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HY OPIC > Polypharmacy drugs > Flashcards

Polypharmacy drugs Flashcards

1
Q

State the drug class, indication, relevant side effects and interactions for haloperidol

A
  • Drug class: Anti-psychotic
  • Indication:
    • N&V (palliative)
    • Acute delirium
    • Persistent psychomotor agitation
    • Schizophrenia
  • Side effects:
    • Drowsiness, postural hypotension, QT interval prolongation
    • Extra-pyramidal- muscle rigidity, movement disorders
  • Interactions:
    • Drugs that prolong QT interval (amiodarone, macrolides)
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2
Q

State the drug class, indication, relevant side effects and interactions, including STOPP/START criteria for macrogol

A
  • Drug class: Osmotic laxative
  • Indication: Chronic constipation
  • Side effects: flatulence, GI discomfort, N&V
  • Interactions: Effects of warfarin may be slightly increased
  • STOPP/START
    • STOP: bowel obstruction (risk of perforation)
    • START: opioids (prevent constipation)
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3
Q

State the drug class, indication, relevant side effects and interactions, including STOPP/START criteria for alendronate

A
  • Drug class: Bisphosphonate
  • Indication: Osteoporosis
  • Side effects:
    • Oesophagitis
    • Hypophosphataemia
    • Arthralgia
    • GI discomfort
    • Rare- osteonecrosis of jaw, atypical femoral #
  • Interactions: Absorption reduced when taken with calcium salts (milk) and antacids and iron salts
  • STOPP/START
    • STOP: Unable to sit upright/ swallowing difficulties/ compliance issues, recent hx of upper GI bleeding
    • START: maintenance corticosteroid therapy w/ previous fragility #
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4
Q

State the drug class, indication, relevant side effects for Strontium Ranelate

A
  • Drug class: Anti-osteoporotic agent
    • Stimulates bone formation & reduces resorption
  • Indication: Severe osteoporosis with risk of fragility #
  • Side effects: Arthralgia, GI discomfort, headache, insomnia, memory loss, MI, nausea, pain, paraesthesia, peripheral oedema
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5
Q

State the drug class, indication, relevant side effects and interactions, including STOPP/START criteria for colchicine

A
  • Drug class: Anti-gout medication
  • Indication: Acute gout, short term prophylaxis during initial therapy w/ allopurinool
  • Side effects: abdo pain, diarrhoea, N&V
  • Interactions: atorvastatin
  • STOPP/START
    • STOP: if eGFR < 10 (risk of toxicity)
      For chronic treatment when no C/I to allopurinol which is first choice prophylactic in gout
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6
Q

State the drug class, indication, relevant side effects and interactions, including STOPP/START criteria for allopurinol

A
  • Drug class: Xanthine oxidase inhibitor
  • Indication: Prophylaxis of gout, Prophylaxis of hyperuricaemia in chemo
  • Side effects: Rash (discontinue), hypersensitivity, N&V, Steven Johnson syndrome
  • Interactions
    • Azathioprine (toxicity)
    • ACEi (hypersensitivity reactions)
    • Amoxicillin (skin rash)
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7
Q

State the drug class, indication, relevant side effects and interactions, including STOPP/START criteria for prednisolone

A
  • Drug class: Corticosteroid (glucocorticoid)
  • Indication:
    • Acute COPD exacerbation
    • Asthma attack
    • IBD, ITP, generalized MG, severe RA, PMR, GCA, SLE
  • Side effects:
    • Immunosuppression- infections
    • Metabolic- DM, osteoporosis
    • Mood & behavioural- insomnia, confusion, psychosis
    • Mineralcorticoid- htn, hypoK, oedema
    • Addisonian crisis
  • Interactions:
    • CYP450 inhibitors (efficacy reduced) – carbamazepine, rifampicin, phenytoin
    • NSAIDs (GI bleeding risk)
    • Beta agonists, theophylline, loop or thiazide diuretics (enhance hypoK)
  • STOPP/START:
    • STOP: if used instead of ics for maintenance in severe COPD, as long term monotherapy for RA< treatment of OA rather than intra-articular injections, with concurrent NSAIDs w/o PPI prophylaxis (risk of PUD)
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8
Q

State the drug class, indication and relevant side effects for pizotifen

A
  • Drug class: Antamine
  • Indication: Migraine prophylaxis
  • Side effects: Increased appetite, dizziness, drowsiness, dry mouth, fatigue, nausea, weight increase
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9
Q

State the drug class, indication, relevant side effects and STOPP/START criteria for zopiclone

A
  • Drug class: Non-benzodiazepine hypnotic Z-drug
  • Indication: Insomnia (short-term use)
  • Side effects: Dry mouth, taste bitter, fatigue, fall
  • STOPP/START:
    • STOP: potentially inappropriate in elderly as can cause protracted daytime sedation or ataxia
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10
Q

State the drug class, indication and relevant side effects for entecapone

A
  • Drug class: COMT (Catechol-O-Methyl Transferase) inhibitor
  • Indication: Adjunct to dopamine therapy in PD (because COMT is an enzyme involved in breakdown of dopamine)
  • Side effects: Abdominal pain, confusion, constipation, diarrhoea, dizziness, dry mouth, fall fatigue, hallucination, hyperhidrosis, IHD, movement disorders, vomiting
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11
Q

State the drug class, indication and relevant side effects for ropinirole

A
  • Drug class: Dopamine agonist
  • Indication:
    • PD, either alone or as adjunct to dopamine therapy
    • Moderate to severe restless legs syndrome
  • Side effects:
    • Confusion, dizziness, drowsiness, fatigue, GI discomfort, hallucination, movement disorders, nausea, peripheral oedema, vomiting, vertigo, syncope
    • Hypotension- caution in CVD
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12
Q

State the drug class, indication, relevant side effects and interactions, including STOPP/START criteria for Amitryptyline

A
  • Drug class: Tricyclic antidepressant
  • Indication:
    • Low-dose for neuropathic pain
    • Migraine prophylaxis
    • Depression
    • Abdo pain if pt not responded to laxatives, loperamide, antispasmodics
    • Emotional lability in MS
  • Side effects:
    • (Anticholinergic syndrome)
    • Drowsiness, dry mouth, blurred vision, constipation, urinary retention, lengthening of QT interval
    • Use low dose for elderly pts- susceptible to psychiatric & cardiac S/E
  • Interactions:
    • Monoamine oxidase inhibitors- both drug classes increase 5-HT and noradrenaline levels at the synapse and can precipitate htn and hyperthermia or serotonin syndrome
    • Can augment antimuscarinic, sedative or hypotensive adverse effects of other drugs
  • STOPP/START:
    • STOP: dementia, glaucoma, cardiac abnormalities, combination w/ opiate or CCB (severe constipation risk), hx of UR or prostatism (risk of UR)
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13
Q

State the drug class, indication, relevant side effects and interactions for Co-beneldopa/ Co- careldopa

A
  • Drug class: Dopaminergic drugs- Levodopa combined w/ benserazide or carbidopa to prevent peripheral metabolism of levodopa to dopamine
  • Indication: Parkinson’s Disease
  • Side effects: Dyskinesia, on-off effect, dry mouth, anorexia, palpitations, postural hypotension, psychosis, drowsiness
  • Interactions:
    • Metoclopramide
    • First-generation antipsychotics
    • Do not acutely stop
      (risk of neuroleptic malignant syndrome and rhabdomyolysis)
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HY OPIC (3 decks)

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