Podcast
Questions and Answers
Why is it important to consider drug-drug interactions when prescribing medications like Ciprofloxacin?
Why is it important to consider drug-drug interactions when prescribing medications like Ciprofloxacin?
- They primarily affect the color and texture of medications, which may cause patient confusion.
- They only affect the speed at which drugs are administered intravenously.
- They can potentially alter the absorption, distribution, metabolism, or excretion of one or both drugs, leading to decreased therapeutic effect or increased toxicity. (correct)
- They always lead to increased drug efficacy, enhancing the intended therapeutic effect.
A patient is prescribed both levofloxacin and ferrous sulfate. What is the recommended administration guideline to minimize potential drug interactions?
A patient is prescribed both levofloxacin and ferrous sulfate. What is the recommended administration guideline to minimize potential drug interactions?
- No special administration guidelines are necessary as these drugs do not interact.
- Administer ferrous sulfate 4 hours before levofloxacin to maximize iron absorption.
- Administer levofloxacin 2 hours before or 2 hours after ferrous sulfate to avoid decreased levofloxacin effects. (correct)
- Administer levofloxacin and ferrous sulfate simultaneously to enhance absorption.
What is the primary concern when linezolid is administered to a patient already taking tramadol?
What is the primary concern when linezolid is administered to a patient already taking tramadol?
- Increased risk of serotonin syndrome, respiratory depression, seizures and severe hyponatremia. (correct)
- Elevated liver enzyme levels.
- Increased risk of gastrointestinal bleeding.
- Decreased efficacy of tramadol for pain management.
Which of the following antimicrobial agents is classified as a restricted antimicrobial?
Which of the following antimicrobial agents is classified as a restricted antimicrobial?
Why would aluminum/magnesium hydroxide (antacids) be administered with caution to a patient prescribed cefuroxime axetil?
Why would aluminum/magnesium hydroxide (antacids) be administered with caution to a patient prescribed cefuroxime axetil?
A patient is taking colchicine and starts atorvastatin for hyperlipidemia. What potential risk should the healthcare provider be most concerned about?
A patient is taking colchicine and starts atorvastatin for hyperlipidemia. What potential risk should the healthcare provider be most concerned about?
A patient is prescribed Ciprofloxacin and Dexamethasone concurrently. What is the primary risk associated with this drug combination?
A patient is prescribed Ciprofloxacin and Dexamethasone concurrently. What is the primary risk associated with this drug combination?
Which of the following drug combinations necessitates caution due to an increased risk of hyperkalemia?
Which of the following drug combinations necessitates caution due to an increased risk of hyperkalemia?
Why might the concurrent use of ketorolac and celecoxib be a concern?
Why might the concurrent use of ketorolac and celecoxib be a concern?
What is the likely outcome of combining omeprazole and clopidogrel?
What is the likely outcome of combining omeprazole and clopidogrel?
Flashcards
Restricted Antimicrobials
Restricted Antimicrobials
Antimicrobials with restricted use to control resistance and ensure appropriate usage.
Monitored Antimicrobials
Monitored Antimicrobials
Antimicrobials that require close monitoring due to their potential for causing significant side effects or interactions.
Levetiracetam + Tramadol
Levetiracetam + Tramadol
Levetiracetam and tramadol can cause additive sedation and slowed breathing.
Ciprofloxacin + Calcium carbonate
Ciprofloxacin + Calcium carbonate
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Cefuroxime + Aluminum/Magnesium hydroxide
Cefuroxime + Aluminum/Magnesium hydroxide
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Linezolid + Tramadol
Linezolid + Tramadol
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Levofloxacin + Ferrous sulfate
Levofloxacin + Ferrous sulfate
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Levofloxacin + Insulin glargine
Levofloxacin + Insulin glargine
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Study Notes
- Restricted antimicrobials are a list of medications with restricted use
- Monitored antimicrobials are a list of medications that require monitoring
Restricted Antimicrobials
- IV antifungals (excluding Fluconazole): Amphotericin B (Amphotret) and Voriconazole (Vfend)
- Aztreonam (Santron, Aztram) is a restricted antimicrobial
- All Carbapenems: Ertapenem (Ertapen, Invanz), Imipenem + Cilastatin (Vexpinem, Tienam), and Meropenem (Carmepem, Ecopenem, Meromax, Meronem, Merop, Ero-S, Merrox, Meropevex, Merosan, Merozan, Natronem)
- All 4th generation Cephalosporins: Cefepime (Axera, Cefevex, Cepefil, Supime)
- Colistin (Colisan)
- IV and PO Linezolid (Zyvox, Linzowel, Linelid)
- Vancomycin (Vancotan, Vancojor, Eurovan, Vancolom, MERSA, Hospira Vancomycin)
- All 3rd generation Cephalosporins with Combination: Ceftazidime, Avibactam (Zavicefta) and Ceftriaxone, Sulbactam (Zeftrax-S, Trilactam)
Monitored Antimicrobials
- All aminoglycosides: Amikacin (Nica, Cocine, Amikacide), Streptomycin, Gentamicin (Adelanin, Gentacare, Gentam, Rocygen, Maxigen), Tobramycin (Tobrex), and Streptomycin.
- All Fluoroquinolones: Ciprofloxacin (Ciprobay, Zalvos, Xipro, Cipronat), Moxifloxacin (Avelox), and Levofloxacin (Levox, Celevo, Floxel, Levocin, Levonat, Omnivox)
- Gemifloxacin
- All 3rd generation Cephalosporins: Cefotaxime (Cefotax, Pantaxin, Ximvex), Ceftriaxone (Ceftriabas, Ceftriovinn, Ceftripen, Forgram, Keptrix, Triavex, Xtenda), Ceftazidime (Ceftamedz, Tazivex), Cefixime (Fixbact, Ultraxime, Tergecef, Penxime), and Cefpodoxime (Swich)
- Clindamycin (Dalacin C, Clindal, Tidact, Clinsea, Klindex, Peldacyn)
Drug-Drug Interactions
- Levetiracetam + Tramadol leads to increased sedation
- Ciprofloxacin + Calcium carbonate results in decreased ciprofloxacin effects due to chelation, administer ciprofloxacin 2 hrs before or 6 hrs after CaCO3
- Cefuroxime Axetil + Aluminum/Magnesium hydroxide results in decreased effects of cefuroxime due to lowered absorption at lower gastric pH, administer cefuroxime 1 hr before or 2 hrs after AlOH.
- Linezolid + Tramadol increases the risk of resp. depression, seizures, severe hyponatremia (additive effects on inhibiting MAO), and serotonin syndrome and is contraindicated within 14 days of use.
- Levofloxacin + Ferrous sulfate results in decreased levofloxacin effects due to chelation, administer levofloxacin 2 hrs before or 2 hrs after ferrous sulfate
- Levofloxacin + Insulin glargine increases risk for hyperglycemia and less frequently, hypoglycemia
- Levofloxacin + Betamethasone increases risk for tendonitis and tendon rupture
- Gabapentin + Pregabalin increases risk of profound CNS and resp. Depression and additive effects: psychomotor impairment
- Colchicine + Atorvastatin increases colchicine levels which can lead to myopathy and rhabdomyolysis.
- Colchicine + Atorvastatin is contraindicated for patients with hepatic or renal impairment, reduce colchicine dose on and after 14 days of atorvastatin use
- Ciprofloxacin + Tramadol increases risk of CNS and resp. depression, psychomotor impairment, seizures, cardiac arrhythmias, and QT prolongation
- Colchicine + Azithromycin increases risk of damages in muscles, blood cells, nervous system and other organs.
- Colchicine + Atorvastatin increases risk of damages in muscles and kidneys
- Captopril + Valsartan increases risk of low blood pressure, kidney impairment and hyperkalemia
- Tramadol + Metoclopramide increases risk of seizures
- Clopidogrel + Rosuvastatin increases risk of liver damage and rhabdomyolysis due to high rosuvastatin levels
- Ketorolac + Celecoxib increases risk of Gl inflammation, bleeding, ulceration and rarely, perforation
- Omeprazole + Clopidogrel decreases effects of clopidogrel in preventing heart attack or stroke
- Enoxaparin + Aspirin increases risk of bleeding in the GI
- Enoxaparin + Clopidogrel increases risk of bleeding and hemorrhage
- Nalbuphine + Tramadol increases risk of seizure.
- Epinephrine + Sevoflurane increases risk of chest tightness, irregular heartbeat, blurred vision, nausea and seizures as it affects the rhythm of your heart.
- Potassium chloride + Spironolactone + Valsartan increases risk of hyperkalemia
- Potassium chloride + Losartan increases risk of hyperkalemia
- Ciprofloxacin + Dexamethasone increases risk of tendonitis and tendon rupture
- Potassium chloride + Olanzapine increases irritant effects of potassium chloride in the stomach and upper intestine
- Potassium chloride + Diphenhydramine increases risk of ulcers, bleeding, and other GI injury
- Potassium chloride + Telmisartan increases risk of hyperkalemia
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