Interactions and ADRs

Question 1

SE/ADR reports what to consider

Answer 1

1. Is there a relationship between event and drug’s pharmacology
2. has this reaction been reported before this drug? or onset of effect
3. Any other possible explanation of reported symptom
4. any attempts to dechallenge or rechallenge and their results

Question 2

SE of cotrimoxazole

Answer 2

1. fever
2. NV, diarrhoea
3. rash, itch
4. sore mouth
5. hyperkalemia
6. thrombocytopenia (rarely significant)

Question 3

TMX what to watch for

Answer 3

Warfarin - sulfamethoxazole displaces warfarin with plasma albumin binding site => bruising

Question 4

NSAID for Li pt

Answer 4

reduced renal clearance, increase serum levels

Question 5

rx of suspected ADR

Answer 5

1. Discontinue if
   - non-essential, event life-threatening, continue may worsen condition
2. lower dose if
   - essential, no reasonable alternatives, ADR mild and likely to resolve with time
3. rx
   antidote, symptomatic rx, supportive care
4. dechallenge, rechallenge or desensitization
5. report to ADRAC

Question 6

RF for fluclox/diclox => cholestatic jaundice

Answer 6

>55

>2 weeks

(not preexisting hepatic impairment)