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Interactions, NOT Contra-Indications
Hi
I'am a trainee pharmacy technician. I was doing a few questions for my BTEC course.
Question was to state whether the below was a caution, contra-indication or interation.
Metronidazole and Alcohol
Warfarin and Aspirin
I said Contra-Indication for both, in fact I was marked down. They are both actually Interactions.
Are we being over cautious??
Keep it surreal
I don't think so:
Metronidazole is thought to block the breakdown of alcohol in the body leading to a build-up of acetaldehyde. This could lead to breathlessness, facial flushing, headache, blood pressure problems. The problem is that the reaction is unpredictable and can become severe. Presumably the lack of robust clinical data regarding this reaction is the reason why it is not "black dotted" in the BNF, but caution should still be exercised.
Warfarin and aspirin should not really be given together because of the risk of increased bleeding, although studies have shown that in patients at low risk of bleeding, the two given together have beneficial effects on ACS
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Newly registered in 1981
Its tricky terminology time!Originally Posted by laura/nottingham
Depends how you look at it and what you are defining an interaction as.
I would say they are "Interactions".
Sometimes you get contraindications and use with caution mentioned in drug interactions.
Not all drug interactions are contraindications, many of them turn out to be use with caution, for example monitoring dose of the drug affected by the other while titrating to effect. Similarly when withdrawing the drug.
Low dose aspirin can be used with Warfarin provided that it is taken into account.
Which dispensary system do you use?
Hope this helps.
Where am I?; In the Pharmacy.
Who are you?; The new Number 2.
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What do you want?;..................
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Weird question...
I would have said that they are contra-indicated because there is an interaction between them;
How about bisacodyl and loperamide?
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The system is by positive solutions. Its called Analyst PMR.
It does strike up BNF cautions, interactions etc alot and gives possibility of printing a label explaining the effect etc.
Newly registered in 1981
"Pharmacy Manager" uses Stockley under license (so I'm told) it gives you advice on what to do about it as well as explaining the effect.
Where am I?; In the Pharmacy.
Who are you?; The new Number 2.
Who is number 1?; You are number 6.
What do you want?;..................
Newly registered in 1981
Ibuprofen and Salbutamol?Weird question...
I would have said that they are contra-indicated because there is an interaction between them;
How about bisacodyl and loperamide?
My favourite is Levothyroxine and Carbimazole as blocking therapy.
Where am I?; In the Pharmacy.
Who are you?; The new Number 2.
Who is number 1?; You are number 6.
What do you want?;..................
King Amongst Members
Interesting this one.
Warfarin & aspirin I would say interaction from BNF- Increased risk of bleeding due to antiplatelet effect
Metronidazole & Alcohol I woudl say interaction - from BNF Possible Disulfiram-like reaction when metronidazole given with ethanol containing preparations.
From the BNF
Interactions are in appendix 1. Drug X causes problem with Drug Y
Cautions are in drug sections: Be wary of this drug in medical condition X
Contra-indications are in drug sections. Do not use this drug in medical Condition X
Look at aspirin on page 230 of BNF 57
Cautions: asthma, allergic disease etc )all these are medical things
Contra-Indications: Children under 16, breast feeding etc. all these are medical things
Drug Interactions are on page 726
Kaolin, NSAIDs etc.
Hope this helps!
Last edited by Web Ferret; 10th, March 2009 at 01:06 PM.
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