Top 200
Pesky Interactions
Risky Business
Cool Counseling Points
Fascinating Formulations
100

Outside of clindamycin (Cleocin), this drug can be used for the treatment of necrotizing fasciitis via its ability to mimic the effects of clindamycin on toxin-producing bacterial species.

What is Zyvox (linezolid)?

It is often the preferrable choice as its ADE profile is more favorable and it is available via oral route. In other words, patients can go home sooner.

100

This drug class historically interacts with P2Y12 inhibitors by decreasing the antiplatelet effect, although there is now conflicting data.

What are PPIs/proton pump inhibitors?

100

This organization determines if a REMS program is required

What is the FDA?

100

Overuse of this allergy product, available as both OTC and RX, may result in stunted growth/height in pediatric patients.

What is Flonase?

(**In the US, the RX strength is discontinued)

100

Term that describes a product that has been intentionally modified so that drug release begins sometimes after drug administration (ie, there is a lag when minimal to no drug is released)


What is "delayed release"?

Ex: mesalamine for Chrons disease

(ER- formulated so drug release is extended for a significant length of time)

200

These drugs can lead to false readings/artifact on continuous glucose monitoring devices 

What are acetaminophen (high-doses only), hydroxyurea, and vitamin C (high-doses only)?

*This is NOT an exhaustive list 

200

This substance should not be consumed while a patient is taking Flagyl (metronidazole) OR Bactrim (sulfamethoxazole/trimethoprim) due to a disulfiram reaction.

What is alcohol?

(Disclaimer- there is newer, conflicting evidence around Flagyl.)

200

The REMS program for this drug is called iPLEDGE?

Bonus- This testing be done before receiving the first rx. 

What is isotretinoin? 

What is 2 pregnancy tests, 19+ days apart?

200

This anti-arrhythmic, sometimes called 'oral lidocaine', is commonly used if a patient had at least one instance of SVT. It can be used in place of amiodarone if the patient has VENTRICULAR associated arrhythmias and the provider wishes to avoid the ADR profile of amiodarone.

What is mexiletine (Mexitil)?

200

A suspension containing a very high concentration of finely dispersed powders

What is a paste?

(high solids content gives stiffness so it doesn't easily spread)

What is rabeprazole/omeprazole?

300

This loop diuretic can be used if a patient has a sulfa allergy.

What is ethacrynic acid?

300

This supplement will falsely elevate T3 and T4 (thyroid hormones) and falsely lower TSH (thyroid stimulating hormone)

What is Biotin (vitamin B7)?

**This can lead to a false diagnosis of hyperthroidism or reduction of thyroid hormone dose

300

These are the sx that must be monitored after Spravato use per the REMs. 

What are sedation, respiratory depression, and dissociation? (intranasal esketamine)

300

Shortness of breath is a transient and common side effect of this oral antiplatelet drug.

What is Brillinta (Ticagrelor)?

--It is a common occurence with this agent and does NOT necessitate a therapeutic switch, but can be switched if the patient cannot tolerate the side effect.

300

This PO formulation bypasses the first pass effect

What is ODT?

400

ORAL amiodarone is commonly given and titrated up in divided doses due to this side effect.

What is GI intolerance?


*For oral formulations, GI side effects are much more common than CV side effects. However, IV formulations may cause hypotension if pushed too quickly.

400

This class of antibiotics can cause seizures and significantly lower valproic acid levels.

What are the carbapenems--especially meropenem?

400

This specific formulation (complete generic name) of olanzapine is under a REMS program.

What is olanzapine pamoate extended-release injection? (Zyprexa Relprevv) (post-injection delirium/sedation syndrome)

400

This neuro AE may occur if Topamax is titrated too quickly OR if the dosing is interrupted for 3+ days and the patient is restarted on the same dose.

Significant decline in executive functioning and learning ability (temporarily)


*Fun fact, on APPEs, many preceptors had the fun nickname of "Stupamax" for this drug

400

A "ghost tablet" in the stool can result from this PO formulation

What is OROS (osmotically released oral delivery system)? (ex: Procardia XL, Concerta)

500

This SSRI is preferred in patients with CV disease and is not as likely to be associated with SIADH as other SSRIs.

What is sertraline (Zoloft)?



500

This interaction occurs between ciprofloxacin and tizanidine--but does not seem to be present with other fluoroquinolones.

What is increased exposure of tizanidine that may lead to hypotension and sedation effects?


*Occurs via inhibiting its cytochrome P450 1A2-mediated pre-systemic metabolism

500

The REMS program was removed from this drug in June 2025.

What is clozapine? (agranulocytosis)

500

These anticoagulant capsules should NEVER be opened/crushed/chewed as they exponentially increase the risk of a fatal GI bleed due to vastly increased absorption/bioavailability.

What is Pradaxa (dabigatran)?

500

This is an example of a medication that is applied as a patch every 72 hours

What is fentanyl or scopolamine?