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86 Cards in this Set
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- 3rd side (hint)
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Abdominal Pain following Opoid Administration
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Contraction of Smooth Muscle Cells in Spincter of Oddi → biliary cholic
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DOC: Heparin OD
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Protamine
aka protamine sulfate binds to heparin to form inactive complex |
#pharmacology #drugs #toxicities
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Protamine Sufate
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ie protamine
DOC: Heparin OD binds to heparin to form inactive complex |
#pharmacology #drugs #toxicities
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Mannitol OD
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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
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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
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Warfarin Necrosis
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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
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Antipsychotic associated with retinitis pigmentosa
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Thioridazine
Mn: thior-eye-disease NB: Chlorpormazine ≈ corneal deposits |
#pharmacology #toxicity
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Toxicity of Thioridazine
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retinitis-pigmentosa like retinal deposits
Mn: Thior-eye-disease NB: Chlorpormazine ≈ corneal deposits |
#pharmacology #toxicity
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Antipsychotic assocaited with corneal deposits
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Chlorpromazine
NB: Thioridazine ≈ Retinal Deposits |
#pharmacology #toxicity
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Toxicity of Chlorpromazine
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Corneal Deposits
NB: Thioridazien ≈ Retinal Deposits |
#pharmacology #toxicity
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DOC: Nitroprusside OD
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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
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Toxicity of Hydrocyhloroquine
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retinal damage
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#pharmacology #antimicrobial #toxicity
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Akathisia
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side effect of anti-psychotics
anxiety, restlessness timeline 4h: dystonia 4d: parkinsonianism 4wk: akathisia 4mo: tardive dyskinesia |
#pharmacology #toxicity
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Drug Interaxns of Niacin
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Potentiates Anti-Hypertensives
Induces Insulin Resistance also causes hyperuricemia |
#pharmacology #cardiovascular #toxicity
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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
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MRSA Rx:
Thrombocytopenia |
Linezolid
binds 23S portn of 50S Toxicities: Thrombocytopenia Optic neuritis 5HT Sro |
#pharmacology #drugs #antimicrobials #toxicity
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MRSA Rx:
Optic Neuritis |
Linezolid
binds 23S portn of 50S Toxicities: Thrombocytopenia Optic neuritis 5HT Sro |
#pharmacology #drugs #antimicrobials #toxicity
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MRSA Rx:
5HT Sro |
Linezolid
binds 23S portn of 50S Toxicities: Thrombocytopenia Optic neuritis 5HT Sro |
#pharmacology #drugs #antimicrobials #toxicity
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Anti-depressant which causes priapism
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Trazodone
contraindicated in adolescent boys |
#pharmacology #toxicities #drugs
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Cause of Death: TCA OD
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Fast Na+ Channel inhibition → slowed conduction + prolonged QRS → fatal arrhytmias
else ↓ CO (arrthmias) + α blockade → Refractory Hypotension |
#pharmacology #toxicity
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Aspirin Induced Kidney Damage
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Chronic Interstital Nephritis
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#pharmacology #toxicity #pathology #nephrology
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Thiazide Diuretics
and Serum Constituents |
Causes Hyper
-Uricemia, Calcemia, Glycemia, Lipidemia "GLUC" Hypo Kalmia & Tension |
#pharmacology #toxicity
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What should you monitor when giving Lithium?
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T3 and T4
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#pharmacology #toxicities
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What should you monitor when giving Amiodarone?
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PFT's: Pulmonary Fibrosis
LFT's TFTs |
#pharmacology #toxicities
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What should you monitor when giving INH?
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LFT's
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#pharmacology #toxicities
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What should you monitor when giving Carbamazapine?
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LFT's
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#pharmacology #toxicities
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For what drugs should you monitor thyroid hormone levels?
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Lithium
Amiodarone (LFT, PFT, TFTs) |
#pharmacology #toxicities
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For what drugs should you vigilently monitor LFT's?
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INH
Carbamazapine Amiodarone (LFT, PFT, TFTs) |
#pharmacology #toxicities
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ACEI's → ↑ Cr
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Slight ↑ Cr physiologic 2° to ↓ Renal Filtration
(relaxed efferent arteriole) |
#pharmacology #toxicities #nephrology
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Renal damage from heroine
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focal segmental glomeruloscelrosis
same as pamidronate |
#pharmacology #toxicities #nephrology
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Renal damage from pramidronate
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focal segmental glomeruloscelrosis
same as heroin |
#pharmacology #toxicities #nephrology
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Renal damage from Gold
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membranous nephropathy
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#pharmacology #toxicities #nephrology
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Renal damage from Sulfonamides
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precipitation in renal tubules → failure
sulfonamides, MTX, acyclovir, triamterene |
#pharmacology #toxicities #nephrology
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Renal damage from MTX
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precipitation in renal tubules → failure
sulfonamides, MTX, acyclovir, triamterene |
#pharmacology #toxicities #nephrology
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Renal damage from acyclovir
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precipitation in renal tubules → failure
sulfonamides, MTX, acyclovir, triamterene |
#pharmacology #toxicities #nephrology
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Renal damage from triamterene
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precipitation in renal tubules → failure
sulfonamides, MTX, acyclovir, triamterene |
#pharmacology #toxicities #nephrology
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Renal damage from foscarnet
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drug induced tubular necrosis
aminoglycosides, radiocontrast media, cisplatin, amphotericin B, foscarnet |
#pharmacology #toxicities #nephrology
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Ticlopidine
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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
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Pt on Rx after TIA dvlps fever & oral ulcers
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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
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Coronary Steal Effect
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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
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Antidepressents implicated in Serotonin Sro
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Anti-Depressants
--SSRI's --SNRI (Venlafaxine) --MAOI's --TCA's |
#pharmcology
#toxicities |
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Analgesics implicated in Serotonin Sro
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Tramadol
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#pharmcology
#toxicities |
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Anti-emetics implicated in Serotonin Sro
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Ondansetron (5HT3 antagonist)
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#pharmcology
#toxicities |
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Antibiotics implicated in Serotonin Sro
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Linezolid (Vancomycin resistant enterococcus, MRSA)
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#pharmcology
#toxicities |
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Headache Medicine implicated in Serotonin Sro
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Triptans
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#pharmcology
#toxicities |
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Pt treated for hyperthyroidism presents with fever and sore throat
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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
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Anti-histone antibodies
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Drug induced Lupus
Procainamide Hydralazine Isoniazid Penicillamine |
#pathology #pharmacology #toxicity
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Lymphadenopathy and Serum Sickness from an Anti-Siezure Drug
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Phenytoin
hirsutism gingival hypertrophy |
#pharmacology #toxicities
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Acyclovir Toxicity
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Crytalline Nephropathy if dehydrated
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#pharmacology #toxicity #antimicrobials
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Electrolyte balance of ACEI's
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Sodium wasting
K retaining so check K levels before and during NB: other side effects --angioedema --cough --first dose hypotension |
#pharmcology #toxicities
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Heart Drug
Visual changes and GI disturbances |
Digoxin toxicity
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#cardiovascular #pharmacology #toxicity
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Which part of HAART is responsible for the cushing-like presentation?
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Protease inhibitors
-navirs lipodystrophy, hyperglycemia, and p450 inhibition |
#microbiology #pharmacology #antimicrobials #toxicities
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What kind of heart damage doe doxorubicin & daunocrubicin produce?
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anthracyclines
dose dpt cardiact toxicity swelling SR → loss of individual cardiomyocytes ("myofibrillar dropout" → dilated cariomyopathy preventable with dexrazocane |
#pharmacology #toxocities
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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
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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
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Anti-hyperlipidemic agent which precipitates gouty attack
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Niacin
esp w/ initial threatment also hyperglycemia and then hepatotoxicity at high doses |
#drugs #toxicities
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Which antimicrobials should always be monitored with a complete blood count
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cloramphenicol: aplastic anemia
dapsone TMP SMX: megaloblastic anemia |
#antimicrobials #pharmacology #toxicity
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Which antimicrobials should always be monitored for LFT's
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INH, rifampin, pyrazinamide
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#antimicrobials #pharmacology #toxicity
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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
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DOC: Methotrexate OD
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Leucovorin aka Folinic Acid
Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active |
#pharm #toxicology
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Leucovorin
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aka Folinic Acid
DOC: Methotrexate OD Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active |
#pharm #toxicology
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Folinic Acid
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aka Leucovorin
DOC: Methotrexate OD Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active |
#pharm #toxicology
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Filgrastim
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recombinant G-CSF
↑ granulocyte proliferation |
#pharm #toxicology
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recombinant G-CSF
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Filgrastim
↑ granulocyte proliferation |
#pharm #toxicology
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Fomepazole
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competitive antagonist of alcohol dehydrogenase
DOC: methanol or ethylene glycol poisoning (high anion gap + high osmolar gap metabolic acidosis) |
#pharm #toxicology
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DOC: ethylene glycol poisoning
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Fomepazole: competitive antagonist of alcohol dehydrogenase
also for methanol poisoning |
#pharm #toxicology
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DOC: methanol poisoning
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Fomepazole: competitive antagonist of alcohol dehydrogenase
also for methanol poisoning |
#pharm #toxicology
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Dexrazoxane
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iron-chelating agent used to reduce anthracycline induced (ie doxorubicin) cardiotoxicity
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#pharm #toxicology
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DOC: doxorubicin cardiotoxicity
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Dexrazoxane: iron-chelating agent used to reduce anthracycline induced (ie doxorubicin) cardiotoxicity
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#pharm #toxicology
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Amifostine
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free-radical scavenging agent used to ↓ nephrotoxicity 2° to platinum containing agents (cisplatin)
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#pharm #toxicology
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DOC: cisplatin nephrotoxicity
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Amifostine + aggressive hydration
establish chloride diuresis: cisplatin stays in a non-reactive state when in higher chloride concentration |
#pharm #toxicology
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Pt being treated for Tuberculosis has ataxia and ↓ pain sensation
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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
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Drugs likely to produce SLE
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Hydralazine
Procainamide Isoniazid likely to have anti-histone antibodies but not anti-dsDNA antibodies |
#pathology
#pharmacology #toxicities |
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Distinguishing Neuroleptic Malignant Sro from Serotonin Sro
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Serotonin Sro: Myoclonus
NMS: Rigidity s Myoclonus |
#pharmacology #toxicity
#neurology |
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Preventing Thyroid Toxicity upon exposure to Radioactive materal
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administer overwhelming amts of K+I- potassium iodide
competitively inhibit uptake of radioactive iodide into thyroid gland |
#pharmacology #toxicology
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Drugs which increase lithium levels
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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
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Primary Limitation of BZD's
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Falling
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#pharmacology #toxicities
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statins + fibrates
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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
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statin + bile acid resins
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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
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fibrates + bile acid resins
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fibrates: ↑ LPL
--gemfibrozil & fenofibrate bile acid resins: cholestyramine, colestipol, colesevelam combo: ↑ cholesterol concentration in bile → ↑ gallstones |
#pharmacology #toxicities
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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
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Scopolamine
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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
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Drugs which may cause seizures
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Buproprion- NE + DA reuptake inhibitor
Isoniazid (if given w/o B6) Imipenem (Antibiotic) |
#pharmacology #toxicities
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Inhibits DA + NE Reuptake
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Burproprion "Wellbutrin"
NB: Risk Seizures |
#pharmacology #drugs #toxicities
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Mesna
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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
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Prophylaxis vs Hemorrhagic Cystitis in Anti-neoplastic chemotherapy
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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
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