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Miscellaneous FT > Interactions (I) > Flashcards

Interactions (I) Flashcards

1
Q

Which tetracycline can be given with milk and iron preparations?
A. Demeclocycline
B. Oxytetracycline
C.Doxycycline
D.Tetracycline

A

C

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2
Q

Which interaction is most Likely increases risk of to increase the risk of retinotoxicity?
A. Gentamicin + Amoxicillin
B. Hydroxychloquine +Tamoxifen
C. Simvastatin + Clopidogrel
D. Digoxin + Amiodarone

A

B
Reason Hydrochloroquine binds to rods and cons of the eye increasing melanin and affecting visual acuity whilst tamoxifen acts as glutamate receptor antagonist in retinal pigment epithelium leading to degeneration of axonal cells.

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3
Q

Which interaction did MHRA issue warning concerning the use together?
A. Azithromycin + Hydroxychloroquine
B. Warfarin + Citalopram
C. Valproate+ Digoxin
D. Metronidazole + Warfarin

A

A

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4
Q

Which drugs from this list is P-GP inhibitors ?
A. Verapamil and Diltiazem
B. Rifampicin
C. St John’s wart
D. Digoxin
E. Edoxaban

A

A

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5
Q

Which drug when co-administered with dabigatran results in dose reduction of dabigatran?
A. Amlodipine
B. Verapamil
C. Ticagrelor
D. Citalopram

A

B (due to the fact it is p-gp inhibitor)

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6
Q

Which drug when co-administered with dabigatran results in increased plasma concentration due to drug being a p-gp inhibitor?
A. St John’s Wart
B. Carbamazepine
C. Citalopram
D. Quinidine

A

D: quinidine + verapamil and amiodarone all increase dabigatran conc (Manufacturer advises to decrease dose)

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7
Q

Which drug is strong P-GP inhibitor?
A. Ciclosporin
B. Ketoconazole
C. Aspirin
D. Ticagrelor
E. Carbamazepine

A

Azoles/ Immunosuppressants and Dronedrone
(A) and (B)

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8
Q

Which drug is strong P-GP Inducer?
A. Ciclosporin
B. Ketoconazole
C. Aspirin
D. Ticagrelor
E. Carbamazepine

A

E
Also St.Johns warts
Phenytoin
Rifampicin

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9
Q

Just memorise and re-write

A
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10
Q

Which drug when co-administered with Edoxaban requires Edoxaban dose to reduced by half?
A. Amlodipine
B. Ramipril
C. Ciclosporin
D. Itraconazole

A

© and D (strong p-gp inhibitors: Dronedarone and Macrolides)

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11
Q

Which one from this list DOES not require dose reductions of Edoxaban?
A. Verapamil
B. Ketoconazole
C. Erythromycin
D. Amiodarone

A

(A) and D as well as quinidine

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12
Q

You are completing some CPD on the use of anticoagulant medicines.
Based on the information on interactions given in the BNF, which of the following is most likely to interact with warfarin and increase the INR?
A. Apple juice
B. Grapefruit juice
C. Pineapple juice
D. Pomegranate juice
E. Tomato juice

A

D

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13
Q

Which of the following drugs from the list when co-administered with Simvastatin must require the dose to be reduced to 20mg OD?
A. Amiodarone
B Ciclosporin
C Danazol
D Amlodipine
E Telithromycin
F Ezetimibe
G Cholestyramine

A

D and A; As they are potent CYP3A4 inhibitors.

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14
Q

Which of the following drugs from the list when co-administered with statins reduces the plasma concentration of statins?
A. Amiodarone
B Ciclosporin
C Danazol
D Amlodipine
E Telithromycin
F Ezetimibe
G Cholestyramine

A

Bile sequestrants are positively charged molecules that bind to negatively charged intestinal bile acids to block cholesterol absorption. They also inhibit bile acid reabsorption thus increasing bile acid synthesis and competitive inhibition of cholesterol synthesis.

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15
Q

Which of the following drugs from the list is contraindicated in use with simvastatin?
A. Amiodarone
B Ciclosporin
C Danazol
D Amlodipine
E Telithromycin
F Ezetimibe
G Cholestyramine
H. Gemfibrozil

A

C and B and H
Ciclosporin in CYP3A4 inhibitor increasing conc of statin
Danazol and Gemfibrozil (fibrates) has been reported to increase rhabdomyolysis risk. Also gemfibrozil is contraindicated in use with rosuvastatin.

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16
Q

Which of the following drugs requires dose reduction of rosuvastatin to 5mg when co-adminstered.
A. Ramipril
B. Ticagrelor
C. Fusidic acid
D. ketoconazole

A

(B)- reported incidence of rhabdomyolysis as it is potent CYP2C19 inhibitor.

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17
Q

Which drug when co-administered with atorvastatin requires atorvastatin dose to be at 10mg daily?
A. Amiodarone
B Ciclosporin
C Danazol
D Amlodipine
E Telithromycin
F Ezetimibe
G Cholestyramine
H. Gemfibrozil

A

B

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18
Q

Which drug when co-administered with statin induces its metabolism?
A. Amiodarone
B Ciclosporin
C Danazol
D Amlodipine
E Telithromycin
F Rifampicin
G Cholestyramine
H Efavirenz

A

F and H (efavirenz is the only HIV NNRTI; protease inhibitors of HIV increase dose statin e.g. ritonavir (ends in NAVIR)

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19
Q

84) 50 female takes solifenacin 5mg OD for urinary incontinence, she isn’t sure that the dose is high
enough and knows that a 10mg tab is available, her GP has told her that she cannot increase the
strength of solifenacin due to another med that she takes, which of the following is the most likely
med that her GP is referring to?
A aspirin
B furosemide
C itraconazole
D ramipril
E salbutamol

A

C; azole increase solificean conc thus cks recommends dose reduction of Solificean.

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20
Q

RE Miss F, 32 year old female, takes theophylline, which of the following factors will
decrease theophylline concentration?
A heart failure
B hepatic impairment
C viral infection
D starting smoking
E increased alcohol consumption

A

D

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21
Q

Which drug when co-administered with amiodarone increases the risk of bradycardia?
A. Donepezil
B. Colestyramine
C. Escitolopram
D. St Johns’ Wart

A
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22
Q

Which drug when co-administered with amiodarone increases the risk of QT-PROLONGATION
A. Donepezil
B. Colestyramine
C. clomipramine
D. St Johns’ Wart

A

C

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23
Q

Which drug when co-administered with amiodarone results in myopathy.
A. Donepezil
B. Colestyramine
C. clomipramine
D. Simvastatin

A

D

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24
Q

Which drug when co-administered with Amiodarone requires a dose reduction of 1/2?
A. Cholestyramine
B. Digoxin
C. Simvastatin
D. St Johns Warts

A
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25
Q

Which drug when co-administered with Amiodarone requires it be at 20mg OD dose?
A. Cholestyramine
B. Digoxin
C. Simvastatin
D. St Johns Warts

A
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26
Q

Which drug reduces amiodarone concentration by 50%?
A. Cholestyramine
B. Digoxin
C. Simvastatin
D. St Johns Warts

A

A

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27
Q

Which drug increases Ptx INR when on warfarin?
A. Donepezil
B. Amiodarone
C. St John’s Wart
D. Simvastatin

A

B

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28
Q

Which drug when co-administered with amiodarone results in severe bradycardia or heart block?
A. sofosbuvir with ledipasvir
B. Colestyramine
C. Escitolopram
D. St Johns’ Wart

A

A

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29
Q

Which drug increases the risk of Supraventricular tachyarrythmia in elderly population?
A. Digoxin
B. Verapamil
C. Amiodarone
D. Diltiazem

A

C

30
Q

Which PPI increases the risk digoxin toxicity?
A. Omeprazole
B. Pantoprazole
C. Lansoprazole
D. Rabeprazole

A

(A) According to SPS Omeprazole causes significant increase in plasma levels of digoxin. This is because digoxin, may be absorbed more extensively when gastric acid is reduced; thus, digoxin toxicity may occur with PPI use.

31
Q

Which diuretic causes increase risk of Dig toxicity due to hypokalaemia?
A. Amiloride
B. Indapamide
C. Eplerone
D. Spironolactone

A

(B) Thiazide diuretics cause hypokalaemia, among other electrolyte disturbances. Spironolactone is also implicated in Dig toxicity but not because it causes hypokalaemia it is potassium sparring diuretic after all.

32
Q

Which antidepressant agent would you use in patient newly started on Digoxin?
A. Nortriptyline
B. Clomipramine
C. Trazodone
D. Venlafaxine
E. Mirtazapine

A

(E) The rest of the drugs are TCAs and SNRI which are pro-arrythmia. Citalopram wouldn’t be used due to hERG pharmacophore potentiating QT-prolongation. Other SSRI’s would be safe in this instance if mirtazapine wasn’t the only option (NICE CKS).

33
Q

Which drug when co-administered with Digoxin increases the risk of Dig toxicity?
A. Carvedilol
B. Diltiazem
C. Hydroxychloroquine

A

B AND C

34
Q

Which drug when co-administered with digoxin results in increase with dig toxicity?
A. Tetracycline
B. Levothyroxine
C. Prednisolone
D. Exenatide

A

(A)

35
Q

Which drug in this list increases risk of vasoconstrictions when used along with triptans?
A. Metoclopramide
B. Bromocriptine
C. Clarithromycin
D. Sertraline

A

B Ergotamine or derivatives of ergotamine increases risk of vasoconstriction.

36
Q

Which drug from this list requires a dose reduction when prescribed with propranolol? What counselling advice is given?
A. Metoclopramide
B. Bromocriptine
C. Rizatriptan
D. Sertraline

A

C. This is due to propranolol inhibiting MAO-A resulting in increased conc of Rizatriptan requiring a dose reduction to 5mg OD and should NOT be taken within two hours of taking propranolol.

37
Q

Which drug when co-administered with Domperidone results in QT-prolongation?
A. Fluconazole
B. Ramipril
C. Ropinirole
D. Pramipexole

A

(A) Azoles, macrolides, HIV protease inhibitors, antidepressants and quinolone antibitoitcs are all predicted to increase risk QT interval when co-administered with Domperidone.

38
Q

Which drug when co-administered with Domperidone results in the increased concentration of Domperidone?
A. Ramipril
B. Lithium
C. Diltiazem
D. Pramipexole

A

(C)CCB are CYP3A4-I

39
Q

Which agent when interacting with metoclopramide potentiates EPS and neurotoxicity?
A. Alcohol
B. Lithium
C. Alprazolam
D. Bromocriptine

A

B

40
Q

Which agent when interacting with Prochlorperazine causes hypotension ?
A. Alcohol
B. Lithium
C. Alprazolam
D. Bromocriptine

A

A

41
Q

Which drug when given with metoclopramide would experience decreased therapeutic effect?
A. Alcohol
B. Lithium
C. Alprazolam
D. Bromocriptine

A

(D) Metoclopramide reduces D2 agonist efficacy.

42
Q

Which drug when given with metoclopramide would experience decrease in drug concentration?
A. Levodopa
B. Lithium
C. Alprazolam
D. Bromocriptine

A

A

43
Q

Which agent when given with Ondansetron causes torasade de pointes and why?
A. Apomorphine
B. Fluoxetine
C. Carbamazepine
D. Aminophylline

A

(D) Aminophylline causes Hypokalemia potentially increasing the risk of torsade de pointes when given with ondansetron.
All drugs that cause Hypokalemia when given with ondansetron will potentiate the risk of arrythmia and the fatal torsade pointes.

44
Q

Which drug when co-administered with Domperidone results in QT-prolongation?
A. Fluconazole
B. Ramipril
C. Ropinirole
D. Pramipexole

A

A) Azoles, macrolides, HIV protease inhibitors, antidepressants and quinolone antibitoitcs are all predicted to increase risk QT interval when co-administered with Domperidone.

45
Q

Which drug when co-administered with Domperidone results in the increased concentration of Domperidone?
A. Ramipril
B. Lithium
C. Diltiazem
D. Pramipexole

A

(C)CCB are CYP3A4-I

46
Q

Which drug in the list when co-administered with Valproate is displaced from albumin and is highly protein bound to albumin?
A. Aspirin
B. Lamotrigine
C. Meropenem
D. Warfarin

A

(A) Effect: High free levels of Aspirin

47
Q

Which drug in the list when co-administered with Valproate is displaced from albumin and is less strongly protein bound to albumin?
A. Aspirin
B. Lamotrigine
C. Meropenem
D. Warfarin

A

(D) Effect: High free levels of warfarin

48
Q

Which drug in this list when co-administered with Valproate leads to increased level of its own drug concentration due to inhibition of cytochrome P450?
A. Erythromycin
B. Lamotrigine
C. Meropenem
D. Warfarin

A

(A) Macrolides, SSRI, Cimetidine, TCA (Clomipramine) are all increased when co-admnistered with valproate.

49
Q

Which drug in this list when co-administer with Valproate leads to decrease in valproate concertation by 60-100%?
A. Erythromycin
B. Lamotrigine
C. Meropenem
D. Warfarin

A

(C)

50
Q

Which interactions leads to increase level of phenytoin as well as increased risk of aplastic anaemia?
A. Amiodarone
B. Ciclosporin
C. Boceprevir
D. Digoxin
E. Diltiazem
F. Co-trimoxazole

A

f

51
Q

Which interaction leads to increase in phenytoin concertation?
A. Amiodarone
B. Ciclosporin
C. Boceprevir
D. Digoxin
E. Diltiazem
F. Co-trimoxazole

A

A, C, F, E (inhibitors)

52
Q
A
53
Q

Which drug when co-prescribed with Ivabradine, requires Ivabradine dose to be reduced to 2.5 mg OD?
A.phenytoin
B.Valporate
C. Erthromycin
D. Verapamil

A

B

54
Q

Which drug when co-prescribed with Ivabradine, is contraindicated in use?
A. Phenytoin
B.Valporate
C. Erthromycin
D. Verapamil

A

C and D

55
Q

Which drugs from this list increase INR of warfarin?
A. Atoquovane w/progunil
B. Doxycyline
C. Ramipril
D. Aspirin

A

A and B

56
Q

Mr T has come for his travel clinic appointment in your pharmacy. He states that he is
travelling to a high risk country north africa. He asks your advice about which antimalarial he should take. He has a past medical history of chronic kidney disease stage 4 (eGFR 24mL/min).
Which of the following anti-malarials would be the LEAST appropriate for this patient?
A. Chemoprophylaxis is not recommended
B. Mefloquine
C. Doxycycline
D. Atovaquone with proguanil hydrochloride
E. Chloroquine

A

Atovaquone with proguanil cannot be
used if the eGFR is less than 30mL/min. Doxycycline is advised to use with caution in renal
impairment. Mefloquine is advised to be used in caution in renal impairment.
(D)

57
Q

Which agent when co-administered with metronidazole requires avoidance for at least 48 hours after treatment?
A. Alcohol
B. Warfarin
C. Ciclosporin
D. Phenytoin
E. Lithium

A

A

58
Q

Which agents are increased in serum concentration when co-administered with metronidazole?
A. Alcohol
B. Warfarin
C. Ciclosporin
D. Phenytoin
E. Lithium

A

C, B and E. Lithium can be closely monitored. Monitor INR. Monitor serum ciclosporin concentration

59
Q

Which agent when co-administered with metronidazole increases the risk of peripheral neuropathy?
A. Alcohol
B. Warfarin
C. Ciclosporin
D. Phenytoin
E. Lithium

A

D

60
Q

Which drug when co-administered with trimethoprim causes this adverse event: hyponatremia
A. Acyclovir
B. Amitriptyline
C. Ramipril
D. Azathioprine and mercaptopurine
E. Methotrexate
F. Carbamazepine
G. Ciclosporin
H. Citalopram
I. Warfarin
J. Digoxin
K. Amiloride
L. Phenytoin
M. Celecoxib

A

M, B, H, F

61
Q

When co-administered with macrolide which drug results in this adverse event: hypokalemia
A. Carbamazepine
B. Rivaroxaban
C. Warfarin
D. Diltiazem
E. Haloperidol
F. Bendrofluthiazide
G. Prednisolone
H. Insulin
I. Theophylline
J. Ciclosporin

A

F and G

62
Q

When co-administered with macrolide which drug results in this adverse event: moon face, excess weight gain.
A. Carbamazepine
B. Rivaroxaban
C. Warfarin
D. Diltiazem
E. Haloperidol
F. Bendrofluthiazide
G. Prednisolone
H. Insulin
I. Theophylline
J. Ciclosporin

A

G

63
Q

When co-administered with macrolide which drug results in this adverse event: QT prolongation
A. Carbamazepine
B. Rivaroxaban
C. Warfarin
D. Diltiazem
E. Haloperidol
F. Bendrofluthiazide
G. Prednisolone
H. Insulin
I. Theophylline
J. Ciclosporin

A

D, E, B (MHRA Rivaroxaban and Erthromycin)

64
Q

When co-administered with flucloxacillin what drug results in the following adverse event: erythematous rash, unexplained shortness of breath and mouth ulcer.
A. Methotrexate
B. Paracetamol
C. Warfarin
D. Voriconazole

A

(A) Methotrexate at high dose results in toxicity as flucloxacillin reduces its clearance.

65
Q

When co-administered with flucloxacillin what drug results in the following adverse event: increase blood clot formation.
A. Methotrexate
B. Paracetamol
C. Warfarin
D. Voriconazole

A

C

66
Q

When co-administered with Amoxicillin what drug results in the following adverse event: rash formation
A. Allopurinol
B. Paracetamol
C. Warfarin
D. Voriconazole

A

A

67
Q
A

Nitrates and Alpha blocker potentiate hypotension when co-administred with PDE-5 inhibitors

68
Q
A

Anastrozole lowers the level of oestrogen. It does this by blocking a substance in the body called aromatase. Anastrazole belongs to a type of hormone therapy called aromatase inhibitors. Lowering the level of oestrogen aims to prevent, stop or slow the growth of these cancers.

69
Q

Which drug when paired with sildenafil requires it to be reduced to 25mg starting dose?
A. clarithromycin
b. warfarin
c. carbamazepine
d. solficean

A

A
dose reduction would also be seen with alpha blocker at 25mg for sildenafil

70
Q

Which drug from this list when co-administered with mirobegron requires it to be reduced to 25mg OD?
A. Ramipril
B. Itraconazole
C. Amlodopine
D. Phenytoin

A

In mild hepatic impairement co-concurrent-B

Miscellaneous FT (12 decks)

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