Prescriber Update Articles
Answers to the Prescriber Update Quiz – December
2010
Website: December 2010
Prescriber Update 2010; 31(4):35
- There is evidence that these medicines are no more effective than
maximum recommended doses of paracetamol alone, and have the potential to
cause more adverse reactions than paracetamol used at recommended doses.
Deaths related to overdose (intentional and unintentional) have occurred.
Prescribing restrictions failed to ensure these medicines were only used in
patients for whom the benefits outweigh the risks. Since these medicines
were withdrawn in New Zealand, the FDA has also required their withdrawal in
the US, following new clinical trial evidence showing that
dextropropoxyphene causes QT interval prolongation at therapeutic doses.
- The ten most common are:
- Doxycycline
- Hydrochlorothiazide
- Amiodarone
- Piroxicam
- Chlorpromazine
- Trimethoprim/sulfamethoxazole
- Captopril
- Enalapril
- Bendroflumethiazide
- Carbamazepine
- Changing brands of fentanyl patches requires careful clinical monitoring
as different brands may not be interchangeable in an individual patient. A
change in dose may be required for some patients.
- b) Class C(4) controlled drug
- True
- Finasteride (Fintral)
- Monitoring valproate plasma levels or adjusting the dose is unlikely to
manage this interaction given its extent and rapid onset. Prescribers are
advised to avoid the use of carbapenem antibiotics in patients taking sodium
valproate.
- Acitretin is indicated for the treatment of severe psoriasis, disorders
of keratinisation and other dermatoses responsive to etretinate (Acitretin
is an active metabolite of etretinate) whereas isotretinoin is indicated to
treat severe forms of nodulo-cystic acne which are resistant to therapy.
- Any three of: clarithromycin, erythromycin, chloroquine, pentamidine,
domperidone, cisapride, haloperidol, chlorpromazine, methadone, terfenadine.
- Hypomagnesaemia