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Pharm II: Exam 1 > Drug Toxicity > Flashcards

Drug Toxicity Flashcards

1
Q

What are the four categories of Adverse Drug Reactions?

A
  1. Drug binding to intended receptor but at inappropriate concentration
  2. Drug binding to a target/receptor not intended
  3. Mediated by the immune system
  4. Idiosyncratic responses (unknown mechanism)
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2
Q

What is a Type I hypersensitivity reaction?

A

Immediate hypersensitivity (results from production of IgE after exposure to an antigen); Antigen may be a foreign protein or an endogenous protein modified by a hapten to become immunogenic

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3
Q

What is a Type II hypersensitivity reaction?

A

Antibody-dependent cytotoxic reaction; drug recognized by immune system (usually IgG)

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4
Q

What is a Type III hypersensitivity reaction?

A

Immune-complex mediated reaction; antibodies formed against soluble antigens (A-A complex deposits in tissue leading to serum sickness or imflammation of the tissues)

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5
Q

What is a Type IV hypersensitivity reaction?

A

Delayed-type reactions; Activation of cytotoxic T-cells

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6
Q

What four drugs mentioned can intiate autoimmune reactions? What reactions might they cause?

A

Hemolytic anemia: Methyldopa

Lupus-like reaction: Hydralazine, Isoniazid, Procainamide

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7
Q

What are common skin rashes to occur from ADRs?

A
  • Erythema multiforme
  • Stevens-Johnson syndrome
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8
Q

What drugs are reported to cause Stevens-Johnson syndrome?

A
  • Barbituates
  • Sulfonamides
  • Phenytoin
  • Penicillins
  • Carbamazepine
  • Allopurinol
  • NSAIDs
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9
Q

T or F: Stevens-Johnson syndrome is a fully understood pathology.

A

F

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10
Q

What immune toxicities are presented with cytotoxic agents?

A
  • Routinely damages proliferating nml cells
  • INC’d risk of infection (cytotoxic to WBC)
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11
Q

T or F: Immunotherapies that target specific cell types are associated with INC’d risk of infection.

A

T

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12
Q

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

A

Hepatotoxicity

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13
Q

What may metabolites cause? Example?

A

Liver damage; Acetaminophen (oxidized to N-acetyl-p-benzoquioneimine)

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14
Q

What are possible manifestations of renal toxicity?

A
  • Renal hemodynamic
  • Tubular damage
  • Tubular obstruction
  • Glomerular nephropathy
  • Interstital nephritis
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15
Q

What are drugs that may cause progressive renal failure?

A
  • Anti-neoplastic (cancer) agents
  • Contrast media
  • Amphotericin B
  • Gentamicin
  • ACE Inhibitors
  • Immunomodulators
  • NSAIDs

“A/C AGAIN”

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16
Q

T or F: Renal tubular injury caused by Gentamicin is reversible upon cessation

A

T

17
Q

T or F: Amphoterican B has a high frequency of injury.

A

T; Mechanism for efficacy is shared by the mechanism responsible for toxicity

18
Q

T or F: Contrast media has a DOSE-RELATED nephrotoxicity

A

T

19
Q

What are the three major mechanisms of Cardiovascular toxicity?

A
  1. Interact with cardiac potassium channels (cause QTc prolongation, delayed repolarization and cardiac arrythmias)
  2. Directly cytotoxic to myocytes
  3. Toxic to heart valves
20
Q

What drugs interact with cardiac potassium channels cause QTc prolongation?

A
  • Antipsychotics
  • Anti-emetics
21
Q

What drugs are directly toxic to myocytes?

A

Doxorubicin (produces reactive oxygen species)

22
Q

How can drug toxicity affect pulmonary function?

A

Toxicity might cause anything from acute reversible exacerbations to chronic remodeling (i.e. pulmonary fibrosis)

23
Q

What drugs may cause pulmonary fibrosis?

A
  • Bleomycin
  • Amiodarone
24
Q

What is a teratogen?

A

Substance that may induce defects in the developing fetus (TORCH)

25
Q

How does the timing of the drug administered affect the pregnancy?

A

< 3 weeks: usually results in death

3-8 weeks: organogenesis is being greatly affected

26
Q

How do you TX drug toxicity?

A
  • Reduce/eliminate exposure
  • Provide supportive care
  • Provide antidote

Pharm II: Exam 1 (7 decks)

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