Black Box Warnings Trivia Quiz

Answer: Urinary tract infection caused by a bacteria

Drugs in this class include ciprofloxacin, levofloxacin and moxifloxacin. Fluoroquinolones have various musculoskeletal side effects including arthralgias and tendonitis and, very rarely, Achilles tendon rupture. Pain, swelling, unexplained soreness in any of your body's tendons while on these medications warrants an immediate call to your physician. Antibiotics will have no pharmacologic effect on eradicating viruses such as influenza, shingles caused by the herpes zoster virus or human immunodeficiency virus (HIV).

Answer: Attention Deficit Disorder

All classes of antidepressants carry the black box warning stated in the question. Example medications include Prozac (fluoxetine), Zoloft (sertraline) and Elavil (amitriptyline). Classes of antidepressants can include selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs) among others. Antidepressants can be used for anxiety disorders, depressive disorders but have no labeled or off label indication for the treatment of attention deficit disorder.

Answer: Chronic Pain + Anxiety

Hydrocodone, the generic name for Norco, and alprazolam, the generic name for Xanax, are classified as an opioid and benzodiazepine respectively. Combinations of these medications can result in increased sedation and respiratory depression which can lead to coma or even death. Hydrocodone is prescribed for chronic pain management and alprazolam is typically prescribed as an anti anxiety (anxiolytic) agent.

Answer: All of these are potential complications of C. diff infection

All antibiotics can alter your body's gut flora and can cause diarrhea as a side effect, but clindamycin has an increased risk of Clostridium difficile infection related diarrhea as opposed to other antibiotics. Pseudomembranous colitis induced by C. diff is an inflammation of the large intestine due to the release of toxins which causes the intestine to produce fluids causing diarrhea and abnormal membranes to form. Toxic megacolon occurs when the colon becomes abnormally enlarged as a result of infection and often has concomitant symptoms of bloating, fever, abdominal pain and shock. Sepsis is a general term for an infection that infiltrates the bloodstream and can spread to all major organs and organ systems in the body.

Infection with C. diff is the most common cause of infectious diarrhea in the healthcare environment.

Answer: Seizures

Stephen Johnson's syndrome is a serious skin reaction characterized by blisters and peeling of the skin and can affect mucous membranous regions of skin such as the lips and eyelids along with non mucous skin layers. SJS is associated with anticonvulsants notably and occurs due to a type of hypersensitivity reaction the immune system mounts against certain drugs or drug metabolites.

Answer: Obesity

Antipsychotics are most commonly used for the treatment of manic episodes in bipolar disorder and for schizophrenia. Antipsychotics work pharmacologically in a general sense by blocking the effects of the neurotransmitter dopamine from interacting with its various receptors. Elevated dopamine levels are thought to be responsible for increased mania and delusions and hallucinations associated with psychosis. One of the most common side effects for antipsychotics is obesity which is in part due to the drug being able to bind to many receptors in the area of the brain responsible for controlling appetite and food intake.

More than half of patients will gain anywhere from 5-15 lbs during the first six months of taking antipsychotics.

Answer: Varenicline

Serious neuropsychiatric events would pertain to significant mood alterations such as increased violence, suicidal ideation and even psychosis. Chantix (generic varenicline) works by dampening the amount of dopamine released when smoking cigarettes, in essence decreasing the pleasurable effects associated with nicotine and decreasing cravings for cigarettes. Clonidine is a blood pressure medication that is sometimes utilized to decrease the intensity of nicotine withdrawals.

Answer: Isotretinoin

This medication's appropriate usage is restricted to registered users of the risk management distribution program iPLEDGE. Both male and female patients must enroll in the iPLEDGE program prior to the dispensing of isotretinoin products at a pharmacy that must also be registered in the iPLEDGE system along with the doctor prescribing the medication. Isotretinoin is a vitamin A derivative that is used in severe cystic acne. Females who have the potential of becoming pregnant are required to take two methods of birth control while on Isotretinoin.

Answer: Thyroid gland

Levothyroxine is a synthetic thyroid hormone drug used to treat low thyroid hormone levels or hypothyroidism.

Answer: Stimulant

Adderall is used for attention deficit hypersensitivity disorder and is unfortunately abused due to its euphoric effects due to its effects on increasing the amount of dopamine available to bind to receptors in various regions of the brain. Adderall and amphetamine derivatives are classified as stimulants.