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What class of medication can cause tooth discoloration, deposits on bones, and bone growth restriction?
- ✔✔Tetracycline antibiotics
What are the risks to a postpartum mother and newborn if the mother is an ultra-rapid metabolizer
taking codeine? - ✔✔opioid toxicity
*in ultrarapid metabolizers, there may be an increase in morphine from codeine, resulting in opioid
toxicity.
Combined oral contraceptives increase blood levels of _____________________,
_____________________, _______________, and ________________. - ✔✔theophylline
valium
TCA's
Lithium
Grapefruit juice is a CYP450 ____________, and leads to ______________ pharmacologic effect of drugs.
- ✔✔inhibitor
increased
What electrolyte do you need to monitor while a patient is taking Drospirenone (COC)? - ✔✔Potassium
It also interacts with other K+ sparing drugs, causing hyperkalemia (ACEi, ARBs, K+ sparin diuretics,
NSAIDs)
Iron supplementation is contraindicated in whom? - ✔✔children <6 years
overdose is fatal
,What are the risks to a pregnant woman who takes an NSAID? (2 listed) - ✔✔Hypertension
bleeding at delivery
What are the risks to a fetus if the mother takes an NSAID? (2 listed) - ✔✔premature closure of DA
may cause GI bleeds
Probiotic use is contraindicated in whom? - ✔✔immunocompromised individuals
What fatal rhythm is the risk when taking a medication that causes a QT prolongation? - ✔✔torsades
T/F: A 30-year old woman with hyperlipidemia can safely continue to take her statin when pregnant. -
✔✔False
*Statins are teratogenic in pregnancy
Excessive intake of what vitamin is teratogenic in pregnancy? - ✔✔Vitamin A/Retinoic Acid
What is the black box warning for fluoroquinolones? - ✔✔tendon rupture
fluoroquinolones should not be prescribed for patients with peripheral atherosclerotic vascular disease,
HTN, Marfan's syndrome and the elderly d/t the increased risk of what? - ✔✔aortic aneurysm
Clarithromycin (Biaxin) should not be taken with what two HMG-CoA reductase inhibitors (statins)? -
✔✔lovastatin
simvastatin
Live vaccines are contraindicated in ___________, children <______ years old, and
_____________________ individuals. - ✔✔pregnancy
children <12 years old
immunocompromised
,Clients at high risk for low B6 (HIV, DM, RF, Alcoholics, pregnant/lactating women) should take
supplemental vitamin B6 when taking what drug? - ✔✔Isoniazid (INH)
* also need backup contraceptive while using INH
When taking Isoniazid (INH), patients at risk of what vitamin deficiency should supplement with it? -
✔✔B6
* also need backup contraceptive while using INH
Why is Macrobid contraindicated in the third trimester and during labor? - ✔✔Can cause hemolytic
anemia of the newborn
T/F: Macrolides "mycins" can cause QT prolongation. - ✔✔True
Clients taking metronidazole (Flagyl) must be cautioned to avoid ___________ during treatment and for
24-48 hours after the last dose. - ✔✔alcohol (includes cough syrup and alcohol based herbals)
taking oral antifungals during pregnancy can cause what? - ✔✔congenital anomalies
Use of Sulfonamides during pregnancy can lead to what 4 adverse effects to the fetus? -
✔✔cardiovascular defects
oral cleft defects
hyperbilirubinemia
kernicterus
Use of Trimethoprim-Sulfamethoxazole (TMP-SMX) is contraindicated when using what two classes of
anti-hypertensives? Why? - ✔✔ACEi
ARBs
, increased risk of hyperkalemia and sudden cardiac death (especially in elderly or pt's with kidney
disease)
Trimethoprim-sulfamethoxazole (TMP-SMX) use is associated with what electrolyte deficiency when
used alone? - ✔✔Hypokalemia
What class of antibiotics is associated with bilateral hearing loss that is reversible in 24 hours-2 weeks? -
✔✔Sulfonamides
Bismuth Subsalicylate (Pepto-Bismol) contains _________________ and is contraindicated in
_____________, _______________, and ________________. - ✔✔aspirin
pregnancy, lactation, children <12 years
*can cause Reye's Syndrome
Cimetidine (Tagamet) can cause what two issues for men? - ✔✔gynecomastia
impotence
What is the black box warning for Metoclopramide (Reglan)? - ✔✔tardive dyskinesia with chronic use
*do not use >12 weeks if possible
Use of PPI's can cause deficiencies in what 3 vitamins? - ✔✔B12
calcium
magnesium
Chronic use of ________ can increase the risk of fractures and cause hyperplasia of the stomach lining
(pre-condition of gastric carcinoid). - ✔✔PPI's
What is the black box warning for Promethazine (antiemetic)? - ✔✔fatal respiratory depression in
children