INTERACTIONS

Question 1

PHY and enzyme inhibitors

Answer 1

INCREASE toxicity of PHY (INcrease levels)

Question 2

PHY and enzyme inducers

Answer 2

cause therapeutic failure of PHY (reDUCE levels)

Question 3

PHY and MTX or trimethoprim

Answer 3

All antifolate so can lead to blood dyscrasias

Question 4

PHY and quinolones

Answer 4

increased seizure risk

Question 5

PHY and SSRI

Answer 5

increased toxicity risk of PHY

Question 6

PHY and tramadol

Answer 6

increased seizure risk

Question 7

PHY and Antipsychotics

Answer 7

increased seizure risk

Question 8

PHY and HRT

Answer 8

reduces HRT concentration

Question 9

PHY and COC/POP

Answer 9

reduces COC/POP concentration

Question 10

PHY and warfarin

Answer 10

reduces warfarin levels, reduces INR

Question 11

PHY and levothyroxine

Answer 11

reduces levothyroxine concentration

Question 12

PHY TOXICITY LEVELS

Answer 12

SNAtCHeD
slurred speech
nystagmus
ataxia
confusion
hyperglycaemia
diplopia

Question 13

PHY monitor

Answer 13

FBC

LFT

Question 14

Lithium interaction MNEMONIC

Answer 14

So Quinn Really Hid Erin’s Sexy Nightime Stuff

Seizures QT Renal EPSE Salt Neurotoxicity Serotonin Syndrome

Question 15

Lithium and Seizures

Answer 15

quinolones, SSRI, Antiepileptics

Question 16

Lithium and QT

Answer 16

quinolones, macrolides, SSRI, Antipsychotics, Amiodarone, TCA, Theophylline, B2 Agonist

Question 17

Lithium and Reduced Renal Excretion

Answer 17

ACEI/ARBs, NSAIDs, diuretics, metformin, statins

Question 18

Lithium and HypOnatremia

Answer 18

SSRI, diuretics

Question 19

Lithium and EPSE

Answer 19

Metoclopramide, Parkinson’s, Antipsychotics

Question 20

Lithium and Salt balance

Answer 20

Effervescent products and Gaviscon

Question 21

Lithium and Neurotoxicity

Answer 21

Antipsychotics, CBZ, PHY, Amitriptyline

Question 22

Lithium and Serotonin Syndrome

Answer 22

SSRI, SJW, MAOI, tramadol, sumatriptan