it/CI/AE

Question 1

It lincosamide(clindamycin)

Answer 1

.Neuro mascular blockade
.vitamin K antagonist

Question 2

AE clindamycin

Answer 2

1)GIT from mild(abdominal pain,diarrhea,mucus and blood in feces to pseudomemberamous colitis
2)rash=>more common in paitent with aids

Question 3

calithromycin(macrolide)IT

Answer 3

cyp3A4 inhbitor inhibit metabolism calithromycin and increase its level

Question 4

azithromycin (macrolide) SE

Answer 4

not that much SE often used in therapy

Question 5

It maccrolide

Answer 5

1)STATIN because statin metabolized by cyp3aA4 and macrolide are strong inhibitors of CYP3A4 that can lead to rhabdomyolisis and myopathy
2)interference with the effects chloramphenicol and clindamycin
3)azhithromycin without this it

Question 6

CI macrolide

Answer 6

1)not with statin(hmg-coa reductase inhibitor)
2)hypokalemia=>risk of QT prolongation
3)ergotamine

Question 7

side effect macrolide

Answer 7

:Rare
alkergic reaction:rush,fever
GIT:only for classical drug
cholestatic hepatitis
infusion may cause thrombophebitis

Question 8

SE chloramphenicol children

Answer 8

can pas BBB in contrast lincosamide and macrolide

Gray babay syndrom=>because baby can’t excrete chloramphenicol through glucrodination(by urine)
and lead to accumuluation of chloramphenicol in body
thats why its contraindicated under 3 years

Question 9

SE chloramphenicol adults

Answer 9

GIT=>risk of pseudomemberanous colitis
Rare:blood problem
1)eryhtroid suppression in bone marrow:dose related l/reversible
2)aplastic anemia agranulocytosis thrombocytopenia :not dose related/not reversible (mortality)

Question 10

CI chloramphenicol

Answer 10

1)under 3
2)not with drug that supress bone marrow

Question 11

It chloramphenicol

Answer 11

1)chloramphenicol inhibit hepatic enzyme and may prolong half life other drug eg.warfarin
2) not with bactericide ATB(pen,AG)
3)an alcohol intolerance=>disulfiram reaction

Question 12

TTC SE(drug:doxycycline)

Answer 12

because formation chelate =>GIT problem(nausea,vomiting diarrhea) dont combine with antacid,Fe
2)risk of pseudomemberanous colitis
3)chelate with Ca in teeth and bone =>brown coloration of of teeth
4)skin photosensivity
5)hepatotoxicity(not with alcohol)

Question 13

CI TTC

Answer 13

1)not with milk products
2)children
3)pregnancy,breast feeding
4)not recommended in paitent with renal failure but for doxycycline its ok because excreted by bile

Question 14

it ttc

Answer 14

1)B-lactam=>decrease effect
2)increase effect oral anticoagulants, sulfonyl urea,
immunosuppressant,digoxin
3)alcohol=>lower half life
4)pheytoin and barbiturate =>lower halflife

Question 15

AG distribution

Answer 15

because it’s highly polar =>poor distribution in body fluid
.c only high in renal and ear and thats cause toxicity
in pregnancy if use C is high in fetal plasma
.transport facilate by ATB effecting cell wall

Question 16

SE AG

Answer 16

because accumulation in ear and kidney
a)ototoxicity (irreversible)
b)nephrotoxicity(reversible)
streptomycin has the lowest nephrotoxicity
rare se:
1)neuromuscular blockade and apnea
2) dysfunction of optic nerve(streptomycin)
not pseudomemberanous colitis
**allergic rare*

Question 17

CI AG

Answer 17

myastenia gravis=>bc of neuromuscular blockade SE
pregnancy

Question 18

IT AG

Answer 18

1)neuromascular blocking agents
2)nephrotoxic drug
3)increase risk of ototoxicity

Question 19

AE estrogen

Answer 19

1.frequent:nausea,anorexia,high breast tenderness
2.fluid retention(effect renin angiotensin),edema
3.hepatic(higher enzyme choleastitis(fat in liver))
4,Risk of**thromboembolic* imp but rare bc of effect coagulation factor
5.hypertension(renin angiotensin)
6.higher risk of breast cancer(proliferation effects)
7.higher risk of endometrial cancer can be offset by progesterone
8.irregular bleeding
9.change in libido,headache

Question 20

AE progestene

Answer 20

1.headache,breast or abdominal pain
2.depression,nervousness,insomnia
3.liver function=>elevated transaminase
4.andregonic problem=>acne,hiristicum(for 19nortestesterone der
5.weight gain
6.dissorder of mensturation,metorrhagia(increase in duration of menstruation )
7.change in libido
8.hypertension

Question 21

CI estrogen

Answer 21

1.pregnancy,breast feeding
2.liver dysfunction
3.breast cancer
4.hypertrophy of endometr or endometr carcinoma
5.caution in diabet or hypertension

Question 22

CI progestene

Answer 22

1.liver dysfunction
2.pregnancy
3.thromboembolism=>related to estrogen but we dont know why?
4.breast cancer

Question 23

AE methylergoamine

Answer 23

1.emesis=>D2 effect
2.vasoconstriction,high BP,blured vision,headache
3.spasm of cronary artery=> angina sympton

Question 24

nimesulid AE

Answer 24

hepatotoxicity

Question 25

AE methotroxate
AE leflunomide
AE sulfasalazine

Answer 25

hepatotoxicity 3 tashon
pulmonary toxicity(MTX)
GIT toxicity vase sulfasalazine=>dyspeptic
myelotoxicity 3 tashon
increase risk of infection(MTX,Lfn)
phototoxicity(MTX,sulf)
teratogenecity(Lfn)

Question 26

CI methotrexate

Answer 26

pregnancy
liver,kindey,lung disease
alcoholism
immunodeficiency state
infection

Question 27

CI leflunomide

Answer 27

planned pregnancy
pregnancy
infection
breastfeeding

Question 28

CI sulfasalazine

Answer 28

1.GIT and urogential obstruction
2.glucose 6 phosphate dehydrogenase deficiency
3.hypersensitivity to sulphonamide and salicylate
4.helatic dissorder

Question 29

adalimumab,enterocept,infiximab SE

Answer 29

rare
1.allergic=>low immunogenic capacity for entercept often in infiliximab treated paitent
2.infection
3.increase malignancies
4.haematological AE
5.TBC=>also reactivation of latent TBS lower in entercept

Question 30

rituximab AE

Answer 30

infusion reaction
increase risk of infection
HBV reactivation

Question 31

AmphotericinB AE

Answer 31

1.infusions related:chick,fever..
2.renal damage decreases GFR hypokalemia hypomagnesemia
3.anemia(reduced erythropoietin)
4.neurological effect according to intratechal administration)=>seizure