CONTRAINDCATIONS

Question 1

All aminoglycosides

Answer 1

Myasthenia gravis (impairs neuromuscular transmission)

Question 2

Neomycin

Answer 2

Intestinal obstruction (also causes diarrhoea and GI disorders)

Question 3

Vancomycin IV

Answer 3

previous hearing loss

Question 4

Clindamycin

Answer 4

Diarrhoeal states

Question 5

Co-amoxiclav

Answer 5

history of penicillin related jaundice or hepatic dysfuction

Question 6

Pivmecillinam hydrochloride (3)

Answer 6

• Carnitine deficiency (prevents absorption in gut and endogenous production of L-carnitine high helps transfer fat-> energy)
• GI obstruction
• Oesophageal strictures (can cause GI disorders)

Question 7

All quinolones

Answer 7

history of tendon disorders related to quinolone use

Question 8

Moxfloxacin

Answer 8

Risk factors for QT interval prolongation (acute MI/ bradycardia/ congenital long QT syndrome/ HFrEF/ symptomatic arrhythmia/ electrolyte disturbances

Question 9

Co-trimoxazole
Sulfdiazine

Answer 9

Acute porphyrias (can precipitate attack)

Question 10

Lymecycline

Answer 10

Children under 8 years old (bind to calcium in growing bones and teeth- staining and hypoplasia)

Question 11

Minocycline
Oxytetracycline
Tetracycline

Answer 11

Children under 12 (bind to calcium in growing bones and teeth- staining and hypoplasia)

Question 12

Tigecycline

Answer 12

Diabetic foot infections (SEs include abscess, increased risk of infection, hypoglycaemia)

Question 13

Chloramphenicol

Answer 13

acute porphyrias

Question 14

Trimethoprim

Answer 14

Blood dyscriasias (SEs include agranulocytosis, bone marrow suppression, eosinophilia, anaemia, leucopenia, thrombocytopenia)

Question 15

Rifampicin (2)

Answer 15

acute porphyrias (can precipitate attack)
Jaundice (SEs include hepatitis)

Question 16

Ethambutol (2)

Answer 16

optic neuritis (inflammation of optic nerve- ses include nerve disorders and visual impairment)
poor vision

Question 17

Isoniazid

Answer 17

drug-induced liver disease (can cause liver injury especially with rifampicin)

Question 18

Pyrazinamide

Answer 18

acute attack of gout (aggravated gout)

Question 19

Methenamine hippurate (hiprex) (3)

Answer 19

(decreases pH of urine)
- gout (precipitates rate crystals in urine)
- metabolic acidosis
- severe dehydration

Question 20

Nitrofurantoin (3)

Answer 20

• acute porphyria
• G6PD deficiency (precipitates haemolytic anaemia in these individuals)
  infants less than 3 months old (immature red blood cells prone to haemolysis)

Question 21

Fluconazole
Itraconazole

Answer 21

acute porphyrias

Question 22

Griseofulvin (2)

Answer 22

acute porphyrias
SLE (risk of exacerbation)

Question 23

Artemether and lumefantrine (Riamet)

Answer 23

family history of: congenital QT interval prolongation/ sudden death
Personal history: arrythmas/ clinically relevant bradycardia/ congestive heart failure with REF
(causes QT interval prolongation and palpitations)

Question 24

Artenimol with piperaquine (Eurartesim)

Answer 24

acute MI/ severe hypertension
bradycardia/ long QT/ risk factors for QT prolongation history of symptomatic arrhythmia/ electrolyte disturbances/ HRrEF/ left vent hypertrophy (can cause arrhythmia/ conduction. disorders of <3)

family history of sudden death

Question 25

Mefloquine (3)

Answer 25

- history of psychiatric disorder (including depression- can cause abnormal dreams, psychosis and suicidal ideation) - history of black water fever (massive haemolysis following malaria tx or prophylaxis) - history of convulsions (seizure is a SE)

Question 26

Quinine (4)

Answer 26

haemoglobiuria (can be a SE) myasthenia gravis (aggrevates condition) optic neuritis (vision disorders & ocular toxicity are SEs) tinnitus (can worsen)

Question 27

Retrovir (zidovudine)

Answer 27

abnormally low haemoglobin/ neutrophil counts (may cause anaemia and myelosupression)