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26 Cards in this Set
- Front
- Back
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Name the CYP inducers |
Barbiturates Rifampicin Griseofulvin Phenytoin Ethanol Carbamazepine St Johns Wort |
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CYP Inhibitors |
Cimetidine Antifungals: ketoconazole Erythromycin Ciclosporin Psoralen |
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What is CI with simvastatin? What does simvastatin also interact with? |
CI: macrolides Interactions: Amlodipine, verapamil, diltiazem |
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Max dose of simvastatin that can be used with amlodipine? |
20mg Use amlodipine as it doesn't interact |
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Explain the risk with aspirin and MTX co-prescription |
Aspirin and MTX compete for renal elimination and NSAIDs in general may reduce renal perfusion |
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Explain the link between pH and renal elimination |
Secretion is related to pH, increase pH: increase excretion of weak acids |
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Risk of Diuretics and ACEi? |
Severe first dose hypotension |
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Diuretics and digoxin? |
Loops and thiazides cause hypokalemia so increase toxicity of digoxin |
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Issues with potassium sparing diuretics? |
Increase potassium May be a problem if the patient takes K supplements of ACEis |
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Theophylline and salbutamol? |
Theophylline augments salbutamol |
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Beta blockers and rate-limiting calcium channel blockers |
Beta blockers and verapamil: risk of bradycardia/asystole (potentially fatal! AVOID) Beta blockers and diltiazem may interact (Avoid or extreme caution) |
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What drugs does St John's Wort be avoided with? |
OCP Antiepileptics Some HIV drugs Ciclosporin Warfarin Simvastatin MAOIs and SSRIs: serotonergic syndrome |
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Explain the major food interactions |
Cranberry juice shown to potentiate warfarin leading to fatalities Grapefruit juice interacts with terfenadine, simvastatin and some Ca-antagonists |
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Which drugs interact with alcohol? |
Mostly CNS depressant/sedation actions enhanced e.g. TCAs, sedating antihistamines, benzodiazepines Metronidazole |
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Adverse side effects of b blockers |
Cold extremities Bradycardia |
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Adverse side effects of Cimetidine/spironolactone |
Gynaecomastia |
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Drugs that cause constipation as an adverse side effect
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Opioids Antimuscarinics |
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Digoxin toxicity? |
Nausea Vomiting Visual disturbances Heart block Arrythmias |
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How do you treat penicillin adr? |
H1 antagonist |
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Causes of agranulocytosis? |
Clozapine Carbimazole Carbamazepine |
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Symptoms of agranulocytosis? |
Mouth ulcers Severe sore throat (Infections) |
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ADR of NSAIDs? |
Peptic damage and ulceration |
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How should GI damage be minimised? |
Prophylaxis with PPI Misoprostol (stable PGE1 analogue) |
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Effects of NSAIDs in CVD? |
May cause fluid retention May exacerbate HTN/CHF |
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How do NSAIDs cause renal damage? |
By inhibiting renal PGs Reduced renal blood flow Reduced GFR (Especially in CHF) |
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Statins and muscles? |
Rarely, statins may cause muscle damage/myopathy Often due to a drug interaction Myopathy may rarely progress to rhabdomyolysis - may result in renal damage |
