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84 Cards in this Set
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- 3rd side (hint)
M3 receptors
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smooth muscle contraction and gland secretion; eg endothelial cells --> EDRF/NO --> dec BP; bronchoconstriction; saliva release; NO effect on HR
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isoproterenol
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nonspecific beta agonist
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hexamethonium
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nicotinic ganglionic blocker --> blocks peripheral ganglia, prevents baroreceptor response
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parasympathetic tone in BV
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absent (muscarinic receptors are not parasympathetically innervated)
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M2 receptors
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cardiac tissue: slowed SA depol, decreased conduction vel --> dec HR
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tx of Varicella (VZV)
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acyclovir possible, but not as good as it is for HSF. FAMCICLOVIR and VALACYCLOVIR are preferred
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foscarnet
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tx CMV retinitis when gancyclovir fails; viral DNA pol inhibitor (pyroFOSphate analog)
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beta blockers with intrinsic sympathomimetic activity
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acebutolol, pindilol (not recommended for angina)
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ACEi effects on K
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hyperkalemia??
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metoprolol side effects (2)
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bradychardia / varying degrees of AV block; dyslipidemia
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CCBs a/w cardiac block
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Diltiazem and Verapamil (not felodipine or __________)
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Triamterene
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K+ sparing diuretic -- blocks ENaC
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Anti-hypertensives in pts with Diabetic Nephopathy?
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ACEi, eg. Captopril
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minoxidil
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direct vasodilator; profound s/e: hypertrichosis (exceess hair), pericardial effusion, tachycardia, angina --> rarely used as initial tx for HTN
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epinephrine reversal
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epi (large doses) causes vasoconstriction --> inc BP; if anti-alpha agent administered (eg phentolamine), only beta effects left --> vasodilation --> *decreased* BP
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antihypertensive in adult polycystic kidney disease
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ACEi; hypretension usu caused by decreased glomerular perfusion --> RAA;
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drug to decrease conduction rate thru AV node
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digoxin; used to tx afib, aflutter, and CHF; indirect vagomimetic action (??)
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lidocaine in arrythmias
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class IB anti-arrythmic; used to tx ventricular arrythmias
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atropine's cardiac conduction effects
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increases conduction thru AV node (anticholinergic) --> used for AV block
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procainamide
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class IA anti-arrythmic; both supraventricular and ventricular arrythmias
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None
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Quinidine
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afib/flutter, but exerts indirect anticholinergic effect --> decrease vagal tone --> increase AV conduction
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1st tx in hypertrophic cardiomyopathy
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beta-blockers --> prevent dyspnea, angina, arrythmias; CCBs also useful
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tx for HACEK endocarditis
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ceftriaxone (haemophilus, actinobacillus, cardiobacterium, elkenella, kingella kingae)
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clinical signs of infective endocarditis
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OSLER nodules (purplish/red subq nodules on fingers/toes); JANEWAY lesions (hemorrhagic painless plaques on palms/soles); PETECHIAE; SPLINTER hemorrhages
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Alprostadil
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PGE1 analog (like misoprostol), used to maintain PDA
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atropine's effects on blood pressure
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NO EFFECT; atropine blocks muscaranic receptors, but BV have no vagal tone (muscarinic receptors are not innervated); atropine will increase HR (blocks M2 receptors in SA node)
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which tetracycline is bad for pregnancy
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doxycycline ('dox bad for the (baby in the) box')
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S3
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dilated CHF ('plop as blood fills into blood-filled chamber'?)
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S4
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hypertrophic cardiomyopathy (atrial kick into thickened heart)
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nitroprusside use, s/e
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vasodilator, used for HTN; can cause cyanide toxicity (releases CN)
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methyldopa use, s/e
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sympathoplegic used for HTN; can result in positive Coombs test
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reserpine mech, use, s/e
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mech: blocks VMAT, depletes NE; use: HTN; s/e: sedation, depression
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hydralazine mech, use, s/e
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MECH: vasodilator (decreases afterload); USE: HTN and CHF; S/E: lupus-like syndrome
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CCBs, targets of action, tox
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Nifedipine (vasculature); Verapamil/Diltiazem (heart); TOX: flushing, constipation, cardiac depression, edema
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None
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captopril s/e
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CAPTOPRIL (Cough, Angioedema, Proteinuria, Taste Changes from electrolyte shifts, hypOtension, Pregnancy problems, Rash, Increased K/Renin, Lower ATII)
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Nitroglycerin, isosorbide dinitrate: mech, use s/e
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mech: NO --> cGMP -> VENODILATE, dec preload; s/e: "Monday disease" -- tolearnce develops over week, lost over weekend --> tachycardia, hypotension, headache
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digoxin/digitalis toxicity
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arrhythmia (AV block?), changes in color vision (think Van Gogh)
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what potentiates digoxin/digitalis tox? (3)
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1) renal disease: impaires excretion; 2) hypokalemia: potentiates action; 3) quinidine: displaces digoxin from tissue binding sites, decreases clearance
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1' tx of lung abscess in alcoholic
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clindamycin (cover anaerobes)
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tx of choice for paroxysmal SVT
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adenosine (rapid acting, slows conduction thru AV node)
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uses of amiodarone
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"broad spectrum anti-arrhtymic:" SVT and PSVT
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uses of lidocaine
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ventricular arrhythmias
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drug of choice for mucor and its toxicity
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Amphotericin B; tox: RENAL -- hypoK, hypoMG --> can casue arrhythmias
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amphotericin B tox
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renal damage --> electrolyte imbalanace
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milrinone: class, mechanism
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inodilator; PDE III inhibitor --> increased cAMP --> vasodilation + positive inotropy
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cause of angioedema in ACEi
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increased levels of bradykinin --> itchy swelling of face and hands
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most common side effect of nitrates (nitroglycerine and isosorbide)
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throbbing headaches (because of vasodilation)
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treatment for nephrogenic DI
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HCTZ
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most use-dependent subclass of Class I anti-arrhythmics
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Class IB: lidocaine, mexiletine, tocainide
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s/e of verapamil
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flushing, constipation, av block (CCBs are anti-arrhythmic because they slow conduction)
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diuretics with mortality benefits
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ACEi, spironolactone
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amiodarone tox
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"check LFTs, PFTs, TFTs": hepatotox, pulm fibrosis, hyper- or hypothyroidism, photosensitivity, NO TPD (for some reason, minimal TPD risk even tho QT interval is prolonged)
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foscarnet use/tox
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use: CMV retinitis not treatable by gancyclovir; tox: hypoCa/hypoMg (foscarnet is a pyrophosphate --> chelates cations)
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gancyclovir tox
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neutropenia
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s/e of protease inhibitors
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fat redistribution, insulin resistance, hypertriglyceridemia
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potassium levels in digoxin tox
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elevated (causes hyperkalemia)
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use of thiazides vs ACEi
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Thiazides are first line for essential hypertension in absence of CHF / diabetes. If CHF or diabetes, give ACEi (mortality benefit and nephroprotective)
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potassium effects of ACEi/HCTZ
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ACEi retain potassium, HCTZ waste potassium
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which part of action potential does QRS correspond to?
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"phase 0," i.e. NA influx (depolarization)
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sulfa-derived diuretics
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acetazolamide, furosemide (NOT ethacrynic acid), HCTZ
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indications for mannitol
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increased intracranial pressure, shock, drug OD
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contraindications for mannitol
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anuria, CHF (can rapidly pull water out of cells --> pulmonary edema, exacerbating CHF)
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indications for acetazolamide
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glaucoma, need for urinary alkalinization (eg secrete weak acids like salicylate tox), metabolic acidosis
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furosemide toxicity
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ototox and nephrotox (like aminoglycosides and cilastin); also: hypokalemia, gout, sulfa allergy, dehydration
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ethacrynic acid
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like furosemide minus the sulfa tox
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HCTZ use
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idiopathic hypercalciuria (stones risk), nephrogenic DI, HTN, CHF (though prefer ACEi in CHF)
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HCTZ tox
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hyperGLUC (glucose, lipids, uricemia, calcemia), sulfatox
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cyclosporine tox and prevention
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predispose to viral infec/lymphoma; nephrotoxicity (preventable by mannitol diuresis)
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Name the nitrosourea ending and the exception
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"-mustin" (carmustine, lomustine, semustine) and Streptozocin
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None
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cyclosporine vs tacrolimus (FK506)
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both inhibit calcineurin, both used for organ transplant, both cause nephrotocity; cyclosporine predisposes to lymphoma/viral infections, tacrolimus causes peripheral neuropathy, pleural effusions, and hyperglycemia
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AZA use, tox, what drug precipitates
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USE: kidney transplant, AI disorders (GN, hemolytic anemia; TOX: bone marrow suppression; precipitated by allopurinol (prevents breakdown of active metabolite 6-MP)
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Aldesleukin
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IL-2, used for RCC and metastatic melanoma
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gamma interferon used to tx
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chronic granulomatous disease (CGD)
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Oprelvekin
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IL-11; tx thrombocytopenia
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Tx for RA
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3 prong: Anti-Inflammatories (Salicylates, NSAIDs), Bridging therapies (Corticosteroids), and DMARDs [Methotrexate (anti-metabolite, --| purine synth), Etanercept/Infliximab/adalimumab (anti-TNFalpha), sulfasalazine, hydroxychloroquine]
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Acute tx for gout
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NSAIDs (eg indomethacin), followed by colchicine; corticosteroids often added for immediate symptomatic relief, or if NSAIDS/colchicine contraindicated (eg renal failure)
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Chronic tx for gout
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Uricosuric agents (eg probenecid), Allopurinol
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Methotrexate tox
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Stomatitis, hepatotox (macrovesicular fatty change)
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None
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digoxin vs digitalis
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digoxin: renal clearance, shorter halflife; digitalis: hepatic clearance, longer half life (longer name)
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muscle weakness and cramping suggests
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hypokalemia
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Tetracycline in pregnancy can cause what
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growth retardation and discolored teeth (because of cation chelation, specifically calcium)
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bumetanide
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loop diuretic like furosemide
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toxicity of herpes treatments (3 tx)
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foscarnet + IV acylovir: nephrotox + neurotox (seizures, delirium); gancyclovir: nephrotox + neurotox + BM-tox
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tx of lyme dz
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penicillin type Abx, esp ceftriaxone or doxycycline
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