Usmle Step 1 Pharmacology-Toxicities And Side Effects

Front 1

Type of toxicity and treatment for following signs/symptoms:
Miosis, salivation, sweating, GI cramps, diarrhea, seizures, anxiety/agitation, muscule fasciculations followed by muscle paralysis (incl diaphragm (resp failure, coma)

Back 1

AChE inhibitor poisoning
Treat w/respiratory support; atropine + pralidoxime

Front 2

Type of toxicity and treatment for following signs/symptoms:
Increase HR, increase BP, hyperthermia, decr GI motility, urinary retention, delirium, hallucinations, seizures, coma

Back 2

Atropine and muscarinic blocker poisoning
Treat: control CV sx and hyperthermia plus physostigmine (crosses BBB)

Front 3

Type of toxicity and treatment for following signs/symptoms:
HA, dizziness, N/V, SOB, chest pain, incr HR, decr BP, arryhthmias, confusion, coma

Back 3

CO poisoning
Treat w/ hyperbaric O2 and decontamination

Front 4

Type of toxicity and treatment for following signs/symptoms:
Anxiety/agitation, hyperthermia (warm, sweaty skin), mydriasis, incr HR, incr BP, psychosis, seizures

Back 4

CNS stimulant poisoning
Treat: control CV, hyperthermia, and seizures; BZ"s or antipsychotics may be beneficial

Front 5

Type of toxicity and treatment for following signs/symptoms:
Lethargy, sedation, coma, decr HR, decr BP, miosis, hypoventilation, resp failure, decr GI motility

Back 5

Opioid analgesic poisoning
Treat: ventilatory support; naloxone at frequent intervals

Front 6

Type of toxicity and treatment for following signs/symptoms:
Confusion, lethargy, hyperventilation, ototoxicity, hyperthermia, dehdration, hypokalemia, acid base disturbances, seizures, coma

Back 6

Salicylate poisoning
Treat: correct acidosis and electrolytes, urinary alkalinization, possible hemodialysis

Front 7

Type of toxicity and treatment for following signs/symptoms:
Disinhibition, lethargy, stupor, coma, atazia, nystagmus, hypothermia, respiratory failure

Back 7

Sedative-hypnotics and ethanol toxicity
Treat: ventilatory support-flumazenil if BZ's implicated

Front 8

Type of toxicity and treatment for following signs/symptoms:
Agitation, confusion, coma, muscle rigidity, hyperthermia, seizures, autonomic instability

Back 8

SSRI toxicity
Treat: control hyperthermia, seizures-possible use of cyproheptadine and BZ's

Front 9

Type of toxicity and treatment for following signs/symptoms:
Mydriasis, hyperthermia (hot, dry skin), convulsions, coma, cardiotoxicity

Back 9

TCA toxicity
Treat: control seizures and hyperthermia, correct acidosis plus possible antiarrhythmics

Front 10

Antidote for the following toxin: acetaminophen

Back 10

N acetylcysteine

Front 11

Antidote for the following toxin: salicylates

Back 11

Sodium bicarb (alkalinize the urine), dialysis

Front 12

Antidote for the following toxin: amphetamines (basic)

Back 12

Ammonium chloride to acidify the urine

Front 13

Antidote for the following toxin: anticholinesterases, organophophates

Back 13

Atropine, pralidoxime

Front 14

Antidote for the following toxin: beta blockers

Back 14

Glucagon

Front 15

Antidote for the following toxin: digitalis

Back 15

Stop dig, normlize K+, lidocaine, anti Dig Fab frags, Mg2+

Front 16

Antidote for the following toxin: iron

Back 16

Deferoxime

Front 17

Antidote for the following toxin: lead

Back 17

CaEDTA, dimercaprol, succimer, penicillamine

Front 18

Antidote for the following toxin: mercury, arsenic, gold

Back 18

Dimercaprol (BAL), succimer

Front 19

Antidote for the following toxin: copper, arsenic, gold

Back 19

Penicillamine

Front 20

Antidote for the following toxin: cyanide

Back 20

Nitrite, hydroxocobolamin, thiosulfate

Front 21

Antidote for the following toxin: Methemoglobin

Back 21

Methylene blue, vitC

Front 22

Antidote for the following toxin: CO

Back 22

100% oxygen, hyperbaric oxygen

Front 23

Antidote for the following toxin: methanol, ethylene glycol (antifreeze)

Back 23

Ethanol, dialysis, fomepizole

Front 24

Antidote for the following toxin: opioids

Back 24

Naloxone

Front 25

Antidote for the following toxin: TCA's

Back 25

Sodium bicarb (serum alkalinization)

Front 26

Antidote for the following toxin: heparin

Back 26

Protamine

Front 27

Antidote for the following toxin: warfarin

Back 27

vitK, fresh frozen plasma

Front 28

Antidote for the following toxin: tPA, streptokinase

Back 28

Aminocaprioc acid

Front 29

Antidote for the following toxin: theophylline

Back 29

Beta blocker

Front 30

Antidote for the following toxin: non specific-all oral poisonings except Fe, CN, Li, solvents, mineral acids, or corrosives

Back 30

Activated charcoal

Front 31

Arsenic poisoning:
(a) signs/symptoms
(b) treatment

Back 31

(a) Acute: GI distress, garlic breath, "rice water" stools, hypotension
Chronic: paresthesias, stocking glove neuropathy, pallor from anemia, skin
Arsine gas: HA, n/v, abd pain, dyspnea, jaundice
(b) dimercaprol, penicillamine, succimer, supportive care

Front 32

Iron
(a) signs/symptoms
(b) treatment

Back 32

(a) severe GI distress, GI bleeding, hepatocellular injury, seizures, shock, coma
Chronic: metabolic acidosis, scarring leading to GI obstruction
(b) deferoxamine

Front 33

Lead
(a) signs/symptoms
(b) treatment

Back 33

(a) Acute: abdominal (colic, n/v) CNS (HA, ataxia, seizures, coma, encephalopathy)
Chronic: sideroblastic anemia, neuropathy (wrist drop), GI sx, nephropathy, developmental delays, growth retardation, decreased fertility, still births
(b) EDTA< dimercaprol, succimer

Front 34

Mercury
(a) signs/symptoms
(b) treatment

Back 34

(a) acute: vapor inhalation-chest pain, dyspnea, pneumonitis, confusion
Acute: tremors, gingivitis, CNS disturbances, GI distress, renal failure
ChronicL renal failure, dementia, acrodynia
Organic: CNS (paresthesias, auditory and visual loss, movement disorders
(b) dimercaprol, penicillamine, succimer

Front 35

Drug rxn(s): TCA's

Back 35

Atropine like side effects

Front 36

Drug rxn(s): cocaine, sumatriptan

Back 36

Coronary vasospasm

Front 37

Drug rxn(s): Niacin, CCB, adenosine, vanc

Back 37

Cutaneous flushing

Front 38

Drug rxn(s): doxorubicin, daunurubicin

Back 38

Dilated cardiomyopathy

Front 39

Drug rxn(s): class III (sotalol), class IA (quinidine), antiarrhythmics, cisapride

Back 39

Torsades de pointes

Front 40

Type of toxicity and treatment for following signs/symptoms:
Miosis, salivation, sweating, GI cramps, diarrhea, seizures, anxiety/agitation, muscule fasciculations followed by muscle paralysis (incl diaphragm (resp failure, coma)

Back 40

AChE inhibitor poisoning
Treat w/respiratory support; atropine + pralidoxime

Front 41

Type of toxicity and treatment for following signs/symptoms:
Increase HR, increase BP, hyperthermia, decr GI motility, urinary retention, delirium, hallucinations, seizures, coma

Back 41

Atropine and muscarinic blocker poisoning
Treat: control CV sx and hyperthermia plus physostigmine (crosses BBB)

Front 42

Type of toxicity and treatment for following signs/symptoms:
HA, dizziness, N/V, SOB, chest pain, incr HR, decr BP, arryhthmias, confusion, coma

Back 42

CO poisoning
Treat w/ hyperbaric O2 and decontamination

Front 43

Type of toxicity and treatment for following signs/symptoms:
Anxiety/agitation, hyperthermia (warm, sweaty skin), mydriasis, incr HR, incr BP, psychosis, seizures

Back 43

CNS stimulant poisoning
Treat: control CV, hyperthermia, and seizures; BZ"s or antipsychotics may be beneficial

Front 44

Type of toxicity and treatment for following signs/symptoms:
Lethargy, sedation, coma, decr HR, decr BP, miosis, hypoventilation, resp failure, decr GI motility

Back 44

Opioid analgesic poisoning
Treat: ventilatory support; naloxone at frequent intervals

Front 45

Type of toxicity and treatment for following signs/symptoms:
Confusion, lethargy, hyperventilation, ototoxicity, hyperthermia, dehdration, hypokalemia, acid base disturbances, seizures, coma

Back 45

Salicylate poisoning
Treat: correct acidosis and electrolytes, urinary alkalinization, possible hemodialysis

Front 46

Type of toxicity and treatment for following signs/symptoms:
Disinhibition, lethargy, stupor, coma, atazia, nystagmus, hypothermia, respiratory failure

Back 46

Sedative-hypnotics and ethanol toxicity
Treat: ventilatory support-flumazenil if BZ's implicated

Front 47

Type of toxicity and treatment for following signs/symptoms:
Agitation, confusion, coma, muscle rigidity, hyperthermia, seizures, autonomic instability

Back 47

SSRI toxicity
Treat: control hyperthermia, seizures-possible use of cyproheptadine and BZ's

Front 48

Type of toxicity and treatment for following signs/symptoms:
Mydriasis, hyperthermia (hot, dry skin), convulsions, coma, cardiotoxicity

Back 48

TCA toxicity
Treat: control seizures and hyperthermia, correct acidosis plus possible antiarrhythmics

Front 49

Antidote for the following toxin: acetaminophen

Back 49

N acetylcysteine

Front 50

Antidote for the following toxin: salicylates

Back 50

Sodium bicarb (alkalinize the urine), dialysis

Front 51

Antidote for the following toxin: amphetamines (basic)

Back 51

Ammonium chloride to acidify the urine

Front 52

Antidote for the following toxin: anticholinesterases, organophophates

Back 52

Atropine, pralidoxime

Front 53

Antidote for the following toxin: beta blockers

Back 53

Glucagon

Front 54

Antidote for the following toxin: digitalis

Back 54

Stop dig, normlize K+, lidocaine, anti Dig Fab frags, Mg2+

Front 55

Antidote for the following toxin: iron

Back 55

Deferoxime

Front 56

Antidote for the following toxin: lead

Back 56

CaEDTA, dimercaprol, succimer, penicillamine

Front 57

Antidote for the following toxin: mercury, arsenic, gold

Back 57

Dimercaprol (BAL), succimer

Front 58

Antidote for the following toxin: copper, arsenic, gold

Back 58

Penicillamine

Front 59

Antidote for the following toxin: cyanide

Back 59

Nitrite, hydroxocobolamin, thiosulfate

Front 60

Antidote for the following toxin: Methemoglobin

Back 60

Methylene blue, vitC

Front 61

Antidote for the following toxin: CO

Back 61

100% oxygen, hyperbaric oxygen

Front 62

Antidote for the following toxin: methanol, ethylene glycol (antifreeze)

Back 62

Ethanol, dialysis, fomepizole

Front 63

Antidote for the following toxin: opioids

Back 63

Naloxone

Front 64

Antidote for the following toxin: TCA's

Back 64

Sodium bicarb (serum alkalinization)

Front 65

Antidote for the following toxin: heparin

Back 65

Protamine

Front 66

Antidote for the following toxin: warfarin

Back 66

vitK, fresh frozen plasma

Front 67

Antidote for the following toxin: tPA, streptokinase

Back 67

Aminocaprioc acid

Front 68

Antidote for the following toxin: theophylline

Back 68

Beta blocker

Front 69

Antidote for the following toxin: non specific-all oral poisonings except Fe, CN, Li, solvents, mineral acids, or corrosives

Back 69

Activated charcoal

Front 70

Arsenic poisoning:
(a) signs/symptoms
(b) treatment

Back 70

(a) Acute: GI distress, garlic breath, "rice water" stools, hypotension
Chronic: paresthesias, stocking glove neuropathy, pallor from anemia, skin
Arsine gas: HA, n/v, abd pain, dyspnea, jaundice
(b) dimercaprol, penicillamine, succimer, supportive care

Front 71

Iron
(a) signs/symptoms
(b) treatment

Back 71

(a) severe GI distress, GI bleeding, hepatocellular injury, seizures, shock, coma
Chronic: metabolic acidosis, scarring leading to GI obstruction
(b) deferoxamine

Front 72

Lead
(a) signs/symptoms
(b) treatment

Back 72

(a) Acute: abdominal (colic, n/v) CNS (HA, ataxia, seizures, coma, encephalopathy)
Chronic: sideroblastic anemia, neuropathy (wrist drop), GI sx, nephropathy, developmental delays, growth retardation, decreased fertility, still births
(b) EDTA< dimercaprol, succimer

Front 73

Mercury
(a) signs/symptoms
(b) treatment

Back 73

(a) acute: vapor inhalation-chest pain, dyspnea, pneumonitis, confusion
Acute: tremors, gingivitis, CNS disturbances, GI distress, renal failure
ChronicL renal failure, dementia, acrodynia
Organic: CNS (paresthesias, auditory and visual loss, movement disorders
(b) dimercaprol, penicillamine, succimer

Front 74

Drug rxn(s): TCA's

Back 74

Atropine like side effects

Front 75

Drug rxn(s): cocaine, sumatriptan

Back 75

Coronary vasospasm

Front 76

Drug rxn(s): Niacin, CCB, adenosine, vanc

Back 76

Cutaneous flushing

Front 77

Drug rxn(s): doxorubicin, daunurubicin

Back 77

Dilated cardiomyopathy

Front 78

Drug rxn(s): clozapine, carbamazepine, colchicine, propylthiouracil, methimazole

Back 78

Agranulocytosis

Front 79

Drug rxn(s): chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole

Back 79

Aplastic anemia

Front 80

Drug rxn(s): chloramphenicol

Back 80

Gray baby syndrome

Front 81

Drug rxn(s): INH, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin

Back 81

Hemolysis in G6PD deficient patients

Front 82

Drug rxn(s): pheyntoin, methotrexate, sulfa drugs

Back 82

Megalblastic anemia

Front 83

Drug rxn(s): OCP's

Back 83

Thrombotic complications

Front 84

Drug rxn(s): ACEI's

Back 84

Cough

Front 85

Drug rxn(s): bleomycin, busulfan, amiodarone

Back 85

Pulmonary fibrosis

Front 86

Drug rxn(s): macrolides

Back 86

Acute cholestatic hepatitis

Front 87

Drug rxn(s): halothane, valproic acid, acetaminophen, Amanita phalloides

Back 87

Focal to massive hepatic necrosis

Front 88

Drug rxn(s): INH

Back 88

Hepatitis

Front 89

Drug rxn(s): clindamycin, ampicillin

Back 89

Pseudomembranous colitis

Front 90

Drug rxn(s): glucocorticoid withdrawal

Back 90

Adrenocortical insufficiency

Front 91

Drug rxn(s): spironolactone, difitalis, cimetidine, chronic alcohol use, estrogens, ketoconazole

Back 91

Gynecomastia

Front 92

Drug rxn(s): tamoxifen, clomiphene

Back 92

Hot flashes

Front 93

Drug rxn(s): pheyntoin

Back 93

Gingival hyperplasia

Front 94

Drug rxn(s): furosemide, thiazides

Back 94

Gout

Front 95

Drug rxn(s): corticosteroids, herparin

Back 95

Osteoporosis

Front 96

Drug rxn(s): sulfonamides, amiodarone, tetracyline

Back 96

Photosensitivity

Front 97

Drug rxn(s): ethosuximide, lamotrigine, carbamazepine, phenobarbital, pheytoin, sulfa drugs, penicillin, allopourinol

Back 97

Rash (S-J syndrome)

Front 98

Drug rxn(s): hdralazine, INH, procainamide, phenytoin

Back 98

SLE like syndrome

Front 99

Drug rxn(s): fluoroquinolones

Back 99

Tendonitis, tendon rupture, cartilage damage (kids)

Front 100

Drug rxn(s): expired tetracycline

Back 100

Fanconi's syndrome

Front 101

Drug rxn(s): methicillin, NSAIDs, furosemide

Back 101

Interstitial nephritis

Front 102

Drug rxn(s): cyclophosphamide, ifosfamide

Back 102

Hemorrhagic cystitis (prevent by coadmin w/mesna)

Front 103

Drug rxn(s): quinidine, quinie

Back 103

Cinchonism

Front 104

Drug rxn(s): lithium, demeclocyline

Back 104

Diabetes insipidus

Front 105

Drug rxn(s): haloperidol, chlorpromazine, reserpine, metoclopramide

Back 105

Parkinson like syndrome

Front 106

Drug rxn(s): bupropion, imipenem/cilastatin, isoniazid

Back 106

Seizures

Front 107

Drug rxn(s): tardive dyskinesia

Back 107

Antipsychotics

Front 108

Drug rxn(s): metronidazole, certain cephalosporins, procarbazine, 1st generaton sulfonylyreas

Back 108

Disulfiram like rxn

Front 109

Drug rxn(s): polymyxins

Back 109

Nephrotoxicity/neurotoxicity

Front 110

Drug rxn(s): aminoglycosides, vancomycin, loop diuretics, cisplatin

Back 110

Nephrotoxicity/ototoxicity

Front 111

Sulfa drugs

Back 111

Celecoxib, furosemide, probenecid, thiazides, TMP-SFX, sulfasalazine, sulfonylurea, sumatriptan

Front 112

Sulfa drug possible toxicities in patients with sulfa allergies

Back 112

Fever, pruritic rash, SJ syndrome, hemolytic anemia, thrombocytopenia, agranulocytosis, and urticaria (hives). Sx range from mild to life threatening