Cwm Taf Pre-registration MI Training October 21st 2015 Claire Ganderton Helen Morteo

Enquiry 2 - interactions A ward pharmacist calls MI to ask about an interaction between ciprofloxacin and theophylline What further information do you need?

Enquiry 2 Enquirers name and contact details Sarah Smith, ext 3508 Patient: Sally James, DOB 1/1/88 Hosp no: M7654321 Patient admitted with UTI. Ciprofloxacin has been selected because the C&S results show sensitivity only to trimethoprim and ciprofloxacin and the patient has had a week of trimethoprim already.

Enquiry 2 Retrospective – prescribed ciprofloxacin 500mg po bd, has had two doses so far. Enquirer has noted that the patient is also on theophylline (Uniphyllin 200mg nocte) and is aware of an interaction between ciprofloxacin and theophylline, but is unsure of the clinical significance. The patient has MS and is on a list of other medications too, but enquirer is not asking for us to check these. No theophylline levels have been done.

Enquiry 2 Renal & liver function - normal Enquirer keen to get ciprofloxacin changed to an alternative, but needs supporting evidence, i.e. evidence of a significant interaction before doing so. Urgency – next 2 hours.

Search strategy BNF SPCs on eMC (for both theophylline and ciprofloxacin) Stockley’s Drug Interactions DrugReax Prepare your answer for verbal communication