Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Drugs > Contra-Indications and Interactions > Flashcards

Contra-Indications and Interactions Flashcards

(58 cards)

Start Studying
1
Q

Antacids

A

Can reduce serum concentration of ACEi’s, some Abx, digoxin, levothyroxine and PPI’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

H2 antagonists

A

Reduce dose in CKD and can disguise symptoms of gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PPI

A

Reduces effect of clopidogrel

Can disguise symptoms of gastric cancer and can increase risk of osteoporotic #

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Loperamide

A

Avoid in acute UC/bloody diarrhoea and in possibility of C-diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Laxatives

A

Do not use in obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Aminosalicylate

A

Don’t use in children < 2 or in renal impairment

Have pH resistant coating so affected by gastric pH modifying drugs (PPI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Antiemetics

A

Risk of side effects increased when prescribed with antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Loop Diuretics

A

Effects drugs that are renally excreted

Contraindicated in severe hypovolaemia/dehydration and caution in hepatic encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thiazide diuretics

A

Avoid in hypokalaemia/natraemia
Can precipitate acute gout attacks - increases uric acid levels
Effectiveness reduced by NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Potassium Sparing Diuretics

A

Contraindicated in severe renal impairment, hyperkalaemia, addisons and pregnant women
Caution when using other K+ elevating drugs - ACE/ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Beta Blockers

A

Do not use in heart block, reduce dose in hepatic failure and dont use with non-dihydropyridine Ca blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Calcium Blockers

A

Caution in those with poor LV function, avoid in AV node conduction delay and unstable angina
Do not use non-dihy…… with B-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

ACE inhibitors/ AT1 Blockers

A

Avoid in those with Renal Artery Stenosis and pregnancy/ breastfeeding
Low doses in CKD
Avoid using with other K+ elevating drugs and risk of renal failure increased when used with NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nitrates

A

Contraindicated in severe aortic stenosis and if hemodynamically unstable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cardiac Glycosides

A

Contraindicated in 2nd degree hear block
Do not use if risk of ventricular arrythmias, reduce dose in renal failure
Duiretics, amiodarone, Ca blockers and quinine can all increase risk of toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Amiodarone

A

Only use when risk/benefits are balances as can be dangerous particularly in severe hypotension, heart block and active thyroid disease
Increases plasma levels of digoxin, diltiazem and verapamil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Aspirin

A

Not used in < 16yrs due to Reye’s syndrome
Avoided in 3rd trimester of pregnancy
Caution in peptic ulceration and can cause acute attack of gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Clopidogrel

A

Caution in renal/hepatic impairment

CP450 metabolised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Heparin/NOACs

A

Use in caution with other anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Warfarin

A

Do not give in 1st trimester of pregnancy

Low therapeutic dose and CP450 metabolised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Statins

A

Caution in hepatic and renal impairment and pregnant/breasfeeding women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Beta-2-agonists

A

B-blockers reduce effectiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anticholinergics

A

Caution in those at risk of Angle Closure Glaucoma as can cause rise in IOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Corticosteoids

Study These Flashcards
A

Use with NSAIDs increases risk of peptic ulceration + GI bleeding
Enhances hypokalaemia in those taking B2 agonists
CP450 metabolised

25
Theophylline
Contraindicated in porphyria Smoking and alcohol increase clearance CP450 metabolised
26
O2
Can disturb fine balance between hypoxia and hypercapnia in those with T2 resp failure - leading to rise in blood CO2
27
Insulin
Increased risk of hypo in renal impairment
28
Sulphonylureas
Reduce dose in hepatic impairment Risk of hypo increased when used with other anti-diabetic drugs Efficacy reduced by prednisolone, thiazides and loop diuretics as increase blood glucose
29
Biguanides
Contraindicated in severe renal impairment, caution in hepatic impairment Withhold in acute alcohol intoxication and caution in chronic alcohol Withhold for 48yrs post IV contrast
30
Thyroxine
In hypopituitarism, must administer corticosteroids first to avoid addisonian crisis GI absorption reduced by antacids, calcium and iron salts
31
Carbimazole
Contraindicated in haematological/hepatic condition | Vit K antagonist so can enhance anticoagulative effects
32
Bisphosphonates
Avoid in severe renal impairment, hypocalcaemia and upper GI disorders Absorption reduced with antacids, calcium and iron salts
33
Mineralocorticoids
Contraindicated in systemic infections, myasthenia gravis, increased eye pressure, cataracts, hypertension, Caution when used with theophylline, loop and thiazide diuretics as all reduce K+
34
Penicillin
Reduce dose in severe renal impaiment | They reduce renal excretion of methotrexate and enhance warfarin effect
35
Cephalosporins
Caution in epilepsy and reduce dose in renal impairment. | Enhances effect of warfarin and can increase nephrotoxicity of aminoglycosides
36
Trimethoprim
Contraindicated in 1st trimester of pregnancy - foetal abnormalities Used in caution in folate deficiency and reduce dose in renal impairment
37
Nitrofurantoin
Do not use in near term pregnancy/ babies < 3months | Contraindicated in patients with renal impairment
38
Tetracyclines
Dont use in pregnancy, breastfeeding, < 12 yrs or in renal impairment Do not give within 2 hrs of iron, antacids or calcum as prevent absoption
39
Aminoglycosides
Avoid in myasthenia Gravis Ototoxicity more likely if used with loop diuretics or vancomycin Nephrotoxicity more likely if used with cyclosporin or vancomycin
40
Macrolides
Caution in renal/hepatic impairment | CP450 inhibitor
41
Quinolones
Calcium and antacids reduce absorption CP450 inhibitor Use with NSAIDs increases risk of seizures and use with prednisolone increase risk of tendon rupture
42
Metronidazole
CP450 metabolised | Inhibits acetaldehyde dehydrogenase which clears alcohol metabolites so no alcohol to be drunk
43
Glycopeptides
Dose adjustement in elderly and renal impairment | Increased risk of toxicity when prescribed with aminoglycosides, loop diuretics or ciclosporins
44
NSAIDs
Aspirin and corticosteroids increase risk of GI ulceration Anticoagulants and SSRI's increase risk of bleeding ACEi's and diuretics increase risk of renal impairment Reduce efficacy of antihypertensives and duiretics
45
Codeine
Caution in sever respiratory disease, reduce dose in renal/hepatic impairment and the elderly Do not use with other sedating drugs
46
Morphine
Reduce dose in hepatice failure and renal impairment and elderly Do not give in resp failure or biliary colic
47
Paracetamol
Overdose can lead to liver failure due to saturation of pathway leading to build up of NAPQI
48
Xanthine-Oxidase Inhibitors
Reduce dose in severe hepatic/renal impairment Reduces efficacy of mercaptopurine + azathioprine as require xanthine oxidase for metabolism Use with amoxicillin increase risk of rash Use with ACEi's and thiazides increase risk of hypersensitivity
49
Alpha Blockers
Contraindicated if already postural hypotension
50
5-alpha-reductase inhibitors
Do not use in pregnancy (or even come into contact with) as can cause abnormal development of male external genitalia
51
L-dopa
Do not use with antipsychotics or metoclopramide as effects contradictory
52
Phenytoin
Reduce dose in hepatic impairment | In utero exposure associated with craniofacial abnormalities and reduced IQ
53
Carbamazepine
In utero exposure associated with neural tube defects, cardiac and urinary abnormalities and cleft palate Contraindicated in previous Antiepileptic Hypersensitivity syndrome
54
Sodium Valproate
Avoid in women of childbearing age and in 1st trimester as related to foetal abnormalities Avoid in severe hepatic/ renal abnormalities Inhibits CP450
55
Tricyclics
Caution in elderly, those at risk of CV disease and epilepsy and those with constipation, prostatic hypertrophy or raised IOP
56
SSRI's
Dose reduction in hepatic impairment Gastroprotection needed if also taking NSAIDs Do not prescribe with other drugs that prolong QT interval
57
Benzodiazepines
Reduce dose in elderly Avoid in significant resp/neuro impairment Avoid in liver failure
58
Acetylcholinesterase Inhibitors
Do not use whilst driving, breastfeeding or pregnant Itraconazole, erythromycin and fluoxetine inhibit metabolism Can interfere with anticholinergic medications such as atropine, amitriptyline and codeine

Drugs (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions