Pharmacology- DRUGS Flashcards
a. Antibiotics are commonly used in dental practice. Write down 2 antibiotics that are commonly contraindicated in patients taking warfarin. (1)
- The antibiotics most likely to interfere with warfarin are TMP/SMX, ciprofloxacin, levofloxacin, metronidazole, fluconazole, azithromycin, and clarithromycin
- When prescribing antibiotics for patients taking warfarin, try to choose agents with a lower likelihood of affecting IMR such as penicillin G, clindamycin, and 1st and 4th generation cephalosporins.
b. State the mechanism of interaction between warfarin the antibiotics mentioned in question, and the clinical implications of the interactions (2)
Inhibit / kill the intestinal bacteria that produce Vitamin K → increase effect of warfarin
Metronidazole: inhibit liver enzyme → inhibit metabolism of the warfarin
- What the use of bisphosphonate? Negative effects?
- Side effects for all the bisphosphonates (alendronate, ibandronate, risedronate and zoledronic acid) may include bone, joint or muscle pain.
- Side effects of the oral tablets may include nausea, difficulty swallowing, heartburn, irritation of the esophagus (tube connecting the throat to the stomach) and gastric ulcer.
- Bisphosphonates should not be given to patients with active upper GI disease.
- Bisphosphonates should be discontinued in patients who develop any symptoms of esophagitis.
- Bisphosphonates should be taken alone on an empty stomach first thing in the morning with at least 240 mL of water
- What are the three groups of medications for treating hypertension? How many groups in total are on the market? (4) (Formative, 2008)
In Hong Kong, antihypertensive drugs can only be obtained from pharmacy with a prescription. They should be used under close supervision by healthcare professionals. Antihypertensive drugs are available in different dosage forms. They include oral (e.g. tablet and capsule) and injectable (e.g. intramuscular and intravenous injection). The most widely used medications for treating hypertension includes:
1. ACE inhibitors
- Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by relaxing your blood vessels, e.g. enalapril, lisinopril, perindopril.
2. Angiotensin II receptor blockers - Angiotensin II receptor blockers help relax your blood vessels which lower your blood pressure and makes it easier for your heart to pump blood, e.g. losartan, valsartan.
3. Calcium channel blockers - Calcium channel blockers keep calcium from entering the muscle cells of the heart and blood vessels. This widens your arteries and reduces your blood pressure, e.g. diltiazem, nifedipine and amlodipine.
4. Diuretics - Sometimes known as water pills, diuretics work by flushing excess water and salt from the body through urine, e.g. amiloride, frusemide, indapamide.
5. Beta-blockers - Beta-blockers work by making your heart beat more slowly and with less force, thereby reducing blood pressure, e.g. atenolol, metoprolol, propanolol.
6. Alpha-blockers - Alpha-blockers work by relaxing your blood vessels, making it much easier for blood to flow through them, e.g.doxazosin, prazosin.
7. Centrally acting antihypertensive drugs - Centrally acting antihypertensive drugs, like methyldopa and clonidine, act by stimulation of alpha 2 adrenoceptors in the central nervous system which results in a reduction in sympathetic tone and a fall in blood pressure. Methyldopa may be used for the management of hypertension in pregnancy.
8. Vasodilators - Vasodilators reduce blood pressure by dilatation of blood vessels, e.g. hydralazine.
23/F, radiographer, self-referred to your clinic to ask for extraction of wisdom teeth.
History: pain at wisdom teeth region for several times
Pan: 18, 28 vertical, fully erupted, 38 horizontal impaction, 48 horizontal/mesio angular impaction
a. List three useful types of antihypertensive. How many types are there in the market totally?
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