random drug facts Flashcards
ACEi common s/e
dry cough due to accumulation of bradykinin via reduced degradation by ACE
hyperkalaemia - reduced aldosterone production, reduced potassium excretion
reducing renal blood flow by inhibiting angiotensin-II which preserved GFR
ibuprofen s/e
gastric inflammation and ulceration - inhibition of prostaglandins needed for gastric mucosal protection from acid
also cuz of that reduced renal diameter and blood flow, reducing kidney perfusion and function
antimuscarinic tox + elderly
confusion in elderly
tox - pupillary dilation, loss of accommodation, dry mouth, tachycardia (after transient Brady)
methotrexate and NSAIDs
caution due to risk of increased nephrotoxicity
asthma and NSAIDs
bronchoconstriction
trimethoprim and methotrexate
direct contraindication as both folate antagonists -> BM toxicity
may lead to pancytopenia and neutropenic sepsis
methotrexate and active infection
withheld, as missing one dose should not affect control due to long half life
diuretics and potassium
hypokalaemia - loop + thiazide like
hyperkalaemia - potassium sparing + ACEi
prophylactic enoxaparin + stroke
not post acute ischaemic stroke - risk of haemorrhagic transformation
verapamil and BB
severe cardiodepression - so don’t use together
when should you not use stimulant laxatives?
eg: Senna, bisocodyl
if suspected bowel obstruction do not use and increases risk of perforation
when is best to use stool softener?
eg: docusate
if hard stool on DRE
when should you not use osmotic laxatives?
eg: lactulose, macrogol
if patient already bloated or dehydrated do not use, as drawn water out from large bowel
when would you prefer bulking laxatives?
eg: ispaghula husk
inadequate fibre intake, not when bloated as takes 72h to work
what laxatives would you give if patient on opioids?
osmotic + stimulants
avoid bulk forming
what specific about loops diuretics must you know regarding the ototoxicity?
- rapid IV administration of furosemide increases risk
- if impaired renal function bumetanide increases deafness risk
what are some common ototoxic drugs worth knowing?
gentamicin
bumetanide
furosemide
vancomycin
what are the 4 C’s that increase C.diff risk?
clindamycin
co-amoxiclav
ciprofloxacin
cephalosporin - ceftriaxone and cefalexin
what drugs cause constricted pupils?
heroine
opioids
codeine
hydrocodone
what drugs cause red eyes?
weed
cocaine
benzo
depressants
what drugs cause dilated pupils?
amphetamines
methamphetamines
cocaine
hallucinogens
speed
what are CYP450 inducers?
carbamezapine
barbituates
phenytoin
rifampicin
pioglitazone
what are CYP450 inhibitors?
omeprazole
amiodarone
SSRI
grapefruit juice
cimentadine (cement stops)
macrolide (erythro and clarythro)
what are some important information to be aware of with metformin?
risk of lactic acidosis - look for signs
dyspnoea, muscle cramps, abdo pain
what are some important information to be aware of with sulfonylureas?
signs of hypoglycaemia
*higher risk in renal impairment and elderly
what are some important information to be aware of with SGLT2i?
risk of DKA even if glucose normal
most important thing about insulin?
*when unwell
when unwell higher insulin resistance so higher basal doses may be needed
*increases DKA risk
what are some common side effects of anti-psychotics?
photosensitisation
drowsiness
alcohol effects enhanced
common lithium info?
report toxicity, hypothyroidism and renal dysfunction
benign intracranial hypertension
maintain adequate fluid and avoid dietary changed or increase in salt
AVOID NSAIDs
clozapine info?
agranulocytosis - risk of infection
sodium valproate info?
teratogenic
effective contraception
what medications to be aware of in asthma and COPD?
NSAIDs - 10-20% experience worsening asthma, increased risk in those with nasal polyps
*if no alt give risks and trial
BB - bronchospasm, nebivolol more cardioselective so may be better
adenosine - contraindicated, use verapamil if needed
what does warfarin do?
inhibits synthesis of vitamin K dependent clotting factors (2,7,9 and 10)
- this prolongs PT from which INR is derived (higher the PT higher the INR)
- normal INR is 1
What is important to communicate regarding insulin regime?
when unwell, blood glucose increases, higher basal dose required otherwise DKA
when patients have reduced oral intake risk of hypo high so decrease insulin intake
