[ADR] Adverse drug reactions + Interactions Flashcards
(42 cards)
TNF-α inhibitors
Reactivation of tuberculosis
Methotrexate (lungs)
Pneumonitis
(also pulmonary fibrosis)
BNF recommends that the patient seeks medical attention if they experience dyspnoea, cough or fever.
Patients who are allergic to aspirin may also react to what?
Sulfasalazine
Main SE of colchicine
diarrhoea
Patients who are allergic to co-trimoxazole may also react to what?
Sulfasalazine
It is a sulfa drug and should be stopped in patients with a documented allergy to other sulfa drug, in this case, it is co-trimoxazole.
What is the treatment for malignant hyperthermia?
May occur secondary to suxamethonium chloride
Dantrolene sodium
Side effects of lithium
Mild lithium toxicity - tremor
Moderate lithium toxicity - lethargy
Severe lithium toxicity - arrhythmias, seizures, coma, and renal failure.
Which drugs can significantly reduce lithium excretion?
Lithium excretion is significantly reduced by ACE-inhibitors, in this case lisinopril, diuretics (and particularly thiazides, in this case bendroflumethiazide), and NSAIDs (not given here).
If a diuretic must be given, loop diuretics (e.g. furosemide) are the safest.
Which antiepileptic causes SIADH?
Carbamazepine
If a patient reacts to co-amoxiclav, which other antibiotic can cause cross-reactivity?
Meropenem (a carbapenem)
What should you do with methotrexate during illness?
STOP taking it
Which antihypertensive can cause facial flushing?
Calcium channel blockers
How do NSAIDs cause AKI?
Through acute interstitial nephritis
NOTE: NSAID-induced nephrotoxicity is more likely to occur in patients with preexisting renal impairment.
Take care when coprescribing NSAIDs and ACE-inhibitors.
Why can co-dydramol cause constipation?
It contains dihydrocodeine (an opioid).
All opioids (including codeine, morphine and, to a lesser extent, tramadol) slow transit through the bowel.
What drugs are considered antimuscarinics?
Cyclizine
Oxybutynin
Tolterodine
What are common side effects of antimuscarinic?
urinary retention, constipation, blurred vision, dry mouth, and GI disturbances
How should vitamin K be given?
By slow IV injection
If no bleeding, by mouth.
Example of Vitamin K drug: Phytomenadione
Which urinary incontinence medications should be avoided in myasthenia gravis?
All antimuscarinics - oxybutynin, tolterodine, solifenacin, trospium
Can give: mirabegron or duloxetine
Signs of diazepam withdrawal
Tremor, anxiety, insomnia
Which diabetes drug(s) are most associated with hypoglucaemia?
insulin and sulphonylureas
Sulphonylureas increase insulin release from the pancreas
Most common side effect of oxybutynin
Dry mouth (anti-muscarinic side effects)
Other common anti-muscarinic side effects include constipation, dizziness, drowsiness, dyspepsia, flushing, headache, nausea, palpitations, skin reactions, tachycardia, urinary disorders, vision disorders and vomiting. The BNF also lists diarrhoea as a general side effect of oxybutynin.
Drugs associated with pancreatitis - FATSHEEP
- Furosemide
- Azathioprine/asparaginase
- Thiazides/tetracyline
- Statins/sulfonamides/sodium valproate
- Hydrochlorothiazide
- (O)Estrogens
- Ethanol
- Protease inhibitors & NRTIs (antiretroviral medications)
Drug class associated with tendon rupture
Fluoroquinolones e.g. ciprofloxacin (often within 48 hours of starting or if combined with corticosteroid)
Major bleeding and an INR above 8
stop warfarin sodium; give phytomenadione (vitamin K1) by slow intravenous injection; give dried prothrombin complex (factors II, VII, IX, and X); if dried prothrombin complex unavailable, fresh frozen plasma can be given but is less effective; recombinant factor VIIa is not recommended for emergency anticoagulation reversal
