ADR's Flashcards
(129 cards)
1
Q
Name some drugs that cause HYPO kalaemia?
A
Loop/thiazide diuretics, beta agonists, theophylline, corticosteroids, stimulant laxatives
2
Q
Name some drugs that cause HYPER kalemia?
A
ACE/ARBS, tacrolimus, K sparing diuretics, heparins, NSAIDS, trimethoprim
3
Q
Name some drugs that cause HYPO natremia?
A
Antidepressants, carbamazepine, NSAIDS, desmopresson
4
Q
Drugs that have antimuscarinic SE’s?
A
Antimuscarinic drugs i.e. oxybutynin , hyoscine , Atropine, TCS, antihistamines, clozapine, antipsychotics
5
Q
Drugs causing ototoxicity
A
Aminoglycosides, cisplatin, glycopeptides, loop diuretics, vinca alkaloids
6
Q
Drugs that lower seizure threshold?
A
Quinolones Mefloquine SSRIs Antipsychotics Tramadol Lithium Baclofen
7
Q
Drugs associated with QT prolongation
A
CLAMS HMV Citalopram Lithium AMiodarone Sotalol Haloperidol Macrolides Venlafaxine
8
Q
Drugs that cause photosensitivity?
A
QARTS
Q = quinine A = amiodarone R = Retinoids T = tetracyclines S = Sulfasalazine
Other = antimalarials, antipsychotics, tacrolimus, topical NSAIDS, voriconazole
9
Q
What colour does dantron colour the urine?
A
Red
10
Q
What colour does Doxorubicin colour the urine?
A
Red
11
Q
What colour does Levodopa colour the urine?
A
Red
12
Q
What colour does Rifampicin colour the urine?
A
Red/orange
13
Q
What colour does sulfasalazine colour the urine?
A
Orange
14
Q
What colour does senna colour the urine?
A
Yellow/brown
15
Q
What colour does nitrofurantoin ?
A
rust yellow/brown
16
Q
What colour do prostaglandin analogues colour the urine?
A
Brown
17
Q
What colour does iron colour the bodily secretions i.e. stools?
A
Black
18
Q
What colour does triamterene colour the urine?
A
Blue
19
Q
Name the teratogenic drugs:
A
MTX Trimethoprim Statins Tetracyclines Prostaglandin analogues ACE inhibitors/arbs Isotretinoin Lithium (avoid if possible) Na valproate Warfarin (not in 1st trimester) Chloramphenicol (grey baby syndrome) Aspirin/NSAIDS Topiramate Finasteride Quinolones Aminoglycosides
20
Q
Name some drugs affecting BFing
A
Ethosuximide, lamotrigine
Fluvastatin
Phenobarbital
Bromocriptine
21
Q
Contraception required for isotretinoin?
A
Females of childbearing age must practise effective contraception for at least 1 month before starting treatment, during treatment, and for at least 1 month after stopping treatment.
They should be advised to use at least 1 highly effective method of contraception (i.e. a user-independent form such as an intra-uterine device or implant) or 2 complementary user-dependent forms of contraception (e.g. combined oral contraceptives and barrier method)
22
Q
Name the enzyme inhibitors
A
SICKFACES.COM
Sodium valproate Isoniazid Cimetidine Ketoconazole Fluconazole Alcohol Chloramphenicol Erythromycin Sulphonamides Ciprofloxacin Omeprazole Metronidazole
23
Q
Name the enzyme inducers
A
BS CRAP GPS
Barbiturates St johns wort Carbamazepine Rifampicin Alcohol Phenytoin Griseofulvin Phenobarbital Sulfonylureas
24
Q
What drugs lead to a max dose of 20mg in simvastatin
A
VADAR
Verapamil Amiodarone Diltiazem Amlodipine Ranolazine
25
What are the high intensity statins?
Rosuvastatin 10mg and above
Atorvastatin 20mg and above
Simvastatin 80mg
26
When would you give a stimulant and osmotic laxative first line?
FOCOS
```
F= faecal impaction
O = opioid induced
C = children
```
27
Name the smoking interactions
COAT
Clozapine, Olanzapine, Aminophylline and theophylline
28
Drugs that decrease effect of warfarin? THINK INDUCERS
SCRAP
```
St Johns Wart
Carbamazepine
Rifampicin
Alcohol
Phenytoin
```
29
Drugs that increase effect of warfarin? THINK INHIBITORS
McMACS
```
Metronidazole
Cranberry juice
Macrolides
Azole antifungals
Ciprofloxacin
```
30
What antibiotics can't you have with milk?
DOT
| Demeclocycline, oxytetracycline, tetracycline
And ciprofloxacin
31
What tetracyclines can you have milk with?
Doxy, Lymecycline and minocycline
32
Safest abx in pregnancy?
PECC
Penicillins, erythromycin (risk benefit), clindamycin, cephalosporins
33
What drugs are used in TB (initial and continuation and durations)
RIPE
Rifampicin
Isoniazid (with pyroxidine)
Pyrazinamide
Ethambutol (eye toxicity, doesn't cause liver toxicity like others)
```
Initial = 2 months of RIPE
Continuation = 4 months of RI
```
34
Use of pyridoxine?
Prevent peripheral neuropathy
35
Abx that you must take with food?
PMN
Pivemecillinam
Nitrofurantoin
Metronidazole
36
What are the short acting insulins?
LAG
Lispro (humalog)
Aspart (novo rapid/fiasp)
Glulisine (apirda)
37
What are the long acting insulins?
DDG
```
Insulin detemir (levemir)
Insulin degludec (tresiba)
Insulin glargine (lantus)
```
38
What are the warfarin colours and their corresponding doses?
BRUPE
```
Brown = 1mg
Blue = 3mg
Pink = 5mg
```
39
What age can naproxen be given etc for dysmennorhoea?
15-50 years
40
What is the dose for naproxen for dysmennorhoea?
1st dose = 2 tablets and 2nd dose after 6-8 hours is one more tablet if needed
No more than 3 a day and no more than 3 days of treatment in a month
41
Indication and age for tranexamic acid for menorrhagia?
18 and over, regular 21-35 days cycles and if no more than 3 days individual variability in cycle duration.
42
Contraindications for tranexamic acid?
Taking warfarin/any other anticoagulants
Taking COC or tamoxifen
Pregnancy
Mild to moderate renal insufficiency
43
Tranexamic acid dosage?
Take once heavy bleeding has started (2 tablets 2 times daily for as long as needed but for a maximum of 4 days) - no more than 8 tablets if severe
44
Age for tamsulosin?
45-75 years
45
Dosage for tamsulosin?
400micrograms capsule swallowed whole after the same meal each day
46
Contraindications for tamsulosin?
symptoms are <3 months duration
Prostate surgery
Unstable or undiagnosed diabetes
Postural hypotension
47
Counselling for tamsulosin?
Must see their doctor within 6 weeks of starting treatment and then every 12 months for confirmation that they can continue taking it
Interacts with antihypertensives
48
Indication for ED treatment with sildenafil?
Men over 18
49
Dose for sildenafil?
50mg an hour before SI - no more
50
Counselling points for sildenafil?
- Healthy living advice
| - General check up within 6 months of treatment
51
What treatments are available OTC for malaria?
Proguanil (paludrine 100mg tablet)
Chloroquine (avloclor 250mg tablet).
Atovaquone/proguanil (250/100) Maloff Protect
52
Dose for proguanil (paludrine)?
Daily dose week before entering country then 4 weeks after leaving the region.
Adutlts =200mg OD
53
Dose for avloclor (chloroquine)?
Weekly dose - a week before entering malarial region, continue during stay, then 4 week after leaving region
2 tablets
54
Dose for atovaquone/proguanil (250/100) Maloff protect?
Daily dose
1-2 days before entering malarial region and continue during stay
Carry on for another week after leaving the region
1 tablet
55
Cautions and when to refer with proguanil (paludrine)?
Those with renal impairment
56
Cautions and when to refer with avloclor (chloroquine)?
```
Risk of hypoglycaemia
Renal disease
History of epilepsy
Those with psoriasis
Those planning to conceive or are pregnant
```
57
Cautions and when to refer with maloff (atovaquone/proguanil)?
Not for anyone who weights <40kg
Those planning to conceive or are pregnant/breastfeeding
Only licensed up to 12 weeks (may need rx or PGD)
58
Contraindications for avloclor?
not to be used alongside amiodarone
59
Contraindications for maloff protect?
If renal or hepatic impairment and in children and adolescents
60
Interactions with paludrine (proguanil)
can increase effect of warfarin, antiretrovirals
| Antacids must be taken 2 hours apart
61
Interactions with avloclor?
Drugs that increase QT interval
Antacids
Increased TSH levels with concomincant use of levothyroxine
62
Interactions with maloff protect?
Antiretrovirals
| Rifampicin
63
Cousnelling with antimalarials?
Always use bite repellant
| Those that fall ill within 1 year and especially within 3 months after coming back should immediately see their doctor
64
What drugs do you give in tonic clinical seizures:
SALOC
Sodium valp
Lamotrigine
Oxcarbamazepine
Carbamazepine
65
Absense seizures??
SEAL
Sodium valproate
Ethosuximide
Levetiracetam
Topiramate
66
Treatment for focal seizures?
FOCAL
Carbamazepine and lamotrigine
67
Category 1 antiepileptics?
Carbamazepine, primidone, phenytoin, perampanel
68
What are the extra pyramidal side effects?
ADAPT
Acute dystonia
Akathisia (an inability to remain still)
Parkinsonism
Tardiva dyskinesia
69
Lithium monitoring?
Renal, plasma levels, cardiac and thyroid function
70
How is lithium cleared?
Renally
71
Side effects of lithium?
```
GI disturbances,
Visual disturbances
CNS disturbances
Fine tremor
Incontinence
Signs and symptoms of hypothyroidism
Signs of renal dysfunction (polyuria and polydispsia)
Signs and symptoms of benign intracranial hypertension
```
MAKE SURE STICK TO SAME BRAND
Maintain adequate salt and oral intake
72
What do you have to screen for with hydroxychloroquine?
Occular toxicity
73
ADR's with leflunamide?
Hepatic toxicity and teratogenic
74
How long do you need contraception for for leflunamide?
2 years after treatment for women and 3 months for men
75
How long before you can have kids with cyclophosphamide?
Permanent male sterility!
76
How long do you need to be on contraception for after methotrexate?
3 months, both men and women
77
What can be used to treat acute gout?
Colchicine or high dose NSAID
78
What can be used to treat chronic gout?
Allopurinol first line or febuxostat
79
What drugs can cause gout?
- Diuretics
- Ciclosporin, tacrolimus
- Cytotoxics
- Cancer drugs
80
Maximum dose for colchicine?
6mg for course
| 500mcg 2-4 times a day
81
Do you start long term control straight after gout attack?
No
82
If attack occurs during prophylaxis, do you continue prophylactic treatment?
Yes
83
Anti cholinesterase side effects?
Opposite of antimuscarinic so
- Increased sweating
- Increased saliva
- Increased uterine motility
84
Example of an anti-cholinesterase?
Neostigmine
85
How do anti-cholinesterases work?
Prolong action of acetylcholine
86
Side effects of quinine?
QT prolongation (MHRA), toxic in overdose
87
Drug treatment for sciatica?
- Oral NSAID
- Weak opioid alone or with paracetamol
- Benzo's sometimes used
- Tricyclics SHOULDNT BE USED FOR LOWER BACK PAIN
88
NSAIDs should be taken on an empty stomach. True or false?
False - with or after food
89
Can a GTN patch be applied to people with small veins to prevent extravasation?
Yes
90
How is extravasation managed?
Corticosteroids, antihistamines, analgesics
91
Side effects of tacrolimus?
Pretty much everything:
Cardiomyopathy, nephrotoxicity, hepatoxicity, blood dycrasias, hypertension, hyperglycaemia, hyperkalaemia, hyperurcaemia, headaches, tremors, blurred vision, can cause photosensitivity.
92
Can you have mycophenlatep during pregnancy?
No - genotoxic and teratogenic
2 methods of contraception until 6 weeks after discontinuing in women
Men = condoms until 90 days after
93
Is tacrolimus brand specific?
YES
94
Side effects of cyclosporin?
Nephrotoxic, hepatotoxicity, blood dycrasias, hyperlipidaemia, hypertension, high K and low Mg,
visual disturbances, gingival hyperplasia and photosensitivity
95
What happens in tumour lysis syndrome?
Hyper K+, Urea, Hypocalcaemia
96
What drugs does bone marrow suppression occur in?
All cytotoxic apart from vincristine and bleomycin
97
How is hyperuricaemia prevented?
Allopurinol 24 hours before treating tumour
| OR febuxistat 2 days before if allopurinol CI'ed
98
Most emetogenic cancer drugs?
Cisplatin and high dose cyclophosphamide
99
Treatment of chemo N+V?
Lorazepam for anticipatory and
if high risk = dexamethasone or lorazepam
If low risk/moderate = 5HT3 antagonist = ondansertron
100
Drugs that are bad for extravasation?
Vinca alkaloids and anthrcyclines = worst case = amputation
101
What are the anthracyclines?
Rubicins!
Doxorubicin
102
Side effects of the anthracyclines (the rubicund)?
Cardiotoxicity (dose related) and red urine
103
What are antineoplastic abx?
Bleomycin
104
Sife effects of antineoplastic abx?
Pulmonary toxicity, rest failure, hypersensitivity, dermatological toxicity
105
Examples of vincalkaloids?
The vins
- Vincristine
- Vinblastine
IV ONLY
106
Example of antimetabolites?
Methotrexate, flurouracil
107
Side effects of antimetabolites?
Oral mucositis, myelosupression
108
Examples of alkylating drugs?
Cyclophosphamide - permanent male sterility
109
Treatment for breast cancer (post menopausal)
Aromotase inhibitors i.e. letrozole then tamoxifen if AI's are inappropriate
110
Treatment for breast cancer (pre menopausal and men)
Tamoxifen - if oestrogen receptor positive invasive breast cancer
111
Bisphosphonate therapy in BC?
Zolendronic acid - every 3-4 weeks
112
What biologic is used in BC and what is it recommended for?
Trastuzumab - treatment of her2 positive BC
113
What to do if on HRT and get breast cancer?
Discontinue HRT
114
Can aromatase inhibitors be used in pre menopausal women?
no
115
What is the name of the chemo drug for prostate cancer?
Docetaxel
116
Treatment options for prostate cancer?
- Anti angroden therapy
- Active surveillance
- Radical prostatectomy
- Radiotherapy
- Androgen depravation therapy
- Chemo with docetaxel
117
How often is hypromellose added?
hourly
118
Is closed angle glaucoma an emergency?
Yes
119
How long to refer for ulcers?
3 weeks
120
How long can fusidic acid be used for in impetigo?
10 days
121
Example of a mild topical steroid?
Hydrocortisone
122
Example of a very potent topical steroid?
Dermovate
123
How long do you need to continue contraception before and after isotretinoin?
1 month before, during and after
124
What to do if you get psychiatric reactions with isotretinoin?
STOP
125
Side effects of isoretinoin?
Hyperglycaemia, high cholesterol, dryness, pancreatitis , hepatoxicity, visual disturbances
126
What common allergen is in the flu vaccine?
Egg
127
Age for topical degongestants?
18
128
Age for oral decongestants
6 - Max 5 days for 6-12
129
Age for diphenhydramine?
16
