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74 Cards in this Set
- Front
- Back
what heart drug can cause pulmonary fibrosis, thyroid dysfunction and hepatocellular necrosis?
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amiodarone class IA and III antiarrhythmic drug
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what is a possible drug given to someone with supraventricular tachycardia (220 bpm)?
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amiodarone
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what heart drug can lead to bronchospasm, 1st degree heart block, hypotension and bradycardia?
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beta-blockers (class II antiarrhythmics)
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what drug is used to treat HTN, tachyarrhythmias, hypertrophic cardiomyopathy, prevention of angina and migraines, treating glaucoma and hyperthyroidism?
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beta-blocker
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what HTN drug is contraindicated in pregnancy (fetotoxicity), causes taste changes, rash, proteinuria, hyperkalemia, angioedema? what is a well-known X?
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ACE inhibitors cough
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what is a predisposing factor for digitalis toxicity? what drugs can cause this condition?
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hypokalemia diuretics
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what local anesthetic can cause tonic-clonic convulsions if given systemically? how is it treated?
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lidocaine diazepam or barbiturates
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how does lidocaine work?
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it's an amide that blocks sodium channels in rapidly firing cells (myocardium, pain fibers, CNS)
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what antihypertensive can cause impotence, positive Coombs test (20% of pts), rare hemolytic anemia, orthostatic hypotension and hepatic toxicity?
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alpha methyldopa
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how does alpha methyldopa work?
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activates inhibitory alpha2 receptors in CNS
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what lipid-lowering drug can cause flushing, hepatitis and hyperglycemia?
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niacin
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what drug class can cause angina or MI as a result of rebound coronary vasoconstriction due to withdrawal?
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nitrates
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what angina medication leads to drug tolerance?
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nitroglycerin
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what heart drug causes tinnitus (ringing in ears), poor accomodation (eyes), GI distress? what are these group of side effects called? what is a characteristic EKG pattern?
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quinidine cinchonism widened QRS and prolonged QT
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what heart medication can cause facial flushing, constipation, hyperprolactinemia and peripheral edema? what drug class is it?
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verapamil calcium channel blocker
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what 4 drugs or classes have been associated with the Stevens-Johnson syndrome?
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sulfas penicillin phenytoin barbiturates
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after taking sulfa drug, pt presents with generalized desquamation of the skin, high fever, painful ulcers and bullae in eyes and vagina. also presents with painful mucosal ulcerations in conjunctiva, nose, mouth, oropharynx and vagina. disease?
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Stevens-Johnson syndrome
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define: pseudotumor cerebri what can cause it?
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increased brain pressure in the absence of a tumor certain drugs can cause it: vitamin A, tetracycline, nitrofurantoin, phenytoin, lithium, amiodarone
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define: papilledema what is the condition a sign of?
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swelling of the head of the optic nerve sign of increased inracranial presure
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what are other terms for the "head of the optic nerve"?
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optic disk or papilla
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what is xerophthalmia?
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dry eyes
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after taking vitamins, pt presents with night blindness, xerophthalmia, dry skin with scaling. what vitamin is the pt taking too much of?
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vitamin A
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what causes epigastric pain that is relieved by eating?
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peptic ulcer
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how do steroids work?
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blocks the conversion of phospholipids to arachidonic acid by phospholipase A
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what anti-inflammatory leads to hypertension, moon facies, acne, lymphopenia, hyperglycemia, osteoporosis if taken in high doses over a long time?
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prednisone
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how can in utero exposure to DES affect females? males?
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females: persistence of mullerian glands on upper vagina, clear cell carcinoma males: genital tract abnormality
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what is adenosis?
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squamous metaplasia
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in insulin overdose, glucose uptake by the cells is accompanied by what shift in electrolytes?
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K+ and Mg+ shift into the cell, causing hypokalemia and hypomagnesemia
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what can be the most severe consequences of insulin overdose?
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permanent neuro damage or death
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if taking an oral contraceptive leads to a neurological dysfunction, what is the likely etiology?
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oral contraceptives lead to increased incidence of vascular thrombotic events, either cerebral or myocardial stroke is the likely cause
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what is osteopenia?
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mild thinning of the bone mass...not as severe as osteoporosis
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how does estrogen help in the prophylaxis of osteoporosis in post-menopausal women?
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in short: block IL-6 production, anti-PTH effects decreases bone resorption by inhibiting synthesis of interleukins like IL-6 and retarding bone-resorbing effects of PTH
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when is estrogen therapy contraindicated? what are possible long term effects of estrogen therapy?
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pregnancy, breast cancer, active hepatitis gallstones, breast cancer, thrombophlebitis
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what is the most active metabolite of vitamin D that stimulates bone formation via osteoblasts?
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calcitriol [(1,25)-OH-vitamin D]
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what happens to bone density in osteoporosis?
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decreases
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what is the most potent molecule in the prevention of osteoporosis?
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estrogen
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what are two factors that increase the risk for osteoporosis?
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smoking and nullparity
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what is Trousseau's sign?
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carpopedal spasm on inflating BP cuff
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what type of drugs are alendronate and pamidronate? what are they used to treat?
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bisphophonates used to increase bone mass in osteoporosis alendrONATE and pamidrONATE are bisphosphONATEs
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name 2 bisphosphonates and their side effects.
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alendronate, pamidronate "Al and Pam Drone on" X: hypocalcemia, increased PTH levels, upper GI irritation & esophageal ulceration (when given orally)
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what osteoporosis meds cause GI irritation and esophageal ulceration?
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bisphophonates
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what's the most common cause of congenital hypogonadism?
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Klinefelter's syndrome
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what 2 syndromes are associated with secondary hypogonadism?
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Prader-Willi syndrome Kallmann's syndrome
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when is testosterone contra-indicated in men?
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those with prostatic carcinoma
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what is Ma Huang, an alternative herbal supplement?
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ephedrine, a sympathomimmetic drug that stimulates sympathetic nerve system and is synergistic with caffeine
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orlistat and sibutramine are anti-obesity drugs. how does each work?
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olistat: lipase inhibitor acts in the GI tract and blocks absorption of dietary fat sibutramine: appetite suppression by blocking the reuptake of NE and serotonin (metabolized by p450)
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megestrol acetate and dronabinol are used to stimulate appetite in patients with cachexia and anorexia syndrome. how does each work?
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megestrol acetate: synthetic progesterone analogue that stimulates appetite dronabinol: a synthetic THC, the active component of marijuana, treats nausea and vomiting associated with cancer chemotherapy and to stimulate appetite
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what are 4 drugs that damage the gastric mucosa?
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aspirin, NSAIDs, steroids, alcohol
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marked eosinophilia can indicate what process in a patient?
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allergic reaction
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inhaled anesthetics have what effect on hepatic blood flow?
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decreases
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what are second-line TB drugs?
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fluoroquinolones and aminoglycosides
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what should pts take with INH to help prevent peripheral neurotoxicity? why does this help?
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pyridoxine INH competes with pyridoxine for the same enzyme (apotryptophanase)
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what conditions can result from laxative abuse?
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colonic neuronal degeneration and "lazy intestine syndrome"
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what 2 drugs can be used to treat pseudomembranous colitis?
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metronidazole or oral vancomycin
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what is the main clinical indication for clindamycin?
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life-threatening infections with anaerobes
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how does pseudomembranous colitis present?
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fever, abdominal cramping, diarrhea with pus and mucus
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what drug is used to control hyperammonemia?
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lactulose
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what drugs can be given to lower intracranial pressure in kids?
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mannitol or dexamethasone (synthetic adrenal corticosteroid)
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how does someone with Reye's syndrome present?
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coma, hyperammonemia, acute hepatic necrosis, cerebral edema "hepatoencephalopathy"
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kids with what 2 bugs shouldn't be given aspirin?
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chickenpox or influenza B
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people exposed to anilines, benzidine and beta-naphthylamines are at risk for what cancer?
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papillary transitional cell carcinoma of the bladder
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bleomycin is an antibiotic that is used to treat epideromoid and testicular cancers. what are its side effects?
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hypertrophy of keratinized areas of the body and nail pigmentation in older pts: pulmonary fibrosis
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how does cisplatin work and in what cancers is it administered?
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alkylating agent that cross-links DNA used in bladder and testicular cancers and some ovarian tumors
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what are cisplatin side effects?
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renal damage in dehydrated pts, CN VIII damage (permanent deafness), peripheral neuropathy
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does cyclophosphamide, an anti-cancer alkylating agent, work directly on target cells?
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no, needs to metabolized by the liver first (needs to be CYCLed through liver first)
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what drug, used to treat lymphomas and breast & ovarian carcinomas, causes hemorrhagic cystitis, bladder fibrosis, bladder carcinoma, sterility and inappropriate ADH secretion?
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cyclophosphamide (must feel similar to what you feel after CYCLing for too long)
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doxorubicin (aka. adriamycin) is an antibiotic used as an anti-cancer agent. what is the mxn and what are side effects?
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mxn: binds to DNA and blocks new RNA/DNA synthesis and inhibits cell replication X: dilated cardiomyopathy (dose-related and irreversible) and marrow toxicity
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what is the antidote for heparin overdose?
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protamine sulfate
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how does heparin work?
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complexes with antithrombin III, a potent inactivator for factor Xa and inhibitor of conversion prothrombin -> thrombin
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what is a dose-related complication of heparin in 30% of pts?
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thrombocytopenia (low platelets)
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how do you treat iron overdose?
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1. gastric lavage with bicarb, forms ferrous carbonate which isn't absorbed well 2. chelation therapy with deferoxamine
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how does methotrexate, an anti-cancer drug, work?
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binds reversibly to dihydrofolate reductase to prevent synthesis of purine and pyrimidine nucleotides
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what drug can be given to counter the adverse effects of methotrexate? how does it work?
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leucovorin it's an active form of folic acid which can catalyze the one-carbon transfer reactions for purine and pyrimidine synthesis
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what are methotrexate side effects?
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ulceration of oral mucosa, diarrhea, myelosuppression
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