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Gphc 2022 > Drug Infos > Flashcards

Drug Infos Flashcards

1
Q

What are the side effects of Aminosalicylates?

A
  • Blood disorders

- Lupus - Like Syndrome

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2
Q

What are the monitoring requirements for Aminosalicylates?

A
  • Suspected Blood disorder, monitor Blood count, stopped if suspicion.
  • Renal function; Before starting, 3 months then annually
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3
Q

What is the patient and cared advice for aminosalicylates?

A
  • Report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise
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4
Q

What are the side effects of Azathioprine?

A
  • Hypersensitivity reactions (dizziness, vomiting, diarrhoea, fever, hypotension, renal dysfunction; immediate withdrawal
  • Neutropenia and Thrombocytopenia
  • Nausea
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5
Q

What are the monitoring requirements for Azathioprine (converted to mercaptopurine)?

A
  • TPMT activity before starting; risk of myelosuppression increased
  • Full blood counts; weekly for first 4 weeks then every 3 months
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6
Q

What are the patient and carer advice for Azathioprine?

A

Report signs + symptoms of bone marrow suppression ; bruising, bleeding, infection.

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7
Q

What are the side effects of Amiodarone?

A
  • Corneal microdeposits
  • Thyroid disorders (hypo -and hyperthyroidism
  • Phototoxic reactions (Blue/grey marks)
  • Hepatoxicity
  • Pulmonary toxicity
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8
Q

What are the monitoring requirements for Amiodarone?

A
  • Serum potassium (before treatment)
  • TFTs before treatment + every 6 months
  • LFTs before treatment + every 6 months
  • Chest X-Ray
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9
Q

What are the Patient and Carer advice for Amiodarone?

A
  • Shield skin from sunlight (during treatment and several months after) ; use wide spectrum sunscreen
  • Hepatotoxicity (nausea+vomiting, dark urine, abdominal pain, jaundice); discontinue
  • Report symptoms of shortness of breath + coughing
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10
Q

What are the side effects of Digoxin?

A
  • Bradycardia
  • GI disturbances
  • Rashes
  • Dizziness
  • Visual disturbances (Blurred/Yellow vision)
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11
Q

What are the monitoring requirements for Digoxin?

A
  • Renal Function
  • Plasma-Digoxin concentration 1.5 - 3 mcg/L
  • Check plasma concentration at least 6 hours after a dose
  • Reduce Digoxin dose by half when given with: Amiodarone, Dronedarone, Quinine
  • Hypokalaemia
  • Hypomagnesaemia
  • Hypercalcaemia
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12
Q

What are the Patient and Carer advice for digoxin?

A
  • Seek advice if side effects particularly Bad -
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13
Q

What are the intrinsic sympathomimetic activity (ISA) Beta-Blockers?
When are they useful?

A

PACO - Pindolol, Acebutolol, Celiprolol, Oxprenolol

- They cause less bradycardia and coldness of the extremities

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14
Q

What are the water soluble beta-blockers?

A

CANS - Celiprolol, Atenolol, Nadolol, Sotalol

  • Less likely to enter brain causing less sleep disturbance

Water soluble beta-blockers are excreted by the kidney - reduce dose if patient is renally impaired.

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15
Q

Which Beta blockers should be taken OD due to their long duration?

A

BCAN - Bisoprolol, Celiprolol, Atenolol, Nadolol

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16
Q

Which Beta-blockers are cardio selective and are preferred in asthmatic patients?

A

BAMAN - Bisoprolol, Atenolol, Metoprolol, Acebutolol, Nebivolol

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17
Q

Why should beta blockers and thiazide diuretics be avoided together?

A
  • increased risk of hypotension
  • avoided in uncomplicated hypertension in patients with diabetes or in those at high risk of developing diabetes.
  • contraindicated in diabetes - so cardioselective preferred
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18
Q

When should Lercanidipine be taken?

What should should prescriber remember when prescribing Nifedipine?

A
  • Take 30 to 60 mins before food

- Prescriber should specify the brand when prescribing MR preparations

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19
Q

When should statins not be started?

A

When patient is at increased risk of muscle effects - if baseline creatine kinase concentration is more than 5 times the upper limit

more than 5 times the upper limit - statin should not be started
raised but < 5 times the upper limit - statin should be started at lower dose

Statin suspected cause of myopathy + Creatine Kinase (CK) concentration is elevated = discontinue treatment

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20
Q

What should be checked before starting statin therapy?

A
  • Check thyroid function - hypothyroidism is a reversible cause of dyslipidaemia
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21
Q

Is contraception required during stating therapy?

A

YES - during treatment and for 1 month afterwards

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22
Q

Can Statin be used during pregnancy?

A
  • Should be avoided in pregnancy; congenital anomalies
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23
Q

What are the important dose adjustments for simvastatin?

A

Bezafibrate and Ciprofibrate - Maximum 10mg daily

Amiodarone, Amlodipine and Ranolazine - Maximum 20mg daily

Verapamil, Diltiazem - Maximum 20mg daily

Ticagrelor - Maximum 40mg daily

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24
Q

Which antipsychotics cause the most EPSEs?

A
  • Fluphenazine, Trifluoperazine, Prochloperazine, Haloperidol, Benperidol
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25
Q

Which antipsychotics cause the most sexual dysfunction?

A

BROH- Benperidol, Risperidone, Olanzapine, Haloperidol

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26
Q

Which antipsychotics cause the least sexual dysfunction?

A

AQ - Aripiprazole and Quetiapine

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27
Q

Which drug cause the most Hyperprolactinaemia?

A

RAF - Risperidone, Amisulpride, First-generation

28
Q

Which drug is the least Hyperprolactinaemia?

A

AACQ - Aripiprazole, Asenapine, Clozapine, Quetiapine

29
Q

Which drug cause the most hypotension?

A

Clozapine and Quetiapine

30
Q

What are the side effects of Clozapine?

A
  • Neuroleptic malignant syndrome
  • Constipation
  • Hypersalivation
  • Drows- Dizz, N+V
  • Blood disorder
  • Cardiac problems
  • weight gain
  • decreased appetite
31
Q

What are the monitoring requirements for Clozapine?

A
  • Prolactin ( start, 6 months, yearly)
  • Blood lipids + weight (every 3 months for 1st year, yearly after)
  • Fasting glucose (start, every 1 month, every 4 to 6 months
  • Persistent tachycardia - prompt observation (if myocarditis or cardiomyopathy suspected- discontinue permanently)

Leucocyte + Blood counts - must be normal before starting

Leucocyte + Blood counts - monitor counts every week for 18 weeks, then every 2 weeks for 1 year, then every 4 weeks.

32
Q

What are the Patient and Carer advice for clozapine?

A
  • Fever, increased heart rate + sweating (contact doctor)
  • Constipation develops - seek medical advice before next dose
  • Inform or inquire when adjusting smoking habits
33
Q

What is the Patient and Carer Advice for Clindamycin?

A
  • Diarrhoea (C DIFF)

- Take with a full glass of water

34
Q

What are the side effects of metronidazole?

A
  • N+V
  • Furring of tongue
  • Taste disturbance
  • Sore mouth
35
Q

What are the patient and Carer advice for metronidazole?

A
  • Take with or after food

- avoid Alcohol (disulfram-like reaction - N+V); do not drink while taking and for 48 hrs after finishing

36
Q

Should phenoxypenicilin be taken with food?

A
  • take on empty stomach one hour before or two hours after food
37
Q

What are the Patient and Carer advice for Flucloxacillin?

A
  • take on empty stomach (one hour before or two hours after food)
  • look out for signs of hepatotoxicity and cholestatic jaundice
38
Q

What are the common side effects of Macrolides? (clarithromycin, erythromycin)

A
  • Taste disturbances

- Tooth and tongue discolouration

39
Q

What are the side effects of Quinolones?

A
  • QT prolongation
  • Tendon damage
  • Neurological reactions
  • Psychiatric reactions
  • Hypersensitivity
  • N + V
  • Diarrhoea

avoid exposure to excessive sunlight (during treatment and for 48 hours after treatment

40
Q

What are the Patient and Carer advice for quinolones?

A

Do not drink milk or take antacids or vitamin supplements containing iron or zinc , for two hours before or two hours after taking quinolones (reduces effectiveness)

Avoid taking NSAIDs

41
Q

What may happen when NSAIDs is taking at the same time as quinolones?

A
  • quinolones may induce convulsions

- taking Nsaids at the same time may induce them

42
Q

What is the dietary interaction associated with tetracyclines?

A
  • Do not take with indigestion remedies or medicines containing iron or zinc 2 hours before or after

Demeclocyclines, Oxytetracyclines, Tetracyclines - avoid taking with milk

43
Q

What are the important safety information for Rifampicin?

A
  • N+V, Headaches, Thrombocytopenia
  • Discolours soft contact lenses
  • Discolours urine orange/red
  • Take on empty stomach, an hour before or two hours after food
44
Q

What are the important safety information for Ethambutol?

A
  • Hyperuricaemia, Nerve disorders, Visual impairment
  • visual acuity (snellen chart); if renally impaired avoid ethambutol (increases risk of optic nerve damage)
  • Discontinue therapy immediately if any sign of developed vision impairment and promptly seek further advice.
45
Q

what are the safety information for pyrazinamide?

A
  • Hepatotoxicity

- Discontinue and seek immediate medical attention if persistent N+V, malaise or jaundice

46
Q

What are the important safety information for Isoniazid?

A
  • Damage to peripheral nerves (numbness + tingling in hands and feet) ; pyridoxine co-administered
  • Hepatic disorders
  • N+V
  • Peripheral neuropathy

Avoid tyramine rich foods ( mature cheeses, salami, pickled herring, some beers, lagers or wines) - tachycardia

Avoid histamine rich foods (mature cheeses, fish from scombroid family - tuna, mackarel + salmon) - tachycardia

47
Q

Which antipsychotic causes the most Hyperglycaemia?

A
  • Clozapine, Risperidone, Olanzapine, Quetiapine
48
Q

Which antipsychotic causes the least Hyperglycaemia?

A

First gens ( particularly fluphenazine and haloperidol )

Amisulpride

Aripiprazole

49
Q

Which antipsychotic cause the most weight gain?

A

Clozapine, Olanzapine

50
Q

Which antipsychotics have the most cardiovascular side effects?

A

Haloperidol, Pimozide

51
Q

A patient has her first unprovoked epileptic seizure, or single isolated seizure, how long can they not drive for?

A

Six months

52
Q

A patient experiencing epileptic attacks whilst asleep and awake, when can they start driving again?

A

Reapply if attacks only while asleep for last THREE years

53
Q

When can a patient who is having epileptic attacks whilst only asleep start driving again?

A

Reapply if ONE year since first attack

54
Q

How does Azathioprine interact with Allopurinol and ACE inhibitors?

A
  • Reduce dose of Azathioprine/ mercaptopurine (1/4 of the usual dose) with concomitant allopurinol use = toxic levels
  • Increased risk of anaemia and/or leucopenia with Ace inhibitors
55
Q

What is the interaction between Pomelo juice and ciclosporin?

A

Pomelo juice is predicted to increase ciclosporin exposure

56
Q

What is the interaction between Purple grape juice and Ciclosporin?

A

Purple grape juice is predicted to decrease ciclosporin exposure

57
Q

What is the interaction between allopurinol and ace inhibitors?

A
  • increased risk of leucopenia
58
Q

What are the drugs that cause Hyperkalaemia, when administered together with Ace inhibitors?

A
  • Heparin
  • Ciclosporin
  • Trimethoprim
  • Heparins
59
Q

Which Ace inhibitor is given BD and which one is given 30-60 minutes before food?

A

BD - Captopril

30-60 minutes before food - Perindopril

60
Q

When should ACE inhibitors be stopped?

A
  • Ace inhibitors should be stopped if liver transaminases are 3 times normal or jaundice occurs - can lead to cholestatic jaundice and hepatic failure
61
Q

What can Labetolol cause?

A
  • Can cause Liver damage
62
Q

Which beta blockers are used to reduce mortality in MI?

A
  • MAP Metoprolol , Atenolol, Propranolol
63
Q

What is the interaction between CCBs and domperidone?

A
  • Increases the risk of QT - prolongation when give with domperidone
64
Q

What drugs, when administered together with diuretics may prolong QT interval and may cause torsade de pointes?

A
  • Amiodarone
  • Citalopram
  • Haloperidol
  • Macrolides (Clarithromycin, Erythromycin)

they all cause hypokalemia

65
Q

How do Thiazides diuretics affect diabetes?

A

-Thiazides and related diuretics can exacerbate diabetes, gout and systemic lupus erythematosus

Gphc 2022 (3 decks)

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