Pharma Tips-195

996. Calcium channel blockers interactions may include grapefruit juice and ketoconazole increase levels of CCBs; alcohol with CCBs may cause hypotension and increase side effects CCBs,  St. John's wort decreases levels of CCBs, beta-blockers increase the risk of bradycardia with NHP-CCBs.
997. Selective serotonin reuptake inhibitors (SSRIs) side effects may include nausea, headache, drowsiness, dizziness, constipation, diarrhoea, weakness, insomnia, dry mouth, sexual dysfunction, anorexia, weight loss and weight gain.SSRIs interactions may include alcohol, valerian, St. John's wort increase the side effects of SSRIs, ASA increases the risk of bleeding.
998. Tricyclic antidepressants (TCAs) side effects include weight gain, increase appetite, sedation, dry mouth, constipation, dizziness, drowsiness, palpitation, and nausea. TCAs interactions; alcohol increase side effects of TCAs space between them 6 hours, grapefruit increases side effects of TCAs, NSAIDs increase risk of bleeding, MAOIs may cause serotonin syndrome 1-2 weeks treatment-free period when changing between them, antiarrhythmics such as amiodarone and quinidine increase the risk of arrhythmia. 
999. Aminoglycosides may cause renal failure.
1000. Initial symptoms of hypersensitivity reaction start from 1-8 weeks after starting medication.

Pharma Tips-194

991. Fever is a predictor of a more serious drug reaction.
992. Drug challenges are more useful than the skin test.
993. Most patients who think they are allergic to penicillin are not.
994. Risk of reacting to cephalosporins in a patient with a history of penicillin allergy is less than 1%.
995. Warfarin metabolism is inhibited by Bactrim which leads to increased INR and increased risk of bleeding.

Pharma Tips-193

986. Benzodiazepines side effects may include sedation, confusion, headache, dizziness, fatigue, amnesia, constipation, urinary retention, nausea, weight gain/loss, diplopia, chest pain, nasal congestion, dry mouth, and light-headedness. 
987. Benzodiazepines interactions; for example coffee and tea decrease sedative effect, alcohol increases the sedation effect and headache of BDZs space them by 6 hours, St. John's wort increases CNS depression.
988. NSAIDs side effects may include headache, vertigo, dizziness, nervousness, tinnitus, depression, drowsiness, insomnia, epigastric pain, nausea, and constipation.
989. NSAIDs interactions for example nephrotoxicity may be increased if given with ACEIs, cyclosporin, or diuretics, alcohol and warfarin increase the risk of bleeding, NSAIDs decrease the antihypertensive effect of some antihypertensive agents, NSAIDs decrease excretion of lithium and aminoglycosides, increase lithium concentration leads to confusion, tremor, polydipsia, and polyuria.
990. Calcium-channel blockers side effects may include headache, nausea, dizziness, drowsiness, palpitation (dihydropyridines), bradycardia (non-dihydropyridines), peripheral edema (ankle edema), fatigue, and flushing.

Pharma Tips-192

981. ACE inhibitors side effects may include a dry cough, postural hypotension or hypotension could be avoided by giving the dose at bedtime or to sit down, headache, dizziness, fatigue, hyperkalemia, nausea, angioedema. 
982. Angioedema is swelling in the face, mouth, lips, tongue or throat. 
983. ACE inhibitors interactions such as alcohol, diuretics may cause hypotension with ACEIs, NSAIDs may decrease the antihypertensive effect of ACEIs, ACEIs increase lithium levels, potassium-sparing diuretics with ACEIs may cause hyperkalemia.
984. Quinolones antibiotics side effects may include nausea, stomach upset, headache, drowsiness, dizziness, insomnia, light-headedness and vomiting.
985. Quinolones antibiotics interactions such as excessive caffeine increase nervousness, the absorption of quinolones is reduced by sucralfate, antacids containing aluminium or magnesium and also by calcium, iron, and zinc salts to avoid this take it 2 hours before or 6 hours after, quinolones  elevate levels of antidiabetic agents that may cause hypoglycemia, quinolones increase statins levels causing muscle pain, quinolones enhance the effect of warfarin (risk of bleeding).  

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976. Grapefruit juice decreases the metabolism of the calcium channel blocker drugs and leads to an increase in blood levels of the drug.
977. orthostatic hypotension is feeling dizzy or lightheaded when moving from lying or sitting to standing position.
978. Neutrophils are increased in bacterial infection, monocytes also fight bacterial infection by phagocytic action. lymphocytes, T cells and B cells, are increased primarily in viral infections. Eosinophils and basophils are elevated in an allergic reaction.
979. beclomethasone is a synthetic glucocorticoid that readily penetrates the airway mucosa, used for asthma.
980. Thioridazine side effects are retinal deposits, torsades, postural hypotension, sedation, CNS depression.

Pharma Tips-190

971. Embolism is an obstruction in the vessel.
972. Stenosis is a narrowing of the blood vessel.
973. Epistaxis is bleeding from the nose.
974. Ascites is an increase of fluids in the peritoneal cavity.
975. Renal failure is the most common cause of severe hyperkalaemia.

Pharma Tips-189

966. Brown staining of the teeth frequently follows the use of chlorhexidine mouthwash, the Iron liquid can stain the enamel black.
967. All drugs should be avoided if possible during the first trimester of pregnancy.
968. Pharmacogenomics is the relation of the individual’s genetic structure to his/her response to drugs.
969. Toxicity of furosemide may cause hypovolemia, hypokalemia, orthostatic hypotension, ototoxicity, sulfonamide allergy.
970. Eplerenone (aldosterone antagonist) does not cause gynecomastia.

Pharma Tips-188

961. To lessen the pain, intramuscular injection of Penicillin into a larger gluteal muscle should be administered over 12 to 15 seconds to separate the muscle fibres more gradually.
962. Ketoconazole absorption increases by food which stimulates secretion of gastric enzymes increasing the gastric acid environment.
963. Sunscreen or sunblock applications may not prevent sunburn in clients receiving ciprofloxacin, so a patient should limit the exposure to the sun too.
964. To minimize the metallic or bitter taste of metronidazole; it should be taken with food except for Flagyl ER, which should be taken 1 hour before or 2 hours after meals.
965. "Red man syndrome" or "red neck syndrome" is the flushing of the face, neck, and upper chest associated with too rapid IV administration of vancomycin.

Pharma Tips-187

956.Tetracycline is absorbed best when given on an empty stomach with a glass of water. Food, dairy products, iron, and antacids decrease the absorption of this drug.
957.  NPH insulin is used to lower blood sugar level in diabetes; the drug's effect peaks over 4 to 12 hours and lasts 24 hours.
958. Vitamin K antagonizes Coumadin's effects; any food (such as broccoli or cabbage) or drugs that contain vitamin K decreases the effects of the drug.
959. Administration of vitamin B6 is recommended during therapy with isoniazid (INH) to reduce the incidence of peripheral neuritis, which may be associated with isoniazid.
960. Rifampin causes an orange-red discolouration of body fluids including urine, tears, sweat.

Pharma Tips-186

951. The treatment with alteplase should be initiated within 3 hours after the onset of stroke symptoms and after exclusion of intracranial haemorrhage by CT scan or any other diagnostic image method sensitive for the presence of haemorrhage.
952. Topotecan is a topoisomerase inhibitor and it can cause anaemia, neutropenia, thrombocytopenia.
953. Non-selective beta-blocking agents should be avoided in patients with diabetes type-I & asthma.
954. Heparin can be given by subcutaneous injection, intravenous infusion, or intermittent IV injection.
955. Insulin glargine (Lantus) is long-acting insulin with onsets around 1.5 hours, no peak, and duration of 20-24 hours.