DD French interactions and toxicity

Question 1

What are the FDA drug use categories for pregnancy?

Answer 1

A, B, C, D, X

Question 2

Define pregnancy drug category A.

Answer 2

No risk

Question 3

Define pregnancy drug category B.

Answer 3

No evidence of risk

Question 4

Define pregnancy drug category C.

Answer 4

Risk cannot be ruled out

Question 5

Define pregnancy drug category D.

Answer 5

Positive evidence of risk but may be used in life threatening circumstances.

Question 6

Define pregnancy drug category X.

Answer 6

Contraindicated for any reason

Question 7

What do pharmacodynamic interactions do.

Answer 7

May enhance or antagonize a drug?s action without changing its plasma concentration.

Question 8

What do the elderly, the acutely ill, those with renal/hepatic disease, and those with multiple prescribing physicians have in common?

Answer 8

They are all at high risk for drug-drug interactions

Question 9

T or F: Increasing GI motility decreases the absorption of a drug.

Answer 9

FALSE

Question 10

T or F: Decreasing blood flow lengthens the plasma concentration of a drug.

Answer 10

TRUE

Question 11

T or F: Release of drug from plasma proteins decreases the plasma concentration of a drug.

Answer 11

TRUE

Question 12

T or F: Competition for active kidney tubule excretion decreases plasma concentration of a drug.

Answer 12

FALSE

Question 13

Define indirect pharmadynamic effect.

Answer 13

The pharmacologic effect of one drug indirectly affects the second drug.

Question 14

What is the single most important determinant of poisoning outcomes?

Answer 14

Good supportive care

Question 15

What are the two general ways to decrease toxicity?

Answer 15

Decrease absorption and enhance elimination

Question 16

How can you limit absorption?

Answer 16

Emesis, activated charcoal, gastric lavage, whole bowel irrigation, cathartics

Question 17

Contraindications for emetic use.

Answer 17

Lack of gag reflex, swallow corrosive agent, ingestion of CNS stimulant, ingestion of petroleum distillate, pregnancy cat C drug

Question 18

T or F: Gastric lavage gets rid of approx 90% of toxin.

Answer 18

False. Only 30%

Question 19

T or F: Activated charcoal can reduce eliminations half lives of drugs given IV.

Answer 19

True. Back diffusion of drug from blood with ion-trapping

Question 20

What is an osmotic cathartic?

Answer 20

Decreases time of toxin in GI tract as on osmotic laxative (sorbitol)

Question 21

What drug should be given with activated charcoal?

Answer 21

Sorbitol

Question 22

T or F: Methanol and ethylene glycol are toxic on their own.

Answer 22

False. They are not toxic until they are metabolized (formic acid and oxalic acid, respectively). They damage the retinas and kidneys, respectively.

Question 23

T or F: Methanol and ethylene glycol cause metabolic acidosis.

Answer 23

TRUE

Question 24

How do you prevent toxic metabolite production with methanol and ethylene glycol? (3 ways)

Answer 24

1.) Hemodalysis 2.) Ethanol 3.) Fomepizole

Question 25

Which phase of metabolism primarily processes methanol and ethylene glycol.

Answer 25

Phase II

Question 26

Which phase of metabolism primarily processes methanol and ethylene glycol.

Answer 26

Phase II (conjugations)

Question 27

T or F: Phase II metabolism of acetaminophen produces toxic metabolites.

Answer 27

False. Phase I produces toxic metabolites that are then detoxified by Phase II reactions.

Question 28

T or F: Hemodialysis is most effect for toxins with a large Vd.

Answer 28

False. Small Vd

Question 29

T or F: Hemodialysis is most effect for toxins with a high protein binding capacity.

Answer 29

FALSE

Question 30

T or F: Hemoperfusion and hemodialysis are the same thing.

Answer 30

FALSE

Question 31

T or F: Forced diuresis is not good for patients with poor pulmonary function.

Answer 31

True. Puts them in danger of fluid overload.

Question 32

How do heavy metals affect body function.

Answer 32

They can interact with essential molecules, inhibit enzymes, alter membrane structures (esp. neurons)