Key Points Flashcards
Drugs that cause QT prolongation
‘Long Hearts Make Vampires Always Cry’
- Lithium, Loperamide
- Haloperidol
- Macrolides (azithromycin, clarithromycin)
- Venlafixine
- Amiodarone, Amitriptyline
- Citalopram
Hypokalaemia increase risk
Drugs associated with C.diff
‘Crazy Chimps Buy Flourescent Poo’
- Clindamycin
- Cephalosporins
- Broad-spec penicillin
- Flouroquinolones (Ciprofloxacin)
- PPIs
Smoking interactions
‘TACO’ - Tobacco Can Avoid Overdose
- Theophylline
- Aminophylline
- Clozapine
- Olanzapine
- Ropinirole
Drugs that cause hypokalaemia
‘Don’t Cut Banannas’
- Diuretics
- Corticosteroids
- Beta - 2 agonists
- Macrolides
What is chromaturia?
Harmless red brown colour of the urine caused by medication
Nephrotoxic drugs
- Ciclosporin
- Tacrolimus
- Vancomycin
- Aminoglycosides
Ototoxic drugs
- Aminoglycosides
- Loop diuretics
- Cisplatin
- Vancomycin
- macrolides
Risk factors of QT prolongation
- HypOKalaemia
- HypOMagnesaemia
- Cardiac disease
CP450 inhibitors
’SICKFACES.COM’ - increase drug concentration
Sodium valproate
Isonazid
Cimetidine
Ketoconazole
Fluconazole , Fluoxetine
Alcohol & grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides , Sertraline
Ciprofloxacin
Omeparazole
Metronidazole Macrolides
Rate limiting CCB
CYP450 inducers
’CRAP GPS’ - decrease drug concentration
Carbemazepines
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas, St Johns wort
Drugs that cause photosensitivity
- Amiodarone
- Chlorpromazine
- NSAIDs
- Diuretics (furosemide, bendroflumethiazide)
- Tetracycline
- Quinolones
- Sulfonamides (co-trimoxazole)
Pregnancy prevention programme
- 7 day prescription validity, 30 day supply
- Use highly effective contraception
- Fully informed of the risks and signed Risk Acknowledgment Form
- See specialist for annual review
User independent methods: IUD, POP implant, sterilisation
User dependent methods: two forms of contraceptive eg. COC + barrier method + regular pregnancy test
Linezolide
- Cheese reaction
- Serotonin syndrome
- visual disturbances
- blood disorders
- not over 28 days
Warning with tetracycline
Headache - STOP
Two antibiotics with food or after
Metronidazole
Nitrofurantoin
How long is treatment with Rifampicin and isoniazid in continuous phase
4 months
What to consider with TB drugs
Liver
Rifampicin SE
Urine discolouration
Stains contact
Why would malarone be preferred over doxycycline
Doxy causes photosensitivity and most malaria countries are hot and sunny
Prophylaxis for malaria
Anti malaria and warfarin
Stop warfarin 2-3 weeks before and measure INR more frequently
Where to find information
- Aseptics: yellow guide
- Manufacture and distribution: orange guide
- Interactions: Stockleys
- Immunisation against infectious disease + info about vaccinations: green book
- Martindale: reliable reference resource on drugs and medicines throughout the world
- BP: official standards for pharmaceutical substances and medicinal products
Record keeping
- Private RX for POM = 2 Years
-
Private RX for CD 2 and 3 = submitted to
NHS agency - POM register = 2 years
- Returned/ expired CD = 7 years
- RP record = 5 years
- NMS record = 2 years
Treatment of gout
Cholchicine (first 48 hours)
Indomethacin & Naproxen
Preventing gout
- Allopurinol & febuxostat
- probenecid & sulfinpyrazone
Nitrofurantoin CI
Long term COPD
Which anntifungal interacts with warfarin
Oral - Miconazole
Fluconazole
What is CI in unstable angina
CCB - only used in stable
Calcium carbonate + levothyroxine
Separate dose by atleast 4 hours to reduce interaction
Ferrous sulphate + levothyroxine
Separate dose by at least 2 hours
Side effect of gliptins (DDP)
Acute pancreatitis
Mineralcorticoid steroid
Fludrocortisone & Hydrocortisone
- HypO K, Ca
- HypER Na
- Eyes - MHRA
- Psychiatric reaction - STOP
- Adrenal suppression
- Infections (immunosuppression)
Warning with CHICKEN POX & MEASLES
- Cushing’s syndrome- moon face
- skin thinning
Side effects of glucocorticosteroid
- Diabetes
- Osteoporosis
- Muscle wasting
- GI ulcers
Pneumonic for mineralcorticosteroid
‘ACHING BOSSOM’
Corticosteroids + Sertraline
Bleeding
Hyponatraemia
Give PPI
Hypo in Sulphonylurea- Gliclazide, etc
Refer to hospital
Yellow card - serious SE
CPR
30 compressions (100 - 120 a minute)
2 breaths
Hydoxychloroquine + macrolides
Increased risk of cardiovascular events
Anti diabetic people preferred in renal impairment
‘Gliptins’
Paracetamol dose under 6 (120/5ml)
3 - 6 months: 2.5mL
6 - 24 months: 5mL
2 - 4 years: 7.5mL
4 - 6 years: 10mL
up to 4 times a day
Paracetamol dose over 6 (250/5ml)
6 - 8 years: 5mL
8 - 10 years: 7.5mL
10 - 12 years: 10mL
MHRA warning with hydrocholothiazide
Non melanoma skin cancer
Particularly in long term use
Orlistat interactions
Warfarin
Ciclosporin
DOAC
Antimuscaranic drugs
‘DOTS’
- Darifenacin
- Oxybutinin
- Tolterodine
- Solifenacin
Rosuvastatin + clopidogrel
Max 20mg
Lansoprazole + methotrexate
Increased toxicity - reduce clearance
Drugs that cause falls in elderly
- benzodiazepines
- antihistamines
- antiepileptics (remember lacosamide)
Treatment of hyperkalaemia
Patiromer calcium
Beta blocker in heart failure
BVN
Bisoprolol
Cervidolol
Nebivolol
Treatment for Bacterial vaginosis
Metronidazole 400mg BD 5-7 days
Hypomagnesemia
Sotalol
Digoxin
PPI
Liver toxicity
Alcohol dependency
Choldiazepoxide
How to treat torsade de pointes (prolonged QT prolongation)
IV magnesium sulfate
Serotonin syndrome
- antidepressant
- tramadol
- methadone
- Mirtazapine
- Sertraline
- lithium
Neutropenia
Filgrastim