Archive for the ‘Pharmacology’ Category

ACE inhibitor contraindications

October 20, 2013

PARK

  • Pregnancy – teratogenic
  • Allergy
  • Renal artery stenosis (caution in renal failure especially if creatinine >200umol/L)
  • Kalaemia – hyperkalaemia, also hyponatraemia or hypotension/hypovolaemia
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Contraindications to warfarin with AF

April 14, 2013

AF Bleeds Horrendously

  • Adherence poor
  • Falls history/risk
  • Bleeding/coagulation disorders
  • Hypertension (+ warfarin = brain haemorrhage)

Contraindications to NSAIDS

October 23, 2012

BARS

  • Bleeding (peri-op, coagulopathy)
  • Asthma (10% of asthmatics are sensitive to non-steroidals)
  • Renal disease (hypovolaemia)
  • Stomach (peptic ulcer or gastritis). ┬áCan prescribe PPI for gastro-protection

Drug-induced chronic liver disease

January 25, 2012

MAD CV

  • Methotrexate
  • Amiodarone
  • Diclofenac
  • Chlorambucil
  • Valproate

Antiarrhythmic medication – Vaughan William’s classification

January 22, 2012

Some Block Potassium Channels

  • Sodium (class I) e.g.:
    • Ia – quinidine
    • Ib – lignocaine/lidocaine
    • Ic – flecanide
  • Beta-blockers (class II) e.g. propranolol
  • Potassium (class III) e.g. amiodarone
  • Calcium (class IV) e.g. verapamil, diltiazem

Chemotherapy side-effects

January 7, 2012

MAIN

  • Myelosuppression (bone marrow suppression)
  • Alopecia
  • Infection risk increased
  • Nausea

Toxin-induced neurological change causes

December 19, 2011

OTIS CAMPBELL (The town drunk in The Andy Griffith Show)

  • Oral hypoglycaemics / Organophosphates
  • Tricyclic antidepressants, Theophylline
  • Isoniazid, Insulin
  • Salicylates
  • Cocaine, Carbon monoxide
  • Amphetamines, Anticholinergics
  • Methyl xanthines
  • Pesticides, Propoxyphene, PCP
  • Benzodiazepine withdrawal
  • Ethanol withdrawal
  • Lead, Lithium
  • Lidocaine, Lindane

Sodium valproate side-effects

December 17, 2011

VALPROATE

  • Valproate
  • Appetite increase, so weight gain
  • Liver failure (monitor LFTs during 1st 6 months)
  • Pancreatitis
  • Reversible hair loss (grows back curly, apparently)
  • Oedema
  • Ataxia
  • Teratogenicity, Tremor, Thrombocytopaenia
  • Encephalopathy (due to hyperammonaemia) / Enzyme inducer

Aspirin contraindications

November 18, 2011

ABCD’s LUv TV

  • Allergy
  • Bleeding – gastrointestinal or intracranial
  • Children under 12 – risk of Reye’s syndrome
  • Disorders of bleeding – including haemophilia
  • Liver disease
  • Ulcerations e.g. peptic

For further information see SIGN guidelines here.

Enzyme inhibitors

November 6, 2011

ODE VICES

  • Omeprazole
  • Diltiazem
  • Erythromycin
  • Valproate / Verapamil
  • Isoniazid
  • Chlorpromazine/Cimetidine/Ciprofloxacin
  • Ethanol (acutely)
  • SSRIs
    • Paroxetine, fluoxetine, bupropion and duloxetine are strong CYPD6 inhibitors