Drug Interactions and Adverse Effects Flashcards
6 cards from real Pharm.D. Doctor of Pharmacy practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Drug Interactions and Adverse Effects flashcards as text
Which drug interaction requires INR monitoring when a statin is added to a stable warfarin regimen?
Answer: Rosuvastatin and warfarin (some warfarin level increase reported)
Rosuvastatin has been reported to increase warfarin levels and INR, likely through OATP inhibition and minor CYP2C9 effects, requiring INR monitoring when initiated.
Myopathy and rhabdomyolysis risk is highest when simvastatin 80 mg is combined with:
Answer: Amiodarone (CYP3A4 inhibitor)
Amiodarone inhibits CYP3A4, significantly increasing simvastatin plasma levels and dramatically raising the risk of simvastatin-induced myopathy and rhabdomyolysis.
Which adverse effect of fluoroquinolones prompted an FDA Black Box Warning added in 2016?
Answer: Disabling and potentially irreversible serious adverse effects including tendinitis, peripheral neuropathy, and CNS effects
In 2016, the FDA strengthened the Black Box Warning for systemic fluoroquinolones to highlight the risk of disabling and potentially permanent adverse effects including tendinitis, tendon rupture, peripheral neuropathy, and CNS reactions.
A patient on ACE inhibitor therapy develops a dry, persistent cough. What is the pharmacological mechanism?
Answer: ACE inhibitor-mediated accumulation of bradykinin in the lungs stimulates cough reflex
ACE inhibitors block the degradation of bradykinin, which accumulates in the lungs and stimulates airway sensory nerves, causing a persistent dry cough in up to 15% of patients.
Disulfiram-like reaction occurs when alcohol is consumed with which antibiotic?
Answer: Metronidazole
Metronidazole inhibits aldehyde dehydrogenase, causing accumulation of acetaldehyde when alcohol is consumed, producing flushing, nausea, palpitations, and headache.
Stevens-Johnson syndrome (SJS) is most commonly associated with which drug category?
Answer: Antiepileptic drugs (especially aromatic ones like carbamazepine, phenytoin, lamotrigine)
Aromatic antiepileptic drugs, especially carbamazepine, phenytoin, and lamotrigine, are among the most common causes of Stevens-Johnson syndrome, a severe mucocutaneous reaction.