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77 Cards in this Set
- Front
- Back
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digoxin and B-blockers when overdosed on can cause?
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hyperkalemia
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common unintentional poisonings
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COcaine, heroin, benzos, acetaminophen, opioids
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common intentional poisonings
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benzos, acetaminophen, opioids, and sedatives
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accumulation of NAPQI causes
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hepatocyte and renal tubular death
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calcium oxalate crystalluria + renal failure + cyanosis
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ethylene glycol overdose
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ethylene glycol/ methanol antidote
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fomepizole: competitive inhibitor of ADH
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organophosphate overdose antidote
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atropine and pralidoxime (breaks covalent bonds btwn organophosphates & ACh
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anticholinergic overdose antidote
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physostigmine
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lead overdose tx and chelation thx
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tx: seizures w/ BZD; ICP w/ mannitol & CS; chelation thx:EDTA & dimercaprol
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garlic breath = RICE water stool
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arsenic
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tx of arsenic overdose
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dimercaprol (>1000 microgs, dimercaprol is not all that useful)
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tx of iron overdose
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deferoxamine
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tx: CN poisoning
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sodium nitrite & sodium thiosulfate; if IV access= delayed & pt spontaneously breathing hold amyl nitrite pearls under nose
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urinary metabolite of cocaine
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benzoylecgonine
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tx of anxiety/ agitation/ seizures d/t cocaine; tx of severe HTN d/t cocaine
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tx: severe HTN; nitro or phentolamine; benzo's for everything else
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what poisoning/ overdose should you never give a B-blocker to?
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cocaine
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what poisoning/ overdose should you never give a B-blocker to?
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cocaine
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name the calcineurin inhibitors/ immunophilin ligands
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cyclosporine, tacrolimus, sirolimus
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name the antiproliferative/antimetabolic agents
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mycofenolate mofetil and azthioprine
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name the cytotoxic drugs
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cyclophosphamide
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name the biologics
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anti-lymphocyte abs, anti-T cell abs, ant-TNF alpha abs
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name the immunostimulants
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levamisole, thalidomide, BCG, recombinant cytokines (IFN & IL-2)
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what pts are at a high risk of rejection
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repeat transplants, broadly presensitized pts (multiparous mother from a lot of daddy's, blood transplants), african-american pts, pediatric pts
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histiocytic lymphomas form as a result of what?
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ALG toxicity
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works via rapid internalization of T-cell receptor
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Anti-CD3 (muromonab)
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CI a/w murmonab
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Repeat tx
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murmonab anti-CD3 major se
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CYTOKINE release syndrome: inc levels fo TNF alpha, IL-2, IL-6, INF-gamma
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Name the modulating agents
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Daclizumab and Basilizumab
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CD25 =
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IL-2R alpha
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humanization=
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inc 1/2 life and dec SEs (only the CDR has mouse parts)
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what are the modulating agents used for?
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prophylaxis of acute organ rejection in renal transplants
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Basilixmab vs Daclizumab
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Basilixmimab= worse SEs than daclizumab
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for maintenance immunothx, what is typically involved?
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a calcineurin inhibitor, GCs, mycophenolate mofetil
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immune drug to use with steroid resistant rejection
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mycophenolate mofetil & sirolimus
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drugs to use for GVH dz?
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cyclosporine, GCs (prednisolone), MTX, cytarabine, ATG
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drugs to use for ITP>
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Azathioprine, vincristine
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Drugs for AI hemolytic anemia
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Azathioprine, cyclophosphamide
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drugs to use for dermatologic disorders
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Tacrolimus & mycophenolic mofetil
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Toxic side effects of Tacrolimus and cyclosporine
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nephrotoxic, neurotoxic, HTN, hyperK, hypergly
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sirolimus MOA
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binds to FKBP which inhibits mTOR-- does not block interleukin production by T cells
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sirolimus TOX
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BMS (thrombocytopenia)
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How do GCs induce apoptosis?
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by increases IkB expression and curtailing activation of NFkB
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What three ILs are important for differentiation of B cells that are inhibited by GCs?
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IL-1, IL-2, and IL-6
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what is the toxicity of mycophenolate mofetil?
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BMS (neutropenia)
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Pt on azthioprine + allopurinol
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Should dec dose of azathioprine bc allopurinol inhibits xanthine oxidase which is needed to break down and excrete DNA metabolism--> will lead to toxicity.
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Azathioprine toxicity
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BMS (leukopenia, anemia, thrombocytopenia)
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Cyclophosphamide toxicity
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Pancytopenia & hemorrhagic cystitis
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thx for established rejection
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GCs in high doses, polyclonal ALG, muromonab CD3 mAB
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tx for pts w/ high levels of anti-HLA abs
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plasmpheresis, IVIg
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remission can be obtained in what 5 AI disorders
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hemolytic anemia, ITP, DM-I, hashimoto's thyroiditis, temporal arteritis
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doc for ITP
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prednisone
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doc for AI hemolytic anemia
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prednisone
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DOC for Acute GN
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prednisone
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when is infliximab CI
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CHF pts
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which TNF antibody binds to both TNF-alpha and beta?
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Etancercept (also only one that will should + anti-DS DNA abs when toxic)
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Which TNF ab reduces CRP, ESR, IL-6 and MMP?
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Adalimumab (completely human IgG1 monoclonal ab)
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what should you NOT take abatacept w/?
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anti-TNF drugs or anakinra
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where does abatacept bind?
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CD80/86 on APCs (inhibits T cell activation bc it is a CTLA-4)
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CD152=
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CTLA-4
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When do you use mitoxantrone?
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worsening forms of RRMS
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tx of Dukes class C colorectal CA after surgery
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Levamisole ]
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Tx of hodgkin's dz
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levimasole
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toxicity of levamisole
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severe agranulocytosis
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tx for multiple myeloma, erythema nodosum leprosum
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thalidomide
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nonspecific adjuvant or immunostimulant in bladder CA thx
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BCG
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ILF-alpha txs
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HTLV, CML, malign melanoma, kaposi's sarcoma, hep B & C
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INF-beta txs
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RRMS
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INF-gamma tx
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CGD
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GMCSF, GCSF
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premies and neutropenic pts
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IL-2 TXS
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metastic renal cell CA & malignant melanoma
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specific immune globulin preparations are available for what 6 diseases?
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hep B, rabies, tetanus, VZV, CMV, RSV
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tx of breast CA
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trastuzumab
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tx of follicular B cell and non-hodgkin's lymphoma
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rituximab
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tx of CLL?
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alemtuzumab
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immunosuppressor for RSK infection tx
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palivizumab
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immunosuppressor for CV conditions
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abciximab (binds to GP2b/3a receptor)
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immunosuppressor for psoriasis
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Alefacept
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