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109 Cards in this Set
- Front
- Back
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reduce pancytopenia MTX
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folate
does not interfer FOLIC acid no interfer FOLINIC acid interacts |
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reduce GI MTX
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folic acid
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MTX pregnancy
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women one month
men 3 mths |
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MTX older patients
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reduced renal function
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Radiation recall
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MAD5
MTX actinomycin dactonomycin mc doxorubicin 5-FU Paclitazel, hydroxyurea |
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mc cause of radiation recall
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dactonomycin
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UV recall
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SCEM 5
Suramin Cyclophosphamide Etoposide MTX 5-FU |
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increase MTX by binding to plasma proteins
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The plasma proteins can not sit still
Tetracycline Phenytoin Phenothiazines Chloramphenicol NSAIDs Salicylates Sulfonamides |
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Increase MTX by decrease renal excretion and displacement from plasma proteins
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sulfonamides
Salicylates NSAIDs COX-2 |
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Ciprofloxacin and MTX
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decrease MTX
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Penicillins and MTX
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decrease MTX
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Dipyridamole and MTX
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increase intracellular MTX
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Amiodarone and MTX
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increase MTX
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MTX and theophylline
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increase theophylline
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MTX and digoxin
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decrease digoxin
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MTX and antiviral
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cidofovir, interferons, azt
increase hematologic toxicity |
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MTX and dozapine, lamotrigine, etc
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increase hematologic toxicity
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MTX and increase risk of liver toxicity
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black cohosh, kava
alcohol acitretin, bexarotene |
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MTX and aminoglycosides
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may increase anti-tumor of MTX
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MTX and liver fibrosis when to dc medication
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grades IIIB and IV
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MTX monitor for fibrosis new blood test
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procollagen type 3
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MTX dc WBC? platelets?
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WBC < 3500
Platelets < 100,000 |
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MTX and dosing
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test dose 10 to 15 mg
check CBC and LFTs in one week increase 2.5 to 5 mg/week |
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IFN MOA
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antiviral: induces 2,5 A synthease
induces ribonuclease induces protein kinase P antiproliferative inhibits growth factors increase p53 down regulation c-myc, c-fos, c-ras oncogenes |
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IFN pathway
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transcription factor STAT signal transducer and activator of transcription
Janus kinase-STAT JAKs assoc with IFN receptors phosphorlate both STAT 1 and STAT 2 ISGF3 IFN stimulated gene factor 3 complx forms w STAT1 and STAT2 transcription factor IRF9 moves to nucleus |
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IFN FDA
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kaposis
IFN gamma CGD melanoma IFNalpha |
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IFN monitor
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CK and urinary myoglobulin
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IFN side effects
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fatigue
neutropenia/leukopenia fever myalgia increased LFTs HA |
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serious side effects of IFN
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rhabdo
CV,hypotxn dysrhythmia, tachycardia depression, suicide |
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Increase hematologic effects of interferon
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Ace inhibitors
Folate antagonists MTX HIV AZT Cidovir, clofarbine, imatinib |
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IFN and theophylline
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increae theophylline
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Vinca alkaloids (vinblastine and vincristine) and MTX
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increase neurotoxicity
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IFN and IL-2
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increase risk of renal failure
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IFN gamma
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acid liable C2 type 1 IFN
secreated by Th1 cells,T cells, and NK cells |
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CYP 2C9
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Glyburide
Warfarin Phenytoin |
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CYP2C19
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diazepam
omeprazole pantoprazole |
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CYP2D6
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codeine
imipramine doxepin metroprolol |
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obestiy CYP
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decrease 3A4
increase 2E1 |
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azole and phenytoin
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2C9
increase phenytoin |
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azole and warfarin
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2C9
increase warfarin |
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azole and cyclosporine 3A4
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increase cyclosporine
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azole and benzodiazepines
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3A4
increase benzodiazepines |
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azole and nifedipine
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3A4
itraconzole increases nifedipine leg edema/hypotension |
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Lamisil and BB
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increase BB
bradycardia |
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Lamisil and codeine
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no active metabolite is formed morphine
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lamisil and doxepin
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increase doxepin
excessive sedation |
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Itraconazole and statins
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rhabdomyolysis
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pimozide
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3A4 and 1A2
azole antifugnals macrolide antibiotics |
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abatacept
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fully human CTLA-4 with Fc IgG1
blocks CD80/CD86 with CD28 IV RA treatment |
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cyproheptadine
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cold urticaria and other physical urticarias
1st generation |
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Fexofenadine
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2nd generation
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Loratidine
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2nd generation
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Cetirizine
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2nd generation
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Desloratadine
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2nd generation
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prodrug of fexofenadine
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terfenadine
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2 active metobolites of hydroxyzine
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cetirizine and levocetirizine
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active metabolite of loratadine
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desloratadine
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fexofenadine
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allegra
CYP34A from prodrug terfenadine NO LIVER 80% feces 12% urine Catagory C |
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Loratadine
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desloratadine major metabolite
use lower dose in chronic renal or hepatic Category B |
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desloratadine
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Clarinex
5X more potent than laratadine active metabolite of laratadine NO CYP catergory C |
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Cetirizine
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metabolite of hydroxyzine
most sedating 2nd generation unchanged urine Category B |
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antihistamine pregnancy
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chlorpheniramine
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doxepin metabolism
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CYP 2D6
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Doxepin side effects
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anticolinergic
QT prolongation Seizure Manic-depression Rebound effects if no taper |
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Cimetidine
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blocks H2
competitively inhibits DHT inhibits supressor T cells |
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H2 receptors regulate
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suppress T cell proliferation and cytotoxicity of allogenic target cells
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vasodilation histamine receptor?
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H1 and H2
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stoughton vasoconstriction assay
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potency of topical steroids
1. Prep test corticosteroid in 95% ETOH 2. Apply to volar surface of nl forearm 3. Allow ETOH to evaporate - then cover with occlusive dressing for 16 hrs 4. Wash off 5. Assess vasoconstriction 2hrs later - (0 none, 1 mild, 2 moderate, 3 intense) 6. Statistical analysis Vasoconstriction correlates well with clinical efficacy - indirect assessment of potency |
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EED DRUGS
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IFN BETA
ERYTHROPOIETIN ANTI TIB CISPLATIN` |
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WELL'S SYNDROME
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ENBREL AND HUMIRA AT INJECTION SITE
MINOCYCLINE |
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PG nails medications
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MTX
Topical retinoids 5-FU Capecitabine Mitoxantrone Docetaxel EGFR inhibitors |
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habit tick medication
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isotretinoin
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sulfonamide and sulfonyureas
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Only sulfonamide antibiotics have an arylamine group, which is oxidized to a highly reactive nitroso product
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Sorafenib
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BRAF
VEGFR2 PDGFR |
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Ecluizumab
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C5
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Imatinib
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BCR-ABL
c-KIT PDGFR |
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Mepolizumab
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IL-5
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Omalizumab
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IgE
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yellow lunula (xanthonychia)
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tetracycline
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Diffuse brown nails
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phenolphthalein
antimalarials minocycline gold Addison's disease |
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Brown-black bands nails transverse
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lithium
AZT bleomycin doxorubicin |
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Brown-black bands nails longitudinal
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melanoma
benign nevi Addison's Peutz-Jehgers Laugier-Hunziker |
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Blue nails
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Argryia
Wilson's Blue-gray: ochronosis, quinacrine, phenolphthalein |
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Green nails
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pseudomonas
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Onabotulinumtoxin A medium
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casein hydrolysate
glucose yeast |
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Syntaxin
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cleaved by Botulinum toxin C
transmembrane |
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VAMP
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Synaptobrevin
Botulinum toxins B, D, F, G vesicle assoc |
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SNAP-25
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ACE
membrane assoc |
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botulinum toxins do not affect human CNS
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C, D
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Most potent boluinum toxins
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A and G
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Type of botox
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7 types
A to 6 |
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Cleaves both SNAP-25 and Syntaxin?
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C
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botox toxin surrounded by
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hemagglutins
BTX-A 900 kD BTZ-B 700 kD |
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botox heavy chain
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100 kD
carboxy terminal binds |
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light chain botox
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different for each botox
50 kDA C2 heavy chain 100 kD consistent |
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Enzymatic domain botox located
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light chain
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Botox cleavage site
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between light and heavy
disulfide bonds stable in acidic GI tract dissociated at alkaline pH bloodstream and in neuro |
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Heavy chain botox binds with carboxy terminus to?
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SV2 receptor
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Light chain botox catalyzes?
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zinc-dependent cleavage of different SNARE proteins
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abobotulinum toxin
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dysport
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onabotulinum toxin
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botox
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Enzymatic domain botox located
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light chain
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Glogau Type 2
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Dyanmic wrinkles
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Botox contents
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human albumin
NaCL |
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Dysport contents
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human albumin
Lactose |
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Myobloc
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BTX type B
faster shorter diffuses greater pain/side effects no reconstitution stable mths to yrs synaptobrevine (VAMP) of SNARE complex |
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increase BTX 1/2 life
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aminoglycosides
streptomycin, gentamycin, neomycin |
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drugs interfer with BTX action or increase risk of infection
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CCBs, Tetracyclines
Penicillamine Quinine Succinylcholine, Pancuronium Cyclosporine Magnesium Sulfate |
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drugs for BTX eyelid ptosis
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apraclonidine
Phenyleprhine |
