Pharmacology Flashcards
Clarithromycin
-CYP3A4 inhibitor
- interfere with Theophylline, simvastatin, cyclosporine, warfarin and Digoxin
PPI
Proton pump inhibitors (PPI) cause irreversible blockade of H+/K+ ATPase of the gastric parietal cell.
Examples include omeprazole and lansoprazole.
Adverse effects
1- hyponatraemia, hypomagnasaemia
2- osteoporosis → increased risk of fractures
3- microscopic colitis
4- increased risk of C. difficile infections
ACE inhibitors
Side-effects:
- cough: occurs in around 15% of patients and may occur up to a year after starting treatment. Thought to be due to increased bradykinin levels
- Angioedema: may occur up to a year after starting treatment
- Hyperkalaemia
- First-dose hypotension: more common in patients taking diuretics
Cautions and contraindications
- pregnancy and breastfeeding - avoid
renovascular disease - significant renal impairment may occur in patients who have undiagnosed bilateral renal artery stenosis
- Aortic stenosis - may result in hypotension
- patients receiving high-dose diuretic therapy (more than 80 mg of furosemide a day) - significantly increases the risk of hypotension
hereditary or idiopathic angioedema
Monitoring
- Urea and electrolytes should be checked before treatment is initiated and after increasing the dose
a rise in the creatinine and potassium may be expected after starting ACE inhibitors. Acceptable changes are an increase in serum creatinine, up to 30%* from baseline and an increase in potassium up to 5.5 mmol/l*.
