELDERLY- caution- more sensitive to drugs with CNS effects
  2. OBSTRUCTIVE SLEEP APNOEA = CI
  3. RESPIRATORY MUSCLE WEAKNESS OR RESPIRATORY DEPRESSION = CI
    - worsen resp failure during sleep
31
Q

Z drugs: Important interactions

A
  1. Enhance sedative effects of - alcohol - antihistamine - benzos
  2. Enhance hypotensive effects of - antihypertensive meds
  3. P450 INH eg macrolides - enhance sedation
  4. P450 INDUCERS eg phenytoin, rifampicin - impair sedation
32
Q

Warfarin: Indications (3)

A
  1. DVT + pe
  2. AF
  3. Heart valve replacement
    - tx ST after tissue valvue repl + LT after mechanical valve replacement
    - NOT used to prevent arterial thrombosis eg MI, thrombotic stroke- as this is driven by platelet aggregation so req antiplatelet agents eg aspirin + clopidogrel
33
Q

Warfarin: MoA

A
  • Inhibits production of vit-K dependent coagulation factors and co-factors
  • Vit K must be in its reduced form for synthesis of coagulation factors
  • it is then oxidised during the synthetic process
  • enzyme called vit K epoxide reductase reactivates oxidised vitamin K
  • warfarin inhibits vit k epoxide reductase preventing reactivation of Vit K and coagulation factor synthesis
34
Q

Warfarin: SEs

A
  1. BLEEDING - a slight xs incr risk of bl from existing abnormalities eg peptic ulcers or following minor trauma eg intracerebral haemorrhage after minor head injury
    - large xs of warfarin can trigger spontaneous haemorrhage such as epistaxis (nose bleed) or retroperitoneal haemorrhage
35
Q

Warfarin: Warnings

A

Fine line between thrombosis and haemorrhage
CI in pts with:
-immediate risk of haemorrhage (incl after trauma + pts req surgery)
-liver disease - can’t metabolise drug –> risk of over coagulation/bleeding
-pregnancy - 1st trimester causes foetal malformation incl cardiac and cranial abn

36
Q

Warfarin: Interactions

A

Low therapeutic index

  1. cytochrome P450 inh eg fluconazole, macrolides, protease inhibitors
    - decrease warfarin met + increase bl risk
  2. Cytochrome P450 inducers eg phenytoin, carbamazepine, rifampacin
    - incr warfarin metabolism + risk of clots
    - many antibiotics incr anticoagulation in pts on warfarin by killing gut flora whih synthesise vit K
37
Q

Vitamins: indications (4)

A
  1. THIAMINE (Vit B3) - tx and prevention of Wernicke’s encephalopathy + Korsakoff’s psychosis
  2. FOLIC ACID (Vit B9) - megaloblastic anaemia + 1st trimester of pregnancy to reduce risk of neural tube defects
  3. HYDROXOCOBALAMIN (Vit B12) - megaloblastic anaemia + subacute combined degeneration of the cord
  4. PHYOTMENADIONE (Vit K) - newborn babies to prevent Vit K deficiency bleeding + to remecerse anticoagulant effects of warfarin
38
Q

Vitamins: MOA

A
  • MoA self explanatory as a pharmacological replacement for normal Vit
  • in pregnancy, folic acid req for normal cell division —> facilitates cell proliferation involved in neural tube closure
  • phytomenadione reverses warfarjn by providing a fresh supply of Vit K for the synthesis of Vit K dependant clotting factors by the liver
39
Q

Vitamins: SEs

A

1.IV Phytomenadjone + high dose thiamine can cause anaphylaxis

40
Q

Vitamins: Warnings

A
  1. CO-EXISTING B12 + FOLATE DEF - replace both vits simultaneously as replacing FA alone is associated with progression of neurological manifestations of B12 deficiency - risk of provoking subacute degeneration of the cord
  2. SEVER LIVER DISEASE - phytomenadione less effective in reversing warfarin as clotting factors synthesised in liver
41
Q

Vitamins: interactions

A
  1. Vit K + WARFARIN antagonistic which initially is desirable BUT when attempting to restart warfarin after Vit k has been given, it may result in erratic dosing requirements
42
Q

Vancomycin: Indications (2)

A
  1. Tx Gram +ve infection eg ENDOCARDITIS - where inf is severe +/or penicillins can’t be used due to resistance (MRSA) or allergy
  2. Tx of ANTIBIOTIC ASSOCIATED COLITIS caused by C.Diff (usu 2nd line where metronidazole is ineffective or not tolerated)
43
Q

Vancomycin: MoA

A
  • V inhibits growth and cross linking of peptidoglycan chains —> inhibiting synthesis of CW of G+ve bacteria
  • SO specific activity Vs G+ aerobic and anaerobic bacteria
  • Mech of resistance is modification of CW structure to prevent V binding
44
Q

Vancomycin: SEs

A
  1. Thrombophlebitis - at infusion site
  2. Red man syndrome = anaphylactoid rtn if V infused rapidly - generalised erythema, hypotension + bronchospasm
  3. Immediate or delayed hypersensitivity
  4. IV vancomycin
    —> NEPHROTOXICITY - incl renal failure + interstitial nephritis
    —> OTOTOXICITY- with tinnitus + hearing loss
    —>BLOOD DISORDERS - neutropenia + thrombocytopaenia
45
Q

Vancomycin: Warnings

A
  1. careful monitoring of plasma drug concs + dose adjustment to avoid toxicity
  2. Caution in
    - ELDERLY (incr risk of hearing impairment)
    - RENAL IMPAIRMENT
46
Q

Vancomycin: Interactions

A
  1. Incr risk of ototoxicity +/or nephrotoxicity when prescribed with AMINOGYLCOSIDES, LOOP DIURETICS or CICLOSPORIN (immunosuppressant)
47
Q

Valproate: Indications (2)

A
  1. Epilepsy - 1st choice for generalised or absence seizures + tx option for focal seizures
  2. Bipolar disorder - acute tx of manic episodes + prophylaxis against recurrence
48
Q

Valproate: MoA

A
  • weak inhibitor of neuronal sodium channels
  • stabilises resting membrane potentials + reduces neuronal excitability
  • also incr brain content of GABA, principal inhibitory neurotransmitter, which regulates neuronal excitability
49
Q

Valproate: SEs

A
  1. GI UPSET - nausea, gastric irritation, D
  2. NEUROLOGICAL + PSYCHIATRIC effects - incl tremor, ataxia + behavioural disturbances
  3. THROMBOCYTOPENIA - + transient incr in liver enzymes
  4. HAIR LOSS- due to hypersensitivity rtn - regrow the being curlier then original
  5. RARE, LIFE THREATENING, IDIOSYNCRATIC adverse effects - severe liver injury, pancreatitis, BM failure, antiepileptic hypersensitivity syndrome
50
Q

Valproate: Warnings

A
  1. CI = W OF CHILD BEARING AGE - particularly at time of conception and 1st trimester as —> foetal abnormalities eg neural tube defects = spina bífida, cardiac abnormalities - Epstein abnormality, craniofacial abn, limb abn, + developmental delay
  2. Hepatic impairment
  3. Severe renal impairment - req dose reduction
51
Q

Valproate: interactions

A
  • Valproate inhibits hepatic cytochrome P450 enzyme*
    1. Incr toxicity of drugs METABOLISED by P450 enzymes eg warfarin + other anti-epileptic drugs
    2. Cytochrome P450 INDUCERS eg phenytoin, carbamazepine, carbapenems
  • red conc + incr risk of seizures
    3. Cytochrome P450 INHIBITORS eg macrolides, protease inhibitors
  • incr adverse effects
    4. Drugs that DISPLACE it from PROTEIN BINDING SITES eg aspirin
  • incr adverse effects
    5. Drugs that LOWER SEIZURE THRESHOLD eg SSRIs, TCAs, antipsychotics, tramadol
  • reduce efficecy of antiepileptic drugs
52
Q

Vaccines: Indications (3)

A
  1. Childhood vaccines - routinely -childhood immunisation schedule
  2. Influenza vaccine - annually in at-risk groups
  3. Pneumococcal vaccine - childhood immunisation schedule + once-only administration in at-risk groups (>65, RF for pneumococcal disease- cochlear implant, hx of invasive pneumoc dis, occupational exposure to metal fumes, absence of ftnl spleen, RF for CSF leakage)
53
Q

Vaccines: MoA

A
  • Administer antigen to incite adaptive IR + generate immune memory (B cells)
  • Ag can be inactivated (influenza)
  • live but attenuated (MMR)
  • specifc protein or peptide components of infectious agent (pneumococcal vaccine)
  • exotoxin (tetanus toxoid vaccine)
54
Q

Vaccines: SEs

A
  1. Local rtns - pain, swelling, redness, mild systemic effects eg fever, headache, myalgia
  2. MMR vaccine may cause measles like-illness (incl rash) 1 week after vaccination + ocacsionally mumps like illness (with parotid swelling) in 3rd week
  3. Anaphylaxis - rare
55
Q

Vaccines: Warnings

A
  1. CI- ANAPHYLACTIC rtn to past dose
  2. CI to live vaccines if signifcant IMMUNOSUPRESSION
  3. Avoid live vaccines if PREGNANT
56
Q

Vaccines: Interactions

A

1.Immunosuppressive drugs (incl systemic corticosteroids) reduce IR to (+ so effectiveness) of vaccines

57
Q

Trimethoprim + Co-trimoxazole: Indications (2)

A
  1. Trimethoprim is 1st choice for UNCOMPLICATED UTI - alternatives = nitrofurantoin + amoxicillin
  2. Co-trimoxazole (trimethoprim + sulfamethoxazole) used for tx + prev of PNEUMOCYSTIS PNEUMONIA in ppl with IS eg HIV
58
Q

Trimethoprim + Co-trimoxazole: MoA

A
  • Bacteria need to make folate for essential ftns incl DNA synthesis
  • Trimethoprim INHIBITS BACTERIAL FOLATE SYNTHESIS, slowing bacterial growth (bacteriostatic)
59
Q

Trimethoprim + Co-trimoxazole: SEs

A

1.GI UPSET (nausea, vomiting, sore mouth)
2.SKIN RASH (3-7%)
3.Severe HYPERSENSITIVITY rtns incl anaphylaxis, drug fever + erythema multiforme
occur rarely with trimethoprim but more commonly with sulfonamides
4. As a folate antagonist, trimethoprim can impair haematopoiesis
–> HAEMATOLOGICAL DISORDERS eg megaloblastic anaemia, leucopenia + thrombocytopaenia
5.HYPERKALAEMIA + elevation of plasma creatinine concs

60
Q

Trimethoprim + Co-trimoxazole: Warnings

A
  1. CI in 1st TRIMESTER OF PREGNANCY - folate antagonist –> fetal abn (CV defects, oral clefts)
  2. FOLATE DEF - adverse haematological effects - caution
  3. RENAL IMPAIRMENT -mostly excreted unchanged in urine - caution
  4. NEONATES + ELDERLY + HIV inf –> adverse effects
61
Q

Trimethoprim + Co-trimoxazole: Interactions

A
  1. POTASSIUM ELEVATING DRUGS eg aldosterone antagonists, ACEi, ARB –> hyperkalaemia
  2. FOLATE ANTAGONISTS eg methotrexate –> incr risk of adverse haematological effects
  3. DRUGS THAT INCR FOLATE METABOLISM eg phenytoin –> incr risk of adverse haematological effects
  4. Trimethoprim can enhance anticoagulant effect of WARFARIN by killing normal gut flora that synthesise vitamin K
62
Q

Thyroid hormones: Indications (2)

A
  1. PRIMARY HYPOTHYROIDISM

2. HYPOTHYROIDISM SECONDARY TO HYPOPITUITARISM

63
Q

Thyroid hormones: MoA

A
  • TG produces thyroxine (T4), converted to more active T3 in target tissues
  • Regulate metabolism + growth
  • Def –> hypothroidism –> lethargy, WG, constipation, slowing of mental proceses
  • tx with LT replacement usu levothyroxine (synthetic T4)
  • Liothyronine (synthetic T3) has a shorter 1/2 life + quicker onset (few hrs) + offset (24-48hrs) of action SO use for emergency tx of severe or acute hypothyroidism
64
Q

Thyroid hormones: SEs

A

SEs usu due to xs doses so similar to hyperthyroidism

  1. GI (V,D, W loss)
  2. Cardiac (palpitations, arrythmias, angina)
  3. Neurological (tremor, restlessness, insomnia)
65
Q

Thyroid hormones: Warnings

A
  1. CAD - thyroid hormones incr HR + metabholism –> precipate cardiac ischaemia
  2. HYPOPITUITARISM - corticosteroid therapy started before thyroid hormone replacement to avoid Addisonian crisis
66
Q

Thyroid hormones: Interactions

A
  1. ANTACIDS, CALCIUM OR IRON SALTS- reduce GI absorption of levothyroxine - seperate drugs by 4 hours
  2. CYTOCHROME P450 INDUCERS eg phenytoin, carbamazepine - need to incr dose of levo
  3. INCR INSULIN OR ORAL HYPOGLYCAEMIC REQ IN DM - due to levothyroxine induced changes in metaboism
  4. WARFARIN - enhanced eff due to levo-induced changes in metabolism
67
Q

Thiazolidinediones: Indications (1)

A
  1. T2DM
    - as a single agent in overweight pts where metformin CI or not tolerated
    - added as 2nd agent to metformin or sulphonylurea
    - added as 3rd agent with metformin + sulphonylurea as an alt to starting insulin
68
Q

Thiazolidinediones: MoA

A
  • INSULIN SENSITISERS
  • lower bl gl by activiting PPARγ
  • induces genes which enhance insulin action in skeletal muscle, adipose tissue + liver
  • with incr peripheral glucose uptake. + utilisation + reduced hepatic gluconeogenesis
  • do not stimulate pancreatic insulin seretion, so do not cause hypoglycaemia
  • cause WEIGHT GAIN, which can incr insulin resistance
69
Q

Thiazolidinediones: SEs

A
  1. GI UPSET, ANAEMIA + MINOR NEURO EFFECTS- headache, dizzy
  2. OEDEMA + CARDIAC FAILURE - particularly where pioglitazone prescribed with insulin
  3. Pioglitazone is assoc with small incr in BONE FRACTURES in women
  4. Idiosyncratic reactions include SEVERE LIVER TOXICITY
    - Pioglitazone is the only thiazolidinedione currenyly available for prescription in the UK
70
Q

Thiazolidinediones: Warnings

A
  1. HEART FAILURE - CI
  2. CVD - caution
  3. Bladder C - CI
  4. RF for bladder c (eg smoking, occupational exposure, prior pelvic irradiation) - caution
  5. Elderly pts - careful as incr risk of cardiac disease, bladder c + bone fractures
  6. Hepatic impairment- caution - pioglitazone metabolised in liver + can cause liver toxicity
71
Q

Thiazolidinediones: Interactions

A

1.Often prescribed in combo witth other ANTIDIABETIC DRUGS - incr risk of adverse effects eg hypoglycaemia + cardiac failure

100 Drugs (2 decks)

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