PHARM interactions and side effects Flashcards
Hypokalemic drugs
Diuretics (Furosemide, HCTZ)
Corticosteroids (Hydrocortisone, Prednisone, Dexamethasone)
Cardiac glycosides (Digoxin, Convallaria, Digitalis, Leonarus)
Anti-Arrhythmias (atenolol, propranolol, amiodarone)
Pseudoephedrine
Glycyrrhiza
What meds caused decreased effects of Amoxicillin
tetracycline (Doxycycline, minocycline - protein synth inhib; mirtazapine - for MDD)
Penicillin increases effect and toxicity of what drug
methotrexate
Penicillin decreases effect of what drug class
Beta blockers
Penicillin’s effectiveness is decreased if it’s taken with what antibiotic
Doxycycline
Cephalexin, a cephalosporin (works like Penicillins), may increase effects of what drug
Metformin
A/E of Cephalexin
- C. diff super infection
- diarrhea
- pseudomembranous colitis (higher incidence than other antibiotics)
Fluoroquinolone Ciprofloxacin’s absorption is decreased by what
cations (antacids, iron, zinc, bismuth)
Ciprofloxacin increases serum levels of what drug
warfarin
Nitrofurantoin has antagonistic effects with what antibiotic class
Fluoroquinolones (Ciprofloxacin)
A/E of Nitrofurantoin
PAIN mnemonic
- Pulmonary toxicity
- Anemia in Pts with G6PD
- Irritated GI
- Neurotoxicity
A/E of Doxycyline
- permanent teeth discoloration
- black tongue
- photosensitivity
- GI distress
Doxycycline’s absorption is reduced when used with
antacids, calcium, Magnesium, Iron
Doxycyline decreases effect of what other antibiotic
Penicillin
What antibiotic class is safe for pregnancy
Macrolide (Azithromycin)
antibiotics that prolong QT
Azithromycin and Ciprofloxacin (macrolide and fluoroquinolone)
what kind of antacids reduce rate of absorption of Azithromycin
aluminum and magnesium salts
Trimethoprim-Sulfamethoxazole (TMP-SMZ; sulfonamide) induces folate deficiency which causes what Sxs
- thrombocytopenia/leukopenia
- megaloblastic anemia
(these are preventable with folic acid supplement)
What other drugs might cause additive folate deficiency with TMP-SMZ
- methotrexate
- phenytoin
which antidiabetic drug class does TMP-SMZ affect and how?
Sulphonylureas (increases hypoglycemic effect)
What antimicrobial is usually Rx for impetigo
topical Mupirocin
condition C/I with topical Mupirocin
burns
What anticholinergic antiviral drug is used in parkinsons and herpes zoster (and formerly influenza A)
Amantadine
Amantadine enhances effects of what drugs
- anticholinergics and levodopa
do not take Amantadine with what type of drugs
CNS stimulants
Zidovudine (Antiretroviral) causes what A/E when combined with benzodiazepines
increased incidence of headache
interferon alpha is used for treatment of
chronic hep B and C, condyloma acuminatum (genital warts), tumors (leukemia, Kaposi’s sarcome (AIDS), malign melanoma)
interferon beta is used for treatment of
MS
A/E of interferon alpha and beta
Mnemonic IFN ALPHA
- Inhibits bone marrow
- Flu like sxs
- neurotoxic (depression/psychosis)
- autoimmune disorders
- liver enzyme elevations
- proteinuria
- hypotension and tachycardia
- alopecia
Fluconazole (Triazole) potentiates what drugs
warfarin and oral hypoglycemics
Fluconazole may increase serum levels of what drugs
- phenytoin, cyclosporine, zidovudine, sulfonylureas, carbamazepine
what drug increases fluconazole levels
thiazides
what drugs to avoid when taking Hydroxychloroquine
digoxin and alcohol
what is Hydroxychloroquine used for besides malaria?
SLE, RA
A/E of Hydroxychloroquine
- retinopathy, hair loss, photosens, tinnitus, myopathy, psychosis, seizures, cardiomyopathy
reduced plasma levels of mebendazole (antihelmentic) with what enzyme inducers
phenytoin, carbamazepine
Metronidazole (antiprotozoal) is used for what kind of infections
Anaerobic bacterial (first line), and anaerobic protozoal (ie.trichomonas)
Adalimumab is in what pharmacologic class
TNF alpha blocker
Adalimumab is used for what conditions
inflammatory diseases (RA, AS, psoriatic arthritis, Chrohn’s, UC, psoriasis)
Adalimumab should not be given with what
live vaccines
Tofacitinib (JAK inhibitor) A/E
infections (20%), upper resp tract infx, H/A, diarrhea, nasopharyngitis, UTI, HTN (rarely)
Cyclosporine class
polypeptide Abx
clinical use of Cyclosporine
- transplants
- psoriasis
- RA
A/E of Cyclosporine
- Nephrotoxicity
- increased tremor
- HTN, HA, hyperlipids, hyperplasia of gums, hirsutism
drugs that increase concentration of Cyclosporine
- CCBs,
- antifungals
- antibiotics
- glucocorticoids
triamcinolone (steroid for RA, MS, other inflamm conditions) is contraindicated in what conditions
- systemic fungal infection
- ITP
- with live vaccines
Rifampin (antiTB) A/E
- red colored tears, urine, saliva, sweat
- abd pain/vomit/diarrhea/hepatitis
Rifampin induces CYP and reduces levels of what drugs
warfarin, steroids, opioids, phenytoin, verapamil, reduces efficacy of OCPs
agents that increase effects of warfarin by inhibiting platelets
cephalosporins, NSAIDs, penicillin, salicylates, onions, garlic, ginger, ginkgo
drugs that increase warfarins effects
- acetaminophin
- androgens
- beta blockers
- steroids
- omeprazole
- phenytoin
what drug may increase A/E of pentoxifylline (used for Tx of PAD)
Ciprofloxacin
what commonly used drug increases phenytoin levels
aspirin
Estradiol may enhance effects of what drugs
hydrocortisone and prednisolone
DHEA must be monitored closely when taking with what drugs
amiodarone, atorvastatin, buspirone, cortisone, diazepam, warfarin
conjugated estrogens are metabolized partially by CYP 3A4, thus what inhibitors of CYP3A4 may increase concentration of estrogen (increasing A/Es)
erythromycin, grapefruit juice
Herb interactions with prochlorperazine
Angelica and hypericum increase photosensitivity, kava increases dystonia
sucralfate (pepsin inhibitor/GI protectant) requires an acidic environment for activation, thus should not be taken with
antacids, H2 blockers, PPIs
esomeprazole (PPI) level may be increased with what drug
amoxicillin
esomeprazole increases levels of what drugs
diazepam, phenytoin, warfarin
Loperamide has an additive effect with which herbs
CNS depressants (kava, chamomile, valerian)
