Interactions Flashcards
Which drugs may exacerbate CHF?
NSAIDs, COX-2, Thiazolidinediones
What do statins interact with?
Erythromycin/clarithromycin
Fibrate
Which drugs may worsen constipation?
CCBs, anticholinergics, calcium
Which drugs lower seizure thresholds?
Neuroleptics, tramadol, quinolones (e.g. ciprofloxacin, levofloxacin etc)
Foods rich in vitamin E and K, which interact with warfarin
Kiwi, broccoli, spinach, chickpeas, nuts, apples
Foods rich in potassium and what do they interact with?
Bananas, oranges, leafy green vegetables
Interact with ACEIs, ARBs and K-sparing diuretics
Foods which alter pH and what drugs do they interact with?
Milk, cheese, soy, yoghurt, chicken, turkey
Interact with antibiotics, thyroid meds, digoxin and diuretics
Foods which interact with the cytochrome P450 system and which drugs these interact with
Grapefruit, cranberry, orange and apple
Statins, antihistamines
If you are prescribing someone opioids, what should you start them on prophylactically?
Lactulose or senna
Side effects of steroids in old people
Osteoporosis
Steroid induced diabetes
What can interfere with the absorption of levothyroxine?
Calcium can interfere with the absorption of levothyroxine
Problems with NSAIDs/COX 2 in old people?
- risks
- what do they interact with
- what can you give instead?
Increase risk of GI haemorrhage
Decrease GFR
Interact with diuretics and blood pressure medications
-try give paracetamol instead
If a patient has a side effects from a medication, or even if you only suspect that it is a side effect, where should you report it to?
The yellow card scheme
What was the F.A.M.E trial?
Federal study of adherence to medications in the elderly - looked at patients on multiple meds and introduced regular follow up and customised blister packs (big improvement seen)
Which antibiotic especially interacts with warfarin?
Clarithromycin
(reduces first pass metabolism of warfarin by inhibiting the cytochrome P450 system - can therefore lead to accumulation of warfarin and increased INR)
Side effects of memantine
HEADACHE Constipation CNS: psychosis, and rarely, suicidal ideation Abnormal gait Hypertension
These drugs may precipitate asthma attack
NSAIDs, beta-blockers
Aspirin and analgesics?
Avoid prescribing aspirin with NSAIDs - increases risk of adverse effects
Aspirin and anti-depressants?
Increased risk of bleeding with SSRIs and venlaxafine
Aspirin and methotrexate?
try to avoid prescribing together as aspirin reduces excretion of methotrexate
ACEi/ARBs and ciclosporin?
Increases risk of hyperkalaemia
ACEi/ARBs and diuretics?
Enhance hypotensive effect
Which blood pressure medication do you need to be careful with when giving lithium?
ACEi/ARBs and lithium - increases lithium levels
Potassium supplements and ACEi/ARBs?
Increases risk of severe hyperkalaemia
