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ADR exam q notes Flashcards

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1
Q

Antacids interactions

A
  1. Quinolones (cipro, levo, oflo) – 2 hrs before or 4 hrs after
  2. Tetracyclines – 2-3 hrs gap
  3. Itraconazole – 2 hrs before, 1 hr after
  4. Digoxin – separate by 2 hrs
  5. Rosuvastatin – separate by 2 hrs
  6. Ibandronic – avoid for at least 6 hrs before or 1 hr after
  7. Alendronate – separate by 2 hrs
  8. Levothyroxine – separate by 4 hrs
  9. Iron – 1 hr before or 2 hrs after
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2
Q

Iron drug interactions

A

1) antacids - iron 1 hours before or 2 hours after. iron absorption reduced.
2) calcium - iron 1 hours before or 2 hours after - iron absorption reduced
3) clozapine: risk of intestinal obstruction - caution
4) quinolones (ciprofloxacin, levofloxacin, ofloxacin) - separate by 2 hours at least
5) tetracyclines (doxycycline) Abx 2-3 hours AFTER iron
6) bisphosphonates e.g., residronate, alendronic acid - separate by at least 2 hours
7) carbidopa - may reduce effectiveness of carbidopa
8) levothyroxine - space admin by at least FOUR HOURS - thyroxine reduced absorption 9) methyldopa - may reduce effectiveness of methyldopa

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3
Q

Which drug causes colour vision changes?

A

Tranexamic acid
serious side effect - report

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4
Q

Tranexamic acid and warfarin

A

reduce effect of drugs

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5
Q

Which drug causes halitosis?

A

Disulfiram
Reacts with gram - bacteria

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6
Q

Sildenfafil + doxazosin

A

Hypotensive effect

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7
Q

Antiemetics to avoid in PD

A
  • metoclopramide and prochloperazine
  • can worsen symptoms
  • can induce acute dystonic reactions involving facial and skeletal muscle spasms
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8
Q

What electrolyte imbalance does lithium cause?

A

Hyponatraemia

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9
Q

Drugs to avoid in peanut allergy

A

o Arachis oil,
o Estriol cream
o Utrogesten
o Cortiment
o Abidec multivitamin drop
o Desogestrel brands (e.g., feanolla, lovima, moonia)
o Naseptin cream

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10
Q

CYP enzyme inducers

CRAP GPS

A

 Carbemazepines
 Rifampicin
 Alcohol
 Phenytoin
 Griseofulvin
 Phenobarbitone
 Sulphonylureas

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11
Q

CYP enzyme inhibitors

A

SICKFACES.COM
 Sodium valproate
 Isoniazid
 Cimetidine
 Ketoconazole
 Fluconazole
 Alcohol & Grapefruit juice
 Chloramphenicol
 Erythromycin
 Sulfonamides
 Ciprofloxacin
 Omeprazole
 Metronidazole

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12
Q

Drugs that cause folate deficiency

A

MAT
- Methotrexate
- Anticonvulsants
- Trimethoprim

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13
Q

Which drug causes binge eating disorder

A

Bromocriptine
Apomorphine

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14
Q

Lacosamide SE

A

dizziness, false or unusual sense of well being shakiness and unsteady walk

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15
Q

Are mirtazipine sedative effects greater at higher or lower doses?

A

Lower

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16
Q

ANAESTHESIA + ACEI/ARB

A
  • severe hypotension
  • Induction of anaesthesia
  • May need to be discontinued 24 hrs before surgery
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17
Q

Drugs that cause B12 deficiency

A
  • metformin
  • PPI
  • Colchicine
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18
Q

Amiodarone SE

A

Pulmonary toxicity

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19
Q

Diuretic with risk of non melanoma skin cancer

A

Hydrochlorothiazide

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20
Q

Which drug causes tendonitis

A

Ciprofloxacin

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21
Q

Which DPP4i is preferred in renal impairment?

A

Linagliptin

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22
Q

Which DPP4i is preferred in liver impairment?

A

Linagliptin and sitagliptin

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23
Q

Which drug causes dark yellow,and occasionally brown urine?

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A

Nitrofurantoin

24
Q

What colour does nitrofurantoin turn urine?

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A

dark yellow, and occasionally brown urine

25
What colour does rifampicin turn urine?
reddish-orange
26
Which drugs are likely to cause hyperthyroidism
Levothyroxine Liothyronine Lithium Amiodarone
27
Olanzapine + methotrexate
Agranulocytosis
28
Drugs that can cause gout
ACEi BB Diuretics
29
Domperidone + fluconazole =
QT interval
30
Spironolactone + furosemide =
hyponatraemia
31
Which drug can be continued before surgery and would not require any peri operative advice
Levetiracetam Levothyroxine
32
Which antidiabetic drug can cause pancreatitis?
GLP1 agonists
33
What electrolyte imbalance occurs in SBS?
hypomagnesemia
34
Which treatment is not appropriate in SBS?
Metoclopramide
35
Simvastatin + amlodipine
- increased risk of rhabdomyolsis - ensure simvastatin max dose 20mg
36
Nitrate therapy ADR
* Headache, flushing * Palps, syncope
37
Lithium monitoring
* BMI * eGFR * thyroid function * U&Es
38
olanzapine and smoking
Reduce the dose of olanzapine in quitting smoking, as olanzapine levels can increase
39
Epilepsy and EHC
Refer - IUD fitted
40
Zolendronic acid main SE
Reduced dental mobility osteonecrosis of the jaw
41
Which drugs are likely to cause Lichen Planus? | rash
TLD
42
What is the most important monitoring req for mirabegron?
BP
43
What drugs **increase** the anticoagulant effect of warfarin?
- Clarithromycin - Doxycycline - Erythromycin - Metronidazole
44
What drugs **decrease** the anticoagulant effect of warfarin?
Rifampicin
45
Testosterone exposure in children
Premature puberty and genital enlargement in children in close physical contact with adult using topical testosterone
46
Nitrofurantoin main ADR
pulmonary and hep
47
Which gout treatment is cautioned in CVD?
Febuxostat
48
rivaroxaban + dipyrimadole
increased risk of bleeding
49
cytotoxic drugs which formulations are not interchangeable
paclitaxel
50
Which drugs are CI in acute porphyrias?
clindamycin, pizotifen, tamoxifen, verapamil | sildenafil is OK
51
Levonorgestrel + phenobarbital
decreases the conc of levonorgestrel, so need to increase the dose
52
What is the antidote for anticholinergic poisioning/overdose? →
physostigmine
53
What choice of anaphylaxis is appropriate for a child from age 12 years to 17 years old in case of an emergency in the pharmacy? →
adrenaline injection 1mg/mL IM 500mcg (300mcg if small or prepubertal) - repeat after 5 minutes if necessary
54
What choice of anaphylaxis is appropriate for a child up to 6 months in case of an emergency in the pharmacy? →
adrenaline injection 1mg/mL IM child up to 6m: 100-150mcg (repeated after 5 minutes if necessary)
55
What drugs cause gynaecomastia
REMEMBER 'BOOBS TF' - - Bicalutamide - Omeprazole (PPIs is very rare), - Oestrogen (diethylstillbesterol indicated for prostate cancer), - Blockers H2 receptors (cimetidine/famotidine) - Spironolactone - Testosterone - Finesteride
56
What choice of anaphylaxis is appropriate for a child from age 6 months to 5 years old in case of an emergency in the pharmacy? →
adrenaline injection 1mg/mL IM 150mcg (repeated after 5 minutes if necessary)

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