• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/86

Click to flip

86 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
Abdominal Pain following Opoid Administration
Contraction of Smooth Muscle Cells in Spincter of Oddi → biliary cholic
DOC: Heparin OD
Protamine

aka protamine sulfate

binds to heparin to form inactive complex
#pharmacology #drugs #toxicities
Protamine Sufate
ie protamine

DOC: Heparin OD

binds to heparin to form inactive complex
#pharmacology #drugs #toxicities
Mannitol OD
excessive volume depletion → hypernatremia

even worse
rapid administration rapidly draws fluid from interstitial → vascular compartment, ↑ hydrostatic pressure in lungs → pulmonary edema & death

[Mannitol used for ↑ ICP/Cerebral Edema]
#pharmacology #toxicities
DOC: ↑ ICP/Cerebral Edema

OD?
Mannitol

overaggressive → excessive volume depletion → hypernatremia

even worse
rapid administration rapidly draws fluid from interstitial → vascular compartment, ↑ hydrostatic pressure in lungs → pulmonary edema & death
#pharmacology #toxicities #drugs
Warfarin Necrosis
Proteins C & S are natural anticoagulants

Protien C is vitamin K dependent and has much shorter λ than factors 2, 7, 9 and X.

Rare complication: in pts w/ already defective Protein C, warfarin creates a transient hypercoagulable state

Tx: Vitamin K + FFP
#hematology #pharmacology #toxicity
Antipsychotic associated with retinitis pigmentosa
Thioridazine

Mn: thior-eye-disease

NB: Chlorpormazine ≈ corneal deposits
#pharmacology #toxicity
Toxicity of Thioridazine
retinitis-pigmentosa like retinal deposits

Mn: Thior-eye-disease

NB: Chlorpormazine ≈ corneal deposits
#pharmacology #toxicity
Antipsychotic assocaited with corneal deposits
Chlorpromazine

NB: Thioridazine ≈ Retinal Deposits
#pharmacology #toxicity
Toxicity of Chlorpromazine
Corneal Deposits

NB: Thioridazien ≈ Retinal Deposits
#pharmacology #toxicity
DOC: Nitroprusside OD
Nitroprosside: Ca2+ blocker which acts on both arteries an veins

Cyanide Toxicity

DOC: Sulfur ie Sodium Thiosulfate

provides extra substrate for liver rhodanase to form thiocyanate
#pharmacology #cardiovascular #toxicity
Toxicity of Hydrocyhloroquine
retinal damage
#pharmacology #antimicrobial #toxicity
Akathisia
side effect of anti-psychotics

anxiety, restlessness

timeline
4h: dystonia
4d: parkinsonianism
4wk: akathisia
4mo: tardive dyskinesia
#pharmacology #toxicity
Drug Interaxns of Niacin
Potentiates Anti-Hypertensives

Induces Insulin Resistance

also causes hyperuricemia
#pharmacology #cardiovascular #toxicity
MRSA Rx:

↑ CPK
Daptomycin

Mech: creates transmembrane channels → electrolyte flow → depolarization → proteins now nonfnx

Limitation: cannot get through to inner membrane of gram negatives; also inactivated by pulmonary surfactant

Side Effects: Myopathy ( ↑ CPK)
#pharmacology #drugs #antimicrobials #toxicity
MRSA Rx:

Thrombocytopenia
Linezolid

binds 23S portn of 50S

Toxicities:
Thrombocytopenia
Optic neuritis
5HT Sro
#pharmacology #drugs #antimicrobials #toxicity
MRSA Rx:

Optic Neuritis
Linezolid

binds 23S portn of 50S

Toxicities:
Thrombocytopenia
Optic neuritis
5HT Sro
#pharmacology #drugs #antimicrobials #toxicity
MRSA Rx:

5HT Sro
Linezolid

binds 23S portn of 50S

Toxicities:
Thrombocytopenia
Optic neuritis
5HT Sro
#pharmacology #drugs #antimicrobials #toxicity
Anti-depressant which causes priapism
Trazodone

contraindicated in adolescent boys
#pharmacology #toxicities #drugs
Cause of Death: TCA OD
Fast Na+ Channel inhibition → slowed conduction + prolonged QRS → fatal arrhytmias

else

↓ CO (arrthmias) + α blockade → Refractory Hypotension
#pharmacology #toxicity
Aspirin Induced Kidney Damage
Chronic Interstital Nephritis
#pharmacology #toxicity #pathology #nephrology
Thiazide Diuretics
and
Serum Constituents
Causes Hyper
-Uricemia, Calcemia, Glycemia, Lipidemia
"GLUC"
Hypo
Kalmia & Tension
#pharmacology #toxicity
What should you monitor when giving Lithium?
T3 and T4
#pharmacology #toxicities
What should you monitor when giving Amiodarone?
PFT's: Pulmonary Fibrosis
LFT's
TFTs
#pharmacology #toxicities
What should you monitor when giving INH?
LFT's
#pharmacology #toxicities
What should you monitor when giving Carbamazapine?
LFT's
#pharmacology #toxicities
For what drugs should you monitor thyroid hormone levels?
Lithium
Amiodarone (LFT, PFT, TFTs)
#pharmacology #toxicities
For what drugs should you vigilently monitor LFT's?
INH
Carbamazapine
Amiodarone (LFT, PFT, TFTs)
#pharmacology #toxicities
ACEI's → ↑ Cr
Slight ↑ Cr physiologic 2° to ↓ Renal Filtration

(relaxed efferent arteriole)
#pharmacology #toxicities #nephrology
Renal damage from heroine
focal segmental glomeruloscelrosis

same as pamidronate
#pharmacology #toxicities #nephrology
Renal damage from pramidronate
focal segmental glomeruloscelrosis

same as heroin
#pharmacology #toxicities #nephrology
Renal damage from Gold
membranous nephropathy
#pharmacology #toxicities #nephrology
Renal damage from Sulfonamides
precipitation in renal tubules → failure

sulfonamides, MTX, acyclovir, triamterene
#pharmacology #toxicities #nephrology
Renal damage from MTX
precipitation in renal tubules → failure

sulfonamides, MTX, acyclovir, triamterene
#pharmacology #toxicities #nephrology
Renal damage from acyclovir
precipitation in renal tubules → failure

sulfonamides, MTX, acyclovir, triamterene
#pharmacology #toxicities #nephrology
Renal damage from triamterene
precipitation in renal tubules → failure

sulfonamides, MTX, acyclovir, triamterene
#pharmacology #toxicities #nephrology
Renal damage from foscarnet
drug induced tubular necrosis

aminoglycosides, radiocontrast media, cisplatin, amphotericin B, foscarnet
#pharmacology #toxicities #nephrology
Ticlopidine
Ticlopidine
ADP antagonist like Clopidogrel

2nd line drug for pts who are allergic to clopidogrel

serious side effects: neutropenia → fever & mouth ulcers
#pharmacology #cardiovascular #toxicities
Pt on Rx after TIA dvlps fever & oral ulcers
Ticlopidine
ADP antagonist like Clopidogrel

2nd line drug for pts who are allergic to clopidogrel

serious side effects: neutropenia → fever & mouth ulcers
#pharmacology #cardiovascular #toxicities
Coronary Steal Effect
Vessels in Ischemic Regions are often maximally dilated

addition of adenosine and dipyridamole (coronary-selective vasodilators) may dilate surrounding vessels and divert flow away from ischemic areas.
#pharmacology #cardiovascular #toxicity
Antidepressents implicated in Serotonin Sro
Anti-Depressants
--SSRI's
--SNRI (Venlafaxine)
--MAOI's
--TCA's
#pharmcology
#toxicities
Analgesics implicated in Serotonin Sro
Tramadol
#pharmcology
#toxicities
Anti-emetics implicated in Serotonin Sro
Ondansetron (5HT3 antagonist)
#pharmcology
#toxicities
Antibiotics implicated in Serotonin Sro
Linezolid (Vancomycin resistant enterococcus, MRSA)
#pharmcology
#toxicities
Headache Medicine implicated in Serotonin Sro
Triptans
#pharmcology
#toxicities
Pt treated for hyperthyroidism presents with fever and sore throat
agranulocytosis (PMN <500) rare but serious complication of thyrolytics

PTU - DOC in pregnants

Methimazole - DOC in nonpregnants, teratogenic

both are thionamide class
inhibit thyroid peroxidase which is resposnbiel for I- → I0 and coupling of iodotyrosines
#pharmacology #toxicity
Anti-histone antibodies
Drug induced Lupus

Procainamide
Hydralazine
Isoniazid
Penicillamine
#pathology #pharmacology #toxicity
Lymphadenopathy and Serum Sickness from an Anti-Siezure Drug
Phenytoin
hirsutism
gingival hypertrophy
#pharmacology #toxicities
Acyclovir Toxicity
Crytalline Nephropathy if dehydrated
#pharmacology #toxicity #antimicrobials
Electrolyte balance of ACEI's
Sodium wasting
K retaining

so check K levels before and during

NB: other side effects
--angioedema
--cough
--first dose hypotension
#pharmcology #toxicities
Heart Drug

Visual changes and GI disturbances
Digoxin toxicity
#cardiovascular #pharmacology #toxicity
Which part of HAART is responsible for the cushing-like presentation?
Protease inhibitors
-navirs

lipodystrophy, hyperglycemia, and p450 inhibition
#microbiology #pharmacology #antimicrobials #toxicities
What kind of heart damage doe doxorubicin & daunocrubicin produce?
anthracyclines

dose dpt cardiact toxicity

swelling SR → loss of individual cardiomyocytes ("myofibrillar dropout" → dilated cariomyopathy

preventable with dexrazocane
#pharmacology #toxocities
ACEI's vs Kidneys

what is contraindication
renal artery stenosis

these people are depending on dilated efferent arteriole to decreases resistance and maintain glomerular filtration and interstitial perfusion
#pharmacology #toxicities
Heart Problems on a Med

Nausea, Vomiting, Confusion, Visual Changes
Digoxin used for atrial fib w/ undelrying systolic dysnfx

Not only ↑ contractility, but also induces vagal stim of AV node

Toxicity:
Nausea/Vomitting/Anorexia/Diarrhea
fatigue/HA/Dizziness/Confusion/Delerium
Blurry Vision, Δcolor perception

Hyperkalemia

Tx: activated charcoal
insulin, kayexalate or hemodyalysis for hyperK
avoid Ca2+ gluconate
3. Fab

NB: hypokalemic state ↑ susceptibility to digoxin tocitity
#cardiology #pharmacology #toxicity
Anti-hyperlipidemic agent which precipitates gouty attack
Niacin

esp w/ initial threatment

also hyperglycemia and then hepatotoxicity at high doses
#drugs #toxicities
Which antimicrobials should always be monitored with a complete blood count
cloramphenicol: aplastic anemia
dapsone
TMP SMX: megaloblastic anemia
#antimicrobials #pharmacology #toxicity
Which antimicrobials should always be monitored for LFT's
INH, rifampin, pyrazinamide
#antimicrobials #pharmacology #toxicity
Clostridium difficile

Agent, Toxin, Mechanism, Manifestation
toxin A: enterotoxin
mechanism: PMN chemoattractant → cytokine release → mucosal inflam & fluid loss

toxin B: cytotoxin
mechanism: depolymerizes actin filaments
result: mucosal cell death → bowel wall necrosis & pseudomembrane formation
#microbiology #toxins
DOC: Methotrexate OD
Leucovorin aka Folinic Acid

Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active
#pharm #toxicology
Leucovorin
aka Folinic Acid

DOC: Methotrexate OD

Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active
#pharm #toxicology
Folinic Acid
aka Leucovorin

DOC: Methotrexate OD

Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active
#pharm #toxicology
Filgrastim
recombinant G-CSF

↑ granulocyte proliferation
#pharm #toxicology
recombinant G-CSF
Filgrastim

↑ granulocyte proliferation
#pharm #toxicology
Fomepazole
competitive antagonist of alcohol dehydrogenase

DOC: methanol or ethylene glycol poisoning

(high anion gap + high osmolar gap metabolic acidosis)
#pharm #toxicology
DOC: ethylene glycol poisoning
Fomepazole: competitive antagonist of alcohol dehydrogenase

also for methanol poisoning
#pharm #toxicology
DOC: methanol poisoning
Fomepazole: competitive antagonist of alcohol dehydrogenase

also for methanol poisoning
#pharm #toxicology
Dexrazoxane
iron-chelating agent used to reduce anthracycline induced (ie doxorubicin) cardiotoxicity
#pharm #toxicology
DOC: doxorubicin cardiotoxicity
Dexrazoxane: iron-chelating agent used to reduce anthracycline induced (ie doxorubicin) cardiotoxicity
#pharm #toxicology
Amifostine
free-radical scavenging agent used to ↓ nephrotoxicity 2° to platinum containing agents (cisplatin)
#pharm #toxicology
DOC: cisplatin nephrotoxicity
Amifostine + aggressive hydration

establish chloride diuresis: cisplatin stays in a non-reactive state when in higher chloride concentration
#pharm #toxicology
Pt being treated for Tuberculosis has ataxia and ↓ pain sensation
B6 deficiency

INH is B6 analog, competes in the processes of neurotransmitter production and also ↑ renal excretion of B6

Treat with B6 supplementation
#pharm #toxicities
Drugs likely to produce SLE
Hydralazine
Procainamide
Isoniazid

likely to have anti-histone antibodies but not anti-dsDNA antibodies
#pathology
#pharmacology #toxicities
Distinguishing Neuroleptic Malignant Sro from Serotonin Sro
Serotonin Sro: Myoclonus

NMS: Rigidity s Myoclonus
#pharmacology #toxicity
#neurology
Preventing Thyroid Toxicity upon exposure to Radioactive materal
administer overwhelming amts of K+I- potassium iodide

competitively inhibit uptake of radioactive iodide into thyroid gland
#pharmacology #toxicology
Drugs which increase lithium levels
Li+ treated just like Na+

Thaizide Diuretics (NB: not loop)
Kidney attempts to compensate for Na+ loss by increasing uptake in proximal tubule, ends up reabosrbing Li+

ACEI's -unknown mech
NSAID's -unknown mech
#pharmacology #toxicity
Primary Limitation of BZD's
Falling
#pharmacology #toxicities
statins + fibrates
statin: HMG coA reductase inhibitor
potential toxicity: myopathy and hepatitis
simvastatin is worst

fibrates: ↑ LPL
--gemfibrozil increases the concentration of statins
--fenofibrate itself casues myopathy
#pharmacology #toxicities
statin + bile acid resins
statin: HMG coA reductase inhibitor
potential toxicity: myopathy and hepatitis
simvastatin is worst

bile acid resins: cholestyramine, colestipol, colesevelam
↓ absorption of statins
4 hour separation
#pharmacology #toxicities
fibrates + bile acid resins
fibrates: ↑ LPL
--gemfibrozil & fenofibrate

bile acid resins: cholestyramine, colestipol, colesevelam

combo: ↑ cholesterol concentration in bile → ↑ gallstones
#pharmacology #toxicities
Amphotericin B
what should you monitor
Serum K+ and Mg++

nephrotoxicity is Amphotericin's limitation, most pts will need K+ and Mg++ supplementation

decreased EPO production may also lead to normocytic normochromatic anemia
#pharmacology #toxicity #chemotheraputics
Scopolamine
selective muscarinic antagonist

primarily used vs. motion sickness 2ndary to Dramamine/Antihistamines

may be used to reduce the ANS side effects of cholinesterase inhibitors prescribed for myasthenia gravis.
#pharmacology #drugs #toxicities
Drugs which may cause seizures
Buproprion- NE + DA reuptake inhibitor
Isoniazid (if given w/o B6)
Imipenem (Antibiotic)
#pharmacology #toxicities
Inhibits DA + NE Reuptake
Burproprion "Wellbutrin"

NB: Risk Seizures
#pharmacology #drugs #toxicities
Mesna
antidote for hemorrhagic cystitis 2° to nitrogen mustard based chemothreapeutics eg cyclophosphamide or analoges (ifosfamide)

normally nitrogen mustards → acrolein → uroepithelial toxicity

mesna binds and inactivates metabolites
#pharmacology #drugs #toxicities
Prophylaxis vs Hemorrhagic Cystitis in Anti-neoplastic chemotherapy
Mesna
hemorrhagic cystitis 2° to nitrogen mustard based chemothreapeutics eg cyclophosphamide or analoges (ifosfamide)

normally nitrogen mustards → acrolein → uroepithelial toxicity

mesna binds and inactivates metabolites
#pharmacology #drugs #toxicities