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39 Cards in this Set
- Front
- Back
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contraindications to digoxin |
renal failure - reduce dose elderly - reduce dose hypokalaemia |
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side effects of furosemide |
hyponatraemia, hypokalaemia, raised urea & creatinine, hypotension, fatigue, exacerbation of diabetes, gout, hearing impairment |
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side effects of spironalactone |
hyperkalaemia, gynaecomastia |
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side effects of amiodarone |
Thyroid& liver dysfunction Pneumonitis Cornealdeposits skin pigmentation Phlebitis& necrosis (if given IV) drug interactions - with warfarin, digoxin |
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mechanism of action of metformin |
Decreasesgluconeogenesis & enhances peripheral action of insulin |
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adverse effects of metformin |
anorexia,nausea, vomiting, diarrhoea, abdominalpain rarely, lactic acidosis (in renal impairment) |
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mechanism of action of sulphonylureas e.g. gliclazide |
increase insulin secretion |
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adverse effects of sulphonylureas |
hypoglycaemia, weight gain |
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adverse effects of insulin |
hypoglycaemia, weight gain |
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treatment of a thyroid storm |
IV fluids Propranolol 5mg Hydrocortisone 100mg every 6 hours Oral iodine Carbimazole |
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DMARDs for rheumatoid arthritis |
1. methotrexate 2. hydroxychloroquine 3. sulphasalazine 4. leflunomide |
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DMARDs for psoriatic arthritis |
sulfasalazine methotrexate cyclosporine avoid hydroxycholorquine - skins disease worsens |
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potential toxic effects of methotrexate |
Myelosuppression,hepatic fibrosis, pneumonitis |
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potential toxic effects of hydroxychloroquine |
Bull's eye maculopathy |
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potential toxic effects of sulfasalazine |
Neutropenia,myelosuppression, azoospermia |
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potential toxic effects of lefluomide |
myelosuppression, hepatic fibrosis |
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potential toxic effects of cyclosporine |
renal failure, anaemia, hypertension, hyperkalaemia |
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adverse effects of cyclophosphamide |
Permanent infertility in males Risk of SIADH |
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cephalosporins |
Cefuroxime Cefotaxime Ceftazidime Ceftriaxone |
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macrolides |
Erythromycin Azithromycin clarithromycin |
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tetracyclines |
tetracycline Doxycycline Lymecycline |
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quinolones |
ciprofloxacin |
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aminoglycosides |
gentamicin streptomycin |
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adverse effects of aminoglycosides |
ototoxicity& nephrotoxicity (higher risk in elderly / renal failure) Avoid if furosemide concurrent |
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adverse effects of vancomycin |
redman syndrome, phlebitis, renal function impairment, back spasms |
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interactions of macrolides with theophylline |
mayincrease theophylline serum levels. Monitor serum level with dose adjustment |
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interactions of macrolides with warfarin |
mayincrease anticoagulant effect of warfarin. Monitor INR closely |
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interactions of macrolides with statins |
increased risk of myositis |
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drugs that decrease the effectiveness of warfarin |
Phenytoin Carbamazepine Rifampicin |
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ACEi use in CKD |
ACEi can treat hypertension in CKD but risk of nephrotoxicity if bilateral renal artery stenosis. - If rise in creatinine > 30-50% or fall in eGFR > 15% or potassium >5.5 evaluate for RAS - stop ACEi and ARBs in dehydrating illness |
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Drugsthat require adequate renal function to work |
thiazides nitrofurantoin |
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antibiotics to reduce in renal disease due to renal excretion |
penicillin, ceftriaxone, gentamicin |
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digoxin use CKD |
Reduce both initial and maintenance dose Check serum digoxin levels & potassium regularly |
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metformin use in CKD |
Metformin may induce lactic acidosis in renal failure Avoid metformin when eGFR<30 Consider dose reduction in CKD |
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lithium use in renal impairment |
Avoid - if used, monitor serum levels to avoid toxicity Diuretics, NSAIDs, illnesses that cause dehydration can precipitate lithium toxicity |
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LMWH use in CKD |
LMWH clearance is reduced in CKD Monitor activity using factor Xa assay |
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methotrexate use in renal impairment |
reduce dose to avoid toxicity |
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Beta blocker use in renal impairment |
reduce dose or dose frequency of atenolol & bisoprolol (renally excreted) |
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drugs that impair renal function |
Cyclosporine PPIs NSAIDs Gentamicin + Antibiotics Allopurinol Lithium Acyclovir |
