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Step One Pharmacology > Drug Reactions > Flashcards

Drug Reactions Flashcards

1
Q

Coronary Vasospasm

A

Cocaine
Sumatriptain (5HT-1b/1d, rx: migraines)
ergot alkaloids

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2
Q

Cutaneous Flushing

A

Vancomycin, Adenosine, Niacin, Ca Ch. blockers

VANC

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3
Q

Dilated Cardiomyopathy

A

Doxorubicin (Adriamycin), Daunorubicin

Gen. free radicals, breaks DNA, rx: solid tumors, leuk/lymph

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4
Q

Torsades de pointes

A

Class III (sotalol) and Class IA (quinidine) antiarrhythmics

[Class IAs (Double Quarter Pounder: Disopyramide, Quinidine, Procainamide)
Class IIIs (AIDS, Amiodarone, Ibutilide, Dofetilide, Sotalol)
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5
Q

Amiodarone

A

Pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroid (40% iodine by weight), corneal deposits, skin deposits (blue/grey) resulting in photodermatitis, neurologic effects, constipation, bradycardia, CHF, heart block

Slows everything down, hypothyroid, pulm fibrosis, constipation, bradycardia, CHF, heart block

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6
Q

Agranulocytosis

A

Agranulocytosis Could Certainly Cause Pretty Major Damage

Clozapine, Carbamazepine, Colchicine, Propylthiouracil, Methimazole

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7
Q

Gray Baby Syndrome

A

Chloramphenicol

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8
Q

Hemolysis in G6PD

A

Hemolysis IS PAIN
Isoniazid, Sulfonamides, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin

also Dapsone

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9
Q

Megaloblastic anemia

A

Having a BLAST with PMS

Phenytoin, Methotrexate, Sulfa drugs

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10
Q

Phenytoin

A

Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, MEGALOBLASTIC ANEMIA, teratogenesis (fetal hydantoin syndrome), SLE-LIKE SYNDROME, P450 inducer, lymphadenopathy, STEVENS JOHNSON RASH, osteopenia

1st line: Tonic-Clonic, Prophylaxis for Status, Increased Na channel inactivation

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11
Q

Carbamazepine

A

Diplopia, atazia, blood dyscrasia (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, P450 inducer, SIADH, Stevens Johnson

1st line: Simple Partial, Complex Partial, Tonic-Clonic
Na channel inactivation

Cross-eyed, shooting CARBINE but just winging people (bone marrow, in the limbs), because he’s holding it like an action hero, hitting himself in the liver, inducing P45, he’s too scared even to pee (SIADH), and he’s all red all over like Stevens Johnson rash

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12
Q

Valproic Acid

A

Gi distress, rare but fatal HEPATOTOXICITY, neural tube defects for fetus, tremor, weight gain.

1st line: Tonic Clonic, Myoclonic
Na inactivation, GABA concentration

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13
Q

Ethosuximide

A

GI distress, fatigue, headache, urticaria, Stevens Johnson

1st line: Absence
T type Ca++

EFGH - Ethosux, Fatigue, GI, Headache

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14
Q

Thrombotic complications

A

OCPs (estrogens)

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15
Q

Cough

A

ACE inhibitors (-pril)

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16
Q

Pulmonary fibrosis

A

hard to BLAB with p.f.

BLeomycin, Amiodarone, Busulfan

Bleomycin - free radicals, DNA strand breaks
rx: Testicular cancer and Hodgkins lymphoma
Busulfan - alkylates DNA; CML

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17
Q

Acute Cholestatic Hepatitis, jaundice

A

Erythromycin

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18
Q

Focal to massive hepatic necrosis

A

Liver HAVAC (Havoc)

Halothane, Amanita phalloides, Valproic Acid, Acetaminophen

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19
Q

Hepatitis

A

INH

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20
Q

Pseudomembranous colitis

A

Clindamycin, ampicillin

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21
Q

Adrenocortical insufficiency

A

Glucocorticoid withdrawal (HPA suppression)

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22
Q

Gynecomastia

A

Some Drugs Create Awkard Knockers

Spironolactone, Digitalis, Cimetidine, chronic Alcohol, estrogens, Ketoconazole

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23
Q

Digoxin

A

CHF patient with non-specific neuro and GI complaints think Dig Toxicity

nausea, vomiting, diarrhea, blurry yellow vision
ECG: +PR, -QT, ST scooping, T-wave inversion, arrhythmia, AV block, hyperkalemia poor prognostic marker

Excreted proximal tubule

Can be for A fib and HF

Antidote: KLAM
Normalize K+, Lidocaine, Anti-dig Fab fragments, Mg2+

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24
Q

Amphotericin B

A

Amphoterrible
Fever/Chills “shake and bake”
hypotension, NEPHROTOXICITY, ARRHYTHMIA, ANEMIA, IV phlebitis.

hydration to reduce nephrotox; supplement K and Mg

Rx serious systemic mycosis (crypto, cocci, blasto, histo, mucor, candida)

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25
Q

Hot flashes

A

Tamoxifen, clomiphene (SERMs)

Tamoxifen (antag breast, ag bone; risk endometrial cancer)
Clomiphene (Infertility and PCOS, prevents LH/FSH feedback)

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26
Q

Hyperglycemia

A

Niacin, tacrolimus, protease inhibitors, HCTZ, corticosteroids

tacrolimus - like cyclosporine, inhibits calcineurin and secretion of IL2
Navir tease a protease

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27
Q

Protease Inhibitors

A

Navir tease a protease

hyperglycemia, GI intolerance (ND), lipodystrophy (cushingoid effect), nephropathy, hematuria

N - nephropathy
A - Awkward fat distribution
V - Vomiting, Nausea, Diarrhea
I - Insulin resistance like effect (hyperglycemia)
R - RBCs in urine (hematuria)
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28
Q

NRTIs and NNRTIs

A

Bone marrow suppression (reversible, G-CSF, EPO), peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), Megaloblastic Anemia (ZDV)

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29
Q

Hypothyroid

A

Lithium, amiodarone, sulfonamides

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30
Q

Fat redistribution

A

Glucocorticoids, protease inhibitors

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31
Q

Gingival hyperplasia

A

Phenytoin, verapamil

Very Pink gums (verapamil, phenytoin)

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32
Q

Gout

A

Furosemide, thiazides, niacin, cyclosporine

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33
Q

Myopathies

A

Fish N CHIPS Give you myopathy

Fibrates, Niacin, Colchicine, Hydroxychloroquine, Intereron-a, Penicillamine, Statins, Glucocorticoids

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34
Q

Osteoporosis

A

Corticosteroids, heparin

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35
Q

Photosensitivity

A

SAT for a photo

Sulfonamides, Amiodarone, Tetracycline

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36
Q

Rash (Stevens Johnson)

A

Bad rash after a PEC SLAPP

Penicillin, Ethosuximide, Carbamazepine, Sulfa drugs, Lamotrigine, Allopurinol, Phenytoin, Phenobarbital

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37
Q

SLE-like syndrome

A

its SHIPPE to have lupus (shitty. its shitty to have lupus)

Sulfa drugs, Hydralazine, INH, Procainamide, Phenytoin, Etanercept

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38
Q

Isoniazid

A

INH Injures Neurons and Hepatocytes

Neurotoxicity (seizures), hepatotoxicity, Lupus. B6 can prevent neurotox

Isoniazid, “I say no acid” - inh. mycolic acid synth.

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39
Q

Rifampin

A

RifaMpin - prevents transcription of mRNA
4 R’s - RNA polymerase inh., Revs up P450, Red/orange fluids, Rapid resistance if used alone

hepatotox, red/orange fluids

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40
Q

Ethambutol

A

Optic neuropathy, red-green color blindness

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41
Q

Teeth (kids)

A

Tetracyclines

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42
Q

Tendonitis, tendon rupture, cartilage damage

A

Fluoroquinolones

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43
Q

Diabetes Insipidus

A

Lithium, demeclocycline

44
Q

Lithium

A

LMNOP

Tremor, sedation, edema, heart block, hypothyroid, polyuria, teratogenesis

Fetal cardiac defects include Ebstein anomaly (tricuspid valve displacement), and malformation of great vessels

LMNOP - Lithium: Movement (tremor), Nephrogenic di, hypOthyroidism, Pregnancy problems

45
Q

SSRIs

A

Flashbacks paralyze senior citizens
Fluoxetine, paroxetine, sertraline, citalopram

GI distress, Sexual dysfunction

Serotonin Syndrome: hyperthermia, confusion, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures. Rx: cyproheptadine (5-HT2 antag)
(also MAOI, SNRIs, TCAs)

46
Q

Tricyclic Antidepressants

A

-iptyline, -ipramine, doxepine and amoxapine

Sedation, alpha 1 block effects like postural hypotension, atropine-like side effects like tachycardia, urinary retention, dry mouth. Desipramine less sedating and has higher seizure threshold.

Tri-C’s: Convulsions, Coma, Cardiotoxicity (arrhythmia), also respiratory depression, hyperpyrexia.

Antidote for cardiotoxicity: NaHCO3

47
Q

MAOIs

A

Mao Takes Pride In Shanghai
Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline

Hypertensive crisis (tyramine intake, wine, cheese).

48
Q

Antipsychotics

A

haloperidol + “-azines” (Azin is fucking crazy)

Extrapyramidal side effects - dyskinesias, dystonia, akisthesia (restless), tardive dyskinesia (mouth stuff), parkinson’s like (tremor, bradykinesia)

Endocrine - D antagonism, hyperPRLemia, galactorrhea

Side effects - muscarinic, alpha and histamine block
Dry mouth, constipation, hypotension, sedation

Neuroleptic malignant syndrome (NMS) - FEVER
Fever, encephalopathy, vitals unstable, Elevated enzymes, Rigidity. also myoglobinuria. Rx Dantrolene, bromocriptine

49
Q

High potency vs Low potency antipsychotics

A

High potency: Trifluoperazine, Fluphenazine, Haloperidol
Try to Fly High - extrapyramidal symptoms (flap your arms and fly, you crazy bastard)

Low potency: Chlorpromazine, Thioridazine
Cheating Thieves are low
non-neuro side effects, anticholinergic, antihistamine, alpha 1 block

50
Q

Fanconi’s Syndrome

A

expired tetracycline

loss of bicarb, a.a.’s, glucose, etc in urine instead of being reabsorbed

51
Q

Hemorrhagic Cystitis

A

Cyclophosphamide, ifosfamide

prevent with MESNA coadministration

52
Q

Interstitial nephritis

A

Methicillin, NSAIDs, furosemide

53
Q

Furosemide

A

OH DANG!

Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout

54
Q

Hydrochlorothiazide

A

Hypos and Hypers
Hypo: -kalemia, -natremia
Hyper: -glycemia, -lipidemia, -uricemia, -calcemia.
Sulfa allergy

55
Q

SIADH

A

Carbamazepine, cyclophosphamide

56
Q

Cinchonism

A

(hearing loss, headache, abd pain, vertigo, dizziness, NV, rash)
Quinidine, quinine

named for Cinchona bark, the source of quinine

57
Q

Parkinsons-like syndrome

A

Antipsychotics, reserpine, metoclopramide

reserpine - huntington’s rx
metoclopramide - rx diabetic gastroparesis

58
Q

Seizures

A

with seizures, I BITE My tongue

INH, Bupropion, Imipenem/cilastatin, Tramadol, Enflurane, Metoclopramide

59
Q

Tardive dyskinesia

A

Antipsychotics
Typical - Haloperidol + “azines”
Atypical - its atypical for Old Closets to Whisper Quietly from A to Z
Olanzepine, clozepine, risperidone, quietapine, aripiprazole, ziprasidone

60
Q

Antimuscarinic

A

Atropine, TCA’s, H1 blockers, neuroleptics

61
Q

Disulfiram-like reaction

A

Metronidazole, some cephalosporins, procarbazine, 1st gen sulfonylureas

62
Q

Nephrotoxicity/Ototoxicity

A

Aminoglycosides, vancomycin, loops, cisplatin

63
Q

Sulfa reaction

A

fever, UTI, pruritic rash, Steven’s Johnson syn, hemolytic anemia, thrombocytopenia, agranulocytosis and urticaria. symptoms vary form mild to life-threatening

Popular FACTSSS
Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotics, Sulfasalazine, Sulfonylureas

64
Q

Aminoglycosides

A

Nephrotoxicity, Ototoxity, Neuromuscular blockade, Teratogen

65
Q

Macrolides

A

MACRO

Motility issues, Arrhythmia via prolonged QT, acute Cholestatic hepatitis, Rash, eOsinophilia

66
Q

Trimethoprim

A

TMP Treats Marrow Poorly
Megaloblastic anemia, Leukopenia, Granulocytopenia

Leucovorin rescue (folinic acid)

67
Q

Antibiotics to Avoid in Pregnancy

A 
SAFe Children Take Really Good Care.
Sulfonamides - kernicterus
Aminoglycosides - ototoxicity
Fluoroquinolones - cartilage damage
Clarithromycin - embryotoxic
Tetracyclines - Discolored teeth
Ribavarin (antiviral) - teratogenic
Griseofulvin (antifungal) - teratogenic
Chloramphenicol - Gray Baby
68
Q

Ganciclovir

A

Leukopenia, neutropenia, thrombocytopenia, renal toxicity

69
Q

Cyclosporin

A

Nephrotoxicity, hypertension, hyperlipidemia, hyperglycemia, tremor, gingival hyperplasia, hirsutism

70
Q

Calcium Channel Blockers

A

Cardiac depression, AV block, peripheral edema, FLUSHING, dizziness, constipation

Vasc. smooth muscle:
amlodipine=nifedipine >diltiazem > verapamil
Heart:
verapamil> diltiazem > amlodipine = nifedipine

71
Q

Hydralazine

A

Fluid retention, nausea, headache, SLE-like syndrome

Reflex tachy –> ci in angina/CAD

72
Q

Statins

A

Hepatotoxicity, rhabdomyolysis (myalgias, esp with fibrates)

73
Q

Fibrates

A

Myositis, hepatotoxicity, chol gallstones

myalgia esp with statins

74
Q

Class 1A antiarrhythmics

A

Double Quarter Pounder
Disopyramide - Heart Failure
Quinidine - cinchonism: headache, tinnitus
Procainamide - reversible SLE-like syndrome

thrombocytopenia, TORSADES from increased QT

75
Q

Class 1B antiarrhythmics

A

Lettuce, Tomato, Mayo
Lidocaine, Tocainide, Mexiletine
1B = Is Best post MI

Local anesthetic, CNS stimulation/depression, Cardiovascular depression

76
Q

Class 1C antiarrhythmics

A

More Fries Please
Flecainide, Propafenone

proarrhythmic esp. post MI. Significantly prolongs refractory period in AV node

1C = Is Contraindicated post MI

77
Q

Class II antiarrhythmics

A

Beta blockers
impotence, astma, bradycardia, AV block (decrease PR interval), CHF, sedation, MASKS HYPOGLYCEMIA

metoprolol - dyslipidemia

Overdoes Rx: glucagon

78
Q

Class III antiarrhythmics

A

K Ch. blockers, think Torsades because of increased QT

79
Q

Biguanides

A

metformin

GI upset, LACTIC ACIDOSIS - ci in renal failure

80
Q

Sulfonylureas

A

glyburide, glipizide

hypoglycemia

81
Q

Glitazones/thiazolinediones

A

pioglitazone

Weight gain, edema, hepatotoxicity, heart failure

82
Q

GLP-1 analogs

A

Exenatide, liraglutide

Nausea, vomiting, PANCREATITIS

83
Q

Propylthiouracil/methimazole

A

Agranulocytosis, aplastic anemia, rash

PTU - liver toxicity
MTZ - teratogen

84
Q

H2 blockers

A

cimetidine, ranitidine

Antiandrogenic: PRL release, gynecomastia, impotence
Cross BBB: confusion, dizziness, HA

decrease renal creatinine excretion

85
Q

PPI’s

A

omeprazole

C Diff risk, PNA, hip fx, low Mg++ chronically

86
Q

Specific Antacid complications

A

Aluminum hydroxide - “minimum” feces (constipation)
Magnesium hydroxide - Mg = must go = diarrhea, hypotension, cardiac arrest
Calcium carbonate - hypercalcemia, rebound acid production

87
Q

ADP receptor inhibitors

A

Ticlopidine

Neutropenia

88
Q

Methotrexate

A

Myelosuppression reversible with leucovorin
Macrovesicular fatty liver change
Mucositis
Teratogen

89
Q

5-flurorouracil

A

Myelosuppression, non reversible

Overdose rescue: thymidine

90
Q

6-mercaptopurine, Azathioprine

A

Bone marrow, GI, Liver toxicity (which are increased with coadministration of allopurinol)

91
Q

Vincristine, Vinblastine

A

vincristine - neurotoxicity (areflexia, peripheral neuritis), paralytic ileus
vinblastine blasts bone marrow (suppression)

92
Q

Cisplatin

A

Nephrotoxicity, acoustic nerve damage

prevent nephrotox with Amifostine and chloride diuresis

93
Q

Trastuzumab

A

Herceptin for Her-2 (c-erbB2)

Cardiotoxicity

94
Q

Bisphosphonates

A

Alendronate, for osteoporosis/hyperCa/paget’s

Corrosive esophagitis, osteonecrosis of the jaw

95
Q

Zolpidem

A

Ataxia, headaches, confusion

96
Q

Halothane

A

Hepatotoxicity (fulminant), malignant hyperthermia

97
Q

Methoxyflurane

A

Nephrotoxicity, malignant hyperthermia

98
Q

Enflurane

A

Proconvulsant, malignant hyperthermia

99
Q

Local anesthetics

A

CNS excitation, severe cardiovascular toxicity (bupivicaine), hypertension or hypotension

100
Q

Levodopa

A

Arrhythmias from increased peripheral formation of catecholamines

101
Q

Sumatriptan

A

Coronary vasospasm (ci in CAD pts/prinzmetals angina)

102
Q

Trazodone

A

Priapism, sedation, nausea, hypotension

103
Q

Mannitol

A

Pulmonary edema, dehydration

ci in anuria, CHF

104
Q

ACE inhibitors

A

Captopril’s CATCHH
Cough, Angioedema, Teratogen (fetal renal malf), Creatinine increase (reversible decrease in GFR), Hyperkalemia, Hypotension

105
Q

Estrogens

A

Endometrial cancer, postmenopausal bleeding, clear cell adenocarcinoma of vagina of women exposed to DES in utero, thrombosis risk

106
Q

Antihistamines (1st gen)

A

sedation
antimuscarinic (dry mouth, urinary retention, constipation
anti alpha-adrenergic (hypotension)
end in -en/ine or -en/ate (chlorpheniramine, diphenhydramine)
(2nd gen: loratadine, fexofenadine, desloratadine, end in -adine)

Step One Pharmacology (6 decks)

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