drugs and therapeutics 1

Question 1

what drug requires serology testing before given to those with liver disease

Answer 1

prednisolone, because it can cause hep carriers to become active hepatitis again

Question 2

what drugs to avoid in liver disease

Answer 2

• aspirin
• nsaids
• paracetamol
• benzos
• azoles
• clindamycin

Question 3

azoles should be avoided in which group of patients

Answer 3

liver disease! all hepatotoxic

Question 4

amide LA caution is which group of patients

Answer 4

liver disease

Question 5

what drugs should have decreased dose in liver disease patients

Answer 5

• metro
• carbamazepine
• erythro
• clarithro

Question 6

what AB is safe to give in patients with liver disease

Answer 6

beta lactams as these are metabolised by renal so excreted in urine

Question 7

what drugs to avoid in renal disease

Answer 7

• aspirin
• nsaid
• cox 2 inhibitor
• tetracyclines
• aminoglycosides
• sulphonamides
• ciprofloxacin

Question 8

what drugs to decrease dose in renal disease

Answer 8

• vancomycin
• cephalosporins
• acyclovir

Question 9

what AB are safe for patients with renal disease

Answer 9

macrolides, metronidazole, clindamycin

Question 10

what analgesic safe for patient with renal disease

Answer 10

• paracetamol
• LA

Question 11

in geriatrics, a lot of them take statins. what drugs should we be careful of prescribing and what are their side effectts

Answer 11

1) metro - ddi with simvastatin, increases risk of nerve damage

2) antifungals - will increase the blood levels of atorvastatin and hence increase risk of liver damage and rhabdo

3) macrolides - macrolides inhibit cyp3a4 and cause increased blood levels of statins, increasing risk of myopathy and rhabdo

Question 12

what drugs to caution in geriatrics

Answer 12

• sedatives
• hypnotics
• narcotics
• corticosteroids - fluid retention, severe gastritis, blood sugar goes up, plus these old folks are alrdy osteoporotic so corticosteroids long term will inhibit osteoclasts

Question 13

what drugs cant take with milk

Answer 13

• tetracycline - absorption decreases a lot
• quinolones - calcium binds to fluoroquinolones and make them ineffective

Question 14

what is the interactin of ibuprofen and warfarin

Answer 14

taking ibuprofen increases the chance of bleeding because both are 99% protein bound

concomitant administration reduces warfarin binding to 97% so got lots of free warfarin to increase bleedin

Question 15

what are some AB which are liver enzyme inhibitors

Answer 15

• erythro, clarithro
• cipro
• azole antifungals
• metronidazole

Question 16

3 drugs which are liver enzyme inducers

Answer 16

• carbamazepine
• barbiturates
• rifampin

whihc means that these drugs cause liver enzymes to be more active and other stuff that are mteab by the liver will be faster

Question 17

what are drugs that cause thrombocytopenia

Answer 17

NOT ASPIRIN, NSAIDS, COX 2

those that cause thrombo:
- CHEMOTHERAPY DRUGS
- standard heparin (those that are used for dialysis)

Question 18

What is therapeutic index

Answer 18

is the ratio of mean lethal dose (LD 50) to the mean effective dose (ED 50)

Question 19

do nsaids cause platelet problem

Answer 19

they affect platelet quality but not quantity (so still dont need to do FBC)

BEcuase cox 1 is found in platelts, so inhibition causes platelets to be poorer quality
but cox 2 not found in platelets so wont affect