my NPLEX II > PHARM interactions and side effects > Flashcards

PHARM interactions and side effects Flashcards

(60 cards)

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1
Q

Hypokalemic drugs

A

Diuretics (Furosemide, HCTZ)

Corticosteroids (Hydrocortisone, Prednisone, Dexamethasone)

Cardiac glycosides (Digoxin, Convallaria, Digitalis, Leonarus)

Anti-Arrhythmias (atenolol, propranolol, amiodarone)

Pseudoephedrine
Glycyrrhiza

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2
Q

What meds caused decreased effects of Amoxicillin

A

tetracycline (Doxycycline, minocycline - protein synth inhib; mirtazapine - for MDD)

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3
Q

Penicillin increases effect and toxicity of what drug

A

methotrexate

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4
Q

Penicillin decreases effect of what drug class

A

Beta blockers

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5
Q

Penicillin’s effectiveness is decreased if it’s taken with what antibiotic

A

Doxycycline

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6
Q

Cephalexin, a cephalosporin (works like Penicillins), may increase effects of what drug

A

Metformin

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7
Q

A/E of Cephalexin

A
  • C. diff super infection
  • diarrhea
  • pseudomembranous colitis (higher incidence than other antibiotics)
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8
Q

Fluoroquinolone Ciprofloxacin’s absorption is decreased by what

A

cations (antacids, iron, zinc, bismuth)

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9
Q

Ciprofloxacin increases serum levels of what drug

A

warfarin

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10
Q

Nitrofurantoin has antagonistic effects with what antibiotic class

A

Fluoroquinolones (Ciprofloxacin)

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11
Q

A/E of Nitrofurantoin

A

PAIN mnemonic

  • Pulmonary toxicity
  • Anemia in Pts with G6PD
  • Irritated GI
  • Neurotoxicity
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12
Q

A/E of Doxycyline

A
  • permanent teeth discoloration
  • black tongue
  • photosensitivity
  • GI distress
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13
Q

Doxycycline’s absorption is reduced when used with

A

antacids, calcium, Magnesium, Iron

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14
Q

Doxycyline decreases effect of what other antibiotic

A

Penicillin

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15
Q

What antibiotic class is safe for pregnancy

A

Macrolide (Azithromycin)

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16
Q

antibiotics that prolong QT

A

Azithromycin and Ciprofloxacin (macrolide and fluoroquinolone)

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17
Q

what kind of antacids reduce rate of absorption of Azithromycin

A

aluminum and magnesium salts

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18
Q

Trimethoprim-Sulfamethoxazole (TMP-SMZ; sulfonamide) induces folate deficiency which causes what Sxs

A
  • thrombocytopenia/leukopenia
  • megaloblastic anemia
    (these are preventable with folic acid supplement)
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19
Q

What other drugs might cause additive folate deficiency with TMP-SMZ

A
  • methotrexate

- phenytoin

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20
Q

which antidiabetic drug class does TMP-SMZ affect and how?

A

Sulphonylureas (increases hypoglycemic effect)

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21
Q

What antimicrobial is usually Rx for impetigo

A

topical Mupirocin

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22
Q

condition C/I with topical Mupirocin

A

burns

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23
Q

What anticholinergic antiviral drug is used in parkinsons and herpes zoster (and formerly influenza A)

A

Amantadine

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24
Q

Amantadine enhances effects of what drugs

A
  • anticholinergics and levodopa
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25
do not take Amantadine with what type of drugs
CNS stimulants
26
Zidovudine (Antiretroviral) causes what A/E when combined with benzodiazepines
increased incidence of headache
27
interferon alpha is used for treatment of
chronic hep B and C, condyloma acuminatum (genital warts), tumors (leukemia, Kaposi's sarcome (AIDS), malign melanoma)
28
interferon beta is used for treatment of
MS
29
A/E of interferon alpha and beta
Mnemonic IFN ALPHA - Inhibits bone marrow - Flu like sxs - neurotoxic (depression/psychosis) - autoimmune disorders - liver enzyme elevations - proteinuria - hypotension and tachycardia - alopecia
30
Fluconazole (Triazole) potentiates what drugs
warfarin and oral hypoglycemics
31
Fluconazole may increase serum levels of what drugs
- phenytoin, cyclosporine, zidovudine, sulfonylureas, carbamazepine
32
what drug increases fluconazole levels
thiazides
33
what drugs to avoid when taking Hydroxychloroquine
digoxin and alcohol
34
what is Hydroxychloroquine used for besides malaria?
SLE, RA
35
A/E of Hydroxychloroquine
- retinopathy, hair loss, photosens, tinnitus, myopathy, psychosis, seizures, cardiomyopathy
36
reduced plasma levels of mebendazole (antihelmentic) with what enzyme inducers
phenytoin, carbamazepine
37
Metronidazole (antiprotozoal) is used for what kind of infections
Anaerobic bacterial (first line), and anaerobic protozoal (ie.trichomonas)
38
Adalimumab is in what pharmacologic class
TNF alpha blocker
39
Adalimumab is used for what conditions
inflammatory diseases (RA, AS, psoriatic arthritis, Chrohn's, UC, psoriasis)
40
Adalimumab should not be given with what
live vaccines
41
Tofacitinib (JAK inhibitor) A/E
infections (20%), upper resp tract infx, H/A, diarrhea, nasopharyngitis, UTI, HTN (rarely)
42
Cyclosporine class
polypeptide Abx
43
clinical use of Cyclosporine
- transplants - psoriasis - RA
44
A/E of Cyclosporine
- Nephrotoxicity - increased tremor - HTN, HA, hyperlipids, hyperplasia of gums, hirsutism
45
drugs that increase concentration of Cyclosporine
- CCBs, - antifungals - antibiotics - glucocorticoids
46
triamcinolone (steroid for RA, MS, other inflamm conditions) is contraindicated in what conditions
- systemic fungal infection - ITP - with live vaccines
47
Rifampin (antiTB) A/E
- red colored tears, urine, saliva, sweat | - abd pain/vomit/diarrhea/hepatitis
48
Rifampin induces CYP and reduces levels of what drugs
warfarin, steroids, opioids, phenytoin, verapamil, reduces efficacy of OCPs
49
agents that increase effects of warfarin by inhibiting platelets
cephalosporins, NSAIDs, penicillin, salicylates, onions, garlic, ginger, ginkgo
50
drugs that increase warfarins effects
- acetaminophin - androgens - beta blockers - steroids - omeprazole - phenytoin
51
what drug may increase A/E of pentoxifylline (used for Tx of PAD)
Ciprofloxacin
52
what commonly used drug increases phenytoin levels
aspirin
53
Estradiol may enhance effects of what drugs
hydrocortisone and prednisolone
54
DHEA must be monitored closely when taking with what drugs
amiodarone, atorvastatin, buspirone, cortisone, diazepam, warfarin
55
conjugated estrogens are metabolized partially by CYP 3A4, thus what inhibitors of CYP3A4 may increase concentration of estrogen (increasing A/Es)
erythromycin, grapefruit juice
56
Herb interactions with prochlorperazine
Angelica and hypericum increase photosensitivity, kava increases dystonia
57
sucralfate (pepsin inhibitor/GI protectant) requires an acidic environment for activation, thus should not be taken with
antacids, H2 blockers, PPIs
58
esomeprazole (PPI) level may be increased with what drug
amoxicillin
59
esomeprazole increases levels of what drugs
diazepam, phenytoin, warfarin
60
Loperamide has an additive effect with which herbs
CNS depressants (kava, chamomile, valerian)
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