final safety exam part 2 Flashcards
NSAIDs precautions
Post MI stomach ulcers asthma kidney disease liver disease
BBW for loop diuretics
Diuresis and electrolyte depletion
loop diuretic that can cause ototoxicity
furosemide (Lasix)
BBW for spirinolactone
Tumors in rats
ACE inhibitor safety (lisinopril)
Contraindicated in 2nd and 3rd trimesters d/t fetal injury
Angioedema
Increase bradykinins leading to cough
BBW for ARBs (angiotensin-2 receptor blockers)
Losartan (cozaar)
Fetal injury - discontinue in 2nd and 3 trimester
Is it okay to combine ARBs and ACEs
No!
Safety for angiotensin-2 receptor blockers (ARBs)
renal failure, angioedema
Antihypertensive used in pregnancy
beta blockers
Calcium Channel Blockers (Procardia)
Do not use these antihypertensive drugs with CYP450 inhibitors
Calcium channel blockers (verapamil)
BBW for beta blockers
Abrupt discontinuation can cause cardiac ischemia, increased risk of MI
Asthma
DM
Psych disorders/depression
Calcium channel blockers (do not combine)
can mask hypoglycemia
Heart meds contraindicated in pregnancy
ACEs, ARBs, Statins, warfarin
BBW for warfarin
Fatal bleeding
BBW for heparin
Increased risk for spinal or epidural hematoma
BBW for plavix
CV events in poor metabolizers like variant of CYP2C19
Get genetic test first
Plavix persists (irreversible effect for 7-10 days)
safety with digoxin
toxicity, hypokalemia, dysrhythmias, bradycardia, lots of D2D interactions
BBW for NSAIDs and aspirin
Risk of GI bleed
Pain meds contraindicated in pregnancy
aspirin, NSAIDs (except Tylenol), Cox 1&2 inhibitors, ergot alkaloids (ergotamine)
BBW for ergotamine
Risk of vasospasm, vasoconstriction. DO not use in CV patients
Depakote BBW
Pancreatitis, hepatitis, Neural tube defects in fetus
Increased risk for rhabdomyalsis
do not. use in pregnancy
Do not take with PGP inhibitors or CYP3A4 inhibitors
Colchicine
Pain meds contraindicated in children under 18
codeine, tramadol
opioid partial agonist (buprenorphine) safety
can cause withdrawal if given with opioid - wait until withdrawal has already begun
Do not start until complete withdrawal of opioids has occured
Suboxone (buprenorphine and naloxone/narcan)
BBW for naltrexone
Liver injury
BBW for long-acting beta agonist (salmeterol, fomoterol)
do not use alone - increased risk of asthma-related death
Safety consideration for Zyban (bupriopion)
Increased suicidality
DMARD safety - disease modifying antirheumatic drugs
Infliximab/remicade, hydroxychloroquine
serious infections and malignancy
BBW for methotrexate (DMARD)
bone marrow suppression, renal impairment, hepatotoxicity, malignancy, severe infections.
NO pregnancy, NO breastfeeding, NO alcohol
Anti-rheumatoid drug that prolongs QT interval
Hydroxychloroquine (Plaquenil)
