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173 Cards in this Set
- Front
- Back
28-yr old chemist presents with MTPT exposure. Which neurotransmitter is depleted?
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Dopamine
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Woman takes tetracycline. What are the clinical manifestations of photosensitivity?
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Rash on sun-exposed regions of her body
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Black guy develops hemolytic anemia after taking anti-malarial drugs. Which enzyme is he missing?
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glucose-6-phosphate dehydrogenase
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Farmer presents with dyspnea, salivation, miosis, diarrhea, cramping, blurry vision. What caused this, and how?
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insecticide poisining, due to inhibition of acetylcholinesterase
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27-yr old woman taking a neuroleptic now has urinary retention. What do you treat her with?
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Bethanechol
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Which antifungal drug is contraindicated in people taking cyclosporine?
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ketoconazole
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What routine workups should be done on all patients on carbemazepine?
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LFTs
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A woman taking both rifampin and birth control gets pregnant. How?
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rifampin increases estrogen metabolism in the liver
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A drug with a low Km value has [high/low] affinity for its substrate
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high
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A high Km value means what for a drug?
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that it has low affinity for it's substrate
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What is the formula for Volume of Distribution?
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(amount of drug in body) /
(plasma drug concentration) |
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Where will you find drugs with a low volume of distribution in the body?
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In the blood
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Where will you find drugs with a high volume of distribution in the body?
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distributed in tissues
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Where does a drug have to be in the body to express its effects?
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In the blood, mostly
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What is the equation for drug clearance?
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(rate of drug elimination) / (plasma drug concentration)
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In plain english, what is the half-life of a drug?
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The amount of time it takes for the concentration of a drug to decrease by half
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What is the equation for a drug's half-life?
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0.7 x volume of distribution / clearance
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How many half lives does it take, during constant infusion, for a drug to reach steady state?
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between 4 and 5 half lives
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How is a zero-order elimination drug eliminated from the body?
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constant amount per unit time; on a graph, a linear relationship
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How is a first-oder elimination drug eliminated from the body?
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constant fraction per unit time; on a graph, an exponential relationship
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What are some common drugs with zero-order elimination kinetics?
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aspirin, phenytoin, ethanol
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Drugs that are weak acids get trapped in which body compartments?
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weakly basic ones
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Drugs that are weak bases get trapped in which body compartments?
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weakly acidic ones
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What enzyme carries out Phase I metabolism in the body?
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cytochrome P-450 in the liver
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In general, what are the products of Phase I metabobolism of drugs?
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slightly polar, water soluble, still active metabolites
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In general, what are the products of Phase II metabolism of drugs?
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very polar, water soluble, inactive metabolites
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What 3 reactions are usually involved in Phase I metabolism?
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reduction, oxidation, hydrolysis
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What 3 reactions are usually involved in Phase II metabolism?
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glucuronidation, acetylization, sulfation
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What is the difference between efficacy and potentcy?
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Efficacy is the total effect of the drug. Potency is the amount of drug needed to make an effect.
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How does a competitive antagonist affect the efficacy of a drug?
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It has no change on the efficacy
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How does a competitive antagonist affect the potency of a drug?
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competitive antagonists reduce the potency of drugs
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How does an irreversible antagonist affect the potency of a drug?
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irreversible antagonists reduce the potency of drugs slightly
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How does an irreversible antagonist affect the efficacy of a drug?
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irreversible antagonists reduce the efficacy of drugs quite a bit
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How can you compare efficacy of a partial agonist drug with full agonist drug?
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The both act on the same mechanism, but the full agonist has more efficacy
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How can you compare potency of a partial agonist drug with a full agonist drug?
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they both act on the same system. Potency can be equal, greater, or lesser for either one. It's independant
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What is the formula for finding the Therapeutic index of a drug?
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(median toxic dose) / (median effective dose)
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Safer drugs have a (higher, lower) therapeutic index than dangerous drugs
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safer drugs have a higher therapeutic index than dangerous drugs
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What type of receptors are nicotinic ACh?
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ligand-gates ion channels
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What type of receptors are muscarinic ACh receptors?
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G-protein coupled receptors
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What is Bethanechol and what is it used for?
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Cholinergic agonist, stimulates bladder and bowel muscles
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What is Carbachol, and what is it used for?
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Cholinergic agonist,used for glaucoma because it constricts pupils and reduced intraocular pressure
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What is Pilocarpine, and what is it used for?
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Cholinergic agonist. used for glaucoma, also to stimulate tears, sweat, saliva
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What is Methacholine, and what is it used for?
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Cholinergic agonist. Constricts bronchioles. used as a challenge test to diagnose asthma
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What is Neostigmine, and what is it used for?
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Anticholinesterase. Used to reverse surgical paralysis, to treat myasthenia gravis. Peripheral nerves only.
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What is Pyridostigmine, and what is it used for?
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Anticholinesterase. Long acting. Treats Myasthenia Gravis
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What is Edrophonium, and what is it used for?
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Anticholinesterase. Short acting. used to diagnose Myasthenia Gravis
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What is Physostigmine, and what is it used for?
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Anticholinesterase. Enters the CNS. Used for glaucoma and atropine overdose
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What is Echothiophate, and what is it used for?
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Anticholinesterase. Used for glaucoma
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How do you treat poisoning by cholinesterase inhibitors?
(organophosphates, parathion) |
atropine and pralidoxime
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What is Atropine and what is it used for?
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Muscarinic antagonist. causes mydriasis and cycloplegia in the eye
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What is Benztropine and what is it used for?
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Muscarinic antagonist. Acts in CNS, treats Parkinsons' symptoms
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What is Scopolamine, and what is it used for?
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Muscarinic Antagonist. Acts in the CNS to treat motion sickness
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What is Ipratropium, and what is it used for?
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Muscarinic antagonist. Acts in lung to treat COPD and asthma
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What is Methscopolamine, and what is it used for?
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Muscarinic Antagonist, acts in the GU tract to treat cystis and bladder spasms
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What is Pirenzepine, and what is it used for?
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Muscarinic Antagonist. Acts in the GI tract to treat peptic ulcers
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How does epinephrine help in glaucoma?
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vasoconstriction causes less production of aqueous humor
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What type of glaucoma should you NEVER use epinephrine in?
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closed-angle glaucoma, because epinephrine causes mydriasis
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How does Brimonidine help in glaucoma?
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decreases aqueous humor production. None of the side effects that epinephrine has
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How does Acetazolamide help in treating glaucoma?
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inhibits carbonic anhydrase, causing reduced bicarb secretion, which causes reduced aqueous humor production
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How do beta-blockers like timolol, betaxolol, and carteolol help in glaucoma?
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reduced secretion of aqueous humor
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How do the cholinergic agonists help in glaucoma?
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relaxes the trabecular meshwork and constrict the pupil, both lead to increased humor outflow
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How do prostaglandins like Latanoprost help in glaucoma?
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increases aqueous humor outflow
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What does Hexamethonium do?
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It's a nicotinic antagonist, used to block vagal reflexes
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which receptors does epinephrine work best on?
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alpha 1 and 2, beta 2. Doesn't work well on beta 1
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which receptors does norepinephrine work best on?
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alpha1 and alpha2. Doesn't work well on the betas
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Which receptors does isoproterenol work best on?
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beta 1 and beta 2. Doesn't work well on the alphas
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Which receptors does Phenylephrine work best on?
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alpha 1. Works a little bit on alpha 2
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Which receptors does albuterol/terbutaline work best on?
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beta 2. Works a little bit on beta1
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Which receptors does ritodrine work best on?
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beta2
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How does Amphetamine work, and what do you use it for?
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releases stored catecholamines. Treats narcolepsy, ADHD
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How does Ephedrine work, and what do you use it for?
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releases stored catecholamines. Treats nasal congestion, hypotension, urinary incontinence
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How does Cocaine work, and what do you use it for?
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inhibits reuptake of catecholamines. Causes vasoconstriction and local anesthesia
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How does Clonidine work, and what do you use it for?
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activates alpha2 receptors. Treats hypertension
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What are the common 4 beta2 agonists?
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Metaproterenol, Albuterol, Salmeterol, Terbutaline. MAST
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What is phenoxybenzamine, and what do you use it for?
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alpha antagonist, irreversible. Treats pheochromocytoma
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What is phentolamine, and what do you use it for?
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alpha antagonist, reversible. Treats pheochromocytoma
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What is prazosin, and what do you use it for?
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alpha 1 antagonist. Treats hypertension, urinary retention
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What is terazosin, and what do you use it for?
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alpha 1 antagonist. Treats hypertension, urinary retention
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What is doxazosin, and what do you use it for?
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alpha 1 antagonist. Treats hypertension, urinary retention
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What is mirtazapine, and what do you use it for?
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alpha 2 antagonist. Treats depression.
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What are some side effects of Mirtazapine?
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increased appetite, sedation, increased cholesterol levels
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Which 5 beta blockers affect beta1 and beta2 receptors equally?
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propranolol, timolol, nadolol, pindolol, labetalol
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Which 5 beta blockers prefer beta 1 receptors?
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acebutalol, betaxolol, esmolol, atenolol, metoprolol
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Which beta blockers also affect alpha adrenergic receptors?
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carvedilol, labetalol
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How do beta blockers help in hypertension?
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decreased cardiac output, decreased renin secretion
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How do beta blockers help in treating angina?
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decreased heart rate and contractility reduce the heart's need for oxygen
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How do beta blockers help with super-ventricular tachycardia?
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they decrease AV conduction velocity
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What is the antidote for acetominophen overdose?
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N-acetylcysteine
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What is the antidote for salicylate overdose?
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bicarb and dialysis
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What is the antidote for amphetamine overdose?
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ammonium chloride to acidify the urine
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What is the antidote for organophosphate or anticholinesterase overdose?
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atropine and pralidoxime
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What is the antidote for anti-muscarinic/anti-cholinergic agent overdose?
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physostigmine
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What is the antidote for beta-blocker overdose?
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glucagon
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What is the antidote for digoxin overdose?
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normalize K+, lidocaine, Mg++
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What is the antidote for iron overdose?
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deferoxamine
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What is the antidote for lead overdose?
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EDTA, dimercaprol, succimer, penicillamine
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What is the antidote for arsenic and mercury overdose?
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dimercaprol, succimer
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What is the antidote for copper and gold overdose?
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penicillamine
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What is the antidote for cyanide overdose?
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nitrite, hydroxocobalamin, thiosulfate
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What is the treatment for methemoglobinemia?
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Methylene blue, Vitamin C
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What is the antidote for carbon monoxide poisoning?
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100% or hyperbaric O2
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What is the antidote for methanol and ethylene glycol overdose?
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ethanol, dialysis, fomepizole
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What is the antidote for opiod overdose?
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naloxone or naltrexone
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What is the antidote for benzodiazepine overdose?
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flumanezil
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What is the antidote for tricyclic antidepressant overdose?
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bicarb, to make the serum more basic
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What is the antidote for heparin?
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protamine
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What is the antidote for warfarin?
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vitamin K and fresh frozen plasma transfusion
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What is the antidote for tPA and streptokinase?
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aminocaproic acid
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What are some clinical signs of lead poisoning?
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encephalopathy, stippling on erythrocytes, anemia, belly pain, wrist and foot drop
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What are some clinical signs of iron poisoning?
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gastric bleeding, metabolic acidosis, GI scarring
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How does iron kill cells when you are in iron overload?
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leads to peroxidation of the cell membrane lipids
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What 7 drugs are inducers of P-450?
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Qinidine, Barbiturates, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, St. John's Wort (QBPRGCS)
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What 6 drugs are inhibitors of P-450?
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Isoniazid, Sulfonamides, Cimetidine, Ketoconazole, Erythromycin, Grapefruit juice (ISCKEG)
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What drug can cause atropine-like side effects in the cardiovascular system as a side effect?
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tricyclics
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What drugs can cause coronary vasospasm as a side-effect?
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cocaine, sumatriptan
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What drugs can cause cutaneous flushing as a side-effect?
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niacin, calcium channel blockers, adenosine, vancomycin
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What drugs can cause dilated cardiomyopathy as a side-effect?
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doxorubicin
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What drugs can cause torsades de pointes as a side effect?
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class III and class Ia antiarrhythmics, cisapride
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What drugs can cause agranulocytosis as a side effect?
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clozapine, carbamazepine, colchicine, propylthiouracil, methimazole
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What drugs can cause aplastic anemia as a side effect?
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chloramphenicol, benzene, NSAIDS, propylthiouracil, methimazole
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What drug can cause Coombs-positive hemolytic anemia?
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methyldopa
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What drug can cause gray baby syndrome as a side effect?
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chloramphenicol
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What drugs cause hemolysis in patients with G6PD deficiency?
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Isoniazid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin (IS PAIN)
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What drugs can cause cough as a side effect?
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ACE inhibitors
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What drugs can cause pulmonary fibrosis as a side effect?
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bleomycin, busulfan, amiodarone
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What drugs can cause acute cholestatic hepatits as a side effect?
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macrolides
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What drugs can cause focal and global hepatic necrosis?
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halothane, valproic acid, acetominophen, amanita mushrooms
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What drug can cause hepatits as a side effect?
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isoniazid
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What drugs can cause pseudomembranous colitis?
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clindamycin, ampicillin
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What drugs can cause adrenocortical insufficiency as a side effect?
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withdrawal of glucocorticoid therapy
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What drugs can cause gynecomastia as a side effect?
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Spironolactone, digoxin, cimetidine, alcohol, ketoconazole, estrogen (Some Drugs Create Awesome Knockers, Eh?)
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What drugs can cause hot flashes as a side effect?
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tamoxifen, clomiphene
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What drug can cause gingival hyperplasia as a side effect?
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phenytoin
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What drugs can cause gout as a side effect?
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furosemide, thiazides
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What drugs can cause osteoporosis as a side effect?
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corticosteroids, heparin
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What drugs can cause photosensitivity as a side effect?
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sulfonamides, amiodarone, tetracycline
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What drugs can cause lupus-like symptoms as a side effect?
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hydralazine, isoniazid, procainamide, phenytoin
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what drugs can cause tendonitis and cartilage damage as side effects?
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fluoroquinolones
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What drugs can cause Fanconi's syndrome as a side effect?
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expired tetracycline
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What is Fanconi's syndrome?
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When the proximal tubule of the kidney doesn't reabsorb amino acids, glucose, and electrolytes
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What drugs can cause interstitial nephritis as a side effect?
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methicillin, NSAIDS
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what drugs can cause cinchonism as a side effect?
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quinidine, quinine
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What are the symptoms of cinchonism?
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ringing ears, flushed skin, blurry vision, impaired hearing, confusion, headache, rash, nausea
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What drugs can cause diabetes insipidus as a side effect?
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lithium, demeclocycline
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What drugs can case seizures as a side effect?
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buproprion, imipenem, cilastatin
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What drugs can cause tardive dyskinesia as a side effect?
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antipsychotics
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What drugs can cause disulfiram-like reaction as a side-effect?
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metronidazole, cephalosporins, procarbazine, sulfonylureas
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What drugs have both nephrotoxic and neurotoxic side-effects?
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polymyxins
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What drugs have both nephrotoxic and ototoxic side-effects?
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aminoglycosides, loop diuretics, cisplatin
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Alcohol dehydrogenase metabolizes ethylene glycol into _______, which causes ______.
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oxalic acid / acidosis, nephrotoxicity
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alcohol dehydrogenase metabolizes methanol into ______, which causes ______.
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formaldehyde and formic acid / severe acidosis, retinal damage
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alcohol dehydrogenase metabolizes ethanol into _______, which causes ______.
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acetaldehyde / nausea, vomiting, headache, hypotension
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What enzyme does disulfiram inhibit?
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acetaldehyde dehydrogenase
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What do you use echinacea for?
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the common cold
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What do you use Ephedra for?
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same things you use ephedrine for
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What do you use feverfew for?
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migraines
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What do you use gingko for?
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muscle pain and cramps
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What do you use Kava for?
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chronic anxiety
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What do you use milk thistle for?
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viral hepatitis
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What do you use saw palmetto for?
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benign prostate hyperplasia
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What do you use St. John's Wort for?
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depression
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What do you use dehydroepiandosterone for?
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helps lupus or AIDS symptoms in females
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What do you use melatonin for?
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jet lag, insomnia
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What are common side effects of echinacea use?
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GI distress, dizziness, headache
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What are some common side effects of ephedra use?
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CNS stimulation, arrythmia, stroke, seizure
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What are some common side effects of feverfew?
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GI distress, mouth ulcers, antiplatelet actions
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What are some common side effects of gingko use?
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GI distress, anxiety, insomnia, headache, bleeding
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What are some common side effects of kava use?
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GI distress, sedation, ataxia, hepatotoxicity
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What are some common side effects of milk thistle use?
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loose stools
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What are some common side effects of saw palmetto use?
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GI distress, decreased libido, hypertension
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What are some common side effects of St. John's Wort use?
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GI distress, phototoxicity, serotonin syndrome, induces P-450
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What are some common side effects of dehydroepiandrosterone use?
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virilization in women, feminization in men
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What are some common side effects of melatonin use?
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sedation, suppression of LH, hypoprolactinemia
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