Pharmacology special topics Flashcards
Gout vs hyperuricemia
Gout: hyperuricemia in which monosodium urate crystals are formed within the synovial fluid or tissues
How do diuretics increase uric acid?
They compete with the renal tubular secretion of uric acid
Medications of concern that increase uric acid
- Alcohol
- Diuretics (thiazide, loop)
- Ethambutol
- Levodopa/carbidopa
- Nicotinic acid (Niaspan)
- Pyrazinamide
- Salicylates
- Ticagrelor
What happens in drug-sunlight interactions?
Cause irritation to the skin
What happens in drug-sunlight interaction?
- Medication deposition in skin
- Chemical compound in skin react to certain wavelength
- Causes them to vibrate / change
- Leads to inflammation or irritation
- Can lead to sunburn
Medications that have drug-sunlight interactions
- Cipro
- Tetracyclines (doxycycline, minocycline)
- Isotretinoin
- Vemurafenib (Zelboraf) (BRAK kinase inhibitor)
Glucose 6-phosphate dehydrogenase deficiency background
- Most common ethnicities are African and Mediterranean descent
- Risk factors include stress, fava beans, medications
- X-linked (transferred by mother)
What does Glucose 6-phosphate dehydrogenase deficiency lead to?
- Not able to make toxic drug metabolites soluble for elimination
- Leads to increased oxidative damage to RBC
- Leads to hemolysis
Clinical presentation of Glucose 6-phosphate dehydrogenase deficiency
- Fever
- Fatigue
- Shortness of breath
- Abdominal & back pain
- Dark urine
- Palpitations/tachycardia
- Labs: – Hemolysis (see “bite cells” or Heinz bodies), Elevated T bili
Medications of Concern in Glucose 6-phosphate dehydrogenase deficiency
- Chloroquine (Aralen)
- Dapsone
- Flutamide (Eulexin)
- Methylene blue
- Nitrofurantoin
- Pegloticase (Krystexxa)
- Phenazopyridine (Pyridium)
- Primaquine phosphate
- Rasburicase (Elitek)
- Bactrim
What effect does high fat meal have on efavirenz?
Increases bioavailability and increases psychosis (commonly vivid dreams)
What to avoid with fluoroquinolones?
Di- and tri- valent cations (Ca, Al, Fe, Mg) because it decreases bioavailability
Food counseling points with gemfibrozil
Best to take on empty stomach to increase bioavailability but can cause stomach upset so some pts end up taking w/ food anyways
Food counseling points with iron
Best to take on empty stomach to increase bioavailability but can cause stomach upset so some pts end up taking w/ food anyways
Counseling points with tetracyclines
- Avoid di- and tri- valent cations because it decreases bioavailability
- Take with 8 oz of water to make sure passes esophagus (can cause esophageal ulceration)
