Questions and Answers
What is the main caution for Hydrocodone/APAP?
What should be checked for patients taking Atorvastatin?
Levothyroxine can cause rapid increases in metabolic rate and cardiac output.
True
What is a risk associated with Lisinopril?
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What adjustment is required for Amoxicillin in patients?
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Do not exceed ___ mg/day of Esomeprazole in severe hepatic impairment.
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Clopidogrel can be used safely in patients with bleeding disorders.
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What caution should be noted for Metoprolol Tartrate?
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Montelukast is not indicated to treat or reverse current asthmatic attacks or bronchospasms. What is its only use?
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What risk does Escitalopram increase in young adults?
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What should be monitored during the initial use of the Albuterol Inhaler?
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Study Notes
Hydrocodone/APAP
- Exercise caution in patients with a history of drug or alcohol abuse; prolonged use may lead to physical and psychological dependency.
Atorvastatin
- Associated with a dose-related risk of myopathy, heightened by concurrent 3A4 inhibitors, fibric acid derivatives (e.g., gemfibrozil), or niacin (>1 g/day).
- Elderly patients are at an increased risk of myopathy; monitor CPK levels in case of unexplained muscle soreness and discontinue if CPK exceeds 10 times the upper limit of normal.
- Rhabdomyolysis may lead to acute renal failure if not managed.
- Baseline LFTs required, with rechecking at 3 weeks and semiannually. Discontinue if LFTs increase to >3 times the upper limit of normal.
Levothyroxine
- Can rapidly increase metabolic rate and cardiac output, which may result in angina, myocardial infarction, congestive heart failure, arrhythmias, or sudden cardiac death.
Lisinopril
- Black Box Warning for pregnancy; drugs affecting the angiotensin system can cause fetal injury or death in the 2nd or 3rd trimester.
- Risk of angioedema is present at any time during therapy, particularly in African American patients.
- Occasional chronic cough due to bradykinin buildup; dry and unproductive cough typically resolves after a month once discontinued.
- Use caution due to potential hyperkalemia, especially in renal dysfunction, diabetes, or potassium-sparing diuretics. Discontinue if serum creatinine increases by >35% from baseline.
- Hypotension risk is greater during initial therapy, particularly in volume-depleted patients.
Amoxicillin
- Requires dosage adjustment in patients with renal impairment.
Esomeprazole
- Maximum recommended dose is 20 mg/day for patients with severe hepatic impairment.
Clopidogrel
- Caution advised for patients with bleeding disorders or who are at increased risk of bleeding.
- Use cautiously in individuals with severe renal or hepatic impairment.
Metoprolol Tartrate
- Beta-blockers can induce hypotension and may worsen bronchospastic conditions like asthma.
- Can mask hypoglycemia symptoms; sweating remains the only unmasked symptom of low blood sugar.
Montelukast
- Not suitable for treating bronchoconstriction caused by Aspirin/NSAID hypersensitivity.
- Not for treating acute asthmatic attacks; effective only as maintenance therapy.
Escitalopram
- Black Box Warning for suicidal ideation in children, adolescents, and young adults (18-24 years) with major depressive disorder or other psychiatric conditions; increased energy may precede mood improvement, heightening suicide risk.
- Not approved for bipolar disorder; risk of inducing mania in susceptible patients.
- Can inhibit platelet aggregation, raising bleeding risk, particularly for patients on NSAIDs or anticoagulants.
- Risk of serotonin syndrome with symptoms such as agitation, diarrhea, tachycardia, hallucinations, and more.
- Use cautiously in patients with a history of seizures; taper slowly to mitigate withdrawal symptoms like anxiety, headache, or seizures.
Albuterol Inhaler
- Rarely, may cause paradoxical bronchospasm if symptoms worsen after use.
- Monitor for immediate hypersensitivity reactions upon initial use.
- Caution is advised for patients with a seizure history or cardiovascular issues (hypertension or heart failure).
- May elevate serum glucose levels; important for diabetic management considerations.
- Beta agonists can lower serum potassium levels; use with caution in patients at risk for hypokalemia.
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Description
Test your knowledge on important black box warnings and precautions regarding various medications, including Hydrocodone/APAP and Atorvastatin. This quiz highlights critical safety information that is essential for healthcare professionals.