Drug errors

Question 1

Why do you have to consider clearance of opiates?

Answer 1

Some are hepatically cleared and some renally

Question 2

When. should you not prescribe morphine

Answer 2

Renal failure

Question 3

Anticoagulant errors

Answer 3

• Warfarin is hepatically metabolised and has lots of interactions - clarithromycin
• Use bridging
• LMWH (longer half life - consider when pt is going into surgery and needs 18h window before spinal surgery) vs unfractionated (constant infusion, short half life)

Question 4

Methalazine and modified release

Answer 4

releases at different pH so works in different areas of bowel

Question 5

What are the shells of capsules made from?

Answer 5

Lactose

Question 6

Loperamide interactions

Answer 6

controls diarrhoea but can cause nausea - metoclopramide is a pro-kinetic which speeds gut up and is therefore inappropriate but cyclizine works in a similar manner

Question 7

CYP interactions

Answer 7

slowed down by clarithromycin and gentamicin - this In turn increases the concentration of other drugs

Question 8

Sodium valproate interactions

Answer 8

interacts with imeropenin - renders both useless because it speeds up metabolism

Question 9

erythromycin side effects

Answer 9

Long QT

Question 10

Glucosamine side effect

Answer 10

Anti-coagulant but used for joint pain