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Top 200 Pharmacy > Top 200 - Warnings and Contraindications > Flashcards

Top 200 - Warnings and Contraindications Flashcards

1
Q

Adderall ®

A

BBW: potential for abuse/misuse

Avoid use in patients with severe cardiac disease

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2
Q

adenosine

A

Contraindicated in AV block, sick sinus syndrome, bradycardia, or asthma

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3
Q

albuterol (inhalation)

A

Contraindicated in severe hypersensitivity to milk

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4
Q

alendronate

A

Contraindicated in hypocalcemia and esophageal abnormalities

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5
Q

benzodiazepines

A

BBW: risk for dependence and withdrawal

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6
Q

alteplase tPa

A

Contraindicated in active internal bleeding

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7
Q

amiodarone

A

BBW: increased risk of pulmonary toxicity, hepatotoxicity, and heart block

Can cause sun sensitivity and QTc prolongation.

Can increase INR if taken with warfarin.

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8
Q

amitriptyline

A

BBW: increased risk of suicidality in younger patients.

Contraindicated in MAOi use within 14 days

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9
Q

amlodipine

A

When used with simvastatin, max simvastatin dose is 20 mg daily

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10
Q

amoxicillin

A

Can increase INR when used with warfarin

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11
Q

apixaban

A

BBW: premature discontinuation increases risk for thrombotic events.

Avoid concomitant use with CYP3A4 inducers.

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12
Q

beta blockers

A

Abrupt discontinuation can cause rebound HTN.

Contraindicated in acute decompensated heart failure, severe sinus bradycardia, sick sinus syndrome, bronchial asthma

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13
Q

atomoxetine

A

BBW: increased risk of suicidality in younger patients.

Contraindicated in MAOi use within 14 days and severe cardiac disease

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14
Q

azithromycin

A

QTc prolongation.

Can increase INR when used with warfarin

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15
Q

baclofen

A

BBW: abrupt discontinuation can cause CNS effects, muscle rigidity, and death

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16
Q

inhaled corticosteroids

A

Rinse mouth after use due to risk of oral thrush

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17
Q

bupropion

A

BBW: increased risk of suicidality in younger patients.

Contraindicated in seizure disorders, eating disorders, anxiety, and MAOi use within 14 days

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18
Q

buspirone

A

Contraindicated in MAOi use within 14 days

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19
Q

carbamazepine

A

BBW: life-threatening skin reactions like SJS, DRESS, and TEN

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20
Q

carbidopa and levodopa

A

Contraindicated in MAOi use within 14 days, narrow angle glaucoma

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21
Q

cefdinir

A

Can cause red discoloration of stool.

Space antacids and iron by 2 hours.

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22
Q

cephalexin

A

Can increase INR when used with warfarin

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23
Q

ciprofloxacin

A

BBW: increased risk of tendon rupture

QTc prolongation.

Space dose from antacids. Can increase INR when used with warfarin.

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24
Q

SSRIs

A

BBW: increased risk of suicidality in younger patients

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25
Q

clindamycin

A

administer with full glass of water.

CYP3A4 substrate

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26
Q

clonidine

A

abrupt discontinuation can cause rebound hypertension

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27
Q

clopidogrel

A

BBW: diminished effect if patient has 2 loss-of-function CYP2C19 alleles

PPIs diminish effectiveness of clopidogrel.

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28
Q

diazepam

A

BBW: risk for dependence and withdrawal

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29
Q

digoxin

A

Contraindicated in ventricular fibrillation

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30
Q

diltiazem

A

Contraindicated in bradycardia, sick sinus syndrome, decompensated heart failure, acute MI, and pulmonary congestion.

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31
Q

divalproex

A

BBW: hepatotoxicity, pancreatitis.

Teratogenic med.

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32
Q

doxycycline hyclate

A

Administer with full glass of water and remain upright for 2 hours.

Antacids, calcium, and multivitamins can decrease absorption.

Can increase INR with warfarin.

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33
Q

dulaglutide

A

BBW: risk of thyroid C-cell tumors.

Contraindicated in history of medullary thyroid carcinoma and MEN-2

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34
Q

empagliflozin

A

Contraindicated in GFR < 45 and dialysis. Increased risk of DKA

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35
Q

enoxaparin

A

BBW: risk of spinal hematoma.

Contraindicated in heparin allergy, HIT, and active major bleeding

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36
Q

estradiol

A

Contraindicated in pregnancy, history of breast cancer, thromboembolism, or stroke/MI

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37
Q

famotidine

A

QTc prolongation.

May decrease absorption of drugs that require acidic environment

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38
Q

fenofibrate

A

Contraindicated in liver disease, kidney disease, and breastfeeding

39
Q

finasteride

A

BBW: females of childbearing age should not touch crushed or broken tablets

40
Q

fluconazole

A

QTc prolongation.

Significantly increases INR when used with warfarin.

Strong CYP2C19 inhibitor.

41
Q

gemfibrozil

A

Increased risk of adverse effects when combined with statins or ezetimibe.

Contraindicated in liver disease, kidney disease, and breastfeeding

42
Q

gentamicin

A

BBW: neurotoxicity, nephrotoxicity, fetal toxicity.

43
Q

Genvoya ®

A

BBW: acute exacerbation of Hepatitis B.

Contraindicated in concomitant use with CYP3A4 substrates

44
Q

glimepiride

A

Administer before first meal daily.

Contraindicated in Type 1 diabetes and DKA

45
Q

glipizide

A

Administer ER tablet with first meal of day.

Administer IR tablet 30 minutes before a meal.

Contraindicated in Type 1 diabetes and DKA

46
Q

hydralazine

A

Contraindicated in CAD and mitral valve rheumatic disease

47
Q

hydrochlorothiazide

A

Contraindicated in GFR < 10

48
Q

icosapent ethyl

A

Take with food

49
Q

isosorbide mononitrate

A

Do not use nitrates and PDE5 inhibitors together

50
Q

lamotrigine

A

BBW: life-threatening skin reactions like SJS, DRESS, and TEN

51
Q

levofloxacin

A

QTc prolongation.

Space dose from antacids.

Can increase INR when used with warfarin.

BBW: increased risk of tendon rupture

52
Q

levothyroxine

A

Take the same way every day with regard to meals.

BBW: should not be used for weight loss

53
Q

lidocaine (transdermal)

A

Contraindicated in severe heart block

54
Q

ACE inhibitors

A

Can cause persistant dry cough.

BBW: fetal toxicity. Contraindicated in angioedema

55
Q

lithium

A

BBW: required serum monitoring every week until stable, then every 3-6 months.

Contraindicated in severe cardiovascular or renal disease, dehydration, concurrent use with diuretics

56
Q

Progesterone

A

BBW: reduced bone density, increased risk of breast cancer

57
Q

metformin

A

BBW: lactic acidosis.

Contraindicated if GFR < 30

58
Q

methadone

A

BBW: increased risk of respiratory depression and QTc prolongation

59
Q

metoclopramide

A

Administer 30 minutes before meals.

QTc prolongation

60
Q

metronidazole

A

Avoid alcohol during treatment and for 3 days after.

Can increase INR when used with warfarin.

QTc prolongation

61
Q

mirtazapine

A

BBW: increased risk of suicidality in younger patients.

Contraindicated in use of MAOis within 14 days

62
Q

montelukast

A

Give dose in evening.

BBW: serious psychiatric events reported with use

63
Q

niacin

A

Take with food.

Contraindicated in liver disease, active peptic ulcer, and arterial hemorrhage

64
Q

nifedipine

A

Contraindicated in STEMI patients

65
Q

nitroglycerin

A

Do not use nitrates and PDE5 inhibitors together

66
Q

omeprazole/esomeprazole

A

Administer 1 hour before breakfast.

Capsule contents can be opened and sprinkled on applesauce.

May decrease absorption of drugs that require acidic environment.

Can diminish antiplatelet effect of clopidogrel

67
Q

ondansetron

A

QTc prolongation

68
Q

Ortho-Cyclen®, Sprintec®

A

BBW: cigarette smoking increases risk of cardiovascular events

69
Q

oxybutynin

A

Contraindicated in narrow angle glaucoma, urinary retention, severely decreased GI motility

70
Q

pantoprazole

A

Administer whole capsule without regard to food.

May decrease absorption of drugs that require acidic environment.

May diminish antiplatelet effect of clopidogrel

71
Q

phentermine

A

Avoid late evening administration.

Contraindicated in pregnancy, CVD, SUD, hyperthyroidism, and glaucoma

72
Q

pioglitazone

A

Dose < 15mg daily when used with gemfibrozil.

May need dose reduction if taking clopidogrel.

BBW: increased risk of heart failure exacerbation

73
Q

prednisone

A

Administer after food to decrease stomach upset

74
Q

rivaroxaban

A

Doses >10 mg should be taken with food.

Avoid concomitant use with CYP3A4 inducers.

BBW: premature discontinuation increases risk for thrombotic events.

Contraindicated if GFR < 30

75
Q

sacubitril and valsartan

A

BBW: fetal toxicity.

Contraindicated in pregnancy, angioedema, concomitant use of aliskiren or ACE inhibitors

76
Q

sertraline

A

BBW: increased risk of suicidality in younger patients

77
Q

sildenafil

A

Do not use nitrates and PDE5 inhibitors together.

When used for ED, adminster 30 min to 4 hours before sexual activity

78
Q

simvastatin

A

Can cause muscle pain or dark colored urine.

When used with amlodipine or amiodarone, maximum dose of 20 mg daily

79
Q

spironolactone

A

Contrainidicated in hyperkalemia, concomitant use with eplerenone

80
Q

sucralfate

A

administer on empty stomach. Do not give multivitamins or cation-based antacids within 30 minutes

81
Q

sulfamethoxazole and trimethoprim

A

administer with full glass of water.
Can cause sun sensitivity.
Significantly increases INR when used with warfarin

82
Q

sumatriptan

A

Contraindicated ischemic heart disease, history of strokes, uncontrolled hypertension, arrhythmias

83
Q

tadalafil

A

Do not use nitrates and PDE5 inhibitors together. When used PRN for ED, take 30 m inutes prior to sexual activity

84
Q

tamsulosin

A

administer 30 minutes after same meal every day

85
Q

testosterone (topical)

A

risk of secondary exposure if using transdermal formulations. BBW: hypertension

86
Q

trazodone

A

BBW: increased risk of suicidality in younger patients. Contraindicated in MAOi use within 14 days

87
Q

Triumeq®

A

BBW: hypersensitivity reactions, acute exacerbations of Hepatitis B. Contraindicated in hepatic impairment, concomitant dofetilide, and patients with HLA-B*5701 allele

88
Q

valacyclovir

A

can decrease effectiveness of live vaccines

89
Q

ARBs

A

Contraindicated in concomitant use with aliskiren. BBW: fetal toxicity

90
Q

vancomycin

A

BBW: fetal toxicity

91
Q

verapamil

A

when used with simvastatin, max statin dose is 10 mg daily. Contraindicated in bradycardia, sick sinus syndrome, decompensated heart failure, acute MI, and pulmonary congestion.

92
Q

Vyvanse ®

A

BBW: abuse potential. Contraindicated in MAOi use within 14 days

93
Q

warfarin

A

Increase INR: alcohol, NSAIDs, macrolides, antifungals. Decrease INR: rifampin, leafy greens, St. John’s wort

94
Q

atypical antipsychotics

A

BBW: increased mortality in elderly with dementia-related psychosis

Top 200 Pharmacy (3 decks)

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