Drug Interactions and Safety Flashcards

What is the DRESS syndrome and which medications commonly cause it?

Answer: Drug Reaction with Eosinophilia and Systemic Symptoms — a severe reaction caused by anticonvulsants, allopurinol, or antibiotics occurring 2-8 weeks after starting

DRESS is a severe, potentially fatal drug reaction presenting with rash, fever, eosinophilia, and organ involvement, commonly caused by carbamazepine, phenytoin, allopurinol, and sulfonamides, with delayed onset of 2-8 weeks.

What is the significance of therapeutic drug monitoring (TDM) in DHA pharmacy practice?

Answer: Monitoring blood levels of narrow therapeutic index drugs (vancomycin, aminoglycosides, lithium, digoxin) to ensure efficacy and prevent toxicity

TDM is essential for drugs with narrow therapeutic indices where the difference between effective and toxic levels is small, including vancomycin, aminoglycosides, lithium, digoxin, and phenytoin.

How should DHA pharmacists manage drug allergies versus drug intolerances?

Answer: True allergies involve immune-mediated reactions (anaphylaxis risk) requiring avoidance, while intolerances cause non-immune side effects that may be manageable

DHA pharmacists must distinguish true drug allergies (immune-mediated, potentially life-threatening) from intolerances (non-immune, dose-dependent side effects), as management differs significantly — avoidance versus symptom management.

What is the pharmacist's responsibility regarding medication safety alerts and Dear Healthcare Professional Communications (DHPCs)?

Answer: Review all safety alerts promptly, implement required changes in practice, communicate to relevant staff, and update patient counseling accordingly

DHA pharmacists must promptly review all medication safety alerts and DHPCs, implement required practice changes (new warnings, dosing changes, restrictions), communicate to staff, and update patient counseling.

What are the risks of abrupt discontinuation of certain medications that DHA pharmacists should counsel about?

Answer: Beta-blockers (rebound hypertension), benzodiazepines (seizures), SSRIs (discontinuation syndrome), and corticosteroids (adrenal crisis) require gradual tapering

DHA pharmacists must counsel patients about medications requiring gradual tapering: beta-blockers (rebound hypertension/angina), benzodiazepines (seizures), SSRIs (discontinuation syndrome), and corticosteroids (adrenal insufficiency).

What pregnancy medication safety categories should DHA pharmacists apply?

Answer: Apply risk-benefit assessment using current evidence, avoid known teratogens (isotretinoin, warfarin, methotrexate), and counsel on safer alternatives

DHA pharmacists must evaluate medication safety in pregnancy using current evidence, identify teratogenic drugs (isotretinoin, warfarin, methotrexate, ACE inhibitors), recommend safer alternatives, and counsel on timing of exposure risks.