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my NPLEX II > PHARM interactions and side effects > Flashcards

PHARM interactions and side effects Flashcards

1
Q

Hypokalemic drugs

A

Diuretics (Furosemide, HCTZ)

Corticosteroids (Hydrocortisone, Prednisone, Dexamethasone)

Cardiac glycosides (Digoxin, Convallaria, Digitalis, Leonarus)

Anti-Arrhythmias (atenolol, propranolol, amiodarone)

Pseudoephedrine
Glycyrrhiza

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2
Q

What meds caused decreased effects of Amoxicillin

A

tetracycline (Doxycycline, minocycline - protein synth inhib; mirtazapine - for MDD)

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3
Q

Penicillin increases effect and toxicity of what drug

A

methotrexate

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4
Q

Penicillin decreases effect of what drug class

A

Beta blockers

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5
Q

Penicillin’s effectiveness is decreased if it’s taken with what antibiotic

A

Doxycycline

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6
Q

Cephalexin, a cephalosporin (works like Penicillins), may increase effects of what drug

A

Metformin

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7
Q

A/E of Cephalexin

A
  • C. diff super infection
  • diarrhea
  • pseudomembranous colitis (higher incidence than other antibiotics)
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8
Q

Fluoroquinolone Ciprofloxacin’s absorption is decreased by what

A

cations (antacids, iron, zinc, bismuth)

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9
Q

Ciprofloxacin increases serum levels of what drug

A

warfarin

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10
Q

Nitrofurantoin has antagonistic effects with what antibiotic class

A

Fluoroquinolones (Ciprofloxacin)

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11
Q

A/E of Nitrofurantoin

A

PAIN mnemonic

  • Pulmonary toxicity
  • Anemia in Pts with G6PD
  • Irritated GI
  • Neurotoxicity
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12
Q

A/E of Doxycyline

A
  • permanent teeth discoloration
  • black tongue
  • photosensitivity
  • GI distress
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13
Q

Doxycycline’s absorption is reduced when used with

A

antacids, calcium, Magnesium, Iron

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14
Q

Doxycyline decreases effect of what other antibiotic

A

Penicillin

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15
Q

What antibiotic class is safe for pregnancy

A

Macrolide (Azithromycin)

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16
Q

antibiotics that prolong QT

A

Azithromycin and Ciprofloxacin (macrolide and fluoroquinolone)

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17
Q

what kind of antacids reduce rate of absorption of Azithromycin

A

aluminum and magnesium salts

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18
Q

Trimethoprim-Sulfamethoxazole (TMP-SMZ; sulfonamide) induces folate deficiency which causes what Sxs

A
  • thrombocytopenia/leukopenia
  • megaloblastic anemia
    (these are preventable with folic acid supplement)
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19
Q

What other drugs might cause additive folate deficiency with TMP-SMZ

A
  • methotrexate

- phenytoin

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20
Q

which antidiabetic drug class does TMP-SMZ affect and how?

A

Sulphonylureas (increases hypoglycemic effect)

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21
Q

What antimicrobial is usually Rx for impetigo

A

topical Mupirocin

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22
Q

condition C/I with topical Mupirocin

A

burns

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23
Q

What anticholinergic antiviral drug is used in parkinsons and herpes zoster (and formerly influenza A)

A

Amantadine

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24
Q

Amantadine enhances effects of what drugs

A
  • anticholinergics and levodopa
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25
Q

do not take Amantadine with what type of drugs

A

CNS stimulants

26
Q

Zidovudine (Antiretroviral) causes what A/E when combined with benzodiazepines

A

increased incidence of headache

27
Q

interferon alpha is used for treatment of

A

chronic hep B and C, condyloma acuminatum (genital warts), tumors (leukemia, Kaposi’s sarcome (AIDS), malign melanoma)

28
Q

interferon beta is used for treatment of

A

MS

29
Q

A/E of interferon alpha and beta

A

Mnemonic IFN ALPHA

  • Inhibits bone marrow
  • Flu like sxs
  • neurotoxic (depression/psychosis)
  • autoimmune disorders
  • liver enzyme elevations
  • proteinuria
  • hypotension and tachycardia
  • alopecia
30
Q

Fluconazole (Triazole) potentiates what drugs

A

warfarin and oral hypoglycemics

31
Q

Fluconazole may increase serum levels of what drugs

A
  • phenytoin, cyclosporine, zidovudine, sulfonylureas, carbamazepine
32
Q

what drug increases fluconazole levels

A

thiazides

33
Q

what drugs to avoid when taking Hydroxychloroquine

A

digoxin and alcohol

34
Q

what is Hydroxychloroquine used for besides malaria?

A

SLE, RA

35
Q

A/E of Hydroxychloroquine

A
  • retinopathy, hair loss, photosens, tinnitus, myopathy, psychosis, seizures, cardiomyopathy
36
Q

reduced plasma levels of mebendazole (antihelmentic) with what enzyme inducers

A

phenytoin, carbamazepine

37
Q

Metronidazole (antiprotozoal) is used for what kind of infections

A

Anaerobic bacterial (first line), and anaerobic protozoal (ie.trichomonas)

38
Q

Adalimumab is in what pharmacologic class

A

TNF alpha blocker

39
Q

Adalimumab is used for what conditions

A

inflammatory diseases (RA, AS, psoriatic arthritis, Chrohn’s, UC, psoriasis)

40
Q

Adalimumab should not be given with what

A

live vaccines

41
Q

Tofacitinib (JAK inhibitor) A/E

A

infections (20%), upper resp tract infx, H/A, diarrhea, nasopharyngitis, UTI, HTN (rarely)

42
Q

Cyclosporine class

A

polypeptide Abx

43
Q

clinical use of Cyclosporine

A
  • transplants
  • psoriasis
  • RA
44
Q

A/E of Cyclosporine

A
  • Nephrotoxicity
  • increased tremor
  • HTN, HA, hyperlipids, hyperplasia of gums, hirsutism
45
Q

drugs that increase concentration of Cyclosporine

A
  • CCBs,
  • antifungals
  • antibiotics
  • glucocorticoids
46
Q

triamcinolone (steroid for RA, MS, other inflamm conditions) is contraindicated in what conditions

A
  • systemic fungal infection
  • ITP
  • with live vaccines
47
Q

Rifampin (antiTB) A/E

A
  • red colored tears, urine, saliva, sweat

- abd pain/vomit/diarrhea/hepatitis

48
Q

Rifampin induces CYP and reduces levels of what drugs

A

warfarin, steroids, opioids, phenytoin, verapamil, reduces efficacy of OCPs

49
Q

agents that increase effects of warfarin by inhibiting platelets

A

cephalosporins, NSAIDs, penicillin, salicylates, onions, garlic, ginger, ginkgo

50
Q

drugs that increase warfarins effects

A
  • acetaminophin
  • androgens
  • beta blockers
  • steroids
  • omeprazole
  • phenytoin
51
Q

what drug may increase A/E of pentoxifylline (used for Tx of PAD)

A

Ciprofloxacin

52
Q

what commonly used drug increases phenytoin levels

A

aspirin

53
Q

Estradiol may enhance effects of what drugs

A

hydrocortisone and prednisolone

54
Q

DHEA must be monitored closely when taking with what drugs

A

amiodarone, atorvastatin, buspirone, cortisone, diazepam, warfarin

55
Q

conjugated estrogens are metabolized partially by CYP 3A4, thus what inhibitors of CYP3A4 may increase concentration of estrogen (increasing A/Es)

A

erythromycin, grapefruit juice

56
Q

Herb interactions with prochlorperazine

A

Angelica and hypericum increase photosensitivity, kava increases dystonia

57
Q

sucralfate (pepsin inhibitor/GI protectant) requires an acidic environment for activation, thus should not be taken with

A

antacids, H2 blockers, PPIs

58
Q

esomeprazole (PPI) level may be increased with what drug

A

amoxicillin

59
Q

esomeprazole increases levels of what drugs

A

diazepam, phenytoin, warfarin

60
Q

Loperamide has an additive effect with which herbs

A

CNS depressants (kava, chamomile, valerian)

my NPLEX II (28 decks)

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