Drug Toxicity

Question 1

What system mediates ADRs?

Answer 1

Immune system

Question 2

ADR”s can result from drug binding to an intended receptor but at an inappropriate concentration, _____________ or ______________.

Answer 2

With suboptimal kinetics

In incorrect tissue

Question 3

Can ADRs result from drug binding to a target or receptor not intended?

Answer 3

Yes

Question 4

Name the hypersensitivity rxn: Antibody- dependent cytotoxic hypersensitivity. Occurs when a drug binds to cells and is then recognized by immune system usually IgG

Answer 4

Type II

Question 5

Name the hypersensitivity rxn: Immune-complex mediated hypersensitivity rxn. Antibodies formed against soluble antigens. Antigen-antibody complex deposited in tissues initiating serum sickness (Inflammatory response in tissues)

Answer 5

Type III

Question 6

Name the hypersensitivity rxn: delayed-type hypersensitivity. Activation of cytotoxic T cells

Answer 6

Type IV

Question 7

Name the hypersensitivity rxn: Immediate hypersensitivity; results from production of IgE after exposure to an antigen.

Answer 7

Type 1

Question 8

What autoimmune rxn may methyldopa cause?

Answer 8

Hemolytic anemia

Question 9

What autoimmune rxn can hydralazine, isoniazid, and procainamide cause?

Answer 9

Lupus like syndrome

Question 10

What drug classes has Stevens-Johnson syndrome been reported with?

Answer 10

Barbituates
Sulfonamides
Phenytoin
Carbamezepine
Allopurinal
NSAIDs
Penicillins

Question 11

What is the most frequent reason for drug withdrawals in the US?

Answer 11

Hepatotoxicity

Question 12

Many cases of fulminant hepatitis are __________

Answer 12

Idiosyncratic

Question 13

What metabolite is acetaminophen oxidized to? what can it cause?

Answer 13

N-acetyl-p-benzoquinoneimine; can cause liver damage

Question 14

What drugs are associated with progressive renal failure?

Answer 14

NSAID’s, ACEI, some antibiotics, antineoplastic agents, immunomodulators

Question 15

What drug causes renal tubular injury reversible upon cessation?

Answer 15

Gentamicin

Question 16

What drug causes progressive renal failure because mechanism for efficacy is shared by the mechanism responsible for toxicity.

Answer 16

Amphotericin B

Question 17

Crontrast-media has _________ ___________ nephrotoxicity.

Answer 17

Dose related

Question 18

What are the three major mechanisms of cardiovascular toxicity?

Answer 18

1. Drug interacts with cardiac potassium channels to cause QTc prolongation, delayed repolorization and cardiac arrhythmia
2. Directly cytotoxic to myocytes
3. Toxic to heart valves

Question 19

What leads to production of reactive oxygen species?

Answer 19

Doxorubicin

Question 20

What are 2 drugs that cause pulmonary fibrosis?

Answer 20

Bleomycin

Amiodarone

Question 21

What is the name for substances that can induce defects in the developing fetus?

Answer 21

Teratogens

Question 22

Teratogen exposure prior to what week normally results in death to the embryo?

Answer 22

Week 3

Question 23

In what weeks does organogenesis occur and teratogen exposure can have a profound effect on the developing fetus.

Answer 23

Weeks 3-8

Question 24

What are the three ways to treat drug toxicities?

Answer 24

Reduce or eliminate exposure to drug
Provide supportive measures
Provide an antidote