Top 300 ADRs/Warnings/CI Flashcards

Question 1

Q

amiodarone (Cordarone, Pacerone)

Answer

A

IV: bradycardia, HYPOtension
PO: pulmonary fibrosis, hepatoxicity, thyroid dysfunction, corneal deposits, photosensitivity, QT/QTc prolongation

pulmonary toxicity
hepatoxicity
fatal arrhythmias

second or third-degree heart block
hypersensitivity to iodine

Question 2

Q

amlodipine (Norvasc)

Answer

A

HYPOtension, dizziness, peripheral edema, gingival hyperplasia, headache

none

Question 3

Q

apixaban (Eliquis)

Answer

A

bleeding, bruising

INC risk for hematomas in pt undergoing neuraxial anesthesia
AVOID in pt w/ mechanical heart valves

active bleeding

Question 4

Q

atorvastatin (Lipitor)

Answer

A

hepatotoxicity, muscle sx (i.e. myalgia, myopathy)

none

pregnancy, breastfeeding, unexplained elevation of serum transaminases

Question 5

Q

bivalirudin (Angiomax)

Answer

A

bleeding

none

active bleeding

Question 6

Q

bumetanide (Bumex)

Answer

A

HYPOnatremia, HYPOkalemia, HYPERuricemia, HYPOmagnesemia, HYPOcalcemia, acute renal insufficiency

sulfonamide hypersensitivity

anuria, severe electrolyte depletion

Question 7

Q

carvedilol (Coreg)

Answer

A

bradycardia, HYPOtension

none

second or third-degree heart block
decompensated HF
bronchospastic conditions

Question 8

Q

chlorthalidone (Hygroton, Thalitone)

Answer

A

HYPOnatremia, HYPOkalemia, HYPERuricemia HYPOmagnesemia

none

anuria
sulfonamide hypersensitivity

Question 9

Q

clopidogrel (Plavix)

Answer

A

bleeding

NOT REC in CYP2C19 poor metabolizers

active bleeding
AVOID omeprazole and esomeprazole d/t diminished antiplatelet effect

Question 10

Q

colesevelam (Welchol)

Answer

A

constipation, GI upset, HYPERtriglyceridemia

none

hx of bowel obstruction and HYPERtriglyceridemia-induced pancreatitis
TG >300 mg/dL

Question 11

Q

dabigatran (Pradaxa)

Answer

A

bleeding, GI upset/dyspepsia

AVOID in pt w/ mechanical heart valves
AVOID in severe renal impairment

active bleeding

Question 12

Q

digoxin (Lanoxin)

Answer

A

bradycardia, visual disturbances, anorexia, N/V

HYPOkalemia may INC toxicity
narrow therapeutic index

ventricular fibrillation

Question 13

Q

diltiazem (Cardizem)

Answer

A

bradycardia, HYPOtension, gingival hyperplasia

none

second or third-degree heart block
HFrEF

Question 14

Q

doxazosin (Cardura)

Answer

A

HYPOtension

initial dose may cause CNS depressions

none

Question 15

Q

enoxaparin (Lovenox)

Answer

A

bleeding, thrombocytopenia

none

active bleeding
hx of HIT

Question 16

Q

ezetimibe (Zetia)

Answer

A

diarrhea, elevated transaminases (esp w/ statins)

NOT REC in moderate to severe hepatic impairment

none

Question 17

Q

fenofibrate (Lofibra, Tricor, Trilipix)

Answer

A

elevated transaminases, INC risk of muscle sx esp when used w/ statins, dyspepsia

cholelithiasis
INC risk for hepatoxicity when used w/ statins

active liver disease
severe renal impairment
breastfeeding

Question 18

Q

furosemide (Lasix)

Answer

A

HYPOnatremia, HYPOkalemia, HYPERuricemia, HYPOmagnesemia HYPOcalcemia, acute renal insufficiency

sulfonamide hypersensitivity

anuria
severe electrolyte depletion

Question 19

Q

heparin (none)

Answer

A

bleeding, thrombocytopenia

none

active bleeding
hx of HIT

Question 20

Q

HCTZ (none)

Answer

A

HYPOnatremia, HYPOkalemia, HYPERuricemia, HYPOmagnesemia

AVOID in severe renal impairment

anuria
sulfonamide hypersensitivity

Question 21

Q

hydralazine (Apresoline)

Answer

A

lupus-like syndrome (w/ higher doses and longer durations), HYPOtension, reflexive tachycardia

none

mitral valve rheumatic disease
CAD

Question 22

Q

isosorbide mononitrate (Imdur)

Answer

A

headache, dizziness

INC intracranial pressure

concurrent use w/ PDE-5i (i.e. sildenafil) or riociguat

Question 23

Q

labetalol (Normodyne)

Answer

A

bradycardia, HYPOtension

none

second or third-degree heart block
decompensated HF
bronchospastic conditions

Question 24

Q

lisinopril (Prinivil, Zestril)

Answer

A

HYPOtension, HYPERkalemia, INC SCr, cough

AVOID concomitant ARBs

pregnancy
hx of angioedema
concomitant aliskiren
coadministration w/i 36HR of switching to/from Entresto

Question 25

Q

losartan (Cozaar)

Answer

A

HYPOtension, HYPERkalemia, INC SCr

AVOID concomitant ACEi

pregnancy
concomitant aliskiren

Question 26

Q

metoprolol (Lopressor, Toprol XL)

Answer

A

bradycardia, HYPOtension

none

second or third-degree heart block
decompensated HF

Question 27

Q

nifedipine (Adalat, Procardia)

Answer

A

HYPOtension, peripheral edema, gingival hyperplasia

none

Question 28

Q

nitroglycerin (Nitro-Dur, Nitrostat)

Answer

A

HYPOtension, dizziness

INC intracranial pressure
potential for severe HYPOtension

concurrent use w/ PDE-5i (i.e. sildenafil) or riociguat

Question 29

Q

norepinephrine (Levophed)

Answer

A

cardiac arrhythmias, peripheral ischemia

ensure proper needle/catheter placement and infuse into large vein if possible to avoid extravasation

none

Question 30

Q

omega-3-acid ethyl esters (Lovaza)

Answer

A

eructation (burping), dyspepsia, taste perversion, elevated LDL

use in CAUTION in pt w/ known fish/shellfish allergy
may INC bleeding risk in pt on antiplatelet/anticoag agents

none

Question 31

Q

prasugrel (Effient)

Answer

A

bleeding

NOT REC in pt w/ hx of bleeding or age >75yr

active bleeding
prior hx of stroke

Question 32

Q

rivaroxaban (Xarelto)

Answer

A

bleeding, bruising

INC risk of hematomas in pt undergoing neuraxial anesthesia
AVOID in pt w/ mechanical heart valves

active bleeding

Question 33

Q

rosuvastatin (Crestor)

Answer

A

hepatoxicity, muscle sx (i.e. myalgia, myopathy)

none

pregnancy
breastfeeding
unexplained elevation of serum transaminases

Question 34

Q

sacubitril/valsartan (Entresto)

Answer

A

HYPOtension, HYPERkalemia, INC SCr

D/C ACEi at least 36hr prior to starting Entresto

hx of angioedema
pregnancy
concomitant ACEi or aliskiren

Question 35

Q

simvastatin (Zocor)

Answer

A

hepatotoxicity, muscle sx (i.e. myalgia, myopathy)

none

pregnancy
breastfeeding
unexplained elevation of serum transaminases
AVOID strong CYP3A4/3A5 inhibitors

Question 36

Q

spironolactone (Aldactone)

Answer

A

HYPERkalemia, HYPOnatremia, gynecomastia

none

anuria
acute renal insufficiency
HYPERkalemia

Question 37

Q

ticagrelor (Brilinta)

Answer

A

bleeding, dyspnea

AVOID aspirin doses >100mg/day

active bleeding

Question 38

Q

verapamil (Calan)

Answer

A

HYPOtension, bradycardia, constipation, gingival hyperplasia

none

second or third-degree heart blood
HFrEF

Question 39

Q

warfarin (Coumadin, Jantoven)

Answer

A

bleeding , bruising purple toe syndrome (rare but serious)

use CAUTION when using concomitantly w/ CYP2C9 inhibitors

active bleeding
pregnancy

Question 40

Q

alprazolam (Xanax)

Answer

A

sedation/drowsiness, impaired coordination, memory impairment, dysarthria

may impair respiratory function (esp w/ opioids or severe pulmonary disease)
may lead to abuse, misuse, and addiction
may cause withdrawal reactions
CAUTION when driving or operating heavy machinery
CAUTION w/ CYP3A4 inhibitors
may worsen depression

use w/ strong CYP3A inhibitors (i.e. ketoconazole, itraconazole) EXCEPT ritonavir

Question 41

Q

amitriptyline (Elavil)

Answer

A

anticholinergic side effects (constipation, xerostomia, mydriasis, urinary retention)
orthostatic HYPOtension, sedation/CNS depression, SS (rare), abrupt D/C may cause withdrawal (nausea, headache, malaise)

INC risk of suicidal thinking and behavior in pt aged 24 and younger
may precipitate mania in pt w/ bipolar disorder
may trigger angle-closure attack in glaucoma
CAUTION in hx of serious CV disease
CAUTION in hx of seizures
risk of SS w/ other serotonergics

use w/ MAOIs
use / cisapride
during the acute recovery phase following MI

Question 42

Q

aripiprazole (Abilify)

Answer

A

EPS (esp restlessness/akathisia), N/V, somnolence, insomnia

INC risk of death for elderly w/ dementia-related psychosis
INC risk of suicidal thinking and behavior in pt aged 24 and younger
may cause neuroleptic malignant syndrome
may cause tardive dyskinesia
may cause metabolic problems (e.g. DM, dyslipidemia, weight gain)
may cause pathological gambling and compulsive behaviors
may cause orthostatic HYPOtension
may INC fall risk
may cause neutropenia
CAUTION in hx of seizures
may impair cognition or motor skills
CAUTIOM in pt at risk for aspiration pneumonia

none

Question 43

Q

atomoxetine (Strattera)

Answer

A

N/V, HYPERtension, tachycardia, DEC appetite, hyperhidrosis

INC risk of suicidal ideation i short-term studies in children or adolescents w/ ADHD
may cause severe liver injury
may cause sudden death at usual doses in children and adolescents w/ structural cardiac abnormalities or other serious heart problems
use w/ CAUTION in pt whose underlying medical conditions could be worsened by increases in BP or HR (HYPERtension, tachycardia, or cardiovascular or cerebrovascular disease)
may cause psychotic or manic sx (e.g. hallucinations, delusional thinking, or mania) in pt w/o a hx of psychotic illness or mania
pt w/ bipolar disorder or risk factors for bipolar disorder may be at INC risk of developing mania or mixed episodes
may cause or worsen aggressive behavior
weight and height gain of pediatric pt treated w/ atomoxetine lags behind that predicted by normative population data for about the first 9-12 months of tx
may cause urinary retention/hesitation
may cause priapism

use w/ MAOis
narrow angle glaucoma
pheochromocytoma
severe cardiovascular disorders

Question 44

Q

buprenorphine/naloxone (Suboxone, Zubsolv)

Answer

A

constipation, nausea, oral hypoesthesia

risk of addiction, abuse, and misuse
risk of life-threatening CNS and respiratory depression
risky in combo w/ other CNS depressants or benzos
accidental pediatric exposure can be dangerous
may cause neonatal opioid withdrawal syndrome (NOWS)
risk of adrenal insufficiency
may cause withdrawal upon abrupt D/C
risk of hepatitis
may precipitate withdrawal if given w/ a full opioid agonist such as heroin
may cause dental adverse effects
may impair cognition or motor skills
may cause orthostatic hypotension

none

Question 45

Q

bupropion (Wellbutrin)

Answer

A

anorexia, dry mouth, sweating, tremor, insomnia

INC risk of suicidal thinking and behavior in pt aged 24 and younger
may cause seizures
may cause HYPERtension
may precipitate a manic, mixed, or hypomaniac manic episode
may cause psychosis
may trigger an angle-closure attack

seizure disorder
current or prior dx of bulimia or anorexia nervosa
abrupt D/C of alcohol, benzos, barbiturates, and antiepileptic drugs
use w/ MAOIs

Question 46

Q

buspirone (Buspar)

Answer

A

dizziness, nausea, headache, nervousness

HYPERtension when used w/ MAOIs
potentially life-threatening SS w/ buspirone alone, but particularly w/ concomitant use of other serotonergic drugs
interference w/ cognitive and motor performance
potential for withdrawal reactions in sedative/hypnotic/anxiolytic drug-dependent pt

use w/ MAOIs

Question 47

Q

carbamazepine (Tegretol)

Answer

A

dizziness, drowsiness/somnolence, unsteadiness/ataxia, N/V, HYPOnatremia

may cause serious and sometimes fatal dermatologic reactions, including TEN and SJS
may cause aplastic anemia and agranulocytosis
may cause Drug Reaction w/ Eosinophilia and Systemic Sx (DRESS), AKA multiorgan hypersensitivity
may cause hypersensitivity reactions in pt who previously experienced this reaction to anticonvulsants including phenytoin, primidone, and phenobarbital
do NOT stop abruptly d/t risk of INC seizure frequency, including status epilepticus
INC risk of suicidal thoughts or behavior
may cause fetal harm when administered to pregnant women
may cause HYPOnatremia

hx of bone marrow suppression
use w/ MAOI
use w/ nefazodone
use w/ delavirdine

Question 48

Q

citalopram (Celexa)

Answer

A

N/V, sexual dysfunction, SS (rare), dose-related QT-prolongation

INC risk of suicidal thinking and behavior in pt aged 24 and younger
may cause dose-related QTc prolongation
may precipitate ss
may INC risk of bleeding events
may precipitate a mixed/manic episode in pt w/ bipolar disorder
may cause D/C syndrome
may trigger an angle closure glaucoma attack
may cause HYPOnatremia
may cause sexual dysfunction

use w/ MAOIs
use w/ pimozide
hypersensitivity to citalopram or escitalopram

Question 49

Q

clobazam (Onfi, Sympazan)

Answer

A

sedation/drowsiness, impaired coordination, constipation, dysarthria

use w/ opioids may result in profound sedation, respiratory depression, coma, and death
risk of addiction, abuse, and misuse
the continued used may lead to clinically significant physical dependence
may cause somnolence and sedation
may cause serious skin reactions, including SJS and TEN
INC risk of suicidal thoughts or behavior

none

Question 50

Q

clonazepam (Klonopin)

Answer

A

sedation/drowsiness, impaired coordination, memory impairment, dysarthria, paradoxical reactions

CAUTION against engaging in hazardous occupations requiring mental alertness, such as operating machinery or driving a motor vehicle
concerns about the use of clonazepam during pregnancy
do NOT stop abruptly d/t risk of withdrawal

clinical or biochemical evidence of significant liver disease
acute narrow angle glaucoma

Question 51

Q

clonidine (Catapres)

Answer

A

sedation/somnolence, fatigue/lethargy, HYPOtension and bradycardia, contact dermatitis (transdermal ONLY)

may cause dose-related DEC in BP and HR
may cause somnolence and sedation
abrupt D/C of clonidine can cause rebound HYPERtension
in pt who have developed localized contact sensitization to clonidine transdermal system, continuation of clonidine transdermal system or substitution of oral clonidine therapy may be associated w/ the development of a generalized skin rash
may worsen sinus node dysfunction and AV block, esp in pt taking other sympatholytic drugs

hx of hypersensitivity reaction to clonidine

Question 52

Q

desvenlafaxine (Pristiq)

Answer

A

N/V, dry mouth, DEC appetite and weight loss, insomnia, hyperhidrosis

INC risk of suicidal thinking and behavior in pt age 24 and younger
may precipitate SS
may INC BP
may INC risk of bleeding events
may trigger an angle closure glaucoma attack
may cause mania/hypomania
may cause D/C syndrome
may cause seizures
may cause HYPOnatremia
may cause interstitial lung disease and eosinophilic pneumonia

hypersensitivity to desvenlafaxine
use w/ MAOIs

Question 53

Q

dexmethylphenidate (Focalin)

Answer

A

DEC appetite and weight loss, insomnia, N/V, headache, jittery

CAUTION if hx of drug dependence or alcoholism
may cause sudden death in children and adolescents w/ structural cardiac abnormalities or other serious heart problems
may cause an INC in BP and HR
may exacerbate sx of behavior disturbance and thought disorder in pt w/ a preexisting psychotic disorder
may cause mixed/manic episode in bipolar disorder pt
may cause aggressive behavior or hostility
may cause suppression of growth in children
may lower seizure threshold in pt w/ prior hx of seizures
may cause priapism
may cause peripheral vasculopathy, including Raynaud’s phenomenon
may cause difficulties w/ accommodation and blurring off vision

marked anxiety, tension, and agitation
in pt w/ galucoma,
in pt w/ motor tics or FHx or dx of Tourette’s syndrome
during tx w/ MAOIs

Question 54

Q

diazepam (Valium)

Answer

A

sedation/drowsiness, impaired coordination, memory impairment, dysarthria, muscle weakness

concomitant use w/ opioids may result in profound sedation, respiratory depression, coma, and death
risk of addiction, abuse, and misuse
may INC risk of congenital malformations and other developmental abnormalities

pt w/ myasthenia gravis
severe respiratory insufficiency
severe hepatic insufficiency
sleep apnea syndrome

Question 55

Q

divalproex (Depakote)

Answer

A

N/V, sedation/somnolence, INC appetite/weight gain, tremor, alopecia

risk of hepatoxicity esp in children <2
AVOID in women of childbearing age d/t risk of major congenital malformations, particularly neural tube defects
may cause life-threatening pancreatitis

hepatic disease or significant hepatic dysfunction
mitochondrial disorders caused by mutations in mitochondrial DNA polymerase gamma
hypersensitivity to divalproex
urea cycle disorders
women of childbearing potential unless other medications have failed to provide adequate sx control

Question 56

Q

doxepin (Sinequan, Silenor)

Answer

A

anticholinergic side effects (constipation, xerostomia, mydriasis, urinary retention)
orthostatic HYPOtension, sedation/CNS depression, SS (rare), abrupt D/C may cause withdrawal (nausea, headache, malaise)

INC risk of suicidal thinking and behavior in pt aged 24 and younger
parasomnias
CNS depression

use w/ MAOIs
untreated narrow angle glaucoma
severe urinary retention

Question 57

Q

duloxetine (Cymbalta)

Answer

A

nausea, headache, dry mouth/xerostomia, insomnia, hyperhidrosis

INC risk of suicidal thinking and behavior in pt aged 24 and younger
risk of hepatotoxicity
may cause SS
INC risk of bleeding
severe skin reactions
D/C syndrome
syncope
mania/hypomania
seizures
INC BP
may trigger angle-closure glaucoma

use w/ MAOIs

Question 58

Q

escitalopram (Lexapro)

Answer

A

N/V, sexual dysfunction, SS (rare), dose-related QT-prolongation

INC risk of suicidal thinking and behavior in pt aged 24 and younger
may precipitate SS
may INC of bleeding events
may precipitate a mixed/manic episode in pt w/ bipolar disorder
may cause D/C syndrome
may trigger angle closure glaucoma attack
may cause HYPOnatremia
may cause sexual dysfunction

use w/ MAOIs
use w/ pimozide

Question 59

Q

eszopiclone (Lunesta)

Answer

A

headache, drowsiness

may cause complex sleep behaviors including sleep-walking, sleep-driving, and engaging in other activities while not fully awake
may impair daytime function
additive effects occur w/ concomitant use of other CNS depressants
may cause drowsiness and DEC level of consciousness
elderly pt are at higher risk of falls

complex sleep behaviors after taking eszopiclone

Question 60

Q

fluoxetine (Prozac, Sarafem)

Answer

A

N/V, sexual dysfunction, SS (rare), dose-related QT-prolongation

INC risk of suicidal thinking and behavior in pt aged 24 and younger
may precipitate SS
may INC risk of bleeding events
may precipitate a mixed/manic episode in pt w/ bipolar disorder
may cause D/C syndrome
may trigger an angle closure glaucoma attack
may cause HYPOnatremia
may cause sexual dysfunction
may cause anxiety, nervousness, or insomnia
may cause weight LOSS

NOT approved for children younger than 7
use w/ MAOIs
use w/ pimozide
use w/ thioridazine

Question 61

Q

gabapentin (Neurontin, Gralise)

Answer

A

dizziness, somnolence, peripheral edema, ataxia

may cause Drug Reaction w/ Eosinophilia and Systemic Sx (DRESS)
anaphylaxis and angioedema
may impair motor skills or cognition
may cause somnolence, dizziness, and ataxia
INC risk of suicidal thoughts or behavior
may cause respiratory depression

hypersensitivity to gabapentin or its ingredients
should NOT be abruptly D/C bc of possibility of INC seizure frequency in pt w/ epilepsy

Question 62

Q

guanfacine (Intuniv)

Answer

A

sedation/somnolence, fatigue/lethargy, HYPOtension and bradycardia

may cause dose-dependent DEC in BP and HR
may worsen sinus node dysfunction and AV block
may cause somnolence and sedation
abrupt D/C has resulted in clinically significant and persistent rebound HYPERtension

none

Question 63

Q

lacosamide (Vimpat)

Answer

A

dizziness, blurry vision and diplopia, N/V, cardiac arrhythmias

INC risk of suicidal thoughts or behaviors
may cause dizziness and ataxia
may cause cardiac arrhythmias, including bradycardia, AV block, and ventricular tachyarrhythmia

should be withdrawn gradually (over a minimum of 1 week) to minimize the potential of INC seizure frequency in pt w/ seizure disorders
may cause Drug Reaction w/ Eosinophilia and Systemic Sx (DRESS)

none

Question 64

Q

lamotrigine (Lamictal)

Answer

A

dizziness, somnolence, nausea

can cause serious rash, including SJS, requiring hospitalization and D/C of tx
may cause hemophagocytic lymphohistocytosis (HLH)
may cause Drug Reactions w/ Eosinophilia and Systemic Sx (DRESS)
may slow ventricular conductions (widen QRS) and induce arrhythmias
may cause blood dyscrasias (neutropenia, leukopenia, anemia, thrombocytopenia, pancytopenia)
INC risk of suicidal thought and behavior
should NOT be abruptly D/C (there is possibility of INC seizure frequency) in pt w/ epilepsy

none

Answer 65

A

somnolence, asthenia, dizziness, aggression/irritability

may cause behavioral abnormalities and psychotic sx
may cause somnolence and fatigue
AEDs INC risk of suicidal thoughts or behaviors in pt taking these drugs for any indication
may cause anaphylaxis or angioedema
may cause serious dermatological rxns, including SJS and TEN
should NOT be abruptly D/C (there is a possibility of INC seizure frequency)
may cause hematologic abnormalities

none

Answer 66

A

insomnia, tachycardia and HTN, irritability, DEC appetite and weight loss

CNS stimulants have a high potential for abuse and dependence
may cause sudden death, stroke, and MI
may cause INC in BP and HR
may exacerbate sx of behavioral disturbance and thought disorder in pt w/ a pre-existing psychotic disorder
may cause weight loss or slowing of growth rate in pediatric pr
may cause peripheral vasculopathy, including Raynaud’s phenomenon
may cause SS when used in combo w/ other drugs that affect the serotonergic NT systems

use w/ MAOIs

Answer 67

A

fine tremor, polyuria, peripheral edema, N/V/D, drowsiness

lithium toxicity
may be associated w/ diminution of renal concentrating ability, occasionally presenting as nephrogenic diabetes insipidus, w/ polyuria and polydipsia
may impair mental and/or physical abilities
may cause fetal harm when administered to a pregnant women

should generally NOT be given to pt w/ significant renal or CVD
severe debilitation or dehydration
sodium depletion
pt receiving diuretics

Answer 68

A

sedation/drowsiness, impaired coordination, memory impairment, dysarthria, paradoxical rxns

concomitant use w/ opioids
risk of abuse, misuse, and addiction
may lead to clinically significant physical dependence
INC risk of suicide in pt w/ depression
caution in pt w/ compromised respiratory function (e.g. COPD, sleep apnea syndrome)

acute narrow-angle glaucoma (PO only)
severe respiratory insufficiency (except in those pt requiring relief of anxiety and/or diminished recall of events while being mechanically ventilated)
obstructive sleep apnea (IM/IV only)

Answer 69

A

somnolence, nausea, EPS (esp restlessness/akathisia)

elderly pt w/ dementia-related psychosis treated w/ antipsychotic drugs are at INC risk of death
antidepressants INC risk of suicidal thoughts and behavior in pediatric and young adults
INC risk of development of neuroleptic malignant syndrome (NMS) and tardive dyskinesia
may cause metabolic changes that may INC cardiovascular/cerebrovascular risk (HYPERglycemia, dyslipidemia, and body weight gain)
may cause leukopenia/neutropenia
may cause orthostatic HYPOtension and syncope
may cause somnolence, postural HYPOtension, motor and sensory instability
should be used cautiously in pt w/ hx of seizures or w/ conditions that lower the seizure threshold
has potential to impair judgement, thinking or motor skills

strong CYP3A4 inhibitors
strong CYP3A4 inducers

Answer 70

A

headache, diarrhea, dizziness, agitation and confusion (rarely)

conditions that raise urine pH may DEC the urinary elimination of memantine resulting in INC plasma levels of memantine

none

Answer 71

A

headache, insomnia, anorexia and weight loss, INC BP or HR, priapism (rare but serious)

CNS stimulants have a high potential for abuse and dependence
may cause sudden death, stroke, and MI
may cause INC in BP and HR
may exacerbate sn of behavioral disturbance and thought disorders in pt w/ a pre-existing psychotic disorder
may cause weight loss and slowing of growth rate in pediatric pt
may cause peripheral vasculopathy, including Raynaud’s phenomenon
may cause priapism

concomitant tx w/ MAOIs

Answer 72

A

somnolence, INC appetite and weight gain, orthostatic HYPOtension and dizziness, dry mouth

antidepressants INC risk of suicidal thoughts and behaviors in pediatric and young adult pt
serotonergic antidepressants can precipitate SS, a potentially life-threatening condition
risk is INC w/ concomitant use of other serotonergic drugs
may trigger an angle-closure glaucoma attack
may cause drug rxn w/ eosinophilia and systemic sx (DRESS)
may cause INC risk of appetite and weight gain
may cause somnolence
in pt w/ bipolar disorder, treating a depressive episode w/ an antidepressant may precipitate a mixed/manic episode
may cause HYPOnatremia

concomitant tx w/ MAOIs

Answer 73

A

headache, nausea, nervousness/anxiety, INC in gamma glutamyltransferase (GGT) and alkaline phosphatase (AlkPhos)

may cause serious or life-threatening rash, including SJS, TEN, and DRESS
may cause angioedema and hypersensitivity
may cause excessive sleepiness
may cause psychiatric sx
CAUTION should be exercised when modafinil is given to pt w/ hx of psychosis, depression, or mania
none

Answer 74

A

anticholinergic SE (constipation, xerostomia, mydriasis, urinary retention), orthostatic HYPOtension, sedation/CNS depression, SS (rare), abrupt D/C may cause withdrawal (nausea, headache, malaise)

INC risk of suicidal thinking and behavioral in pt aged 24 and younger
may precipitate mania in pt w/ bipolar disorder
may trigger angle-closure attack in glaucoma
CAUTION in hx of serious CVD
risk of unmasking Brugada syndrome
CAUTION in hx of seizures
risk of SS w/ other serotonergics

concomitant tx w/ MAOIs
during acute recover period after MI

Answer 75

A

somnolence, anticholinergic SE (constipation, xerostomia, mydriasis, urinary retention), orthostatic HYPOtension, EPS

elderly pt w/ dementia-related psychosis tx w/ antipsychotic drugs are at an INC risk of death
possibility of suicide attempts is inherent in schizophrenia and in bipolar I disorder, and close supervision of high-risk pt should accompany drug therapy
may cause DRESS
may cause neuroleptic malignant syndrome (NMS)
typically antipsychotic drugs have been associated w/ metabolic changes including HYPERglycemia, dyslipidemia, and weight gain
may cause tardive dyskinesia (TD) and HYPERprolactinemia
may cause leukopenia/neutropenia, and rare agranulocytosis
has the potential to impair judgement, thinking and motor skills

none

Answer 76

A

dizziness, somnolence, abnormal vision (diplopia, nystagmus), HYPOnatremia

may cause HYPOnatremia
may cause anaphylaxis and angioedema
cross hypersensitivity rxn to carbamazepine
may cause serious dermatological rxns, including SJS and TEN
antiepileptic drugs (AEDs) INC risk of suicidal thoughts or behavior in pt taking these drugs for any indication
should be withdrawn gradually because of risk of INC seizure frequency
may cause DRESS

none

Answer 77

A

somnolence, respiratory depression, HYPOtension and bradycardia, serious skin rashes (rare)

tolerance and psychological and physical dependence may occur w/ continued use
elderly or debilitated pt may reaction to barbiturates should be administered w/ caution and initially in reduced doses

porphyria
marked impairment of liver or respiratory function

Answer 78

A

nausea, somnolence, constipation, sexual dysfunction

INC risk of suicidal thinking and behavior in pt aged 24 and younger
SS
may INC risk of bleeding events
may trigger an angle closure glaucoma attack
may cause HYPOnatremia
may precipitate a mixed/manic episode in pt at risk for bipolar disorder
withdrawal

concomitant tx w/ MAOI
concomitant use w/ thioridazine or pimozide

Answer 79

A

somnolence, nystagmus, dysgeusia (metallic taste), gingival hyperplasia, dyskinesia

abrupt withdrawal of phenytoin in epileptic pt may precipitate status epilepticus
INC risk of suicidal thoughts or behavior
may cause severe cutaneous adverse rxns (SCARs), including TEN, SJS, acute generalized exanthematous pustulosis (AGEP), and DRESS
may cause bradycardia and cardiac arrest
may cause angioedema
may cause acute hepatotoxicity
may cause thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, and pancytopenia
may cause DEC BMD (osteopenia, osteoporosis, and osteomalacia) and bone fractures
may cause fetal harm when administered to pregnant women
may cause HYPERglycemia

Answer 80

A

dizziness, somnolence, peripheral edema, ataxia

may INC risk of suicidal thoughts or behavior
may cause angioedema and other types of hypersensitivity
may cause respiratory depression
may cause dizziness and somnolence
withdrawal gradually to minimize the potential of INC seizure frequency in pt w/ seizure disorders
may cause peripheral edema
may cause weight gain
may cause blurry vision

none

Answer 81

A

somnolence, anticholinergic SE (constipation, xerostomia, mydriasis, urinary retention), orthostatic HYPOtension, EPS

elderly pt w/ dementia-related psychosis treated w/ antipsychotic drugs are at INC risk of death
INC risk of suicidal thoughts and behaviors in children, adolescents, and young adults in short-term studies
INC risk of cerebrovascular adverse reactions (cerebrovascular accidents and transient ischemic attacks) in elderly pt
may cause neuroleptic malignant syndrome (NMS)
may cause metabolic changes that include HYPERglycemia/DM, dyslipidemia, and body weight gain
may cause tardive dyskinesia
may cause orthostatic HYPOtension
may cause leukopenia/neutropenia
may cause QT prolongation
may cause somnolence and has potential to impair judgement, thinking or motor skills

none

Answer 82

A

somnolence, anticholinergic SE (constipation, xerostomia, mydriasis, urinary retention), orthostatic HYPOtension, EPS

elderly pt w/ dementia-related psychosis treated w/ antipsychotic drugs are at INC risk of death
may cause cerebrovascular adverse events (e.g stroke, TIA) in elderly pt
may cause neuroleptic malignant syndrome (NMS)
may cause tardive dyskinesia
may cause HYPERglycemia and DM
may cause prolactinemia
may cause orthostatic HYPOtension
may cause leukopenia, neutropenia, and agranulocytosis
may cause somnolence, w/ a potential to impair judgement, thinking, or motor skills

none

Answer 83

A

dizziness, flushing, drowsiness, chest discomfort/pain, nausea

life-threatening disturbances of cardiac rhythm, including ventricular tachycardia and ventricular fibrillation leading to death, have been reported w/i a few hours following the admin of 5-HT1 agonist
may cause tightness, pain, pressure, and heaviness in the precordium, throat, neck and jaw
may cause cerebral hemorrhage, subarachnoid hemorrhage, and stroke
may cause non-coronary vasospastic reactions, such as peripheral vascular ischemia, gastrointestinal vascular ischemia and infarction (presenting w/ abdominal pain and blood diarrhea), splenic infarction, and Raynaud’s syndrome
may cause HYPERtension

ischemic coronary artery disease
coronary artery vasospasm
hx of stroke or TIA
peripheral vascular disease
ischemia bowel disease
uncontrolled HTN
recent use (i.e. w/i 24HR) of another 5-HT1 agonist, ergotamine-containing medication, or ergot-type medication
migraine
concomitant tx w/ MAOIs

Answer 84

A

N/V/D, sexual dysfunction, SS (rare), insomnia

INC risk of suicidal thinking and behavior in pt aged 24 and younger
SS
may INC risk bleeding events
may precipitate a mixed/manic episode in pt w/ bipolar disorder
may cause D/C syndrome after abrupt D/C
may trigger an angle closure glaucoma attack
may cause QTc prolongation

concomitant tx w/ MAOI
use w/ pimozide

Answer 85

A

dizziness, flushing, tingling, chest discomfort/pain, nausea

life-threatening disturbances of cardiac rhythm, including ventricular tachycardia and ventricular fibrillation leading to death, have been reported w/ i a few hours following the administration of 5-TH1 agonist
may cause tightness, pain, pressure and heaviness in the precordium, throat, neck and jaw
may cause cerebral hemorrhage, subarachnoid hemorrhage, and stroke
may cause non-coronary vasospastic reactions, such as peripheral vascular ischemia, gastrointestinal vascular ischemia and infarction (presenting w/ abdominal pain and blood diarrhea), splenic infarction, and Raynaud’s syndrome
may cause HYPERtension
may cause seizures

ischemic coronary artery disease
coronary artery vasospasm
hx of stroke or TIA
peripheral vascular disease
ischemic bowel disease
uncontrolled HTN
recent use (i.e. w/i 24HR) of another 5-HT1 agonist, ergotamine-containing medication, or ergot-type medication
migraine
concomitant tx w/ MAOIs

Answer 86

A

drowsiness, dizziness, hangover effect, paradoxical reactions (e.g. euphoria)

use w/ opioids may result in profound sedation, respiratory depression, coma, and death
risk of abuse, misuse and addiction, which can lead to overdose or death
may lead to clinically significant physical dependence
may cause angioedema

pregnancy

Answer 87

A

somnolence, word-finding difficulties, DEC appetite and weight loss, nephrolithiasis

may cause visual field defects and a syndrome consisting of acute myopia associate w/ secondary angle closure glaucoma
may cause DEC sweating and HYPERthermia
may cause metabolic acidosis
INC risk of suicidal thoughts or behavior
may cause fetal harm when admin to pregnant women
may cause serious skin reactions (SJS, TEN)
may cause HYPERammonemia w/ or w/o encephalopathy
may cause kidney stones

none

Answer 88

A

somnolence, HYPOtension, N/C, priapism

INC risk of suicidal thinking and behavior in pt aged 24 and younger
may precipitate SS, a potentially life-threatening condition may cause arrhythmias in pt w/ preexisting cardiac disease
may cause HYPOtension
may INC risk of bleeding events
may cause priapism
may precipitate a mixed/manic episode in bipolar pt
may cause somnolence or sedation and may impair the mental and/or physical ability required for the performance of potentially hazardous tasks
may trigger an angle closure glaucoma attack
may cause HYPOnatremia

concomitant tx w/ MAOIs

Answer 89

A

nausea, headache, dry mouth/xerostomia, insomnia, hyperhidrosis

INC risk of suicidal thinking and behavior in pt aged 24 and younger
may precipitate SS
may cause HYPERtension
may INC risk of bleeding events
may precipitate a mixed/manic episode in pt w/ bipolar disorder
may cause D/C syndrome after abrupt D/C
may trigger an angle closure glaucoma attack
may cause seizures
may cause HYPOnatremia
may cause sexual dysfunction

concomitant tx w/ MAOIs
pimozide

Answer 90

A

headache, nausea, diarrhea, sexual dysfunction

INC risk of suicidal thinking and behavior in pt aged 24 and younger
precipitate SS
may cause arrhythmias in pt w/ preexisting cardiac disease
may cause HYPOtension
may INC risk of bleeding events
may precipitate a mixed/manic episode in bipolar disorder pt
may cause D/C syndrome
may trigger an angle closure glaucoma attack
may cause seizures
may cause HYPOnatremia

concomitant use w/ MAOIs

Answer 91

A

somnolence, QT-prolongation, orthostatic HYPOtension, EPS

elderly pt w/ dementia-related psychosis tx w/ antipsychotic drugs are at INC risk of death
INC risk of stroke and TIA in elderly pt
may prolong QTc interval
may cause neuroleptic malignant syndrome (NMS)
may cause tardive dyskinesia
may cause DRESS
metabolic changes that may INC cardiovascular/cerebrovascular risk
may cause HYPOtension
may cause leukopenia, neutropenia, and agranulocytosis
may cause HYPERprolactinemia
may cause somnolence and impair judgement, thinking or motor skills

known hx of QT prolongation (including congenital QT syndrome)
pt w/ recent acute MI
uncompensated HF

Answer 92

A

drowsiness, dizziness, headache

may cause abnormal thinking and behavior changes
may cause anaphylactic reactions
has CNS-depressant effects and should only be taken immediately prior to going to bed
INC sensitivity to sedative/hypnotic drugs in elderly and/or debilitated pt

none

Answer 93

A

constipation, headache, malaise, prolonged QTc

QT prolongation
SS
use in ileus or gastric distention
may contain benzyl alcohol and derivatives associated w/ toxicity in neonates

concomitant apomorphine

Answer 94

A

abdominal pain, acid regurgitation, constipation, diarrhea, dyspepsia

upper GI ADR
severe bone/joint/muscle pain
risk of osteonecrosis of the jaw
risk of atypical femur fractures
renal impairment

abnormalities of the esophagus which delay stomach emptying such as stricture or achalasia
inability to stand/sit upright for at least 30 min
HYPOcalcemia

Answer 95

A

tachycardia, confusion, blurred vision, confusion

risk of anhidrosis/HYPERthermia
risk of anticholinergic effects
do NOT use in pt w/ tardive dyskinesia
AVOID use in pt w/ glaucoma, GI obstruction or urinary retention

age <3 yo

Answer 96

A

conjunctival HYPERemia

pigmentation and reversible eyelash thickening

none

Answer 97

A

allergic conjunctivitis, burning sensation, HYPERtension, visual disturbances, xerostomia

potentiation of vascular insufficiency
risk of CNS depression

concurrent MOAI therapy
children <2yo (higher risk of systemic adverse events)

Answer 98

A

dyskinesia, orthostatic HYPOtension, constipation, nausea, headache

somnolence
HYPERprexia and confusion
compulsive behaviors

narrow-angle glaucoma
concurrent MAOI or linezolid w/i last 14 days

Answer 99

A

pruritis of ear

none

Answer 100

A

headache, abdominal pain, vaginal hemorrhage, breast pain, arthralgias

breast cancer
cardiovascular disease
endometrial cancer
dementia

undiagnosed abnormal genital bleeding
hx of estrogen- or progesterone-dependent neoplasia
active or hx of DVT or PE
active or hx of arterial thromboembolic disease
severe liver dysfunction
pregnancy
known protein C, protein S, antithrombin deficiency or other known thrombophilic disorders

Answer 101

A

burning sensation in the eye, eye pain

none

active ocular infection

Answer 102

A

xerostomia, constipation, headache

risk of angioedema

gastric retention
glaucoma
urinary retention

Answer 103

A

diarrhea, nausea, insomnia, weight loss

risk of rhabdomyolysis
risk for GI bleeding
risk of arrhythmias, SA and AV block

hypersensitivity to piperidine derivatives

Answer 104

A

DEC libido, impotence, orthostatic HYPOtension

AVOID blood donation 6 months after tx
CAUTION in those w/ diminished urinary flow

pregnancy

Answer 105

A

weight change, N/V, disturbances in mood, breast tenderness/pain, headache

endometrial and breast cancer risk
dementia risk
should NOT be used to reduce cardiovascular disk
secondary exposure risk
INC risk of endometrial cancer

hx of thromboembolic disorders
breast cancer
any estrogen-dependent neoplasm
known or suspected pregnancy

Answer 106

A

edema, abdominal pain, depression, headache, nasopharyngitis, breakthrough bleeding

endometrial and breast cancer risk
dementia risk
should NOT be used to reduce cardiovascular risk
secondary exposure risk (transdermal solution)
INC risk of endometrial cancer

hx of thromboembolic disorders
breast cancer
any estrogen-dependent neoplasm
known or suspected pregnancy

Answer 107

A

intermenstrual bleeding, vaginitis, headache

cigarette smoking INC risk of cardiovascular events
INC risk of migraine
higher risk of HYPERtension

hx of thromboembolic disrders
endometrial cancer
uncontrolled HYPERtension
pregnancy
smoking 15+ cigarettes per day and >35 yo

Answer 108

A

DEC libido, impotence, orthostatic HYPOtension

AVOID blood donation 6 months after tx
CAUTION in those w/ diminished urinary flow

pregnancy

Answer 109

A

conjunctival irritation, INC lacrimation, keratitis, papillary conjunctivitis

risk of resistant organisms w/ prolonged use
corneal endothelial cell injury

none

Answer 110

A

blurred vision, burning and stinging, conjunctival HYPERemia, foreign body sensation, INC pigmentation of the iris

pigmentation of the iris and eyelashes
INC length and thickness of eyelashes

none

Answer 111

A

chemosis, application site burning, blurry vision, eye watering

INC risk of cataracts, corneal thinning, and glaucoma

active eye infection (viral, mycobacterial or fungal disease of the eye)

Answer 112

A

amenorrhea, weight gain, abdominal pain, headache, nervousness

NOT used for prevention of cardiovascular disorders (PO)
INC risk of breast cancer (PO)
NOT used for DEC risk of dementia (PO)
NOT rec for long-term use (>2 years - INJ)
risk of loss of BMD (INJ)
risk vs benefit (PO)
cardiovascular, dementia risk
loss of BMD
breast cancer

abnormal genital bleeding
hx of estrogen- or progesterone-dependent neoplasia
active or hx of DVT or PE
severe liver dysfunction
known or suspected pregnancy

Answer 113

A

conjunctivitis, eye irritation

risk of superinfection w/ prolonged use

none

Answer 114

A

constipation, xerostomia, blurred vision, drowsiness

use w/ CAUTION in those w/ dementia and HYPERthyroidism

gastric retention
glaucoma
urinary retention

Answer 115

A

nausea, alopecia, diarrhea

risk of INC bleeding
pigmentary changes in retina

none

Answer 116

A

asthenia, dyskinesia, nausea, somnolence, constipation

dyskinesia
may execerbate psychotic disorders

none

Answer 117

A

fluid retention, headache, amenorrhea, breast tenderness, abdominal pain

NOT used for prevention of cardiovascular disorders (PO)
INC risk of breast cancer (PO)
NOT used for DEC risk of dementia (PO)
risk vs benefit (PO)

abnormal vaginal bleeding
hx of estrogen- or progesterone-dependent neoplasia
active or hx of DVT or PE
known or suspected pregnancy (PO)

Answer 118

A

dizziness, N/V, HYPOtension, somnolence

dyskinesias
CAUTION in those w/ CVD (elevates BP)

none

Answer 119

A

flushing, headache, visual disturbances, dyspepsia

impairment of color discrimination
risk of HYPOtension w/ concurrent alcohol use
CAUTION in those w/ CVD

concurrent nitrates
concurrent HIV protease inhibitors when used for treating pulmonary HYPERtension
concurrent guanylate cyclase stimulators

Answer 120

A

constipation, xerostomia, blurred vision

risk of angioedema
QT prolongation
CAUTION in those w/ DEC GI motility and bladder outlet obstruction (BPH)

gastric retention
uncontrolled glaucoma
urinary retention

Answer 121

A

diarrhea, headache, HYPERtension, elevated BG (DM), HYPERkalemia, neurological sx (tremors, numbness, seizures, confusion), anemia, OI, nephrotoxicity

risk of infection
risk of malignancies
INC mortality in female transplant pt w/ Astagraf XL
Astagraf XL NOT approved for liver transplant

hypersensitivity to HCO-60

Answer 122

A

flushing, headache, visual disturbances, dyspepsia, myalgias

impairment of the color discrimination
risk of HYPOtension w/ concurrent alcohol use
CAUTION in those w/ CVD
risk of sudden DEC or loss of hearing

concurrent nitrates
concurrent guanylate cyclase stimulators

Answer 123

A

drowsiness, restlessness

tardive dyskinesia
depression and suicidal ideation
risk of neuroleptic malignant syndrome

situations when GI stimulation may be dangerous (GI hemorrhage, mechanical obstruction or perforation)
pheochromocytoma
concomitant use w/ drugs likely to cause extrapyramidal reactions
epilepsy
hx of tardive dyskinesia

Answer 124

A

agitation, insomnia, fluid retention, HYPERglycemia, peptic ulcer, myopathy, cataracts/glaucoma

adrenal suppression
CAUTION in those w/ GI diseases (peptic ulcer, UC)

administration of live vaccines w/ immunosuppressive dose of prednisone
fungal infections

Answer 125

A

orthostatic HYPOtension, abnormal ejaculation, dizziness, headache, rhinitis

risk of floppy iris syndrome
CAUTION in those w/ sulfonamide allergy

none

Answer 126

A

xerostomia

risk of QT prolongation
CAUTION in those w/ bladder flow obstruction
CAUTION in those w/ glaucoma

fesoterodine
gastric retention
uncontrolled narrow-angle glaucoma
urinary retention

Answer 127

A

ocular HYPERemia, eye pain

may produce eye color changes
risk of ocular inflammation

none

Answer 128

A

flushing, headache, rhinitis

impairment of color discrimination
risk of HYPOtension w/ concurrent alcohol use
CAUTION in those w/ CVD
risk of vision/hearing loss

concurrent nitrates
concurrent guanylate cyclase stimulators

Answer 129

A

HYPERtension (low risk w/ topical route), polycythemia, PSA INC, application site blistering (topical)

BP INC (PO, SQ)
pulmonary oil microembolism (IM)
secondary exposure (topical)
may INC risk of depression or suicidal ideation
CAUTION in those w/ hepatic or renal impairment

concurrent nitrates
concurrent HIV protease inhibitors when used for treating pulmonary HYPERtension
concurrent guanylate cyclase stimulators

Answer 130

A

hot flashes, flu-like sx, arthralgias, leg cramps, edema

venous thromboembolism
stroke
pregnancy/lactation
men
premenopausal women
concurrent hormone replacement therapy

active or hx of venous thromboembolism

Answer 131

A

infection, arthralgia, diarrhea, headache, UTI, skin rash

upper GI adverse reactions
severe bone/joint/muscle pain
risk of osteonecrosis of the jaw
risk of atypical femur fractures
renal impairment

abnormalities of the esophagus which delay emptying such as stricture or achalasia
inability to stand/sit upright for at least 30ming
HYPOcalcemia

Answer 132

A

skin rash, infection, antibody development, injection site reactions, diarrhea

infections
malignancies
tuberculosis
antibody formation
demyelinating CNS disease

sepsis

Answer 133

A

abdominal pain, diarrhea, dizziness, visual disturbances, HYPERpigmentation

porphyria
psoriasis
pediatric pt

hypersensitivity

Answer 134

A

myelosuppression, N/V, oral mucosal ulcer, hepatotoxicity

serious adverse effects are possible including bone marrow suppression, serious infections, renal toxicity, GI toxicity, hepatic toxicity, pulmonary toxicity and dermatologic reactions
fetal toxicity
pregnancy
tumor lysis syndrome
radiotherapy
secondary malignancy

breastfeeding
in pt treated for psoriasis and RA - preexisting blood dyscrasias, pregnancy, alcoholism, alcoholic liver disease, immunodeficiency syndromes

Answer 135

A

bradycardia, HYPOtension, HYPOglycemia unawareness, bronchoconstriction/SOB, fatigue

use w/ CAUTION in HF

asthma
sinus bradycardia
heart block greater than 1st degree
sick sinus syndrome
cardiogenic shock
uncompensated HF

Answer 136

A

INC BP, palpitations/tachyarrhythmia, insomnia, tremor, restlessness

renal impairment
seizures
CVD

hypersensitivity to phentermine or other sympathomimetic amines
use in agitates states
CVD - arrythmias, HF, CAD, stroke, uncontrolled HTN
hx of drug abuse
glaucoma
HYPERthyroidism
concomitant use w/ MAOIs - at least 14 days should elapse between use of phentermine and MAOIs
pregnancy
lactation

Answer 137

A

nausea, headache, fatigue

risk of HepB reactivation in pt coinfected w/ HCV and HBV
use w/ amiodarone, p-glycoprotein inducers, or moderate to potent CYP2B6, CYP2C8 or CYP3A4 inducers NOT rec

none

Answer 138

A

nausea, headache, fatigue

risk of HepB reactivation in pt coinfected w/ HCV and HBV
concomitant use w/ carbamazepine, efavirenz, or St John’s wort is NOT rec

moderate or severe hepatic impairment (Child-Pugh B or C) or those w/ any hx of prior hepatic decompensation
concomitant use w/ atazanavir or rifampin

Answer 139

A

peripheral edema, dizziness, fatigue, nausea, pruritus

superinfection - C. diff infection risk

hypersensitivity to rifaximin/rifamycins

Answer 140

A

HYPERtension, GI upset, INC risk of infection, weight gain

adrenal suppression/insufficiency
CVD
GI disease
pheochromocytoma

concurrent use of live or live attenuated vaccines
fungal infections

Answer 141

A

HYPERtension, GI upset, INC risk of infection, HYPERglycemia, weight gain

adrenal suppression/insufficiency
hepatic disease
immunosuppression
CVD
GI disease

concurrent use of live or live attenuated vaccines
fungal infections
intrathecal administration
administration to premature infants
immune thrombocytopenia

Answer 142

A

HYPERtension, GI upset, INC risk of infection, HYPERglycemia, weight gain

adrenal suppression/insufficiency
hepatic disease
immunosuppression
CVD
GI disease

concurrent use of live or live attenuated vaccines

Answer 143

A

abdominal pain, leukopenia, antibody development, injection site reactions, flu-like sx, INC LFTs

autoimmune disorders
bone marrow suppression
hepatic toxicity
tuberculosis
injection site reactions
neuropsychiatric disorders (depression)

hypersensitivity to human albumin

Answer 144

A

tremor, nervousness, tachycardia

paradoxical bronchospasm

none

Answer 145

A

worsening gout at first, maculopapular rash

SJS
toxic epidermal necrolysis
hepatotoxicity
immune hypersensitivity reaction
renal failure

none

Answer 146

A

bitter taste in mouth
headache
somnolence

none

Answer 147

A

weakness, dizziness, vertigo, drowsiness, withdrawal syndrome

abrupt withdrawal - especially w/ the intrathecal route
AVOID in pt w/ psychiatric and seizure disorders

injecting IV, IM, SQ, or epidural administration

Answer 148

A

oral candidiasis, hoarseness

may cause a reduction in growth velocity in pediatric pt
INC risk of pneumonia in COPD pt
paradoxical bronchospasm

none

Answer 149

A

oral candidiasis, hoarseness, tremor, nervousness

may cause a reduction in growth velocity in pediatric pt
INC risk of pneumonia in COPD pt
paradoxical bronchospasm

none

Answer 150

A

dizziness, drowsiness, headache, rare but serious: seizures

CNS depression: may impair physical or mental abilities
concomitant use of other CNS depressants
acute intermittent porphyria
seizures

hypersensitivity to carbamates

Answer 151

A

AKI, INC bruising or bleeding, GI upset (less than other NSAIDs)

serious cardiovascular risk - including MI and stroke, which can be fatal
serious GI events - including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal

CYP2C9 substrate
hypersensitivity (e.g. anaphylaxis, serious skin reactions) to celecoxib, sulfonamides, aspirin, other NSAIDs (though sulfa cross reactivity is questionable)

Answer 152

A

pruritis

none

Answer 153

A

GI issues (N/V/D)

biliary obstruction
renal impairment
hepatic disease
renal disease

concomitant use of P-glycoprotein or CYP3A4 inhibitor and colchicine in the presence of renal or hepatic impairment

Answer 154

A

anticholinergic SE - urinary hesitancy, constipation, dizziness, drowsiness

No boxed warnings
risk for arrhythmias and QTc prolongation
risk for SS

MAOIs
arrhythmias
heart block of conduction disturbances
acute recovery phase of MI
AVOID in pt w/ HF

Answer 155

A

stomach pain and diarrhea, C. diff diarrhea, HYPOmagnesemia

none

Answer 156

A

AKI, INC bruising and bleeding, GI upset (less than other NSAIDs), INC liver enzymes

serious cardiovascular risk - including MI and stroke, which can be fatal
serious GI events - including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal

hx of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
major substrate of CYP2C9

Answer 157

A

anticholinergic SE - urinary hesitancy, constipation, dizziness, drowsiness, tachycardia

NO boxed warnings
psychosis/delirium: in pt w/ an extreme sensitivity to anticholinergic effects or at excessive dosages, such as the elderly or pt w/ mental illness

obstructive diseases of the GI tract
severe UC
reflux esophagitis
obstructive uropathy
glaucoma
myasthenia gravis
breastfeeding women
infants <6 months of age

Answer 158

A

flushing, tachycardia, confusion, abdominal distress

NO boxed warnings
atropinism
CNS depression
slow GI mobility

hypersensitivity to drug or its components
obstructive jaundice
C. diff diarrhea

Answer 159

A

abdominal pain, C. diff diarrhea, headache, HYPOmagnesemia

none

Answer 160

A

AKI, INC bruising or bleeding, GI upset (less than other NSAIDs), pancreatitis, INC liver enzymes

serious cardiovascular risk - including MI and stroke, which can be fatal
serious GI events - including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal
risk for SJS or DRESS

hypersensitivity (e.g. anaphylaxis, serious skin reactions) to etodolac, aspirin, other NSAIDs

Answer 161

A

constipation, diarrhea, nausea, skin rash

none

Answer 162

A

constipation, respiratory depression, opioid withdrawal, CNS depression, dependence

life threatening respiratory depression
abuse, addiction, and misuse
accidental exposure
cytochrome P450 CYP3A4 interactions
neonatal opioid withdrawal syndrome
concomitant use of opioids w/ benzos or other CNS depressants
substantial differences exist in the pharmacokinetic profile of fentanyl buccal, intranasal, lozenge, and sublingual
REMS program
exposure to heat (patch only)

significant respiratory depression
GI obstruction, including paralytic ileus (known or suspected)
pt requiring short-term therapy, management of acute of intermittent pain, postoperative or mild pain
pt who are NOT opioid tolerant

Answer 163

A

oral candidiasis, hoarseness, paradoxical bronchospasm

may cause a reduction in growth velocity in pediatric pt
INC risk of pneumonia in COPD pt
paradoxical bronchospasm

none

Answer 164

A

oral candidiasis, hoarseness, tremor, nervousness, paradoxical bronchospasm

may cause a reduction in growth velocity in pediatric pt
INC risk of pneumonia in COPD pt
paradoxical bronchospasm

none

Answer 165

A

constipation, respiratory depression, opioid withdrawal, CNS depression, dependence

addiction, abuse and misuse
REMS program
life threatening respiratory depression
accidental ingestion
neonatal opioid withdrawal syndrome
cytochrome P450 3A4 interactions
risk from concomitant use w/ benzos or other CNS depressants
interaction w/ alcohol

significant respiratory depression
GI obstruction, including paralytic ileus (known or suspected)

Answer 166

A

tremor, nervousness, tachycardia, bitter metallic taste, xerostomia

paradoxical bronchospasm

none

Answer 167

A

skin irritation, hair loss w/ shampoo, application site reaction w/ foam, rash

none

Answer 168

A

abdominal pain, C. diff diarrhea, headache, HYPOmagnesemia

none

Answer 169

A

tremor, nervousness, tachycardia

paradoxical bronchospasm

none

Answer 170

A

skin irritation, somnolence

none

hypersensitivity to lidocaine

Answer 171

A

headache, nausea, diarrhea

HYPOtension
syncope

hypersensitivity
bowel obstruction

Answer 172

A

AKI, INC bruising or bleeding, GI upset (less than other NSAIDs), INC liver enzymes

serious cardiovascular risk - including MI and stroke, which can be fatal
serious GI events - including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal
risk for SJS
CYP2C9 substrate

hypersensitivity to meloxicam
hx of asthma, urticaria or other allergic-type reactions after taking aspirin or other NSAIDs

Answer 173

A

dizziness/drowsiness, irritability/nervousness, hemolytic anemia, leukopenia, liver enzyme elevations

CNS depression
SS

significantly impaired hepatic or renal function
tendency to drug-induced, hemolytic or other anemias

Answer 174

A

constipation, respiratory depression, opioid withdrawal, CNS depression, QTc prolongation

addiction, abuse or misuse
REMS program
life threatening respiratory depression
QT prolongation
accidental ingestion
neonatal opioid withdrawal syndrome
requires supervision for detoxification and maintenance for opioid dependence
CYP interactions: 3A4, 2B6, 2C19, 2C9, or 2D6
concomitant use of opioids w/ benzos or other CNS depressants
risk of medication errors 1mg/mL solution and 2mg/mL solution

significant respiratory depression
GI obstruction, including paralytic ileus (known or suspected)

Answer 175

A

N/A

none

hypersensitivity to methocarbamol or any component of the formulation
renal impairment

Answer 176

A

headache, pharyngitis, nasal irritation and burning, epistaxis

none

Answer 177

A

headache, upper respiratory tract infections, nausea

neuropsychiatric events including agitation, aggression, depression, sleep disturbances, suicidal thoughts/behaviors

none

Answer 178

A

constipation, respiratory depression, opioid withdrawal, CNS depression, pruritus

monitor pt for at least 24HR in a fully equipped and staffed environment if giving intrathecal or epidural
ethanol use
addiction, abuse, and misuse
REMS
life threatening respiratory depression
neonatal opioid withdrawal syndrome
accidental ingestion
multiple concentrations of oral solution
risk from concomitant use w/ benzos or other CNS depressants

significant respiratory depression
GI obstruction, including paralytic ileus (known or suspected)

Answer 179

A

AKI, INC bruising or bleeding, GI upset (less than other NSAIDs), INC liver enzymes

serious cardiovascular risk - including MI and stroke, which can be fatal
serious GI events - including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal

hypersensitivity to nabumetone or any component of the formulation, urticaria or allergic-type reactions after taking aspirin or other NSAIDs
use in setting of coronary artery bypass graft surgery

Answer 180

A

abdominal pain, C. diff diarrhea, headache, HYPOmagnesemia

none

Answer 181

A

constipation, respiratory depression, opioid withdrawal, CNS depression, dependence

addiction, abuse and misuse
REMS
life-threatening respiratory depression
accidental ingestion
neonatal opioid withdrawal
cytochrome P450 3A4 interaction
risk from concomitant use w/ benzos
risk of medication errors w/ multiple formulations of the oxycodone

significant respiratory depression
GI obstruction, including paralytic ileus (known or suspected)

Answer 182

A

abdominal pain, C. diff diarrhea, headache, HYPOmagnesemia

none

Answer 183

A

GI - abdominal pain and cramping, bloating and diarrhea

NO boxed warnings
prolonged use may cause electrolyte disturbances
stop using if diarrhea occurs

known or suspected bowel obstruction

Answer 184

A

abdominal pain, C. diff diarrhea, headache, HYPOmagnesemia

none

Answer 185

A

constipation

none

Answer 186

A

xerostomia, cough

paradoxical bronchospasm

none

Answer 187

A

hepatotoxicity, HYPOtension, sedation, withdrawal syndrome

no boxed warnings
AVOID in hepatic and renal impairment
AVOID in older adults

concomitant therapy w/ potent CYP1A2 inhibitors (e.g. ciprofloxacin, fluvoxamine)

Answer 188

A

constipation, respiratory depression, opioid withdrawal, CNS depression, seizure and SS

risk of medication errors
addiction, abuse and misuse
REMS program
life threatening respiratory depression
accidental ingestion
ultra-rapid metabolism of tramadol
neonatal opioid withdrawal syndrome
interactions w/ drugs affect cytochrome P450 enzymes
risk from concomitant use w/ benzos

hypersensitivity to tramadol, opioids or any component of the formulation
use in pediatric pt <12yo
significant respiratory depression
concomitant use w/i 14 days of an MAOI

Answer 189

A

nasal irritation and burning, headache, pharyngitis, epistaxis, taste perversion

none

Answer 190

A

dry skin, burning sensation, stinging, pruritis/atrophy at site of administration

none

Answer 191

A

N/V, constipation, flatulence, sleep disturbances (insomnia, abnormal dreams)

serious neuropsychiatric events
seizure
MI

hypersensitivity

Answer 192

A

sedation, headache, dry mouth fatigue

none

documented hypersensitivity or related product product including cetirizine and levocetirizine and components of the formulation
QT prolongation

Answer 193

A

nephrotoxicity through crystalluria or acute interstitial nephritis (AIN) –> hydrate w/ NS and use adjBW in obesity (BMI >30) to not overdose, neurotoxicity (confusion, agitation, hallucinations) –> AVOID in pt w/ underlying neurological conditions, nausea, diarrhea, rash

extravasation w/ IV acyclovir (rotate infusion sites)
tx should begin ASAP w/i 72HR of first dx and 24HR of recurrent episode

buccal tab: hypersensitivity to milk protein concentrate

Answer 194

A

nephrotoxicity through crystalluria or acute interstitial nephritis (AIN) –> hydrate w/ NS and use adjBW in obesity (BMI >30) to not overdose, neurotoxicity (confusion, agitation, hallucinations) –> AVOID in pt w/ underlying neurological conditions, thrombotic thrombocytopenic purpura (TTP) w/ valacyclovir in immunosuppressed pt, nausea, diarrhea, rash

tx should begin ASAP w/i 72HR of first dx and 24HR of a recurrent episode

none

Answer 195

A

headache, elevated LFTs, AVOID in pregnancy or while breastfeeding, GI discomfort

bone marrow suppression
LFT elevation
do NOT use in pregnancy or while breast feeding

none

Answer 196

A

insomnia, depression, myalgia, weight gain

hepatotoxicity
rash
false elevation of SCr w/i 1-2 weeks w/ no effect on GFR
INC CPK

concurrent use w/ dofetilide

Answer 197

A

emtricitabine-associated hyperpigmentation, bictegravir may cause transient elevation of SCr w/ no effect of GFR, tenofovir alafenamide (TAF) may DEC BMD, TAF may cause renal impairment (AVOID CrCl <30), TAF may cause HYPERlipidemia, TAF if preferred over its other salt form tenofovir disoproxil fumarate (TDF) whenever possible

hepatomegaly w/ steatosis and lactic acidosis

concurrent use w/ dofetilide and rifampin

Answer 198

A

DEC BMD (less than TDF), renal impairment (AVOID in CrCl <30), higher incidence of HYPERlipidemia than TDF, preferred over TDF whenever possible

severe exacerbation of HepB
hepatomegaly w/ steatosis and lactic acidosis
renal impairment - AVOID ise in CrCl <30
when used for HepB, need to rule out co-infection w/ HIV-1
IRIS (immune reconstitution syndrome) can occur

none

Answer 199

A

weight gain, INC cholesterol and TG, abnormal vivid dreams, many DDI (CYP 450 substrate and inhibitor), teratogenic, resistance associated w/ mutations in HIV

CNS SE (abnormal dreams, insomnia, impaired concentration, hallucinations)
psychiatric SE (depression, delusions, suicidal ideations)
fat redistribution (e.g. central obesity)
hepatotoxicity
QT prolongation
HYPERcholesterolemia

rash including SJS
do NOT administer w/ elbasvir, grazoprevir, midazolam, St John’s wort or ergot alkaloids

Answer 200

A

DEC BMD, renal impairment (do NOT use in CrCl <50), hyperpigmentation, rash, HYPERglycemia, HYPERlipidemia, HYPOphosphatemia, upper respiratory tract infection

acute exacerbation of HepB
lactic acidosis and hepatomegaly w/ steatosis

do NOT use to treat HIV
do NOT used as PEP in pt w/ unknown HIV status

Answer 201

A

INC LFTs, acute exacerbation of HepB after D/C, DDI - do NOT use concurrently w/ ribavarin d/t hepatoxicity or ganciclovir d/t hematologic toxicity

HIV resistance in chronic HepB pt w/ undiagnosed HIV co-infection
do NOT use in HIV positive pt
lactic acidosis and hepatomegaly w/ steatosis

none

Answer 202

A

hepatotoxicity, skin rash, CNS effects (dizziness or even seizures), DDI - AVOID concurrent use w/ agents that prolong QTc (QTc prolongation), HMG-CoA reductase inhibitors (rhabdomyolysis), or sulfonylureas (HYPOglycemia)

renail impairment (dose adjust if CrCl <50)
some dosage forms may contain benzyl alcohol associated w/ “gasping syndrome”
do NOT use doses >400mg/d in pregnancy

QT prolongation if administered w/ CYP3A4 substrates
concurrent ergot alkaloids

Answer 203

A

infusion reactions (phlebitis, pruritis, facial swelling), abnormal LFTs, fever, AVOID co-administration w/ sirolimus

histamine-mediated infusion related reactions
phlebitis w/ IV administration
hepatotoxicity

none

Answer 204

A

GI SE (N/V/D, stomach pain), skin irritation or rash

topical formulations are for external use only - do NOT get into eyes, nose, or mouth

none

Answer 205

A

GI SE - N/V, suspension contains sorbitol, which can cause diarrhea in fructose intolerance, neuropsychiatric SE - confusion, delirium, hallucinations can occur, headache

renal impairment (dose adjust in CrCl <60)

none

Answer 206

A

GI (N/V/D), rash

infective mononucleosis (because of rash)
hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to amoxicillin or other beta-lactams

Answer 207

A

GI (diarrhea), rash

d/t differing content of clavulanate, NOT all formulations are interchangeable d/t clavulanate content
hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to amoxicillin, beta-lactamase inhibitors, or other beta-lactams
hx of cholestatic jaundice or hepatic dysfunction w/ amoxicillin/clavulanate

Answer 208

A

GI (N/V/D), rash, phlebitis (IV)

use w/ CAUTION w/ severe renal impairment and in those w/ seizure disorders
electrolyte imbalance (HYPERkalemia w/ penicillin G potassium and HYPERnatremia and HF w/ penicillin G sodium), hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to penicillin or other beta-lactams

Answer 209

A

GI (N/V/D), rash, phlebitis

electrolyte imbalance (HYPERnatremia d/t sodium content in piperacillin)
hypersensitivity reactions (including anaphylaxis)
may INC risk of nephrotoxicity w/ vancomycin

serious hypersensitivity to piperacillin, beta-lactamase inhibitors or other beta-lactams

Answer 210

A

GI (N/V/D), rash, seizures, phlebitis

CNS effects (seizures, confusion) - dose modify in renal impairment to minimize
may DEC valproic acid levels
hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to imipenem/cilastatin or other beta-lactams

Answer 211

A

GI (N/V/D), rash

hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to cephalexin or other beta-lactams

Answer 212

A

GI (N/V/D), rash

iron containing products: may cause red stools
hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to cefdinir or other beta-lactams

Answer 213

A

GI (N/V/D), rash, phlebitis

hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to cefazolin or other beta-lactams

Answer 214

A

GI (N/V/D), rash, gallbladder sludge (pseuocholelithiasis), C. diff infection, injection site reaction (induration, warmth, tightness)

hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to ceftriaxone or other beta-lactams
HYPERbilirubinemia in neonates
concomitant use w/ IV calcium-containing solution in neonates
IV use of ceftriaxone w/ lidocaine solutions

Answer 215

A

GI (N/V/D), rash, positive direct Coombs test (w/o hemolysis), CNS (seizures, confusion)

hypersensitivity reactions (including anaphylaxis)
CNS effects (seizures, confusion) - dose modify in renal impairment to minimize

serious hypersensitivity to cefepime or other beta-lactams

Answer 216

A

GI (N/V/D), rash, phlebitis (IV), INC LFTs

hypersensitivity reactions (including anaphylaxis)

serious hypersensitivity to cefuroxime or other beta-lactams

Answer 217

A

tendinitis and tendon rupture, CNS effects, cardiac (QT prolongation), HYPO/HYPERglycemia, dermatologic, aortic dissection and rupture, C. diff colitis

serious ADRs (tendinitis and tendon rupture, peripheral neuropathy, CNS effects, cardiac (QT prolongation), HYPO/HYPERglycemia, dermatologic)
may exacerbate muscle weakness in myasthenia gravis
aortic dissection and rupture
NOT generally used in children <16yo d/t joint cartilage injury

hypersensitivity to ciprofloxacin or other quinolones
concurrent administration of tizanidine

Answer 218

A

tendinitis and tendon rupture, CNS effects, cardiac (QT prolongation), HYPO/HYPERglycemia, dermatologic, aortic dissection and rupture, C. diff colitis

serious ADRs (tendinitis and tendon rupture, peripheral neuropathy, CNS effects, cardiac (QT prolongation), HYPO/HYPERglycemia, dermatologic)
may exacerbate muscle weakness in myasthenia gravis
aortic dissection and rupture
NOT generally used in children <16yo d/t joint cartilage injury

hypersensitivity to levofloxacin or other quinolones
concurrent administration of tizanidine

Answer 219

A

tendinitis and tendon rupture, CNS effects, cardiac (QT prolongation), HYPO/HYPERglycemia, dermatologic, aortic dissection and rupture, C. diff colitis

serious ADRs (tendinitis and tendon rupture, peripheral neuropathy, CNS effects, cardiac (QT prolongation), HYPO/HYPERglycemia, dermatologic)
may exacerbate muscle weakness in myasthenia gravis
aortic dissection and rupture
NOT generally used in children <16yo d/t joint cartilage injury

hypersensitivity to moxifloxacin or other quinolones
concurrent administration of tizanidine

Answer 220

A

GI (N/V/D), INC LFTs, myasthenia gravis, QTc prolongation

QT prolongation
myasthenia gravis
hepatic effects
hypersensitivity reactions

hypersensitivity to azithromycin or any macrolide or ketolide antibiotic
hepatic dysfunction w/ prior azithromycin therapy

Answer 221

A

GI (N/V/D), taste disturbance, INC LFTs, myasthenia gravis, QTc prolongation

QT prolongation
myasthenia gravis
hepatic effects
hypersensitivity reactions

hypersensitivity to clarithromycin or any macrolide or ketolide antibiotic
concomitant use w/ cisapride, pimozide, colchicine (in renal or hepatic impairment), lomitapride, lovastatin, simvastatin, ergotamine dihydroergotamine
hx of cholestatic jaundice or hepatic dysfunction

Answer 222

A

GI (N/V, abdominal pain, GI hemorrhage, bowel obstruction), hematologic (anemia, neutropenia), hypersensitivity

hypersensitivity reactions
macrolide allergy
do NOT use for system infections

hypersensitivity to fidaxomicin or component in the formulation

Answer 223

A

GI (N/V/D), erosive esophagitis, photosensitivity reactions, tooth discoloration and abnormal skeletal development in children <8yo (but can be used safely for <22days)

photosensitivity reactions
tooth discoloration and abnormal skeletal development in children <8yo (but can be used safely for <22days)
intracranial HYPERtension

hypersensitivity to doxycycline, other tetracyclines, or any component of the formulation

Answer 224

A

GI (N/V/D), dizziness and vertigo, tissue hyperpigmentation (slate-gray or blue-black coloration of the skin), photosensitivity reactions, tooth discoloration and abnormal skeletal development in children <8yo

photosensitivity reactions
tooth discoloration and abnormal skeletal development in children <8yo
intracranial HYPERtension

hypersensitivity to minocycline, other tetracyclines, or any component of the formulation

Answer 225

A

GI (N/V/D), C. diff colitis, esophagitis, rash

colitis

hypersensitivity to clindamycin, lincomycin, or any component of the formulation

Answer 226

A

GI (N/V/D), hematologic (thrombocytopenia, anemia, neutropenia), neuropathy (optic, peripheral), INC LFTs

myelosuppression
SS
neuropathy (peripheral and optic)
HYPOglycemia
C. diff

hypersensitivity to linezolid or any component of the formulation
concurrent use or w/i 2 weeks MAOIs

Answer 227

A

dermatologic (rash, severe hypersensitivity such as SJS), hematologic (pancytopenia, hemolytic anemia), renal failure, arrhythmias, HYPERkalemia

glucose-6-phosphate dehydrogenase deficiency (G6PD) (hemolysis)

hypersensitivity to sulfonamides
children <2mo
pregnant pt at term
megaloblastic anemia d/t folate deficiency
hx of drug-induced thrombocytopenia w/ use of sulfonamides or trimethoprim
marked hepatic damage or severe renal disease
concomitant administration w/ dofetilide

Answer 228

A

GI (N/V/D, abnormal taste), hypersensitivity reactions (rash, severe such as SJS), neuropathy

carcinogenic (rats, mice)

hypersensitivity to metronidazole

Answer 229

A

discoloration of urine (brown color), GI (N/V/D), interstitial pneumonitis w/ progressive fibrosis, hypersensitivity reactions

G6PD deficiency (hemolysis)
renal impairment (short-term use ok w/ CrCl 30-60)

hypersensitivity to nitrofurantoin
use in neonates or pregnant pt at term (38-42 weeks) d/t risk of hemolytic anemia, anuria, or oliguria

Answer 230

A

IV: renal failure, ototoxicity, vancomycin histamine release syndrome (vancomycin infusion reaction), rash, phlebitis, DRESS, hematologic (thrombocytopenia, neutropenia)
PO: nausea, abdominal pain, HYPOkalemia

use w/ CAUTION in renal impairment (INC risk of nephrotoxicity)

hypersensitivity to vancomycin or any component of formulation

Answer 231

A

hot flashes, mood changes, weakness, arthralgia, osteoporosis

INC ischemic cardiac events in women w/ pre-existing cardiac disease
DEC BMD
INC cholesterol levels

hypersensitivity
women of premenopausal endocrine status (including pregnant women)

Answer 232

A

hot flashes, irregular periods, vaginal discharge, peripheral edema, mood changes, weakness, arthralgia

INC risk of uterine malignancies and thromboembolic events
risk of embryo-fetal toxicity and liver abnormalities
tamoxifen is a pro-drug activated mainly through CYP2D6, utilize 2D6 inhibitors/induces w/ CAUTION

hypersensitivity
do NOT administer w/ warfarin
in pt w/ a hx of DVT/PE, tamoxifen is also CI if the indications for tx if either reduction of breast cancer incidence in high-risk pt or risk reduction of invasive breast cancer after tx of DCIS

Answer 233

A

HTN, thrombosis (including DVT), injection site reactions, pure red cell aplasia, seizures, SJS and TEN

erythropoiesis-stimulating agents (ESAs) INC the risk of serious cardiovascular events, MI, stroke, venous thromboembolism (VTE), vascular access thrombosis, and mortality in clinical studies when administered to target Hb levels >11 g/dL
ESAs shortened overall survival and/or INC risk of tumor progression or recurrence in clinical studies of pt w/ breast, non-small cell lung, head and neck, lymphoid, and cervical cancers
to DEC these risks, as well as risk of serious cardiovascular and thromboembolic reactions, use lowest dose needed to avoid RBC transfusions
use ESAs only for anemia from myelosuppressive chemo
ESAs are NOT indicated for pt receiving myelosuppressive chemo when anticipated outcome is cure
D/C following the completion of chem course
perisurgical: d/t risk of DVT, DVT ppx is recommended
AVOID use in HF and uncontrolled HTN
use CAUTION in pt w/ hx of seizures

serious allergic reactions
uncontrolled HTN
pure red cell aplasion

Answer 234

A

hepatotoxicity

alcoholism
hepatic impairment
limit dose from all sources/routes to <4g/day

hepatic disease or impairment
hypersensitivity

Answer 235

A

edema, INC BP, abdominal discomfort, heartburn

may INC risk of ASCVD events
INC risk of GI events/bleeding
CAUTION in older adults d/t GI bleeds
CAUTION in HTN, fluid retention, and HF
INC risk of renal injury
AVOID in pregnancy

NSAID allergy or hypersensitivity
CABG surgery

Answer 236

A

edema, INC BP, abdominal discomfort, heartburn

may INC risk of ASCVD events
INC risk of GI events/bleeding
CAUTION in older adults d/t GI bleeds
CAUTION in HTN, fluid retention, and HF
INC risk of renal injury
AVOID in pregnancy

NSAID allergy or hypersensitivity
CABG surgery

Answer 237

A

INC BP, dyspnea/GI ulcer, confusion, Reye’s syndrome, dizziness

AVOID chronic use >325mg/day in elderly
GI bleed
INC bleeding risk
AVOID in severe liver disease
AVOID if GFR <10
AVOID in pregnancy

asthma
rhinitis
nasal polyps syndrome

Answer 238

A

fatigue, dizziness

do NOT use in children <2yo
CAUTION in cough w/ excessive secretions

MAOI use concurrently or w/i 14 days

Answer 239

A

dizziness, drowsiness, dyskinesia, anticholinergic SE, xerostomia

AVOID in elderly d/t strong anticholinergic effects
CAUTION in glaucoma
CAUTION in BPH
excitation may occur in children

newborns/premature infants
nursing mothers

Answer 240

A

N/V

AVOID in children <2yo
CAUTION in cough w/ excessive secretions

none

Answer 241

A

HTN, tachycardia, insomnia, anxiety, MI

CAUTION in HTN, glaucoma, HYPERthyroidism, ischemia heart disease, BPH, arrhythmias

CAD
HTN
MAOI use concurrently or w/i 14 days

Answer 242

A

headache, nasal irritation and burning, epistaxis, glaucoma

immunosuppression w/ prolonged use
nasal effects (nasal alteration, nasal erosion, epistaxis)

N/A

Answer 243

A

headache

CAUTION in hepatic and renal impairment

none

Answer 244

A

headache, sedation, dry mouth, nausea, insomnia

CAUTION in renal impairment
do NOT administer at same time w/ aluminum or magnesium antacids or w/ fruit juices

none

Answer 245

A

drowsiness

CAUTION in hepatic and renal impairment
older pt may become more sensitive to SE

none

Answer 246

A

dry nose, sneezing, nasal irritation

local nasal effects
rebound nasal congestion

do NOT use >3 days

Answer 247

A

patch: dermatological SE (erythema, pruritis, burning), sleep disturbances
gum and lozenge: mouth/throat irritation, hiccups, GI (dyspepsia, nausea), lightheadedness especially if NOT used correctly
gum ONLY: jaw muscle aches, may stick to dental work

ideally, stop smoking while using but pt may lapse and continue to use
active PUD
<2 weeks since MI, serious arrhythmias or angina
pregnancy/breastfeeding
legally, CANNOT sell to <21yo
gum: TMJ

lozenge MINT: soy allergy/hypersensitivity

Answer 248

A

red to orange color of urine and feces and staining of contacts and clothing, headache, hemolytic anemia, methemoglobinemia

CAUTION in G6PD deficiency - may lead to hemolytic anemia

renal insufficiency

Answer 249

A

diarrhea, flatulence, nausea, stomach cramps, swollen abdomen

prolonged/frequent/excessive use may lead to electrolyte imbalance

known or suspected bowel obstruction

Answer 250

A

abnormal taste in mouth, diarrhea, stomach cramps, hepatotoxicity

none

concomitant use of mineral oil
intestinal obstruction
acute abdominal pain
N/V

Answer 251

A

stomach cramps, diarrhea

none

appendicitis
intestinal obstruction
gastroenteritis

Answer 252

A

abnormal electrolytes, stomach cramps, diarrhea

none

Answer 253

A

stomach cramps, diarrhea, flatulence

CAUTION in phenylketonuria - some have phenylalanine

none

Answer 254

A

stomach cramps, diarrhea, flatulence, borborygmus (stomach growling/rumbling)

AVOID in pt that have difficulty swallowing
CAUTION in phenylketonuria - some products have phenylalanine

none

Answer 255

A

burning, irritation, pruritis

none

Answer 256

A

sedation

use CAUTION in pt w/ BPH, asthma, and glaucoma given anticholinergic effects
use CAUTION in elderly (65+ yo) d/t these effects and sedation

N/A

Answer 257

A

sedation

use CAUTION in pt /w BPH, asthma, and glaucoma given anticholinergic effects
use CAUTION in elderly (65+ yo) d/t these effects and sedation

N/A

Answer 258

A

fecal discoloration, tongue discoloration, tinnitus

none

hypersensitivity to salicylates
ulcer/bleeding problems
children <12yo
children and teens recovering from chicken-pox or flu-like sx
breastfeeding
pregnant

Answer 259

A

constipation, abdominal pain, dizziness

Torsade’s, cardiac arrest, and death d/t high doses

bloody/black stools
febrile
invasive gut bacterial infections
antibiotic-associated diarrhea (C. diff)

Answer 260

A

acne, application site reactions, pruritis, dry skin

for use on lips/face ONLY

none

Answer 261

A

redness, irritation

AVIOD contact w/ eyes

recent ear surgery or tubes
ear drainage/discharge/pain
eardrum perforation
age <3yo

Answer 262

A

headache, burning sensation in eyes

AVOID in children <2yo

none

Answer 263

A

dry skin, burning sensation/pruritis/stinging at site of administration, headache

AVOID in infected, open or cracked lesion

none

Answer 264

A

redness, scaling, dryness, itching, burning - improves after 1st month

AVOID contact w/ eyes, lips, mouth, nose
scrapes
cuts
photosensitivity

none

Answer 265

A

none

Answer 266

A

flushing, headache, hepatotoxicity, gout, HYPERglycemia

INC bleeding risk, fasting blood sugars, uric acid levels
unstable angina

active liver disease
PUD
arterial hemorrhage

Answer 267

A

irritation, burning, itching/dryness

none

Answer 268

A

nasal irritation and burning, headache, pharyngitis, epistaxis, taste perversion, glaucoma, pneumonia, secondary HYPOcortisolism, osteoporosis

none

Answer 269

A

application site reactions (e.g. blistering, bruising, burning sensation, etc) have been reported, interruption of tx may be necessary

INC risk of systemic absorption associated w/ irritated or broken skin
application of external heat sources
a covered application site
large doses
large treatment areas

none

Answer 270

A

skin irritation and potential systemic toxicity, syn sensitivity (use sunscreen SPF 15+), peeling

none

hypersensitivity to aspirin
children/teens - recovering from chicken pox/flu
r/o Reye syndrome

Answer 271

A

bleaching, photosensitivity, dermatological SE (peeling, drying of skin, erythema, scaling, itching, swelling)

none

Answer 272

A

constipation, flatulence, swollen abdomen, nephrolithiasis

none

HYPERcalcemia

Answer 273

A

burning sensation, pruritis

none

Answer 274

A

burning sensation, pruritis, blistering, edema, erythema

none

Answer 275

A

UTI, genital mycotic infections, euglycemia DKA, HYPOtension, INC urinary frequency

hx of genitourinary infections
hx of lower-limb amputations

dialysis

Answer 276

A

UTI, genital mycotic infections, euglycemic DKA, HYPOtension, INC urinary frequency

hx of genitourinary infections

dialysis

Answer 277

A

UTI, genital mycotic infections, euglycemic DKA, HYPOtension, INC urinary frequency

hx of genitourinary infections

dialysis

Answer 278

A

N/V/D, worsening of diabetic retinopathy, pancreatitis

risk of medullary thyroid carcinoma, pancreatitis, severe GI disease

multiple endocrine neoplasia type 2
personal or family hx of medullary thyroid carcinoma

Answer 279

A

N/V/D, worsening of diabetic retinopathy, pancreatitis

risk of medullary thyroid carcinoma, pancreatitis, severe GI disease

multiple endocrine neoplasia type 2
personal or family hx of medullary thyroid carcinoma

Answer 280

A

HYPOglycemia

elderly pt d/t INC risk of HYPOglycemia (BEERs)
G6PD deficiency

none

Answer 281

A

HYPOglycemia

elderly pt d/t INC risk of HYPOglycemia (BEERs)
G6PD deficiency

none

Answer 282

A

d/t excessive dosing: palpitations, nausea, diarrhea, insomnia

NOT indicated for weight lot
new or worsening cardiac disease
elderly pt

acute MI
nontoxic diffuse goiter or nodular thyroid disease
uncorrected adrenal insufficiency

Answer 283

A

diarrhea, headache, arthralgia

none

Answer 284

A

N/V/D, worsening of diabetic retinopathy, pancreatitis

risk of medullary thyroid carcinoma
pancreatitis
severe GI disease

multiple endocrine neoplasia type 2
personal or family hx of medullary thyroid carcinoma

Answer 285

A

vitamin B12 deficiency, diarrhea, lactic acidosis

INC risk of lactic acidosis in pt w/ renal or hepatic impairment
hypoxic states
receiving IV contrast
severe GI disease

acute or chronic metabolic acidosis
severe renal impairment (eGFR <30)

Answer 286

A

edema, weight gain, hepatotoxicity

CHF
elderly pt (BEERs)
bladder cancer
hx of fractures

NYHA Class 3 or 4 HF

Answer 287

A

rash, goiter, HYPOthyroidism

pregnancy

none

Answer 288

A

HYPOglycemia

elderly pt d/t INC risk of HYPOglycemia

concomitant therapy w/ gemfibrozil

Answer 289

A

dehydration, N/V/D, worsening of diabetic retinopathy, pancreatitis

risk of medullary thyroid carcinoma
pancreatitis
severe GI disease

multiple endocrine neoplasia type 2
personal or family hx of medullary thyroid carcinoma

Answer 290

A

diarrhea, headache, peripheral edema, arthralgia

pt w/ HF

none

Answer 291

A

diarrhea, headache, arthralgia

none

Answer 292

A

d/t excessive dosing: palpitations, nausea, diarrhea, insomnia

NOT indicated for weight loss
new or worsening cardiac disease
elderly pt

acute MI
nontoxic diffuse goiter or nodular thyroid disease
uncorrected adrenal insufficiency

Answer 293

A

HYPOglycemia, injection site reactions, weight gain

elderly pt d/t INC risk of HYPOglycemia (BEERs)

none

Answer 294

A

HYPOglycemia, injection site reactions, weight gain

elderly pt d/t INC risk of HYPOglycemia

none

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Top 300 ADRs/Warnings/CI Flashcards

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