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Clinical pharmacology and therapeutics > Drug choices and prescribing in special cases > Flashcards

Drug choices and prescribing in special cases Flashcards

1
Q

How can renal impairment affect drugs

A

May reduce elimination of renally excreted drugs which leads to accumulation/toxicity

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2
Q

How to measure renal function

A

eGFR

or

Creatinine clearance

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3
Q

When to use creatinine clearance vs eGFR

A

Older patients etc

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4
Q

What are alternative approaches when there is renal impairment

A

Choose short acting agents

Choose non renally excreted alternatives

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5
Q

How do prescribe gentamicin in renal impairment

A

Increase the dosage interval

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6
Q

Which drugs must be avoided in renal impairment

A

Metformin

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7
Q

Which dries may become ineffective in renal impairment

A

Thiazide diuretics

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8
Q

Which drug does not cross the placenta

A

Heparin

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9
Q

Which drugs have issues with pregnancy

A 
Anti-epileptics
Anticoagulants
Antibiotics
Antihypertensives
Antidiabetics
Antidepressants
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10
Q

How to counsel entiepileptic drugs during pregnancy

A

Continuation of treatment is preferable

Or plan discontinuation gradually

Carbamazepine is preferred along with high doses of folic acid

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11
Q

What drug is considered the safest anti-epileptic drug during pregnancy

A

Lamotrigine

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12
Q

Which drugs affect effectiveness of oral contraceptives

A

Inducing agents

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13
Q

Which anti epileptic drugs can’t be used with oral contraceptives

Which other drug can’t be used

A

Phenytoin
Carbamazepine
Phenobarbital

Rifampicin

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14
Q

Which anticoagulant should be avoided in first and 3rd trimester of preg

How to overcome

A

Warfarin

favour LMWHs

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15
Q

What is not an appropriate guide to follow when prescribing in hepatic impairment

A

LFT

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16
Q

What effect can prescribing drugs in hepatic impairment have

A 
Hepatic clearance 
Protein binding
Sodium retention
Effects on InR
gastric effects
CNS effects
Sedation

Clinical pharmacology and therapeutics (16 decks)

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