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Medications & Drug Interactions Flashcards

1
Q

Acetaminophen

A

Increased effect with caffeine | Decreased effect with antacids, anticholinergics, carbamazepine, phenytoin | Alcohol may increase hepatotoxicity risk

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2
Q

AcetaZOLAMIDE (Diamox, Diamox Sequels)

A

Increased risk of severe acidosis and CNS toxicity with high-dose aspirin | Use caution with diuretics and anticonvulsants | May potentiate the effects of hypoglycemics | Increased risk of renal calculus formation with sodium bicarbonate administration

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3
Q

Acetic Acid (Vinegar)

A

N/A

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4
Q

Acetylcysteine (Mucomyst, Acetadote)

A

Nitroglycerin

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5
Q

Activated charcoal

A

Bonds with and inactivates whatever it is mixed with | Moderate interactions with acetylcysteine, citalopram, digoxin, dyphylline, methotrexate, and theophylline

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6
Q

Adenosine (Adenocard)

A

Additive effects are possible if used in combination with beta blockers | Methylxanthines (like caffine and theophylline-like drugs) block the actions of adenosine | Dipyridamole (Persantine) potentiates the effect | Carbamazepine (Tegretol) may potentiate the AV node blocking effect | Nicotine can enhance the cardiovascular effects | An increase in angina-like chest discomfort or heart rate | A decrease in BP may be observed

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7
Q

Albumin (Albumarc, Albutein, Flexbumin)

A

N/A

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8
Q

Albuterol

A

Additive effects with TCAs, MAOIs, other sympathomimetics | Beta blockers may inhibit pulmonary effects | May potentiate hypokalemia caused by diuretics

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9
Q

Amiodarone (Cordarone, Pacerone)

A

May increase the effects of digoxin, disopyramide, fentanyl, lidocaine, procainamide, quinidine, or warfarin | Cimetidine may increase amiodarone levels | Use with beta blockers or calcium channel blockers may potentiate bradycardia, sinus arrest, and AV blocks | Persistent use of echinacea can potentiate amiodarone’s hepatotoxic effects

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10
Q

Aspirin (Acetylsalicylic Acid)

A

Increased risk of bleeding with anticoagulants and other NSAIDs | Diminished effects of ACE inhibitors and loop diuretics | Antacids reduce ASA absorption | Increased risk of hypoglycemia occurs with administration of oral hypoglycemic drugs | Effects are decreased by corticosteroids | Increased bleeding can occur when ASA is taken with certain herbs (ex: quai, feverfew, garlic, ginger, ginkgo, Korean ginseng, and saw plametto - because these herbs interfere w/ platelet aggregation)

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11
Q

Atropine sulfate

A

Potential adverse effects when administered with digitalis, cholinergics, physostigmine | Effects enhanced by antihistamines, procainamide, quinidine, antipsychotics, benzodiazepines, and antidepressants

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12
Q

Benzocaine Spray (Hurricane)

A

Rare and sometimes fatal cases of methemoglobinemia related to the topical or oromucosal benzocaine products | Nitrites and nitrates may induce methemoglobin formation

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13
Q

Bumetanide (Bumex)

A

NSAIDs reduce the effects of diuretics | May increase risk of lithium poisoning | Antihypertensives can cause further hypotension

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14
Q

Calcium chloride

A

May increase ventricular irritability and precipitate digitalis toxicity when taken with digoxin | Potentiated by thiazide diuretics | May antagonize the effects of calcium channel blockers | Incompatible with most all medications, so Flush the IV/IO line before and after its administration

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15
Q

Calcium gluconate

A

May cause severe bradycardia in pts taking digitalis | May antagonize the effects of calcium channel blockers | Incompatible with most medications, so Flush the IV/IO line before and after its administration

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16
Q

Cimetidine (Tagamet)

A

Inhibition of specific liver enzymes may result in increased plasma levels of certain drugs, including: warfarin-type anticoagulants, TCAs, Class I antidysrhythmics, calcium channel blockers, diazepam, phenytoin, theophylline, propranolol, and metoprolol

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17
Q

Hetastarch (Hespan)

A

Should NOT be administered to patients who are receiving anticoagulants | Patients allergic to corn may be allergic to hetastarch

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18
Q

Plasma Protein Fraction (Plasmanate)

A

Solutions should NOT be mixed with or administered through the same administration sets as other IV fluids

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19
Q

0.9% Sodium Chloride (Normal Saline)

A

Few in the emergency setting

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20
Q

0.45% Sodium Chloride

A

Few in the emergency setting

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21
Q

Lactated Ringer Solution (Hartmann Solution)

A

Few in the emergency setting

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22
Q

3% Sodium Chloride (Hypertonic Saline)

A

None currently identified

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23
Q

5% Dextrose in 0.45% Sodium Chloride

A

Should NOT be used with phenytoin (Dilantin) or amrinone (Inocor)

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24
Q

5% Dextrose in 0.9% Sodium Chloride

A

Should NOT be used with phenytoin (Dilantin) or amrinone (Inocor)

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25
5% Dextrose in Lactated Ringer Solution
Should NOT be used with phenytoin (Dilantin) or amrinone (Inocor)
26
Total Parenteral Nutrition
Vary based on the specific mixture
27
Dexamethasone sodium phosphate (Decadron)
Simultaneous use with ASA and NSAIDs increases the risk of GI bleeding and ulceration | Hypokalemia when used concurrently with diuretics | Echinacea may reduce its effectiveness
28
Dextran
Should not be administered to patients receiving anticoagulants because it significantly slows blood clotting
29
Bacteriostatic Water
N/A
30
5% Dextrose in Water
Should NOT be used with phenytoin (Dilantin) or amrinone (Inocor)
31
10% Dextrose in Water
Should NOT be used with phenytoin (Dilantin) or amrinone (Inocor)
32
Dextrose
Sodium bicarbonate | Warfarin (Coumadin)
33
Diazepam (Valium, Diastate, AcuDial)
Incompatible with more drugs and fluids | Concomitant use with other CNS depressants may cause respiratory depression, hypotension, profound sedation, and death | when given orally, milk thistle may decrease diazepam effectiveness and grapefruit juice can significantly increase serum concentrations | motherwort can potentiate the sedative effects and may result in coma
34
Digoxin (Lanoxin)
Amiodarone, verapamil, and quinidine may increase serum digoxin concentrations | concurrent use of digoxin and verapamill may lead to severe AV block | Diuretics may potentiate cardiac toxicity | St. John's wort can reduce the effects of digoxin effectiveness and licorice can potentiate its effects
35
Diltiazem (Cardizem, Dilacor, Diltiaz)
Use with caution in patients taking medications that affect cardiac contractility | Simultaneous use with IV beta blockers can result in decreased cardiac contractility, bradycardia (including AV blocks), and hypotension | Increased risk of sudden cardiac death when given concurrently with erythromycin
36
DiphenhydrAMINE HCl (Benadryl)
Potentiates the effects of alcohol and other CNS depressants | MAOIs prolong and intensify anticholinergic (drying) effects
37
DOBUTamine Hydrochloride (Dobutrex)
Incompatible with sodium bicarbonate and furosemide | Beta blockers may blunt the inotropic effects
38
DOPamine Hydrochloride (Intropin)
Inactivated in alkaline solutions (sodium bicarbonate) | MAOIs prolong and potentiate effects | TCAs may potentiate cardiovascular effects | Beta blockers antagonize cardiac effects | When administered with phenytoin, may cause hypotension, bradycardia, and seizures | Simultaneous use of vasopressor may result in severe hypertension
39
Droperidol (Inaspine)
Potentiates CNS depressants | Reduces pressor effect of epinephrine
40
EPINEPHrine
Potentiates other sympathomimetics | Deactivated by alkaline solutions | MAOIs and antidepressants may potentiate effects | Beta blockers may blunt effects
41
Etomidate (Amidate)
Effects may be enhanced when given with other CNS depressants
42
Famotidine (Pepcid)
Decreased absorption of iron | Decreased effects of ketoconazole, naproxen, pseudoephedrine | Increased action of metformin
43
FentanNYL Citrate (Sublimaze)
Increased respiratory depressant effects when paired with other CNS depressants
44
Furosemide (Lasix)
Lithium toxicity may be potentiated by sodium depletion | Digitalis toxicity may be potentiated by potassium depletion
45
Glucagon (GlucaGen)
Incompatible in solution with most other substances | No significant drug interactions with other emergency medications
46
Glucose, oral
N/A
47
Haloperidol (Haldol)
Enhanced CNS depression and hypotension in combination with alcohol | Additive effect with antihypertensive medications | Antagonizes amphetamines and epinephrine | Other CNS depressants may potentiate its effects
48
Helium Gas Mixture (Heliox)
unknown
49
HydrALAZINE (Apresoline)
MAOIs | Synergistic effects if given simultaneously with other antihypertensives | NSAIDs may diminish the antihypertensive effects
50
Hydrocortisone sodium succinate (Colu-Cortef)
Simultaneous use with ASA and NSAIDs increases the risk of GI bleeding and ulceration | Concurrent use with diuretics increases potassium loss and can result in hypokalemia
51
HYRDROmorphone (Dilaudid)
MAOIs | SSRIs | Concurrent use with other CNS depressants can induce severe respiratory and/or CNS depression
52
Hydroxocobalamin (Cyanokit)
Do not administer in the same IV line with diazepam, DOBUTamine, DOPamine, fentanyl, NTG, propofol, sodium nitrate, or sodium thiosulfate
53
Ibuprofen (Advil, Motrin)
Additive risk for bleeding if given in combination with other agents that affect hemostasis (ex: ASA and other antiplatelet drugs, anticoagulants, SSRIs, SNRIs, and other NSAIDS) | Alfalfa, anise, and bilberry may enhance adverse effects | May diminish the antihypertensive effect of HydrALAZINE | May diminish the diuretic effect of loop, thiazide, and thiazide-like diuretics | TCAs may enhance the NSAID antiplatelet effects | May increase bleeding time in patients taking anticoagulants
54
Insulin
incompatible in solutions w/ all other drugs | Glucocorticoids and immunosuppressants may increase insulin requirements | Some antibiotics may lower insulin requirements | Insulin dosing adjustments may be necessary if the pt is taking beta blockers | alcohol and salicylates may potentiate insulin effects
55
Ipratropium Bromide (Atrovent)
Potential for additive anticholinergic effects when administered with other antimuscarinic or anticholinergic medications
56
Isopropyl Alcohol
N/A
57
Ketamine (Ketalar)
Ketamine may enhance the CNS depressant effects of alcohol, cannabis, opioids, barbiturates, and nondepolarizing neuromuscular blockers | St. John’s wort can reduce its effectiveness
58
Ketorolac Tromethamine (Toradol)
May increase bleeding time in patients taking anticoagulants | TCAs may enhance the NSAID antiplatelet effects
59
Levalbuterol (Xopenex)
Increased actions of bronchodilators, TCAs, MAOIs, and other adrenergic drugs | Increased risk of QT prolongation when administered with other QT-prolonging drugs
60
Lidocaine HCl (Xylocaine)
Apnea induced with succinylcholine may be prolonged by high doses of lidocaine | Cardiac depression may occur in conjunction with administration of IV phenytoin | Procainamide may exacerbate the CNS effects | Metabolic clearance is decreased in patients with liver disease and patients taking beta blockers
61
LORazepam (Ativan)
Concomitant use with other CNS depressants may cause respiratory depression, hypotension, profound sedation, and death | Individuals taking passionflower or St. John’s wort may experience hand tremors, dizziness, and muscular fatigue | Motherwort can potentiate the sedative effects and may result in coma
62
Magnesium sulfate
May enhance the effects of other CNS depressants | Serious changes in overall cardiac function may occur with cardiac glycosides
63
Mannitol (Osmitrol)
Many | May precipitate digitalism toxicity when given concurrently | Avoid use of other diuretics in combination, if possible | Concomitant administration may potentiate renal toxicity | Avoid use with salicylates and NSAIDs | Use with nitrates can cause hypotension
64
Meperidine Hydrochloride (Demerol)
Additive CNS depression with TCAs, alcohol, or other CNS depressants
65
MethylPREDNISolone Sodium Succinate (Solu-Medrol)
Hypoglycemic responses to insulin and hypoglycemic agents may be blunted
66
Metoclopramide (Reglan)
Increased sedation risk when used with CNS depressants, antihistamines, anticholinergics, MAOIs | May decrease the effects of dopamine agonists | Can increase the rate or extent of ASA absorption because of accelerated gastric emptying
67
Midazolam Hydrochloride (Versed)
Concomitant use with other CNS depressant may cause respiratory depression, hypotension, profound sedation, and death | Motherwort can potentiate midazolam’s sedative effects and may result in coma | St. John’s wort and green tea can reduce its effectiveness | Mango and grapefruit juice may potentiate its effects
68
Milrinone (Primacor)
Synergistic with catecholamines
69
Morphine sulfate (Roxanol, MS Contin)
Additive effects with other CNS depressants | MAOIs may cause paradoxical excitation
70
Naloxone Hydrochloride (Narcan, EVZIO)
Incompatible with bisulfite and alkaline solutions
71
NIFEdipine (Procardia, Adalat, Nifedical)
Beta blockers may potentiate NIFEdipine’s effects | Effects of theophylline may be increased | Antihypertensives may potentiate the hypotensive effects
72
Nitroglycerin (NGT)
Increased hypotensive effect with alcohol, beta blockers, calcium channel blockers, antihypertensives, benzodiazepines, phenothiazines, and other vasodilators | Incompatible with other drugs given IV | Hawthorn increases NTG levels
73
Nitroprusside (Nitropress)
Additive effects with ganglionic blocking agents, General anesthetics, Other antihypertensives, and Sympathomimetics
74
Nitrous oxide 50:50 (Nitronox)
Can potentiate the effects of CNS depressants
75
Norepinephrine Bitartrate (Levophed, Levarterenol)
TCAs can markedly increase response to pressors | Concomitant use of sympathomimetics may result in additive cardiovascular effects | Alpha adrenergic effects can be blocked during concurrent administration of phenothiazines | Inactivated by alkaline solutions
76
Ondansetron (Sandostatin)
Decreases cycloSPORINE levels
77
Olanzapine (Zyprexa)
Additive effects with alcohol and other CNS depressants | Concurrent use of IM/IV benzodiazepines and olanzapine IM is NOT recommended | Ginkgo may potentiate effects
78
Onansetron Hydrochloride (Zofran, Zuplenz)
Avoid administration with other drugs that prolong the QT interval | Serotonin syndrome can occur with simultaneous use of several drugs (ex: fentanyl and morphine)
79
Oxygen
N/A
80
Oxymetazoline (Afrin, Dristan 12-hours, Vicks Sinus-12hours)
May diminish the vasoconstricting effects of alpha-1 agonists | May enhance the hypertensive effects of sympathomimetics
81
Oxytocin (Pitocin)
Can cause severe, persistent hypertension if administered with vasopressors | Synergistic effect with black cohosh, cotton root, squaw vine, and cinnamon
82
Pancuronium Bromide (Pavulon)
Calcium channel blockers may prolong neuromuscular blockade | Positive chronotropic drugs may potentiate tachycardia | Coadministration of opioids may enhance neuromuscular blockade and produce an increased degree of respiratory depression, hypotension, or sedation
83
Phenylephrine (Neo-Synephrine)
Exaggerated adrenergic effects if given with, or up to 21 days after, MAOI administration | Hypertensive effects may be potentiated by TCAs, guanethidine, methyldopa, and atropine-like drugs
84
Potassium Iodide (Pima Syrup, SSKI, ThyroSafe, ThyroShield)
Use with caution in patients taking drugs that may increase serum potassium levels, such as ACE inhibitors | NSAIDs may cause potassium retention
85
Pralidoxime (2-PAM, Protopam)
Avoid using concurrently with succinylcholine, morphine, aminophylline, theophylline, and other respiratory depressants
86
Procainamide Hydrochloride (Pronestyl)
Additive effect with other antidysrhythmic agents | Use with beta agonists may be associated with adverse cardiovascular effects, including QT interval prolongation
87
Prochlorperazine (Compazine)
Increased risk of respiratory depression when used with other medications that cause respiratory depression
88
Promethazine Hydrochloride (Phenergan)
Additive with other CNS depressants | Increased extrapyramidal effects with MAOIs
89
Proparacaine Opthalmic (Alcaine, Ophthaine)
Data unavailable
90
Propofol (Diprivan)
Increased anesthetic or sedative effects when combined with alcohol, antihistamines, opioids, and combinations of opioids and sedatives | Avoid mixing with medications that cannot pass through lipids | Simultaneous use with fentanyl can cause profound bradycardia in pediatric patients
91
Rocuronium Bromide (Zemuron)
Additive effects if administered w/ or following an opioid, sedative, or anesthetic agent
92
Sildenafil (Revatio, Viagra)
Can potentiate the hypotensive effects of nitrates, alpha blockers, antihypertensives, or alcohol | Increased risk of side effects when taken with grapefruit juice and grapefruit products
93
Sodium bicarbonate
Increases the effects of amphetamines | Decreases the effects of benzodiazepines and TCAs | May deactivate sympathomimetics
94
Sodium thiosulfate (Nithiodote)
N/A
95
Succinylcholine Chloride (Anectine)
Coadministration with CNS depressants may cause profound sedation, coma, respiratory depression, hypotension, or death | Oxytocin, beta blockers, and organophosphates may potentiate its effects | Diazepam may reduce its duration of action
96
Tadalfil (Cialis, Adcirca)
Can potentiate the hypotensive effects of nitrates, alpha blockers, antihypertensives, or alcohol | Increased risk of side effects when taken with grapefruit juice and grapefruit products
97
Tetracaine Opthalmic Solution (Pontocaine)
Monitor closely for methemoglobinemia signs if coadministered with methemoglobin-inducing drugs
98
Thaimine Hydrochloride (Vitamin B1)
Unstable in alkaline solutions
99
Tranexamic Acid (Cyklokapron, Lysteda)
Hormonal contraceptives and clotting factor complexes increase the risk of thromboembolic disorders
100
Vecuronium Bromide (Norcuron)
Additive effects if administered with or following an opioid, sedative, or anesthetic agent
101
Verapamil Hydrochloride (Isoptin, Calan)
Increases the serum concentration of digoxin | Simultaneous administration with IV beta blockers can produce severe hypotension | Antihypertensives may potentiate the hypotensive effects | May potentiate the activity of depolarizing and nondepolarizing neuromuscular blocking agents | Increased risk of sudden cardiac death when given concurrently with erythromycin | St. John’s wort can reduce its effectiveness
102
Ziprasidone (Geodon)
Avoid simultaneous administration with drugs that prolong the QT interval | CNS depressants increase its effects

pharmacology (9 decks)

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