Drug Toxicity

Question 1

What is the famous ANTI-MANIA DRUG use for BIPOLAR but not for depression?

Answer 1

LITHIUM

Question 2

What is the Therapeutic level of Lithium and what is the toxic level?

Answer 2

Therapeutic level: 0.6-1.2

Toxic level: ≥ 2

Question 3

What is the Drug used to treat Atrial Fibrillation (AFIB) and Congestive Heart Failure (CHF)?

Answer 3

(Digoxin) LanOXIN

Question 4

What is the Therapeutic range of Lanoxin what is the toxic level?

Answer 4

Therapeutic level: 0.5 - 2

Toxic level: ≥ 2

Question 5

Example of METHYLXANTINE DRUGS?

Answer 5

AMINOPHYLLINE

Question 6

What is the difference between THEOPHYLLINE and AMINOPHYLLINE?

Answer 6

AMINOPHYLLINE is a derivative of THEOPHYLLINE but still a METHYLXANTINE

Question 7

What is the Mechanism Of Action of AMINOPHYLLINE?

Answer 7

Airway Anti-Spasmodic drug but not a Bronchodilator (does not stimulate Beta-2). A Muscle Spasm Relaxant
Spasm = constrict

Question 8

Examples of Bronchodilator?

Answer 8

Epinephrine, Tarbutaline, Albuterol, Salbutamol

Question 9

What do you give when Bronchodilator does not work?

Answer 9

Aminophylline/Theophylline just to relax the Spasm then, give Bronchodilator

Question 10

What is the therapeutic range of AMINOPHYLLINE?

Answer 10

Therapeutic: 10 - 20

Question 11

What is the Mechanism Of Action of DILANTIN (Phenytoin)?

Answer 11

Anti-epileptic/Anticonvulsant

Question 12

What is the Therapeutic Range and Toxic Level of DILANTIN (Phenytoin)?

Answer 12

Therapeutic Range: 10 - 20

Toxic Level: ≥ 20

Question 13

Other examples of Anticonvulsant drugs

Answer 13

Carbamazepine
Benzodiazepine
Phenobarbital
Gabapentin
Diazepam
Levetiracetam

Question 14

Considered as a waste product in the breakdown of Red Blood Cells (RBC)?

Answer 14

BILIRUBIN

Question 15

Who has a normal HIGH LEVELS of BILIRUBIN?

Answer 15

NEWBORNS

Question 16

Why is it NORMAL for Newborns to have HIGH BILIRUBIN LEVELS?

Answer 16

Because of GREATER PRODUCTION and FASTER BREAKDOWN of RBC in the 1st few days of life

Question 17

what is the therapeutic ELEVATED LEVEL and TOXIC Level of BILIRUBIN in Newborns?

Answer 17

Elevated Level: 10 - 20

Toxic level: ≥ 20

Question 18

What is the highest level of BILIRUBIN in ADULT?

Answer 18

8

Question 19

At what Therapeutic Level of Bilirubin does the Doctor advice parents HOSPITALIZING Newborns and why?

Answer 19

14 - 15 because 15 is already halfway to toxicity and once it hits toxicity level, they could die.

Question 20

What do you call the BILIRUBIN IN THE BRAIN?

Answer 20

KERNICTERUS

Question 21

What happens in KERNICTERUS?

Answer 21

When Bilirubin crosses the Blood Brain Barrier, it goes in the Cerebrospinal Fluid (CSF), in the Brain and in the Meninges

Question 22

what do you call the YELLOW COLOR cause by BILIRUBIN IN THE SKIN?

Answer 22

JAUNDICE

Question 23

What does Kernicterus causes when the Bilirubin goes up to 20 (toxic level) and gets inside the Brain?

Answer 23

ASEPTIC MENINGITIS
(A - without ; Septic - sepsis [infection])

ASEPTIC ENCEPHALITIS
(sterile encephalitis) = due to IRRITATION of the BILIRUBIN

Question 24

When does KERNICTERIC become lethal?

Answer 24

when Bilirubin goes above 20, the newborn could die

Question 25

What POSITION does the baby assumes when he has a bilirubin in the Brain or gone Kernicteric?

Answer 25

OPISTHOTONUS

Question 26

What happens to the baby in an Opisthotonus position?

Answer 26

The baby HYPEREXTEND due to the IRRITATION of the MENINGES by the BILIRUBIN and turns very RIGID

Question 27

What happens when the baby reaches level 15 of the Bilirubin Therapeutic Range with Hyperextension noted?

Answer 27

It becomes an EMERGENT that could be followed by KERNICTERUS

Question 28

In what POSITION do you place an OPISTHOTONIC Child?

Answer 28

SIDE-LYING (Sim's)

Question 29

What is the difference between PATHOLOGIC JAUNDICE and PHYSIOLOGIC JAUNDICE?

Answer 29

PATHOLOGIC JAUNDICE = BILIRUBIN is HIGH at BIRTH and Baby is YELLOW at BIRTH PHYSIOLOGIC JAUNDICE = BILIRUBIN is NORMAL at BIRTH and HIGH after 2-3 DAYS and Baby turns YELLOW after the NEXT FEW DAYS

Question 30

SIGNS and SYMPTOMS of DIGOXIN TOXICITY?

Answer 30

``` V-isual disturbance; vomiting A-norexia N-ausea D-iarrhea A-bdominal cramps ```

Question 31

What is the ANTIDOTE for DIGOXIN TOXICITY?

Answer 31

DIGIBIND (Digoxin Immune IV)