Black Box Warnings
What is at least 1 BBW of ibuprofen?
- CV thrombotic events
- GI bleeding, ulceration, or perforation
Wha nasal spray is indicated in opioid overdoses?
Naloxone (Narcan)
What is the most significant AE of acetaminophen?
hepatotoxicity
What are the Fab Five drug interactions with warfarin?
Fluconazole, amiodarone, Bactrim, fluoroquinolones, Flagyl
What federal agency was formed in 1930 to enforce drug safety and labeling laws?
The FDA (Food & Drug Administration)
What antiglycemic agent has a BBW of lactic acidosis?
Metformin
What kind of animal bite may elevate a persons PT interval or INR?
Snake bite (more specifically north american pit viper)
What class of anti-hypertensives most commonly causes dry cough?
ACE inhibitors
Which antibiotic drug classes can cause chelation when combined with calcium phosphate binders?
oral fluoroquinolones and oral tetracyclines
What pain reliever was laced with cyanide in 1982, killing 7 people and resulting in new tamper-resistant packaging requirements?
Acetaminophen/Tylenol
Name 2 anti-hypertensive classes that have a BBW of pregnancy
ACE inhibitors, ARBs
What is the treatment for a tylenol (acetaminophen) overdose? (drug and routes)
N-acetylcysteine (NAC). Oral or IV
What diuretic can cause gynecomastia in males?
Spironolactone
What drug class can cause potential serotonin syndrome when combined with dextromethorphan?
MAOis
What law, passed in 1906, was the first to stop the sale of misbranded or adulterated food and medicines in the US?
Pure Food & Drug Act
What class of medications have a BBW for mortality?
JAK inhibitors
Should you give activated charcoal to someone who has ingested a button battery for decontamination?
NO
What serious, but rare adverse effect has been reported with GLP-1 receptor agonists?
These drug classes can cause hypoglycemia if they are combined with GLP-1s!
insulin, sulfonylureas, meglintinides
After more than 100 people died from a toxic “Elixir of Sulfanilamide,” what law was passed in 1938 to ensure new drugs were tested for safety?
Food, Drug, and Cosmetic Act
Name all four BBWs for amiodarone
life threatening arrhythmias, pulmonary toxicity, hepatotoxicity, pro-arrhythmic effects
Name 1 treatment for a b-blocker overdose (9 possible answers)
Atropine, IV fluids, Catecholamines, glucagon, high dose insulin, bicarbonate, calcium, and lipids
(also dialysis depending on what b-blocker)
What anti-arrhythmic can cause blue-gray skin discoloration with long term use?
Amiodarone
Name three CYP3A4 inducers and three CYP3A4 inhibitors that interact with lots and lots of drugs!
Inducers: carbamazepine, phenytoin, phenobarbital, rifampin, St. John’s wort
Inhibitors: azole antifungals, erythromycin, non-DHP CCBs, HIV medications, metoclopramide, grapefruit juice
What sedative was used to treat morning sickness in pregnant women that lead to thousands of birth defects in the 1950’s and eventually the Kefauver-Harris Amendment?
Thalidomide
Kefauver-Harris Amendment: required drug manufacturers to prove both safety AND efficacy before marketing