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Pharmacology Interactions and ADRs Flashcards

1
Q

Digoxin toxicity

A

Narrow QRS, PR interval prolongation, VT, VF

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2
Q

NSAID side effects

A

Renal failure (-> Heart failure)Reduced prostaglandin synthesis, increased gastric acid production, reduced bicarbonate, reduced mucus,

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3
Q

Antidepressant anticholinergic side effects

A 
Dry moth
Dry eyes
Dilated pupils and photosensitivity
Diplopia
Tachycardia
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4
Q

ACEI side effects

A

Cough
Hyperkalaemia
Hypotension
Renal failure (if with a diuretic and NSAID)

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5
Q

Dose dependent hepatotoxicity

A

Paracetamol

Aspirin

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6
Q

Dose independent hepatotoxicity

A 
Isoniazid
Pyrazinamide
Valproate
Methyldopa
NSAID
Phenytoin
Statin
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7
Q

Dose dependent cholestatic drugs

A

Rifampicin

Oestrogens

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8
Q

Dose independent cholestatic drugs

A 
Chlorpromazine
Clavulanic acid (Co-amox)
Cloxacillin (Fluclox)
Clarithromycin
Chlorpropamide
Carbimazole
Cimetidine
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9
Q

Micro vesicular fat deposition (Reye’s syndrome)

A

Valproate
Aspirin
Tetracyclines

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10
Q

Macro vesicular fat and cirrhosis

A

Alcohol
Amiodarone
Methotrexate

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11
Q

Rapid ADR

A

IV vancomycin can cause Red Man syndrome

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12
Q

1st Dose ADR

A

Type I hypersensitivity e.g. Penicillin allergy

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13
Q

Intermediate response ADR

A

Carbimazole or 5-ASAs can cause agranulocytosis after 3 months
Monitor for sore throat

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14
Q

Intermediate response ADR

A

Carbimazole or 5-ASAs can cause agranulocytosis after 3 months
Monitor for sore throat

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15
Q

Late response ADR

A

Corticosteroid and OP

Dopamine receptor antagonist and tardive dyskinesia

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16
Q

Delayed ADR

A

Cancer e.g. on Ciclosporin

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17
Q

Dose toxicity

A

Digoxin
Phenytoin
Theophylline
Modified release lithium

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18
Q

Concentration toxicity

A

Digoxin toxicity from renal insufficiency

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19
Q

Effect of opiate, TCA and antimuscarinics on GI motility

A

Reduced GI motility

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20
Q

Effect of metoclopramide on GI motility

A

Increased GI motility (Dopamine receptor antagonist)

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21
Q

Effect of cholestyramine on absorption of digoxin and warfarin

A

Reduced GI absorption of digoxin and warfarin

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22
Q

Effect of Antacids and milk on absorption of tetracyclines

A

Chelation of tetracycline reduces GI absorption

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23
Q

Effect of iron on prednisolone GI absorption

A

Chelation of prednisolone reduces GI absorption

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24
Q

Effects of antibiotics on warfarin absorption

A

Reduced Vit K synthesis potentiates warfarin

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25
Effect of coeliac disease on digoxin absorption
Decreased GI absorption of digoxin
26
Effect of coeliac disease on propranolol absorption
Increased GI absorption of propanolol
27
Effect of coeliac disease on propranolol absorption
Increased GI absorption of propanolol
28
Interaction of valproate and phenytoin
Displacement of phenytoin from plasma protein, inhibiting metabolism
29
Interaction of ASA/NSAIDs and Methotrexate
Displacement of methotrexate from plasma proteins, reducing its secretion and augmenting its toxicity
30
Interaction of sulphonamides/Vitamin K/Indometacin on bilirubin
Displacement of bilirubin and reduced excretion in neonates causing kernicterus
31
Interaction of amiodarone and digoxin
Displaces digoxin from tissue binding sites, augmenting toxicity
32
Interaction of amiodarone and digoxin
Displaces digoxin from tissue binding sites, augmenting toxicity
33
Liver enzyme inducers
``` Phenytoin Carbamazepine Barbiturates and BBQ food Rifampicin Alcohol Smoking, St John's Wort, Sulphinpirazole ```
34
Liver enzyme inhibitors
``` Grapefruit juice Omeprazole Disulfiram Erythromycin Valproate Isoniazid Cimetidine Ethanol Sulphonamides ```
35
Liver enzyme inhibitors
``` Grapefruit juice Omeprazole Disulfiram Erythromycin Valproate Isoniazid Cimetidine Ethanol Sulphonamides ```
36
Drugs with a narrow therapeutic index
``` Warfarin Anti arrhythmics Ciclosporin Sulphonylureas Theophyllines Oral contraceptive Phenytoin Steroids, statins ```
37
Warfarin is displaced by
Salicylates NSAIDs Sulphonylureas
38
Warfarin is potentiated by c450 inhibitors
``` Cimetidine Amiodarone Acute alcohol intake Metronidazole Suphalyrazone ```
39
Warfarin is inhibited by c450 inducers
``` Phenytoin Carbamazepine Barbiturates/BBQ Rifampicin Alcohol Smoking/St John's Wort ```
40
Interaction of warfarin and atorvastatin
Atorvastatin inhibits action of Warfarin
41
Interaction of warfarin and atorvastatin
Atorvastatin inhibits action of Warfarin
42
Effect of Allopurinol on xanthine oxidase
Inhibition of xanthine oxidase, potentiating action of azathioprine/mercaptopurine Risk pancytopaenia
43
Effect of Carbidopa on Depa decarboxylase
Inhibition of dopadecarboxylase to potentiate the effects of L dopa
44
Effect of Metronidazole on aldehyde dehydrogenase
Inhibition of aldehyde dehydrogenase, potentiating the effects of alcohol
45
Effect of monoamine oxidase inhibitors
Potentiate the effects of amphetamines and tyramine (risk of mania)
46
Cheese effect (hypertensive crisis)
Monoamine oxidase inhibitors and tyramine
47
Effect of rifampicin on oral contraceptive
Oral contraceptive efficacy reduced
48
Effect of omeprazole on phenytoin
Action of phenytoin enhanced
49
Effect of Amiodarone on warfarin
Action of warfarin enhanced
50
Effect of grapefruit juice on Ciclosporin
Effect of ciclosporin enhanced
51
Effect of ciprofloxacin on theophylline
Effect of theophylline enhanced
52
Effect of allopurinol on azathioprine
Effect of azathioprine enhanced
53
Effect of Carbidopa on L dopa
Effect of L dopa enhanced
54
Effect of probenecid on penicillin
Reduced active tubular secretion of penicillin, prolonging action
55
Effect of nifedipine/verapamil/amiodarone on digoxin
Reduced active tubular secret of digoxin, potentiating its effect (MB Digoxin toxicity)
56
Effect of aspirin on methotrexate
Reduced protein binding and reduced active tubular secretion, potentiating its effect (NB Methotrexate toxicity)
57
Effect of sodium bicarbonate on aspirin
Reduced passive renal resorption of aspirin, reducing its effect Use in salicylate overdose
58
Effect of bendrofluazide on lithium
Increased passive tubular resorption of lithium, potentiating its effects
59
Renal unhappy triad causing AKI
Beta blocker, NSAID and ACEI antagonistic effects
60
Interaction of beta blocker and calcium channel blocker (verapamil, diltiazem)
Synergistic effect causing asystole
61
Interaction of theophylline and beta agonist
Synergistic effect causing arrhythmia
62
Interaction of loop diuretic and aminoglycoside
Synergistic effects increase risk of ototoxicity
63
Interaction of amitryptilline and diazepam
Synergistic effect on sedation
64
Interaction of aspirin and streptokinase/NSAID
Synergistic effect on anti-platelet and fibrinolysis
65
Interaction of dipyridamole/theophylline/caffeine on adenosine
Adenosine potentiated. Reduced phosphodiesterase activity increases cAMP, reducing cellular adenosine uptake.
66
Interaction of beta blocker and IV calcium channel blocker (verapamil, diltiazem)
Synergistic effect causing asystole
67
Interaction of dipyridamole/theophylline/caffeine on adenosine
Adenosine potentiated. Reduced phosphodiesterase activity increases cAMP, reducing cellular adenosine uptake.
68
Effect of naloxone on morphine
Antagonistic effect on µ-receptors with morphine
69
Interaction of atenolol and salbutamol
Antagonistic effect on salbutamol. Can result in bronchoconstriction and bronchospasm
70
Interaction of ibuprofen and bendrofluazide
Risk of renal toxicity due to antagonistic effects
71
Interaction of furosemide and digoxin
Risk of hypokalaemia resulting in digoxin toxicity
72
Interaction of theophylline and salbutamol
Risk of hypokalaemia and arrhythmia
73
Interaction of furosemide and gentamycin
Increased risk of ototoxicity
74
Interaction of aspirin and ibuprofen
Anti-platelet effect of aspirin is reduced
75
Causes of hyperkalaemia
``` Reduced renal clearance Increased K+ load Tissue breakdown Increased release from cells Pseudohyperkalaemia ```
76
Management of hyperkalaemia
ABC, ABG, U&E and creatinine Stop precipitating causes IV Calcium gluconate for stabilization of cardiac membrane Insulin and dextrose to promote K+ uptake NaHCO3- if acidotic

Medicine (15 decks)

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