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Paramedic Drugs > drug interactions > Flashcards

drug interactions Flashcards

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1
Q

acetaminophen

A

● Increased effect with caffeine.
● Decreased effect with antacids, anticholinergics, carbamazepine, and phenytoin.
● Alcohol may increase hepatotoxicity risk

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2
Q

activated charcoal

A

● Moderate interactions with acetylcysteine, citalopram, digoxin, dyphylline, methotrexate, and theophylline

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3
Q

adenosine

A

● Methylxanthines (stimulants) block actions of adenosine.
● Actions are potentiated with dipyridamole, carbamazepine, and nicotine

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4
Q

albuterol

A

● May potentiate hypokalemia caused by diuretics

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5
Q

amiodorone

A

● May increase the effects of digoxin, disopyramide, fentanyl, lidocaine,
procainamide, quinide, or warfarin.
● Cimetidine may increase amiodarone levels.
● Beta blockers or calcium channel blockers may potentiate bradycardia, sinus
arrest and AV blocks.
● Amiodarone will precipitate with sodium bicarbonate and heparin. Use a
different IV if coadministering.
● Do not combine with other drugs that prolong the QT interval (ondansetron,
procainamide)

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6
Q

aspirin

A

● Increased risk of bleeding with concurrent anticoagulant/NSAID use.
● Diminishes effects of ACE inhibitors and loop diuretics.
● Decreased effectiveness and absorption with antacids and corticosteroids.
● Increased risk of hypoglycemia when administered with oral hypoglycemic
drugs.

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7
Q

atropine

A

● Potential adverse effects with administered with digitalis, cholinergics, and
physostigmine.
● Effects enhanced by antihistamines, procainamide, quinidine, antipsychotics,
benzodiazepines and antidepressants.

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8
Q

calcium chloride

A

● May increase ventricular irritability and precipitate digitalis toxicity when taken
with digoxin.
● Potentiated by thiazide diuretics
● Incompatible with most medications

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9
Q

calcium gluconate

A

● Severe bradycardia with concurrent digitalis use.
● Incompatible with most medications

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10
Q

dexamethasone

A

● Simultaneous use with ASA/NSAIDs may increase risk of GI bleed and ulcers.
● Concurrent use with diuretics can result in hypokalemia

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11
Q

dextrose

A

Sodium Bicarbonate, Warfarin

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12
Q

diazepam

A

● Incompatible with most drugs and fluids

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13
Q

diltiazem

A

● Use with caution in patients taking medications that affect cardiac contractility

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14
Q

diphenhydramine hydrochloride

A

● Potentiates effects of CNS depressants.
● MAOIs prolong and intensify anticholinergic effects.

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15
Q

dopamine hydrochloride

A

● Deactivated by alkaline solutions.
● MAOIs and TCAs prolong and potentiate effects.
● Beta blockers antagonize cardiac effects.
● Simultaneous use of vasopressors may result in severe hypertension.
● Simultaneous administration of phenytoin may cause hypotension, bradycardia
and seizures

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16
Q

epinephrine

A

none

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17
Q

etomidate

A

● Potentiated by other CNS depressants

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18
Q

fentanyl citrate

A

none

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19
Q

flumazenil

A

● Toxic effects when combined with TCAs

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20
Q

furosemide

A

● May potentiate lithium toxicity and digitalis toxicity because of sodium depletion and potassium depletion, respectively

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21
Q

glucagon

A

● Incompatible in solution with most substances

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22
Q

glucose, oral

A

none

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23
Q

haloperidol

A

● Potentiates antihypertensive medications.
● Antagonizes amphetamines and epinephrine.

24
Q

hydromorphone

A

● MAOIs and SSRIs

25
Q

hydroxocobalamin

A

● Do not administer in the same IV line with diazepam, dobutamine, dopamine, fentanyl, NTG, propofol, sodium nitrate or sodium thiosulfate

26
Q

ibuprofen

A

● Additive risk for bleeding if given in combination with other agents that affect
hemostasis
● May diminish the antihypertensive effects of hydralazine
● May diminish the diuretic effect of loop, thiazide, and thiazide-like diuretics
● TCAs may enhance NSAID antiplatelet effects

27
Q

ipratropium bromide

A

none

28
Q

ketamine

A

● Ketamine may enhance effects of CNS depressants and nondepolarizing
neuromuscular blockers

29
Q

ketorolac tromethamine

A

● TCAs may enhance antiplatelet effects

30
Q

labetolol

A

none

31
Q

lidocaine hydrochloride

A

● High doses of lidocaine may prolong apneic period with succinylcholine
● Cardiac depression may occur in conjunction with IV phenytoin
● Procainamide may exacerbate CNS effects

32
Q

lorazepam

A

none

33
Q

magnesium sulfate

A

● Serious changes in overall cardiac function may occur with cardiac glycosides

34
Q

mannitol

A

● May precipitate digitalis toxicity when given concurrently
● Avoid use with NSAIDs, salicylates, nitrates and diuretics

35
Q

methylprednisolone sodium succinate

A

● Response to insulin and hypoglycemic agents may be blunted

36
Q

midazolam hydrochloride

A

none

37
Q

morphine sulfate

A

● MAOIs may cause paradoxical excitation

38
Q

naloxone hydrochloride

A

● Incompatible with bisulfate and alkaline solutions

39
Q

nitroglycerin

A

● Incompatible with other drugs given IV
● Increased hypotensive effect with alcohol and phenothiazines

40
Q

norephinephrine bitartrate

A

● Inactivated by alkaline solutions
● Alpha-adrenergic effects can be blocked with concurrent administration of
phenothiazines.
● TCAs can markedly increase response to pressors

41
Q

ondansetron hydrochloride

A

● Serotonin syndrome can occur with simultaneous use of several SSRIs or
serotonin receptor-blocking drugs.
● Avoid administration with other drugs that prolong the QT interval.

42
Q

oxygen

A

none

43
Q

oxytocin

A

● Can cause severe, persistent hypertension if administered with vasopressors

44
Q

phenylephrine

A

● Exaggerated adrenergic effects if given with, or up to 21 days after, MAOI use.
● Hypertensive effects may be potentiated by PCAs, guanethidine, methyldopa,
and atropine-like drugs.

45
Q

pralidoxime

A

● Avoid concurrent use with succinylcholine and respiratory depressants

46
Q

procainamide hydrochloride

A

none

47
Q

promethazine hydrochloride

A

● Increased extrapyramidal effects with MAOIs

48
Q

rocuronium bromide

A

● Additive effects if administered with, or following, an opioid, sedative or anesthetic agent

49
Q

sodium bicarbonate

A

● Additive effects if administered with, or following, an opioid, sedative or anesthetic agent.

50
Q

succinylcholine chloride

A

● Diazepam may reduce the duration of action.
● Oxytocin, beta blockers and organophosphates may potentiate effects.

51
Q

terbutaline sulfate

A

● MAOIs may potentiate dysrhythmias

52
Q

thiamine hydrochloride

A

● Unstable in alkaline solutions

53
Q

tranexamic acid

A

● Hormonal contraceptives and clotting factor complexes increase the risk of thromboembolic disorders.

54
Q

vecuronium bromide

A

● Additive effects if administered with, or following, an opioid, sedative, or anesthetic.

55
Q

verapamil hydrochloride

A

● Increases the serum concentration of digoxin
● May potentiate the action of neuromuscular blocking agents
● Increased risk of sudden death when given concurrently with erythromycin

Paramedic Drugs (11 decks)

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