| Alendronic Acid:
-Pathophysiology
-Indicagtion
-Interactions
-Couselling
-Side Effects | -Absorbed onto hydroxyappetite crystals in bone (slows rare of growth and dissolution)--> reduced bone turnover.
- prophylaxis (long term/repeated streoid use)/ Long term established osteoporosis
-Big molecule and chelatged with food and other drugs (struggles to be absorbed so little of drug is used by the body)
-Take 30 mins before food, calcium and vitamin D after a different time to the drug, wiht a full glass of water sitting up right/ standing- gets to the stomach as quickly as possible to reduce risk of ulceration of oseophagus
-Osteonercorsis of jaw (dentist review), Oseophageal reactions (oesoghagitis, uclers & strictures), Osteonecrosis of the external auditory canal. |
| Alfacalcidol:
-Renal
-Colcalciferol
-Red Flag
-Monitoring | -CKD stagfe 4 & 5 (hydroxylated derivative)
-Stage 1,2 & 3 CKD, or if vitamin D deficiency and normal renal fucntion
-Nausea & vomiting (hyperkaelmia)
-Plasma calcium levels (OD/BD weekly) whenever nausea/ vomiting occur |
| Alfuzosin:
-Drug class
-BPH
-Interactions | -Alpha blocker (tamsulosin, prazosin)
-Relaxes smooth muscle- increasse in urinary flow (urinary rentention)
- Antihypertensives (dose reduction)- Decrease in blood pressure |
| Allopurinol:
-Indication
-Dose
-Side effects
-Interactions | -Long term Gout (Xanthine-oxidase inhibitor)
-100-300mg daily (2-3 weeks after attack has settled)- initial management (Nsaids/ Colchicine)- renal dose in renal impairment
-Rash (stop (mild) reintroduce- reaccurnace (Immediately stop)- Allergy
-Interacts with axiothioprine (metabolised by xanthine-oxidase)- toxcitiy of axiothiopurine. |
| Febuxostat:
-Indication
-Side effects | -alternative treatgment to chronic hyperuriceamia in gout
-Hypersensitity (SJS)- rare (first month)- MORE LIKELY if rash wit allopurinol |
| Amiodarone:
-Indication
-Initiation
-dose
-side effects | -Treatment of arrthymias
-under specilist: long half life (Losing dose)-- to get to steady state, stop (can still have sid effects and have interactions with other drugs)
-200mg TDS For one week then reduced to 200 BD for 1 week and then maintenence 200 OD
-Corneal microdeposits (reverisble)- NEED TO have an annual eye checkup
-phototoxic reactions (skin is sensitive to the light)-skin discolouration- shield skin from light during during and several months after
-hypo/hyper thyroidism (monitor TFTs)
-SOB (suspect pneumonitis)
-Hepatotoxcitie- raised transaminases (LFTs) |
| Amitripylline:
-Class
-Side effects
-Overdose
-Indications | -Tricyclic antidepressant
-Antimuscarinic (sedation, dry mouth, blurred vission)- rare glaucoma- angle closure
-Constipation & Urinary retention
-Overdose (narrow dose window)- toxcitiy cardiovascular effects
-Antidepressant- not recomended
-Migrain prophylasix- not licnesed
-Neuropathic pain (specialist)- still quiried (unlicnesed) |
| Amlodipine:
-Class
-indication
-Pathopsiology
-CCB
-Interactions
-rate limiting CCB | -Dihydropyrimidine CCB
-hypertension & propjhylaxis of angina
-it relaxes smooth muscle & dilates coronary and peripheral artieries which reduces blood pressure
-main difference: dihydro has more influence on the vessles and less on the myocardium
-Grapefruit juice; PLASMA CONC: felodipine, nifedipine and verapamil
-Ankle swelling in higher amlodipine doses (dont go over 4mg)
-amlodipine- increase expo to statins- adjust dose
-verapamil & diltiazem (negative inotopic effect- supresses heart function) avoided in heart failure
-interactions with B-BLOCKER (verapimil) |
| Amoxicillin:
-Class
-Allergies | -broad spectrum antibiotic
-always check allergy status (rash and anaphylasis)
-atopic (asthma/ excema/hayfever)- hight risk of naphylasis
-one penecillin allergy
-allergy/ sensitivity penecillins (most likely have a reaction to cephakosporins) |
| Apixaban:
-Class
-Side effects
-Monitoring
-Factors affecting dose | - Anticoagulant (DOAC)
- Increased bleeding risk
- No regular INR monitoring required
-Must monitor: general compliance- short half life (if stopped for a few days, they are no longer anticoagulated), any problematic signs/symptoms, age, weight & renal function (CrCl)
- Dosing depends on renal function (must use Creatinine clereance & not eGFR)
-Dose is reduced if 2 of the following 3 apply: (serum creatinine >133micromol/litre, age>80, body weight <60kg) |
| Aripiprazole:
-Class
-Side effects
-Interactions
-Dispencing
-Monitoring | -Antipsychotic (secondary)
-Cardiovascular (BP)
-Thromboembolism
-QT prolongation
-Neuroleptic Malignant Syndrome
-weight gain
-diabetes
-Increased VTE risk
-Shouldnt be given to people with dementia related conditons (cause strokes & increase motality)
-Metabolised by CYP450
-depo and acute injeciton dose (confirm correct dispenced) 7.5 mg (acute)/ 400mg (depot)
-monitor blood concentration with sings of toxciity/given with medication which may increase concentration |
| Aspirin:
-Analgesic
-Indication
-Dose
-CVD
-GI bleed risk | -Not now used as an analgesic- high bleed risk
-Secondary prevention of cardiovascular events
-Usually 75mg OD
-If they are hypertensive- is a risk facotr for CVD
-If they have angina/MI/stroke/PVD- they have established CVD --> would give aspirin 75mg daily
-If they are at a high risk of GI bleed --> can add a maintenance dose of PPI |
| Atenolol:
-Pathopsyiology
-Indications
-Avoided
-Side effects | -B- blocker, act in the heart, peripheral vaculature, bronchi, pancreus & liver
-Hypertension (not 1/2/3rd line), angina, post MI, Arrhythmias, Heart failure
-In patients with a history of asthma & bronchospasm
-respiratory disease, fatigue (reduction of pulse & rate), Coldness of extramities
-Cross BBB- sleep distubances & nightmares |
| Azathioprine:
-Class
-Uses
-Side effects
-TPMT | -Immmunosupressant- DMARD
-Used in IBS, autoimmune conditions, transplant patients
-Can cause bone marrow supression, neutropenia
-TPMT enzyme metabolises azathiopurine
-Need to determine if they are fast/intermediate/slow TPMT metaboliser of azathioprine
-In TPMT deficiency (reduced activity)- more likely to have neutropenia + azathioprine toxicity |
| Azithromycin:
-Class
-Indication
-Side Effects
-Interations
-Dispencing | -Macrolide (antibiotic)
-Twice Weekly prophylaxis of COPD
-Greater risk to those with a predisposition to QT interval prolongation
-Gastrointestinal disorders
-Reversible hearing loss ( long course)
-Inhibitor of CYP450
-Look Alike, Sound Alike (Azathioprine // Azithromycin) |
| Candesartan:
-Class
-Difference betwene ACEI & ARB
-Indication | -ARB
-Unlike ACEI they dont inhibit the breakdown of bradykinin- unlikley to cause a dry cough
- All licensed for hypertension |
| Citalopram:
-Class (other examples)
-How they differ from TCA (tricyclic antidepressants)
-Side effects
-Dose
-Couselling | -SSRI selecitve serotonin reuptake inhibitor (Escitalopram, fluoxetine & sertraline)- effective when prescribed other medications
-Less sedative and fewer antimuscarinic & CV side effects than TCAs
-GI side effects
-QT interval prolongation (citalopram & escitalopram)- dose dependent
(ECG measurements with those with cardiac disease & electrolyte disturbances- corrected before starting treamtent.
-40mg for adults
-20mg for patients older than 65
-20mg for those with hepatic impairment
-Discuss exspectations with patient (2-4 weeks to start to feel effect)
-Available support
-Not Addictive but slow withdrawal |
| Clarithromycin:
-Class
-Interactions | -Macrolide
-Increases the exposure of statins
-Macrolides have significant interactions with statins- can cause renal failure
-Has lots of significant interactions due to QT prolongation and CYP3A4 inhibition |
| Clindamycin:
-Class
-Indication
-Excreted
-Antibiotic-associated colitis
-Diarrhoea | -lincomycin antibiotics
-Active against gram positive cocci (streptococci & penicillin-resistant staphylococci) & anaerorobes (bacteroids fragilis)
-Bile & Urine
-Can be fatal (Suspected/confirmed C.diff infectio- discontinue the antibiotic if appropriate & seek specalist advice if antiobitc cannot be stopped & expiriencing severe diarrhoea)
- Can progress to highly severe |
| Clopidogrel:
-Class
-Indication
-Interactions | -Antiplatelet
-Secondary prevention of CVD
-Usually given 2nd line (aspirin first) except when secondary prevention of stroke/TIA
-Also used in duel antiplatelet therpay post MI/ACS
-Interacts with omeprazole/esomeprazole
-Clopidogrel is a prodrug & omeprazole/esoomeprazole prevents the conversion of clopidogrel to its active formm
-Trials suggest this may reduce its antiplatelet effect & increase risk of cardiovascular events |
| Clozapine:
-Class
-Indication
-Dose
-Side Effects
-Interactions | -Antipsychotic (2nd gen)
-Used in schizophrenia in patients unresponsive to or intolerant of conventional antipsychotic drugs
-Dose adjustments may be necessary if smoking stopped or started during treamtent (Tobacco is a CYP450 inducer- speeds up metabolism)- increased theophylline toxcitiy (copd)
-Missed 48 hrs (condition can detiorate) need to re-titrate dose
-Agranulocytosis (specalist monitoring services)
-Intestinal obstruction
-Constipation
-Avoid concomitant use of clozapine with drugs which cause agranulosytosis & constipation |
| Codeine Phosphate:
-Class
-Prodrug
-Side effects
-Risks
-8/500 co-codamol | -Weak opiate
-Codeine is a prodrug- tkaing any enzyme inhibitors can make them side side effects without any analgesic effect
-Constipation, drowsiness, sedation (all enhanced in elderly)
-Risk of tolerance & dependence
-it is a sub-therapeutic dose- codeine doesnt have its full analgesic effect but will have all of its side effects & can increase risk of tolerance/ dependence |
| Co-amoxiclav:
-Side effects (increased risk/ how to reduce risk)
-Monitoring | -Cholestatic Jaundice (during or shortly after its use)
-More common in men & over 65
-Usually jaundice is self limiting
-minimum length treatment
-LFTs (raised ALP & Bilirubin) |
| Diclofenac:
-Class
-Side effects | -NSAID
-GI bleeding risk, renal toxicity, inc risk of cardiovascular events
-Cardiovascular risk is inc with COX-2 inhibitors- MHRA guidance mentions that CV risk of diclofenac is similar to that of COX-2 inhibitors.
-This doesn’t apply to topical (gel/cream) |
| Digoxin:
-Class
-Dose
-Indication
-Side effects
-Risks
-Monitoing | -Cardiac glycoside
-Dependent on age/lean body weight & renal function
-Used in heart failure & arrhythmias
-Anorexia, nausea, vomiting, diarrhoea, ab pain, headaches & confusion
-Hypokaelamia (predisposes to toxicity), higher toxicity risk in renal impairment
-Sampling for serum levels should be taken at least 6 hrs after the last dose (therapeutic range 0.5-1microgram/L)
-Heart rate, BP, ECG & K+ |
| Domperidone:
-Class
-Pathophysiology
-Problems | -Anti-emetic
-Acts at the chemoreceptor trigger zone – used for relief of nausea & vomiting
-Doesn’t cross BBB readily- alternative to metoclopramide (which does cross BBB- causes sedation + dystonic reactions)
-Known to increase risk of arrhythmias or sudden cardiac death- risk is higher in older people over 60 yrs + those who receive daily oral doses of above 30 mg
-Reduce treatment length + dose in older people
-Domperidone should be avoided in patients who are taking concomitant medication known to cause QT prolongation (such as ketoconazole and erythromycin). |
| Doxycycline:
-Risks
-Indication
-Dosing | -Tetracycline
-Easily chelates to other metabolites in stomach acid
-Photosensitivity
-Respiratory tract infections in penicillin allergic patients or those who havnt repsonded
-Stat dose first day 200mg then 100mg daily
-Should not be used in children under 12 |
| Enalapril:
-Class
-Side effects
-Renal
-Hyperkalemia
-Monitoring
-Preganancy | -ACE inhibitor
-Angioedema (swelling), may be accompanied by a rash
-Can happen at start/during treatment
-Patients that happemn to have had ACEI induced angioedema shouldnt be given this class of drug again (high risk of recurrence)
-ACEI induced angioedma is due to excessive accumlation of bradykinin
-Renal Impairment
First-Dose hypotension (especially with concomittant diuretics) could take before bed
-Hyperkaelamia
-Persisent dry cough
-Can cause renal toxcity be reno-protective
-Will exspcet a small decline in renal function/eGFR when starting ACEI
-There shouldnt be a massive decline- if there is it means it is contra-indicated
-If they have bilateral renal artery stenosis (narrowed renal arterires-usally caused by atherosclerosis), ACEI reduce/abolish glomerular filtration-likley to cause renal failure
-If they have CVD & known atherosclerosis or suspected/known renovascular disease- try to avoid ACEI in these patients |
| Enalapril- Part 2 | -Concomittant treatment with NSAIDs increased the risk of renal damage
-Angiotension II causes constriction of efferent arteriole (where blood flow comes out of the kidneys)-causes increased intraglomerular pressure → inc filtration + inc permeability (more proteinuria)
-Giving ACEi/ARB→ reduced angiotensin II→ efferent arteriole is dilated→ reduced intraglomerular pressure + proteinuria, and eGFR falls slightly – this reduction in pressure is reno-protective (in diabetes and CKD)
-BUT if there is reduced blood flow coming in afferent arteriole (blood coming into kidneys) and using ACEi allows the efferent arteriole to be dilated→ intraglomerular pressure drops significantly→ eGFR drops significantly- become nephrotoxic
-Blood flow in afferent arteriole may be reduced by: drugs/vasoconstrictors (e.g. NSAIDs), dehydration, diarrhoea, vomiting, renal artery stenosis, sepsis.
-Hyperkalaemia
-Inc risk of hyperkalaemia – avoid giving it with potassium sparing diuretics (e.g. spironolactone), K supplements and any other drugs that increase K levels (e.g. trimethoprim)
-If potassium levels are above 6.5- becomes medical emergency- could cause acute cardiac event
-Monitoring
Renal function + electrolytes should be checked before starting, any dose changes (within 7-10 days) and during treatment
may need to inc monitoring if there are any issues
-Contra-indicated in pregnancy- effect babies BP & renal func (skull defects & oligohydramnois (too little amniotic fluid) |
| Erythromycin:
-Class (others in class)
-Indication
-Side effects
-Enzyme Inhibitor
-Interactions | -Macrolide antibiotic (Azithromycin & clarithromycin)
-Alternative in peneicillin allergic patients
-Nausea, vomiting & diarrhoea
-Important drug interactions (theophylline- avoid conmitant use with simvastain- increased myopathy risk)
-Carbamazepine (macrolides can raise plasma carbamzepine levels)
-Drugs that prolong QT interval (Antiarrhythmics, antipsychotics & TCAs) Methadone
-Drugs that cause hypokaelamia (diuretics, corticosteroids & SAB2A)- hypokaelamia is a risk factor for QT interval prolongation
-Statins- increased risk of myopathy (cyp450 & cyp3a4 inhibiiton)- if clarithromycin/ erythromycin is taken with atorvastatin (avoid concurrent use with antiotibs-moderately metabolized/ simvastatin (Severely metabolised-if antibiotic cant be stopped-stop treatment with simvbastatin during course)
-Theophylline- erythromycin increased plasma concentration and theophylline can reduced absorption of oral erythromycin
-Warfarin- unpredictable- effects of warfarin may be increased by macrolides
-CCBs-amlodipine cap does of simvastatin at 20mg- increased risk of hypotension
-Antidiabetic drugs & Insulin- clarithromycin & antidiabetic drugs (SU/Isulin)- Severe risk of hypoglyceamia |
| Etoricoxib:
-Class
-Concerns/Risks
-General prescribing points
-Renal
-MHRA Guidance | -COX-2 Inhibitors
-There are general GI & Renal concerns & increased risk of CV events
-Use safest NSAID with lowest effective dose for shortest amount of time
-Naproxen (1,000 mg daily or less) and low-dose ibuprofen (1,200 mg daily or less) have the most favourable cardiovascular safety profiles of all NSAIDs
-Discuss any risks and how to mitigate them (e.g. prescribe PPI if necessary)
-Drugs that inc risk of AKI are a double whammy (NSAID + ACEi) or triple whammy (NSAID + ACEi + diuretic)
-NSAIDs can cause renal failure
-Risk factors: existing renal impairment, elderly, people with diseases or taking drugs that predisposes them to renal failure
-MHRA warning about Etoricoxib and its CV risks which increase with dose & duration- lowest effective daily dose should be used
-Etoricoxib should not be Rx to those with BP presistently above 140/90 mmHg & inadequately controlled
- BP needs to be controlled (as it increases CV risk)- before treatment |
| Ferrous Sulphate:
-Indication
-Hb Concentration
-Side effects
-Storage
-Interactions | -Iron deficiency anaemia
-Hb should rise (by 2g/100ml) & get back to normal range after 3-4 weeks, and should continue for a further 3 months to replenish iron stores
-Gi irritation is common- can cause nausea/vomiting particularly if taken on empty stomach
-Constipation- especially in elderly
-Dark stools
-Needs to be stored safely- it is a cuase of accidently overdose in children
-Can affect absorption of other meds if taken at the same time |
| Finasteride:
-Indication
-Safety point (MHRA)
-Excretion (Risk) | Benign prostate hyperplasia, alopecia in men (reduction in prostate size, with improvment in urinary flow rate)
-Can cause depression & suicidal thoughts- should be discontinued if become present- and inform healthcare professional if they develop depression
-Teratogenic (esxcreted in semen- use of a condom if sexual partner is pregnant or likely to become pregnant)
-Women shouldnt handle crushed or broken tablets
-Males- gynocomastia (report signs of changes: lumps, pain or nipple discharge) |
| Furosemide:
-Class
-Pathophysiology
-Renal
-Monitoring
-STOPP Criteria (In older people)
-Hypokaelamia
-Prostate | -Loop diuretic
-By interacting with ascending limb of the loop of henle, it inc excretion of sodium (can cause hyponatraemia- presents with confusion) + water
-Rapid onset of action (IV 5 mins, orally 1-2 hours)
-Duration of action= 4-6 hours – as they will be urinating a lot, can be problematic if they want to go out→ COUNSEL them on this
-Inc risk of renal impairment→ they reduce blood volume- reduces blood flow to the kidneys- reduces eGFR → need to monitor renal function + electrolyte abnormalities
-Need to monitor renal function, electrolytes and blood pressure (as blood vol is reduced- causes reduction in BP) regularly
-If indication unclear, it needs to be reviewed (as it may be inappropriate):
-It is NOT 1st line for hypertension (safer alternatives available)
-For hypertension with concurrent urinary incontinence- may exacerbate incontinence
For ankle oedema, but there’s no evidence of HF, liver failure, nephrotic syndrome or renal failure- safer alternatives available
-Hypokaelamia (Loop diuretics cause- dangerous in patients with CVD- or if on cariac glycosides- digoxin- toxcitiy |
| Furosemide-Part2 | If they are prone to this (and in HF patients)- give potassium sparing diuretics with loop diuretics (to avoid hypokalaemia + the need for K supplements).
Prostate
If they have enlarged prostate and take loop diuretics- can’t pass urine as freely- can cause urinary retention (painful)
Less likely if small doses or less potent diuretic used
Need to determine that they have adequate urinary output before initiating treatment |
| Gabapentin:
-Indications
-Initiation
-Safety points | -Range of indications: anti-epileptic, Neuropathic pain
-Needs to be titrated gradually
-Severe respiratory depression even without concomitant opiod medicines
-CNS depressants & elderly might have a higher risk of experiencing sevre repiratory depression & dose adjustments may be necessary in these patients
-Schedule 3 (except from Safe custody requirements)
-Abuse risk (alcohol interaction & CNS depressants- opioids) |
| Methotrexate:
-Class
-Indication
-Patient
-Dose
-Toxicitites & Monitioring
-Excretion
-NSAIDs
-Folic acid | -DMARD
- Rheumatoid arthritis, IBD, etc
-Taken once a week (take it same day every week at around same time)
- Blood toxicity- regular blood test monitoring is needed- shouldn’t dispense it if we don’t know when last monitoring was done or what the results were (need a follow-up monitoring)
– Liver toxicity- monitor LFTs
– Pulmonary toxicity- check if they have SOB (red flag)
– Monitoring should be done every 1–2 weeks initially until stable, then should be monitored every 2–3 months
-renally excreted- regularly monitor renal function
– Caution with interacting drugs that may reduce renal excretion of methotrexate (e.g. NSAIDs, diuretics, ACEi)
-DON’T sell NSAIDs to methotrexate patient- they reduce renal blood flow- reduces renal excretion of methotrexate
- They have anti-folate activity- need folic acid to reduce toxicity
– Folic acid is given once a week- take it a few days apart from the methotrexate |
| Metoclopramide:
-Class
-Side effects
-Warnings/Risks
-Licensing
-Dose | -Anti-emetic
-Can induce dystonic reactions involving facial and skeletal muscle spasms and oculogyric crises (spasms within eye muscles)
– Risk of neurological effects such as short-term extrapyramidal disorders and tardive dyskinesia
– These risks outweigh the benefits in long-term or high-dose treatment
– So minimise dose + duration of treatment
-Usual dose is 10 mg up to 3 times daily, max daily dose is 500 micrograms/kg |
| Metronidazole:
-Indication
-Pathophysiology
-Alcohol | -Anti-microbial with high activity against Anaerobic bacteria
-Has high activity against anaerobic bacteria
-When taken with alcohol: flushing, feeling sick, vomiting, headache, dizzy & palpitations (avoid alcohol during course & for 48 hours afterwards) |
| Nitrofurantoin:
-Indication
-Renal | -1st line in UTI
– Avoid if eGFR is less than 45ml/min/1.73m2
– This is because it is secreted into urinary tract- it needs to be secreted in a sufficient concentration to be effective |
| Prednisolone:
-Class
-Indication
-Side effects
-Risk
-Withdrawal | -Corticosteroids
-COPD exacerbations, IBD
-Short-term: insomnia, mood disturbances, GI disturbances
– Long-term: same as short-term and… osteoporosis, adrenal suppression, cushingoid state, diabetes, ocular effects (cataracts/glaucoma), skin changes (e.g. thinning, bruising), GI ulceration, growth retardation, hypokalaemia, fluid retention
-If on long courses/high doses- may be immunocompromised– at risk of infection
-Must be tapered down gradually if:
• >3 weeks any dose
• >40mg prednisolone (or equivalent) for more than 1 week
• Multiple recent repeated courses
• Short course within a year of stopping a long course
• Been given repeat doses in the evening
– If stopped abruptly- can cause adrenal suppression |
| Quinine Sulphate:
-Indication
-Patient counselling
-Side effects
-Prescribing
-Interactions
-Overdose | -Not routine treatment for nocturnal leg cramps- only give if necessary (weigh out risk/benefit)
- If there is no benefit after at least 4 weeks- stop using it
– DO NOT exceed the recommended dose
-Tinnitus, impaired hearing, headache, nausea, disturbed vision, confusion, flushing, and abdominal pain
– (rare) Thrombocytopenia- thought to be a hypersensitivity reaction
Need to report any signs of thrombocytopenia: unexplained petechiae rash (pinpoint, round spots), bruising, or bleeding.
-It should not be prescribed to those who have had previous side effects with quinine in drinks
-It should not be prescribed to those who have had previous side effects with quinine in drinks
-Significant interactions with digoxin and warfarin
-Significant toxicity in overdose- can result in death or permanent visual loss |
| Tramadol:
-Class
-Risk
-Seizures
-Interactions | -Moderate opiate
-Can cause tolerance + dependence
-Avoid in patients with a history of epilepsy or those susceptible to seizures
-tramadol lowers the seizure threshold
- Used with caution with medication that can lower the seizure threshold (e.g. SSRIs, TCAs)
– Has serotonergic activity- can cause serotonin syndrome if given with some antidepressants (SSRIs) |
| Trimethoprim:
-Class
-Pregnancy
-Interactions
-Blood disorder | -Anti-folate, antibiotic
-Teratogenic in pregnancy (especially in 1st trimester)
– ACEi + Trimethoprim = increased risk of hyperkalaemia
– Methotrexate + Trimethoprim (both anti-folates) = increased risk of haematological toxicity
-Can cause blood disorders- seek immediate medical attention if symptoms such as fever, sore throat, rash, mouth ulcers, purpura, bruising or bleeding develop |
| Warfarin:
-Class
-Interactions
-Monitoring
-Vitamin K | -Anticoagulant
– Has many interactions with drugs and food
– Examples: cranberry juice, pomegranate juice, alcohol, foods high in vit K, amiodarone, fluoroquinolones, metronidazole, phenytoin, omeprazole, carbamazepine, etc.
– Requires regular INR monitoring
– INR target for warfarin patients is usually between 2-3
– Interacts with vitamin K- vit K counteracts effects of warfarin + lowers INR (can be used if INR is too high) |
