Final Comprehensive Safety Exam Flashcards
Prodrug metabolism
Does not activate until metabolized in liver
rapid metabolizers at risk for drug toxicity
slow metabolizers at risk for ineffectiveness
CYP450 inhibitors
increase drug availability in the body=toxicity
CYP450 inducers
Decrease drug effect=ineffectiveness
Drugs that prolong QT
Zofran Beta Blockers Methadone Albuterol Tricyclic Antidepressants macrolides
examples of CYP450 inhibitors
cimetidine, ketoconazole, erythromycin, estradiol, grapefruit juice, fluoroquinolones, diltiazem, tetracyclines
example of CYP450 inducer
phenobarbital, rifampin
causes ototoxicity and renal toxicity
aminoglycosides (gentamycin, neomycin)
Antibiotics contraindicated in pregnancy
Tetracycline (doxycycline)
fluoroquinolone (ciprofloxacin, levaquin)
GI meds contraindicated in pregnancy
Cytotec, stimulant laxatives, sodium bicarbonate (alka seltzer), pepto bismol
BBW for Phenergan
respiratory depression in children
BBW for lotronex
Ischemic colitis
used to treat women with severe IBS-D
Lotronex
BBW for methotrexate
Blocks folic acid, can lead to fetal toxicity
Immunosuppressant used for rheumatoid arthritis
and crohns disease
methotrexate
BBW for fluoroquinolones
Tendon rupture
Need additional birth control
avoid calcium and other metal supplements
photosensitivity
tetracyclines
can cause yellow discoloration of teeth
no pregnancy or children under 8
tetracyclines
macrolides
erythromycin
azithromycin
avoid in 1st and 3rd trimester
sulfonamides (bactrim, septra)
steven johnson syndrome
hemolytic anemia
sulfonamides (bactrim, septra)
Do not give with calcium channel blockers or warfarin
clarithromycin
interferes with absorption of oral contraceptives
CYP450 Inducer
Decreases warfarin levels
rifampin
BBW: severe hepatitis, liver failure, death
Isoniazid (INH) for TB
Do not give live vaccines
Pregnancy, immunocompromised, children < 1
H2RA GI med that is a CYP450 inhibitor
Tagamet (cimetidine)
prostaglandin analog GI med contraindicated in pregnancy with BBW of causing uterine contractions
Tagamet (cimetidine)
Stimulant laxative with BBW of pregnancy category X
Castor oil
anticholinergics
Atropine (in lomotil) Benadryl Atrovent Spiriva TCAs
GI med that can cause tardive dyskinesia
Phenergan
safety for PPIs
Increased risk of lung infection
Taper off slowly d/t rebound acidity
Give 2 hours apart from enteric coated drugs
