Toxicity And Side Effects

Front 1

Beer criteria

Back 1

Criteria used to reduce potentially inappropriate prescribing and harmful polypharmacy in the geriatric patient

Front 2

Harmful medication on geriatric patients

Back 2

Alpha blocker - risk of hypotension

Anti-cholinergic, antidepressants, antihistamine opioidsbdb - Risk of constipation , urinary retention, delirium, sedation and fall

Benzodiazepines- Risk of delirium, sedation and fall

NSAIDs- Risk of GI bleeding

PPI- Risk of C. Difficle infection

Front 3

Treatment of acetaminophen, anticholinesterase and anticholinergic/Antimuscarinic overdose

Back 3

Acetaminophen- N Acetylcycteine (replenishes glutathione)

Anticholinesterase, organophosphate - atropine

Anticholinergic/Antimuscurinic - Physostigmine

Front 4

Treatment for arsenic, Mercury and lead poisoning

Back 4

Dimercaprol

Succimer

Front 5

Treatment of lead poising

Back 5

Dimercopral

Succimer

EDTA

Calcium disodium

Penicillamine

Front 6

Treatment of beta blockers and benzodiazepines

Back 6

Beta blocker- glucagon, atropine and saline

Benzodiazepines- Flumazinil

Front 7

Treatment of carbon monoxide, copper and cyanide poising

Back 7

Carbon monoxide- 100% O2, hyperbaric O2

Copper- Penicillamine, Tridentine

Cyanide- Hydroxycobalamine, sodium nitrites + thiosulfate

Front 8

Treatment of heparan and warfarin

Back 8

Heparin- Protamine sulfate

Warfarin- Vitamin K, PCC (Prothrombin complex concentrate) FFP( immediate)

Front 9

Treatment of irons and methemoglobin overdoses

Back 9

Iron- Deferoximine, deferoriox, deferiprone

Methemoglobin- Methylene blue, vitamins C

Front 10

Treatment of methanol, ethylene glycol(antifreeze)

Back 10

Fomepizole

Alcohol

Dialysis

Front 11

Treatment of opioid, salicylate and TCA overdose

Back 11

Opioid- Naloxone

Salicylate- sodium bicarbonate

TCA- sodium bicarbonate (stabilize cardiac membrane)

Front 12

Redman syndrome

Back 12

Rate dependent infusion reaction of vancomycin that causing widespread pruritic erythema due to histamine release

Treatment with DOH or slow infusion rate

Front 13

Treatment of digoxin overdose

Back 13

Digoxin specific antibody fragment

Front 14

What drug can be used to reverse dabigatran toxicity

Back 14

Idarucizumab (a monoclonal antibody)

Front 15

What is the treatment for methotrexate toxicity

Back 15

Leucovorin (rescue therapy)

Front 16

Treatment of apixaban toxicity

Back 16

Andexanet Alfa (used for direct factor Xa inhibitor)

Front 17

Drug cause coronary vasospasm

Back 17

Cocaine

Amphetamine

Sumatriptan

Ergot alkaloids

Hint 17

CASE

Front 18

Drugs causing cutaneous flushing

Back 18

Vancomycin

Adenosine

Niacin

Ca channel blockers

Echinocandins

Nitrates

Hint 18

VANCEN

Front 19

Drugs causing cutaneous flushing

Back 19

Vancomycin

Adenosine

Niacin

Ca channel blockers

Echinocandins

Nitrates

Hint 19

VANCEN

Front 20

Drugs causing dilated cardiomyopathy

Back 20

Anthracyclins (Doxorubicin and Daunorubicine

Prevent- Dexrazoxane

Front 21

Drugs causing torsades de pointes

Back 21

Anti arrhythmia- type 1A and 3

AntiBiotics- macrolides

Anti psychotics - haloperidol

Antidepressant- TCA

Antiemetics - ondonsetran

Hint 21

ABCDE

Front 22

Drugs causing adrenocortical insufficiency

Back 22

HPA suppression 2 glucocorticoid withdrawal

Front 23

Drugs causing diabetes insipidus

Back 23

Lithium

Demeclocycline

Front 24

Drugs causing hot flashes

Back 24

SERMs

Tamoxifen

Clomiphene

Raloxifene

Front 25

Drugs causing hyperglycemia

Back 25

Tacrolimus

Protease inhibitor

Niacin

HCTZ

Corticosteroids

Hint 25

The people need hard candy

Front 26

Drugs causing hyperprolactinemia

Back 26

Typical antipsychotic - haloperidol

Atypical antipsychotics- risperidone

Metoclopramide

Methyldopa

Reaper one

Present with hypogonadism and galactohea

Front 27

Drugs causing hyperthyroidism

Back 27

Amiodarone

Iodine

Front 28

Drug causing hypothyroidism

Back 28

Amiodarone

Sulphanomide

Lithium

Hint 28

Am suddenly lethargic

Front 29

Drugs causing SIADH

Back 29

Carbamazepine

Cyclophosphamide

SSRI

Hint 29

Can’t concentrate serum sodium

Front 30

Drugs causing gynecomastia

Back 30

Ketoconazole

Cimetidine

Spironolactone

5 alpha reductase inhibitor

Front 31

Drugs that increase pupils size

Back 31

1- Anticholinergic (atropine, antihistamine, TCA, tropicamide, scopolamine)

2- Drugs of abuse (amphetamine, cocaine, LSD)

3- Sympathomimetics

Front 32

Drugs that decrease pupil size

Back 32

1- Sympatholytics (alpha 2 agonist)

2- Drugs of abuse (heroine, opioids)

3- Parasympathomimetics ( pilocarpine) organophosphate

Front 33

Inducers of cytochrome P 450

Back 33

1- Modafinil

2- Chronic alcohol use

3- St. John’s wort

4- Phenytoin

5- Phenobarbital

6- Nevirapine

7- Rifampin

8- Grisofulvin

9- Carbomazapine

Hint 33

Most chronic alcoholics steal phen phen and never refuse greasy cards

Front 34

Substrates of cytochrome P450

Back 34

Warfarin

Anti- epileptic

Theophylline

OCP

Hint 34

War against the OCP

Front 35

Inhibitors of cytochrome P 450

Back 35

1- Sodium valproate

2- Isoniazid

3- Cimetidine

4- Ketoconozole

5- Fluconazole

6- Acute alcohols abuse

7- Chloramphenicol

8- Erythromycin/ clarithromycine

9- Sulfonamide

10- Ciprofloxacin

11- Omeprazole

12- Metronidazole

13- Amiodarone

14- Ritinovir

15- Grapefruitjucie

Hint 35

SICKFACES.COM After AM Really drinking grapefruit juice

Front 36

Sulfa drugs

Back 36

1- Sulfonamide drugs

2- Sulfasalazine

3- Probenecid

4- Furosemide

5- Acetazolamide

6- Celecoxib

7- Thiazides

8- Sulfonylureas

Hint 36

Sick sulfa pharm FACTS

Front 37

What are 2 dermatological manifestation of sulfa allergy

Back 37

Urticaria (hives)

Steven johnson syndrome

Front 38

What are the 3 hematological manifestation of sulfa allergy

Back 38

Agranulocytosis

Thrombocytopenia

Hemolytic anemia

Front 39

2 genitourinary manifestation of sulfa allergy

Back 39

Urinary tract infection

Acute intestinal nephritis

Front 40

Cause of fanconi syndrome

Back 40

1- Cisplatin

2- Ifosfamide

3- Expired tetracycline

4- Tenofovir

Front 41

Cause of hemorrhagic cystitis

Back 41

Cyclophosphamide

Ifosfamide

Treat with mesna

Front 42

Cause of interstitial nephritis

Back 42

1- Diuretics

2- NSAIDs

3- Penicillins

4- Cephalosprine

5- PPI

6- Rifampin

7- Sulfa drugs

Front 43

Drugs causing dry cough

Back 43

ACE inhibitors

Front 44

Drugs causing Pulmonary fibrosis

Back 44

1- Methotrexate

2- Nitrofurantoin

3- Carmustine

4- Bleomycin

5- Busulfan

6- Amiodarone

Hint 44

My nose cannot breath bad air

Front 45

Cause antimuscarinic

Back 45

1- Atropine

2- TCA

3- H1 blocker

4- Antipsychotics

Front 46

Cause antimuscarinic

Back 46

1- Atropine

2- TCA

3- H1 blocker

4- Antipsychotics

Front 47

Causes of disulfiram like reactions

Back 47

1- 1st line sulfanylurea

2- Procarbazine

3- Cephalosporin

4- Griseofulvin

5- Metrinidazole

Front 48

Cause antimuscarinic

Back 48

1- Atropine

2- TCA

3- H1 blocker

4- Antipsychotics

Front 49

Causes of disulfiram like reactions

Back 49

1- 1st line sulfanylurea

2- Procarbazine

3- Cephalosporin

4- Griseofulvin

5- Metrinidazole

Front 50

Causes of ototoxicity/nephrotoxicity

Back 50

Aminoglycoside

Amphotericin B

Cisplatin

Loop diuretics

Vancomycin

Front 51

What drug may be given to ameliorate ototoxicity and nephrotoxicity caused by cisplatin use

Back 51

Amifostin

Front 52

Histamine (scombroid poising)

Back 52

1- Spoiled dark meat fish- tuna, mahi-mahi, mackerel and bontio

2- Bacterial histidine decarboxylase convert histidine to histamine (frequently diagnoses as fish allergy)

3- Symptoms mimics anaphylaxis 1- Acute burning sensation of the mouth

2- Facial flushing

3- Erythema and urticaria

4- Itching

5- Bronchospasm

6- Angioedema

7- Hypotension

4- Treatment- antihistamine, Albuterol and epinephrine if needed

Front 53

Tetrodotoxin

Back 53

1- Puffer Fish

2- Highly potent toxin, bind fast to voltage gated Na channels in nerve tissue preventing depolarization

2- Symptoms 1- Diarrhea

2- Dizziness

3- Loss of reflexes

4- Paresthesia

5- Nausea

4- Treatment- supportive

Front 54

Ciguatoxin

Back 54

1- Reef fish- barracuda, snapper and moray eel

2- Open Na channel - cause depolarization

3- Symptoms 1- Nausea

2- Vomiting

3- Diarrhea

4- Peri-oral numbness

5- Reverse cold and hold sensation

6- Bradycardia

7- Heart block

8- Hypotension

4- Treatment - supportive

Front 55

What is a unique symptom of ciguatoxin poising

Back 55

Temperature related dysesthesia

Reversal of hot and cold sensation

Front 56

What changes in the elderly May affect distribution of drugs in the body

Back 56

Increase body fat content

Decrease albumin

Decrease total body water

Front 57

What changes in the elderly affect drug metabolism in the body

Back 57

Decrease hepatic mass

Decrease hepatic blood flow

Decrease drug metabolism

Front 58

What changes in the elderly May affect absorption of drugs in the body

Back 58

Increase gastric pH

Decrease gastric emptying

Increase interaction with food

Front 59

What changes in the elderly May affect elimination of drugs from the body

Back 59

Reduce GFR and tubular secretion

Increase plasma concentration of drugs that are eliminated by kidney

Front 60

What are the 4 categories of pharmacokinetics that are helpful in understanding age related changes

Back 60

Metabolism

Absorption

Distribution

Elimination

Front 61

Drug causing acute cholestatic hepatitis jaundice

Back 61

Macrolide

Front 62

Drug causing diarrhea

Back 62

1- Acamprosate

2- Anti-diabetics (metformin, acorbose, promlintide)

3- Colchicine

4- Cephalosporin

5- Chemotherapy (irinitican)

6- Lipid lowering drugs

7- Macrolides

8- SSRI

Front 63

Drug causing diarrhea

Back 63

1- Acamprosate

2- Anti-diabetics (metformin, acorbose, promlintide)

3- Colchicine

4- Cephalosporin

5- Chemotherapy (irinitican)

6- Lipid lowering drugs

7- Macrolides

8- SSRI

Front 64

Drugs causing focal massive hepatic necrosis

Back 64

1- Halothane

2- Amanta phyllodes

3- Valproate acid

4- Acetaminophen

Hint 64

HAVeA

Front 65

Drug causing diarrhea

Back 65

1- Acamprosate

2- Anti-diabetics (metformin, acorbose, promlintide)

3- Colchicine

4- Cephalosporin

5- Chemotherapy (irinitican)

6- Lipid lowering drugs

7- Macrolides

8- SSRI

Front 66

Drugs causing focal massive hepatic necrosis

Back 66

1- Halothane

2- Amanta phyllodes

3- Valproate acid

4- Acetaminophen

Hint 66

HAVeA

Front 67

Drugs causing hepatitis

Back 67

1- Rifampin

2- Isoniazid

3- Pyrazinamide

4- Statins

5- Fibrates

Front 68

Drugs causing pancreatitis

Back 68

1- Didanosine

2- Corticosteroids

3- Alcohol

4- Valproate acid

5- Azathioprine

6- Diuretics (furosemide,HTCZ)

Front 69

Drugs causing pancreatitis

Back 69

1- Didanosine

2- Corticosteroids

3- Alcohol

4- Valproate acid

5- Azathioprine

6- Diuretics (furosemide,HTCZ)

Hint 69

Drugs causing a violent abdominal disease

Front 70

Drugs causing pill-induced eaophagitis

Back 70

1- Bisphosphate

2- Ferrous sulphate

3- Potassium chloride

4- NSAID

5- Tetracycline

Front 71

Drugs causing pseudomembranous colitis

Back 71

1- Ampicillin

2- Cephalosporin

3- Clindamycin

4- Fluoroquinolone

5- PPI

Front 72

What 2 suggestions could help minimize pill induced esophagitis

Back 72

1- Maintain an upright posture

2- Drink enough water

Front 73

What is the most likely location of pill induced esophagitis

Back 73

Esophageal narrowing (near aortic arch)

Front 74

Drug causing agranulocytosis

Back 74

1- Clozapine

2- Carbamazepine

3- Colchicine

4- Dapsone

5- Propylthiouracil

6- Ganciclovir

7- Methamizole

Front 75

Drugs causing aplastic anemia

Back 75

1- Benzene

2- Carbamazepine

3- Chloramphenicol

4- NSAID

5- Methamizole

6- Propylthiouracil

Front 76

Drugs causing direct Coombs positive hemolysis

Back 76

1- Penicillins

2- Alpha methyl dopa

3- Cephalosporin

Front 77

Drugs causing direct Coombs positive hemolysis

Back 77

1- Penicillins

2- Alpha methyl dopa

3- Cephalosporin

Front 78

Drugs cause drug reaction with eosinophils and systemic symptoms DRESS

Back 78

1- Allopurinol

2- Anti-epileptic

3- Antibiotic

4- Sulfa drugs

Front 79

Features of drug reaction with eosinophils and systemic symptoms

Back 79

1- Latent period 2-8 weeks

2- Fever, morbilliform akin rash and multi organ involvement

3- Treat with withdrawal of drug or corticosteroids

Front 80

Drug causing blue baby syndrome

Back 80

Chloramphenicol

Front 81

Drugs causing hemolysis in G6PD deficiency

Back 81

1- Isoniazid

2- Sulfonamide

3- Dapsone

4- Primaquine

5- Aspirin

6- Ibuprofen

7- Nitrofurantoin

Hint 81

IS D PAIN

Front 82

Drug causing megaloblastic anemia

Back 82

1- Phenytoin

2- Hydroxyurea

3- Methotrexate

4- Sulfa drugs

Front 83

Drugs causing thrombocytopenia

Back 83

1- Heparin

2- Indinavir

3- Vancomycin

4- Ganciclovir

5- Abciximab

6- Linezolid

7- Quinidine

Front 84

Drugs causing thrombotic complication

Back 84

1- OCP

2- Hormone replacement therapy

3- SERMs (tamoxifen)

Front 85

Drugs causing drug induce lupus

Back 85

1- Methyldopa

2- Minocycline

3- Hydralazine

4- Isoniazid

5- Phenytoin

6- Sulfa drugs

7- Entonercept

8- Procainamide

Hint 85

Lupus makes my HIPS Extremely Painful

Front 86

Drugs causing fat redistribution

Back 86

1- Protease inhibitor

2- Glucocorticoids

Hint 86

Fat PiG

Front 87

Drugs causing fat redistribution

Back 87

1- Protease inhibitor

2- Glucocorticoids

Hint 87

Fat PiG

Front 88

Drugs causing gingival hyperplasia

Back 88

1- Cyclosporine

2- Ca channel blockers

3- Phenytoin

Front 89

Drugs causing fat redistribution

Back 89

1- Protease inhibitor

2- Glucocorticoids

Hint 89

Fat PiG

Front 90

Drugs causing gingival hyperplasia

Back 90

1- Cyclosporine

2- Ca channel blockers

3- Phenytoin

Front 91

Drugs causing hyperuricemia

Back 91

1- Cyclosporine

2- Niacin

3- Pyrazinamide

4- Thiazides

5- Furosemide

Front 92

Drugs causing fat redistribution

Back 92

1- Protease inhibitor

2- Glucocorticoids

Hint 92

Fat PiG

Front 93

Drugs causing gingival hyperplasia

Back 93

1- Cyclosporine

2- Ca channel blockers

3- Phenytoin

Front 94

Drugs causing hyperuricemia

Back 94

1- Cyclosporine

2- Niacin

3- Pyrazinamide

4- Thiazides

5- Furosemide

Front 95

Drug causing myopathy

Back 95

1- Colchicine

2- Daptomycin

3- Fibrate

4- Hydroxychloroquine

5- Interferon alpha

6- Penicillin

7- Statin

8- Glucocorticoids

9- Niacin

Front 96

Drugs causing fat redistribution

Back 96

1- Protease inhibitor

2- Glucocorticoids

Hint 96

Fat PiG

Front 97

Drugs causing gingival hyperplasia

Back 97

1- Cyclosporine

2- Ca channel blockers

3- Phenytoin

Front 98

Drugs causing hyperuricemia

Back 98

1- Cyclosporine

2- Niacin

3- Pyrazinamide

4- Thiazides

5- Furosemide

Front 99

Drug causing myopathy

Back 99

1- Colchicine

2- Daptomycin

3- Fibrate

4- Hydroxychloroquine

5- Interferon alpha

6- Penicillin

7- Statin

8- Glucocorticoids

9- Niacin

Front 100

Drugs causing osteoporosis

Back 100

1- Aromatase inhibitor

2- Anti-epileptics

3- Corticosteroids

4- Depo medroxyprogesterone acetate

5- GnRH agonist

6- Heparin

7- PPI

Front 101

Drugs causing photosensitive

Back 101

1- Sulphanamide

2- Amiodarone

3- Tetracycline

4- 5-FU

Hint 101

SAT for Photo

Front 102

Drugs causing Steven johnson syndrome

Back 102

1- Allopurinol

2- Anti-epileptic

3- Penicillin

4- Sulfa drug

Front 103

Drug causing teeth discoloration

Back 103

Tetracycline

Front 104

Drug causing tendon/cartilage damage

Back 104

fluoroquinolone

Front 105

Drugs causing cinchonism

Back 105

1- Quinidine

2- Quinine

Can cause tinnitus, vision/hearing loss, psychosis and cognitive impairment

Front 106

Drugs causing cinchonism

Back 106

1- Quinidine

2- Quinine

Can cause tinnitus, vision/hearing loss, psychosis and cognitive impairment

Front 107

Drugs causing Parkinson’s like symptoms

Back 107

1- Antipsychotic

2- Reserpine

3- Metoclopramide

Hint 107

Cogwell rigidity of ARM

Front 108

Drugs causing peripheral neuropathy

Back 108

1- Isoniazid

2- Phenytoin

3- Platinum drugs eg Cisplatin

4- Vincristine

Front 109

Drugs cause idiopathic intracranial hypertension

Back 109

1- Growth hormone

2- Tetracycline

3- Vitamin A

Front 110

Drugs causing seizures

Back 110

1- Isoniazid

2- Bupropion

3- Imipenem

4- Tramodol

5- Enflurance

Hint 110

I BITE

Front 111

Drugs causing seizures

Back 111

1- Isoniazid

2- Bupropion

3- Imipenem

4- Tramodol

5- Enflurance

Hint 111

I BITE

Front 112

Drugs causing tardive dyskinesia

Back 112

1- Antipsychotic

2- Metoclopramide

Front 113

Drugs causing visual disturbance

Back 113

1- Topiramate (blurred vision, diplopia, halo)

2- Digoxin (yellow tinged vision)

3- Isoniazid (optic neuritis)

4- Vigabatrin (bilateral visual field defects)

5- PDE-5 inhibitor (blue tinged vision)

6- Ethambutol (color vision changes)

Hint 113

Theses drugs irritate very precious eyes

Front 114

Where in the synapse does a drug inhibiting acetylcholinesterase act

Back 114

Post synaptic membrane

Front 115

What are the steps by which amphetamines gain access to neurosecretory vesicles in presumptive neurons

Back 115

Amphetamine use norepinephrine transporter (NETs) to enter presynaptic terminals then they enter vesicles via vesicular monoamine transporters

Front 116

What is the pathophysiology of botulism

Back 116

Blocks acetylcholine release from the presynaptic vesicles producing flaccid paralysis

Front 117

What 2 drugs promote the release of norepinephrine from presynaptic vessels into the synapses

Back 117

Amphetamine

Ephedrine

Front 118

How does reserpine affect presynaptic norepinephrine release

Back 118

Block neurotransmitter packing into vesicles by inhibiting vesicular monoamine transporter

Decrease the lease of norepinephrine into the synapse

Front 119

What 3 drugs inhibit the reuptake of norepinephrine from the synapses

Back 119

Amphetamine

Cocaine

TCA

Front 120

Which 2 receptors modulate the presynaptic release of norepinephrine

Back 120

Angiotensin 2 receptors (promote release)

Alpha 2 receptors (inhibit release)

Front 121

What 3 mechanism are used to clear norepinephrine from the synaptic cleft

Back 121

Diffusion

Metabolism

Reuptake

Front 122

Where in the neuron is dopamine converted to norepinephrine

Back 122

Presynaptic vesicles

Front 123

What enzyme breaks down acetylcholine in the synaptic cleft

Back 123

Acetylcholinesterase (AChE)

Front 124

A drug induced presynaptic acetylcholine release by promoting the entry of which ion into the nerve terminal

Back 124

Ca

Front 125

Which enzyme is responsible for the formation of acetylcholine

Back 125

Choline acetyltransferase

Front 126

What are the 2 substrate of choline acetyltransferase

Back 126

Acetyl-coenzyme A

Choline

Front 127

What 2 products result from the breakdown of acetylcholine by acetylcholinesterase

Back 127

Choline

Acetate

Front 128

What molecules are responsible for the packaging of dopamine into neurosecretory vesicles

Back 128

Vesicular monoamine transporters

Front 129

How does angiotensin II receptor antagonist affect presynaptic release of norepinephrine

Back 129

Decrease release of norepinephrine