MHRA ALERTS Flashcards
What is the MHRA alert for ondansetron
Risk of cleft palate in 1st trimester of pregnancy and not to be useed, report to MHRA
What are 2 MHRA alerts for corticosteroids
- risk of central serous choroiretinopathy - visual
2. need for steroid emergency card to support early recognition of adrenal crisis
What is the MHRA alert for topical CCS
risk of TSW after long term use - rebound flare, intense redness, sting etc beyond initial area
e.g. in 2 weeks
what is the MHRA warning regarding hydrocortisone granules Alkindi
RIsk of acute adrenal insufficiency in children when switching from crushed tab to granules due to inaccurate dosing -monitor for tiredness, vomiting, unstable temp. floppy
what is the MHRA warning regarding montelukast
neuropsychiatric rxn and obsessive compulsive symptoms
what does MHRA advise for adrenaline autoinjectors
always carry 2
check expiry dates and obtain replacements
what are MHRA alerts regarding SGLT2 inhibitors
- risk of DKA atypical with only moderately elevated BG, have monitoring of ketones during treatment interruption in surgery or acute medical illness
- fourniers gangrene
- cana=lower limb amputation risk
What is the MHRA warning for haloperidol
Risk of neurological and cardiac effects when treating patients with delium - only use if benefits/risks
(NOTE MHRA alert for pts with dementia small increased risk of stroke when given antipsychotics)
What is MHRA warnring for clozapine
Risk of intestinal obstruction/paralyticileus - seek advice before next dose if constipation develops
and monitoring blood concs of clozapine for toxicity is now advised in certain situations e.g. infection, stopping smoking etc
What is MHRA advice regarding levothyroxine
if experience sx with different products maintain on same manufacturer
what is MHRA alert for PEG laxatives
Addition of PEG laxatives (e.g. movicol, macrogol - osmotic) to liquids that have been thickened with starch based thickener may counteract the thickening action and thus pts with dysphagia will be at risk of aspiration
What is MHRA alert regarding gabapentin and pregabalin
Resp depression
now CD3
What is MHRA alert regarding SSRIs
Risk of post partum haemorrhage when used in month before delivery in pregnancy - benefit Vs risk
What is MHRA alert regarding ulipristal acetate (esmya) when used for uterine fibroids
Risk of liver injury
ONLY for intermittent treatment mod/severe before menopause when surgery failed
What is MHRA alert regarding miconazole
NOT w warfarin-inhibitor
What is MHRA alert regarding warfarin
- Calciphylaxis -painful skin rash
2. with hep C drugs - changes to INR
What is MHRA alert regarding yellow fever vaccine
live vaccine so stronger precuations in people with reduced immunity and >60
What is MHRA alert regarding simvastatin 80mg
High risk of myopathy
What is MHRA alert regarding statins
interstitial lung disease- report SOB, cough, weight loss
What is MHRA alert regarding DOACs
- c/i in bleeds risk
- risk of thrombosis in ptss with antiphospholipid syndome-warfarin preferred
- not in mitral valve
What is MHRA alert regarding lidocaine teething products
Only under supervision of pharmacist when other non pharm have been tried and failed (teething rings. rubbing gums etc)
Only pea sized blob, repeated after3. hours
No more than 6x day
What is MHRA alert regarding domperidone
risk of QT prolongation- CV risk factors and ECG
What is MHRA alert regarding citalopram
interaction with cocaine-illicit drug us
What is MHRA alert regarding etoricoxib
lower dose of 60mg daily in RA/SPA (cardiac risk)
