AE

Question 1

amiodarone

Answer 1

pulmonary fibrosis,hepatotoxicity, hypothyroidism/
hyperthyroidism (amiodarone is 40% iodine byweight), acts as hapten (corneal deposits, blue/gray skin deposits resulting in photodermatitis),neurologic effects, constipation, cardiovasculareffects (bradycardia, heart block, HF).

Question 2

aminoglycosides

Answer 2

Nephrotoxicity, Neuromuscular blockade,
Ototoxicity (especially when used with loop
diuretics). Teratogen.

NNOT

Question 3

Μαννιτόλη (διουρητικο

Answer 3

Proximal renal tubular acidosis, paresthesias,

NH3 toxicity, sulfa allergy.

Question 4

Διουρητικά Αγκύλης Furosemide, bumetanide, torsemide

Answer 4

Ototoxicity, Hypokalemia, Dehydration,
Allergy (sulfa)/metabolic Alkalosis, Nephritis
(interstitial), Gout.
ΟΗ DANG

Question 5

Diourtiko αιθακρινικό οξύ

Answer 5

Similar to furosemide, but more ototoxic.

Question 6

Thiazide diuretics Hydrochlorothiazide, chlorthalidone,

metolazone

Answer 6

Hypokalemic metabolic alkalosis,
hyponatremia, hyperGlycemia,
hyperLipidemia, hyperUricemia,
hyperCalcemia. Sulfa allergy.

Question 7

Potassium-sparing
diuretics Spironolactone and eplerenone; Triamterene,
and Amilorid

Answer 7

Hyperkalemia (can lead to arrhythmias),
endocrine effects with spironolactone (eg,
gynecomastia, antiandrogen effects).

Question 8

b blockers

Answer 8

Impotence, exacerbation of COPD and asthma, cardiovascular effects (bradycardia, AV block, HF),
CNS effects (sedation, sleep alterations). May mask the signs of hypoglycemia.
Metoprolol can cause dyslipidemia. Propranolol can exacerbate vasospasm in Prinzmetal angina.
β-blockers (except the nonselective α- and β-antagonists carvedilol and labetalol) cause unopposed
α1-agonism if given alone for pheochromocytoma or cocaine toxicity. Treat β-blocker overdose with
saline, atropine, glucagon

Question 9

corticosteroids

Beclomethasone, dexamethasone, hydrocortisone, methylprednisolone, prednisone, triamcinolone.

Answer 9

Iatrogenic Cushing syndrome (hypertension, weight gain, moon facies, truncal obesity,
buffalo hump, thinning of skin, striae, acne, osteoporosis, hyperglycemia, amenorrhea,
immunosuppression), adrenocortical atrophy, peptic ulcers, steroid diabetes, steroid psychosis,
cataracts.
Adrenal insufficiency when drug stopped abruptly after chronic use.

Question 10

bisphosphonates

Alendronate, ibandronate, risedronate, zoledronate.

Answer 10

Esophagitis (if taken orally, patients are advised to take with water and remain upright for 30
minutes), osteonecrosis of jaw, atypical stress fractures.

Question 11

Aspirin

Answer 11

Gastric ulceration, tinnitus (CN VIII). Chronic use can lead to acute renal failure, interstitial
nephritis, GI bleeding. Risk of Reye syndrome in children treated with aspirin for viral infection.
Causes respiratory alkalosis early, but transitions to mixed metabolic acidosis-respiratory alkalosis.

Question 12

NSAIDs

Answer 12

Interstitial nephritis, gastric ulcer (prostaglandins protect gastric mucosa), renal ischemia
(prostaglandins vasodilate afferent arteriole).

Question 13

Acetaminophen

Answer 13

Overdose produces hepatic necrosis; acetaminophen metabolite (NAPQI) depletes glutathione and
forms toxic tissue byproducts in liver. N-acetylcysteine is antidote—regenerates glutathione.

Question 14

Doxorubicin

Answer 14

Cardiotoxicity (dilated
cardiomyopathy),
myelosuppression, alopecia.
Dexrazoxane (iron chelating
agent), used to prevent
cardiotoxicity.

Question 15

Angiotensinconverting
enzyme
inhibitors
Captopril, enalapril, lisinopril, ramipril.

Answer 15

Cough, Angioedema (due to  bradykinin;
contraindicated in C1 esterase inhibitor
deficiency), Teratogen (fetal renal
malformations),  Creatinine ( GFR),
Hyperkalemia, and Hypotension. Used with
caution in bilateral renal artery stenosis,
because ACE inhibitors will further  GFR
Ž renal failure.
Captopril’s CATCHH.

Question 16

aminophylline

Answer 16

Stomach pain/cramping, nausea, vomiting, diarrhea, loss of appetite, headache, trouble sleeping, irritability, restlessness, nervousness, shaking (tremors), flushing, and increased urination may occu

Question 17

heparin

Answer 17

Bleeding, thrombocytopenia (HIT), osteoporosis, drug-drug interactions. For rapid reversal

(antidote) , use protamine sulfate (positively charged molecule that binds negatively charged
heparin) .

Question 18

warfarin

Answer 18

Bleeding, teratogenic, skin/tissue necrosis A ,
drug-drug interactions. Proteins C and S have
shorter half-lives than clotting factors II,
VII, IX, and X, resulting in early transient
hypercoagulability with warfarin use. Skin/
tissue necrosis within first few days of large
doses believed to be due to small vessel
microthromboses

Question 19

methotrexate

Answer 19

Myelosuppression, which is
reversible with leucovorin
“rescue.”
Hepatotoxicity.
Mucositis (eg, mouth ulcers).
Pulmonary fibrosi

Question 20

cyclophosphamide

Answer 20

Myelosuppression; hemorrhagic
cystitis, prevented with
mesna (thiol group of mesna
binds toxic metabolites) or
N-acetylcysteine.

Question 21

ΑΥΑ Ανταγωνιστές Υποδοχέα Αγγειοτασίνης ΙΙ

Answer 21

Hyperkalemia, μειωνουν GFR, hypotension; teratogen.

Question 22

β-λακτάμες

Answer 22

Penicillin G, V
Hypersensitivity reactions, direct Coombs ⊕ hemolytic anemia.
Penicillinase-sensitive penicillins
Hypersensitivity reactions; rash; pseudomembranous colitis.
Penicillinase-resistant penicillins Dicloxacillin, nafcillin, oxacillin.
Hypersensitivity reactions, interstitial nephritis.
Antipseudomonal penicillins Piperacillin, ticarcillin.
hypersensivity

Question 23

Infliximab

Answer 23

serious infections
reactivation of hepatitis B
reactivation of tuberculosis[18]
lethal hepatosplenic T-cell lymphoma (generally only when combined with 6-mercaptopurine)
drug-induced lupus
demyelinating central nervous system disorders
psoriasis and psoriasiform skin lesions
new-onset vitiligo

Cases of leukopenia, neutropenia, thrombocytopenia, and pancytopenia (some fatal) have been reported with inflixima

Question 24

statines

Answer 24

Hepatotoxicity ( LFTs),
myopathy (esp. when used
with fibrates or niacin)

Question 25

Tetracyclines

Answer 25

GI distress, discoloration of teeth and inhibition of bone growth in children, photosensitivity.
Contraindicated in pregnancy.

Question 26

πεντασθενούς αντιμμωνίου

Answer 26

Sodium stibogluconate is exceedingly phlebotoxic. One of the practical problems is that after a few doses it can become exceedingly difficult to find a vein in which to inject the drug. The insertion of a PICC does not prevent the problem and can instead exacerbate it: the entire vein along the course of the PICC line can become inflamed and thrombose. Large doses of sodium stibogluconate are often administered as dilute solutions.

Pancreatitis is a common problem and the serum amylase or lipase should be monitored twice weekly; there is no need to stop treatment if the amylase remains less than four times the upper limit of normal; if the amylase rises above the cut-off then treatment should be interrupted until the amylase falls to less than twice the upper limit of normal, whereupon treatment can be resumed. Cardiac conduction disturbances are less common, but ECG monitoring while the medicine is injected is advisable and changes quickly reverse after the drug is stopped or the infusion rate is decreased.

The drug can be given intramuscularly but is exceedingly painful when given by this route. It can also be given intralesionally when treating cutaneous leishmaniasis (i.e., injected directly into the area of infected skin) and again, this is exceedingly painful and does not give results superior to intravenous administration.

Sodium stibogluconate can also cause a reduced appetite, metallic taste in mouth, nausea, vomiting, diarrhoea, headache, tiredness, joint pains, muscle aches, dizziness, and anaphylaxis.

Question 27

Αναστολείς διαύλων ασβεστίων verapamili dialtazemi

Answer 27

Constipation, flushing, edema, cardiovascular effects (HF, AV block, sinus node depression

Question 28

ζολενδρονικό οξύ

Answer 28

difosfoniko

Question 29

δακτυλίτιδα

Answer 29

digoxin
Cholinergic—nausea, vomiting, diarrhea, blurry yellow vision (think van Gogh), arrhythmias, AV
block.
Can lead to hyperkalemia, which indicates poor prognosis.
Factors predisposing to toxicity: renal failure ( excretion), hypokalemia (permissive for digoxin
binding at K+-binding site on Na+/K+ ATPase), drugs that displace digoxin from tissue-binding
sites, and  clearance (eg, verapamil, amiodarone, quinidine).

Question 30

κλαριθρομυκίνη

Answer 30

makrolidi

Question 31

ριτουξιμάμπη

Answer 31

increases risk of progressive multifocal leukoencephalopathy

Question 32

κολχικίνη

Answer 32

?

Question 33

tmp/smx

Answer 33

TMP - Megaloblastic anemia, leukopenia,
granulocytopenia. (May alleviate with
supplemental folinic acid). TMP Treats
Marrow Poorly.
SMX-Hypersensitivity reactions, hemolysis if G6PD
deficient, nephrotoxicity (tubulointerstitial
nephritis), photosensitivity, kernicterus in
infants, displace other drugs from albumin
(eg, warfarin).

Question 34

vancomycin

Answer 34

Well tolerated in general—but NOT trouble free. Nephrotoxicity, Ototoxicity, Thrombophlebitis,
diffuse flushing—red man syndrome A (can largely prevent by pretreatment with antihistamines
and slow infusion rate).

Question 35

macrolides -Azithromycin, clarithromycin, erythromycin.

Answer 35

MACRO: Gastrointestinal Motility issues, Arrhythmia caused by prolonged QT interval, acute
Cholestatic hepatitis, Rash, eOsinophilia. Increases serum concentration of theophylline, oral
anticoagulants. Clarithromycin and erythromycin inhibit cytochrome P-450.