drug adverse effects and ADME Flashcards
which benzodiazepines have short half-lives? what is the consequence?
no problem with cumulative effects with multiple doses
estazolam, oxazepam, lorazepam
what are the contraindications for benzodiazepines and their receptor agonists?
COPD, depression, hepatic disease, closed-angle glaucoma
which insomnia drugs are Cat X, C?
X: benzodiazepines
C: benzodiazepine receptor agonists
what are two adverse effects of ramelteon?
URTI, naso-pharyngitis
what two drugs used in insomnia are associated with suicidal ideation?
doxepin, suvorexant
who shouldn’t anti-histamines be given to for insomnia?
elderly: excessive sedation, urinary retention, falls
who needs a dose adjustment with suvorexant?
obese women: lower dose recommended
what anti-migraine drugs are contraindicated in pregnancy? late pregnancy?
ergots
late: NSAID’s
which triptan is most responsible for adverse effects? what are they primarily?
sumatriptan
CNS effects
what are triptans contraindicated with and why?
any sort of vascular disease
may cause coronary and peripheral vasospasm
which triptans are interact with MAOI’s?
zolmi-, riza-, and sumatriptan
which triptan has increased levels when taken with CYP3A4 inhibitors?
elitriptan
which triptans interact with propranolol, resulting in increased levels?
eli-, zolmi-, and rizatriptan
when are ergots contraindicated, 2 populations?
pregnancy/lactation, vasospastic predisposing conditions
which drug used in migraines may cause hyperprolactinemia, gynecomastia?
metoclopramide
which drug used in migraines may cause Parkinson-like syndrome?
chlorpromazine
which migraine prophylaxis drugs can cause increased weight?
valproate and amytryptiline
which migraine prophylaxis drug can cause increased aggression?
amytryptiline
which migraine prophylaxis drug is Cat X and potentially hepatotoxic?
valproate
what are two contraindications for using muscarinic atnagonists?
glaucoma
sulfit preservative allergies
what two drugs are associated with increased hair growth?
prostaglandin analogs
phenytoin
contacts can’t be worn with which glaucoma drugs?
beta-blockers
which drugs can cause dysgeusia (bitter taste)? what is another common adverse effect?
carbonic anhydrase inhibitors
bacterial keratitis due to contamination of multi-dose vial
which non-antibiotic drugs are sulfonamides?
carbonic anhydrase inhibitors
what glaucoma drugs are associated with decreased night vision?
muscarinic agonists
what drugs have additive effects with carbamate/phosphate insecticides?
AChE inhibitors
which AED’s are CYP inducers?
phenytoin and carbamazepine
which AED’s require serum drug level monitoring to guide therapy?
carbamazepine, phenytoin, valproate, gabapentin, ethosuximide
what are the 4 common adverse effects with AED’s?
- suicidal ideation 2. CNS effects 3. dermatologic toxicity 4. hematologic toxicity
which AED’s are weak carbonic anhydrase inhibitors? what is the adverse outcome?
zonisamide and topiramate
renal stones and metabolic acidosis
what drug has 0-order elimination? what are two other drugs like that?
phenytoin
alcohol and high dose aspirin
what drug is associated with gingival hyperplasia? what other somewhat similar adverse effect is it associated with?
phenytoin
hypertrichosis/hirsutism
what are the BBB for the following drugs: carbamazepine, felbamate, lamotrigine
carbamazepine: agranulocytosis; felbamate: aplastic anemia, BM suppression, hepatic disease; lamotrigine: SJS/TEN
which AED’s are Cat X? Cat D?
Cat X: valproate
Cat D: carbamazepine, phenytoin, others
which AED may cause thrombocytopenia? what can it cause in children?
valproate
hepatotoxicity
