Prescribing: Errors, pregnancy etc

Question 1

Medication error

Answer 1

Error in

• The dispensing or supply process of a drug
• The prescribing process of the drug

Leads to the failure of treatment process, has potential to harm patient.

Question 2

Drugs that increase warfarin’s anticoagulation (8)

Answer 2

Prednisolone

Antibiotics

• METRONIDAZOLE
• Ciprofloaxacin
• Clarithromycin, erythromycin
• Levofloxacin

Cranberry juice

Fluconazole

Question 3

Drugs that decrease warfarin’s anticoagulation

Answer 3

Rifampicin- reduces INR

Carbamazepine

Phenytoin

Chronic alcohol

Question 4

Drugs that increase risk of bleeding

Answer 4

NSAIDs + antiplatelets

• Aspirin
• Diclofenac
• Coxibs
• Clopidogrel

SSRIs

• Citalopram
• Duloxetine
• Fluoxetine

Question 5

Cytochrome P450 inducers

Answer 5

Slower process
- More enzymes available to break down drugs

Examples

• Carbamazepine
• Phenytoin
• Rifampicin
• Chronic alcohol

Question 6

Cytochrome P450 inhibitors

Answer 6

Rapid process
- Increases levels of drugs in the body

Examples

• Amiodarone
• Ciprofloxacin
• Erythromycin, clarithromycin
• Metronidazole
• Fluconazole
• Isoniazid
• Acute alcohol
• Grapefruit juice

Question 7

Phase 1 drug metabolism

Answer 7

Process of drug metabolism that includes:

• Oxidation (cytochrome P450)
• Reduction
• Hydrolysis by esterases

Question 8

Phase 2 drug metabolism

Answer 8

Process of drug metabolism that makes it soluble via conjugation, via these processes:

• Glucuronidation
• Acetylation
• Sulfation
• Methylation

Question 9

Define adverse drug reaction

Answer 9

An undesirable experience that happens to the patient whilst taking a drug.

Question 10

ADR of alendronic acid

Answer 10

Oephagitis/ Ulceration

Jaw necrosis

Question 11

Drugs that prolong QT

Answer 11

Antipsychotics
- Riperidone, Haloperidol, chlorpromazine

SSRIs, SNRIs

• Citalopram, escitalopram
• Venlaflaxine

Macrolides

• Clarithromycin
• Erythromycin

Fluroquinolones
- Ciprofloxacin, levofloxacin

Antiarrythmics

• Flecainide
• Amiodarone
• Sotalol

Question 12

Gentamicin ADR

Answer 12

Tinnitus

Nephrotoxicity

Question 13

Important renally excreted drugs

Answer 13

Penicillins

Aminoglycosides

Glycopeptides

Morphine sulphate

Question 14

First generation antipsychotics

- Mechanism

Answer 14

Main block D2 receptors in a non-selective way

Question 15

Phenothiazine

- Groups and example

Answer 15

Drug class that includes

• Chlorpromazine
• Promethazine

Used in psychiatry and allergy.

Groups
- 1: chlorpromazine, promazine, levopromazine

• 2: Pericyazine
• 3 : fluphenazine

Question 16

Group 1 phenothiazine effects

Answer 16

Pronounced sedative effects

Moderate antimuscarinic effects

EPS effects

Question 17

Group 2 phenothiazine effects

Answer 17

Moderate sedative effects

Less EPS than group 1 and 3

Question 18

Group 3 phenothiazine effects

Answer 18

Fewer sedative and antimuscarnic effects
- than 1 and 2

More EPS than 1 and 2