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BNF: Cardiovascular System > High Risk Drugs > Flashcards

Flashcards in High Risk Drugs Deck (91)
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1

What's amiodarone t1/2? As a result of this what may be required?

About 50days
Loading doses may be required

2

Monitoring requirements for amiodarone

Thyroid function
LFTs
Serum potassium
Chest X-ray
ECG (with IV use)

3

Warning signs of amiodarone

Hypo/hyperthyroidism
Impaired vision
Photophobia
SoB or cough
Liver disease (jaundice)
Tremor & peripheral neuropathy
Phototoxic skin reactions e.g slate grey skin

4

Amiodarone counselling points

Shield skin from sunlight and for several months after stopping treatment
May be dazzled by headlights at night
Clinical effects can occur up to a year after stopping

5

Amiodarone + simvastatin interaction

Increased risk of myopathy

6

Amiodarone increases the plasma concentrations of what drugs

Coumarins
Dabigatran
Digoxin
Flecainide
Phenindione
Phenytoin

7

Why is there potential for drug interactions even when amiodarone is stopped

Cos of its long half life

8

Monitoring requirements for antihypertensives

Blood pressure
Heart rate
Renal function
Serum electrolytes

9

Grapefruit juice increases the plasma concentrations of what antihypertensives

Ivabradine
Aliskiren
CCB

10

Therapeutic range for carbamazepine

4-12mg/L

11

Monitoring for carbamazepine

FBC
Renal function
Liver function

12

Toxicity signs for carbamazepine

Incoordination
Blurred vision
Diplopia
Drowsiness
Nystagmus
Ataxia
Arrhythmias
N&v
Diarrhoea
Hyponatraemia

13

Signs of blood disorders with carbamazepine

E.g leukopenia, thrombocytopenia (fever, sore throat, unexplained bruising or bleeding)

14

Symptoms of antiepileptic hypersensitivity syndrome that can occur with e.g carbamazepine

Fever
Rash
Swollen lymph nodes

15

You get increased plasma concentrations of carbamazepine with what 6 drugs

Acetazolamide
Cimetidine
Clarithromycin
Erythromycin
Fluoxetine
Isoniazid

16

What three drugs decrease carbamazepine levels

Phenytoin
Rifabutin
St. John's wort

17

Carbamazepine decreases the plasma concentration of what 7 classes of drug

Antipsychotics
Corticosteroids
Coumarins
Eplerenone
Oestrogens
Progestogens
Simvastatin

18

The carbamazepine anticonvulsant effect is antagonised by what

Mefloquine
Antipsychotics

19

Reaction between orlistat and antiepileptics (e.g carbamazepine)

Increased risk of convulsions

20

Side effects of chemotherapy

Extravasation
N&V
Bone marrow suppression
Oral mucositis
Neurotoxicity (vinkaalkaloids)
Cardiotoxicity (anthracyclines)
Diarrhoea
Fatigue

21

Monitoring requirements for ciclosporin

FBC
LFT
Serum electrolytes (K, Mg)
Blood lipids,
Renal function
BP
Dermatological and physical exam

22

Warning signs for ciclosporin

Neurotoxicity
Blood disorders
Liver toxicity
Nephrotoxicity
Hypertension
Headache
Gingival hyperplasia

23

Actions required for ciclosporin

Hypertension is common
No live vaccines
Brand specific
Avoid exposure to UV light
Avoid high potassium diet and grapefruit juice

24

Ciclosporin does what to plasma concentrations of digoxin

Increases it

25

Ciclosporin + statin interaction

Myopathy

26

What drugs decrease the plasma concentration of ciclosporin

Carbamazepine
Orlistat
Phenobarbital
Phenytoin
Rifampicin
SJW

27

Increased risk of hyperkalaemia if you have ciclosporin and what?

ACEI
ARB
aldosterone antagonist

28

Monitoring for corticosteroids

BP
Blood lipids
Serum K
Body weight and height
Bone mineral density
Blood glucose
Eye exam
Adrenal suppression

29

Warning signs of corticosteroids

Paradoxical bronchospasm
Symptoms of uncontrolled asthma
Frequent courses of antibiotics
Adrenal suppression
Immunosuppression
Psychiatric reactions

30

Signs of adrenal suppression

Nausea
Vomiting
Weight loss
Fatigue
Headache
Muscular weakness