Pharma Tips-198

1011. Anticonvulsants cause sedation, fatigue, affect liver enzymes, blood count and cognition effects. 
1012. Common drugs with serotonergic properties may include MAOIs (phenelzine, selegiline, tranylcypromine), tricyclic antidepressants (amitriptyline), SSRIs (fluoxetine), miscellaneous (nefazodone, trazodone, venlafaxine, bupropion, buspirone, lithium, amantadine and cocaine).
1013. A woman can breastfeed while taking warfarin.
1014. Fexofenadine levels decrease with aluminium and magnesium antacids (decrease absorption).
1015. Levocabastine, ipratropium, sodium cromoglycate, and beclomethasone each one can be used in allergic rhinitis as a nasal spray.

Pharma Tips-197

1006. Allergic rhinitis often predisposes patients to other conditions like asthma.
1007. Sulfa drugs any compound with a SO2NH2 group like sulfonamide antibiotics, furosemide, thiazide diuretics, dorzolamide, glyburide, acetazolamide, chlorpropamide, and celecoxib.
1008. Aspirin or NSAIDs can cause respiratory reaction, urticaria or angioedema.
1009. Adverse drug reactions are a common problem and 10-15% of them are allergic reactions.
1010. Beta-blockers may cause sexual dysfunction in males.


Pharma Tips-196

1001. Valproic acid causes hepatitis.
1002. Penicillins cause interstitial nephritis.
1003. Clozapine causes agranulocytosis.
1004. First-generation antihistamines should not be used in asthma because they dry up the mucus in the airways.
1005. Anaphylaxis, immediate type of hypersensitivity, type I (IgE) minutes to hours of drug exposure. 

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).