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Essential Drugs > Other and Adverse Drug Reactions > Flashcards

Other and Adverse Drug Reactions Flashcards

0
Q

Dose of folic acid

A

Macro anaemia- 5-15mg/day for 4mo
Pregnancy- 400 micrograms
High risk individuals eg SCD- 5mg/day

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1
Q

Thiamine (B1) dose

A

Mild: 25-100mg daily
Severe: 200-300mg daily in divided doses

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2
Q

Dose of prednisolone

A

Maintenance-2.5-15mg
Start-10-40mg (depending on indication)
Max- 60mg
BONE PROTECT!

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3
Q

Dose of ferrous sulphate

A

Anaemia: 200mg TDS
Prophylaxis: 200mg OD

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4
Q

Dose of chlorphenamine

A

PO: 4mg 4-6hrly, max 24mg /day

IM/Slow IV: 10mg, max 4 times/24hours

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5
Q

Dose of cetirizine

A

10mg OD

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6
Q

Dose of allopurinol

A

100mg OD after food increased to 100-300mg maintenance

Severe: 700-900mg/day

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7
Q

Mechanism of action of latanoprost

A

Prostaglandin F2a analogue to reduce intraocular pressure

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8
Q

Drugs to be therapeutically monitored

A 
Digoxin
Theophylline
Lithium
Phenytoin
Gentamicin
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9
Q

Type A drug reactions

A

Predictable and dose related
Often part of the main action or a side effect (eg N/V)
Caused by wrong dose/route of admin or individual variation

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10
Q

Type B drug reactions

A 
Idiosyncratic and unpredictable
Not dose related
Severe 
Uncommon
Caused by allergies or genetics (eg G6PD)
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11
Q

Type I allergic ADR

A

IgE mediated eg anaphylaxis to penicillin

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12
Q

Type II allergic ADR

A

IgG/IgM mediated eg quinine/platelets or methyldopa/red cells

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13
Q

Type III allergic ADR

A

Immune complex mediated eg co-trimoxazole drug fever, lymphadenopathy, glomerulonephritis

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14
Q

Type IV allergic ADR

A

Delayed hypersensitivity eg contact dermatitis to topical antibiotic

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15
Q

Causes of type B ADR w/rash

A

Stevens-Johnson syndrome to penicillin, sulfonamides, phenytoin

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16
Q

Cause of type B ADR lymphadenopathy

A

Phenytoin

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17
Q

Causes of type B ADR blood dyscrasias

A

Agranulocytosis with carbimazole or clozapine

Thrombocytopenia with heparin and thiazides

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18
Q

Cause of type B ADR nephropathy

A

Aminoglycosides

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19
Q

Cause of type B ADR hepatic disease

A

Chlorpromazine
halothane
statins

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20
Q

Causes of type B ADR SLE

A

Hydralazine

Isoniazid

21
Q

Causes of type B ADR neuropathy

A

Amiodarone

Nitrofurantoin

22
Q

Definition of type C ADR

A

Long term damage occurring with continued drug use

23
Q

Examples of type C ADRs

A 
Corticosteroids = osteoporosis
Neuroleptics = dyskinesia 
Dexfenfluramine = pulmonary HTN/valve stenosis 
Methotrexate = cirrhosis
Amiodarone = pulmonary fibrosis 
HRT = endometrial Ca
24
Q

Definition of type D ADR

A

Delayed reaction or congenital issues

25
Q

Definition of type E ADRs

A

Reaction which occurs when drug is ceased

26
Q

Examples of type E ADR

A 
Prednisolone = addisonian crisis
Atenolol = tachycardia/angina
Diazepam = insomnia/seizures
Alcohol = DTs
Opioids = withdrawal syndrome
27
Q

Drugs not to use in penicillin allergy

A 
Penicillins (obv)
Tazocin
Meropenem
Aztreonam
Use cephalosporins with caution
28
Q

CYP450 enzyme inducers

A 
Rifampicin 
Phenytoin
Barbiturates 
Carbamazepine
Ethanol
Sulphonylureas
Nevirapine
29
Q

CYP450 enzyme inhibitors

A 
Abx
Cimetidine
Ethanol
Ketoconazole
Diltiazem/verapamil 
Omeprazole/lansoprazole 
Sodium valproate
Quinidine
5HT reuptake blockers
Protease inhibitors
30
Q

Effect of cimetidine on warfarin

A

Increased INR

31
Q

Effect of Abx (eryth, clarith, cipro, cimetidine) on theophylline

A

Theophylline toxicity

32
Q

Effect of ketoconazole on cyclosporine

A

Cyclosporine toxicity

33
Q

Effect of cimetidine or omeprazole on phenytoin

A

Phenytoin toxicity

34
Q

Important nephrotoxic drugs

A 
NSAIDs
Diuretics 
Amphotericin B
Cisplatin
Gold
Penicillamine
Aminoglycosides
Lithium
35
Q

Drugs which cause dose dependent hepatitis

A

Paracetamol, alcohol, azathioprine

36
Q

Drug causes of dose independent hepatitis

A

Isoniazid, pyrazinamide, amiodarone, nifedipine, halothane

37
Q

Drug causes of fatty liver diseases

A

Alcohol, tetracyclines

38
Q

Drug cause of decreased bilirubin excretion

A

Oestrogens

39
Q

Drug causes of choleostasis

A

Chlorpromazine, chlorpropamide, erythromycin/clarithromycin, nitrofurantoin, nifedipine, co-amoxiclav

40
Q

Cause of a drug induced raised INR

A

Inhibited P450 enzyme (see card)

41
Q

Sildenafil and nitrates?

A

Nooooooooooooo

Too much vasodilation

42
Q

Monitoring parameters for statins

A

LFT at baseline, 3mo and 12mo

43
Q

Monitoring parameters for ACE inhibitors

A

U&E prior, after increasing dose and annually

44
Q

Monitoring parameters for amiodarone

A

TFT LFT U&E and CXR prior to treatment

TFT AND LFT every 6mo

45
Q

Monitoring parameters for methotrexate

A

FBC, LFT, U&E before treatment, weekly until stabilised therapy, every 2-3mo after

46
Q

Monitoring parameters for azathioprine

A

FBC, LFT before treatment
FBC weekly for 4 weeks
FBC, LFT every 3mo

47
Q

Monitoring parameters for lithium

A

TFT, U&E before treatment
Lithium levels weekly until stabilised then 3monthly
TFT, U&E every 6mo

48
Q

Monitoring parameters of sodium valproate

A

LFT, FBC before treatment

LFT “periodically” during first 6mo

49
Q

Monitoring parameters of glitazones

A

LFT before treatment

“Regularly” during

Essential Drugs (9 decks)

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