Drugs

Question 1

Lithium in pregnancy

Answer 1

Ebstein anomaly

Question 2

Physical dependence from benzos

Answer 2

Short acting ones (Oxaz, Triaz, Midaz, Alpraz)

Question 3

Status epilepticus

Answer 3

Benzo (diazepam)

Question 4

Delerium tremens

Answer 4

Benzo (diazepam)

Question 5

CCB + CHF

Tx? Why?

Answer 5

Flash pulmonary edema

Furosemide - pulmonary smooth muscle relaxation

Question 6

Explosives factory…headaches, dizziness, palpitations every Monday

Risk?

Answer 6

Nitroglycerin (used in explosives)
Tolerance during week, hypotension on Monday

Cardiac arrest (ischemia) - unopposed coronary vasoconstriction (over weekend)

Question 7

Venlafaxine…side effect

Why?

Answer 7

Hypertension

SNRI –> increased NE and Dopamine –> alpha-1 agonism

Question 8

Respiratory depression
Hypotension
Seizure
Dilated pupils
Tachycardia
Arrhythmia

Answer 8

TCA overdose (3 C’s)

Question 9

TCA overdose…
- ABG findings

Tx? Why?

Answer 9

Mixed acidosis (low pH, high CO2, low bicarb)

BICARBONATE - increased pH = more bound to protein = less bound to Na+ channels

Question 10

TCAs - things inhibited (5)

Answer 10

Muscarinic
H1 (central) - respiratory depression
Alpha-1
Fast Na+ channels (QT prolongation) - like Class 1A
GABA-A (seizures)

Question 11

Levodopa –> jaundice, dark urine

Why?

Answer 11

Drug-induced hemolytic anemia

Stimulates anti-RBC antibodies

Question 12

Indinavir

Answer 12

Nephrolithiasis

Question 13

Nephrogenic DI – treatment

Answer 13

HCTZ, Indomethacin, Amiloride

Question 14

Demeclocycline

Answer 14

Inhibits 2nd messenger of ADH receptor (for SIADH)

Question 15

Direct vs. Indirect Sympathomimetics - how do they differ? (besides obvious mechanism of action)

Answer 15

Direct - cannot enter the CNS
Indirect - enter the CNS, can cause central side effects
- Ex. Amphetamines

Question 16

Cyclosporin, Tacrolimus - MoA

Side effect

Answer 16

Inhibit 2nd messenger signaling of T-cell activation

Nephrotoxicity

Question 17

Hep C + hemolytic anemia

Answer 17

Ribavirin

Question 18

Pulmonary fibrosis…drugs?

Answer 18

Bleomycin
Amiodarone
Busulfan
Nitrofurantoin
Methotrexate

Question 19

Goserelin

Other drug w/ same MoA?

Answer 19

GnRH analog

Leuprolide

Question 20

Disulfiram-like reaction…drugs?

Answer 20

Tolbutamide, Chlorpropamide
Metronidazole
Griseofulvin
Chloramphenicol
Cefamandole, Cefoperazone

Question 21

Depression drug + St. John’s Wort

Answer 21

Serotonin syndrome (rigidity, hyperthermia, autonomic changes)

Question 22

Ethosuximide – blistering around nose and mouth

Answer 22

SJS

Question 23

Corticosteroids + leukocytosis

Answer 23

Demargination from walls of BVs

Question 24

Hemolytic anemia in G6PD…drugs?

Answer 24

PAINS

• Primaquine
• Aspirin
• Ibuprofen
• Nitrofurantoin
• Sulfonamides

Question 25

Half life equation

Answer 25

(0.7 x Vd) / Cl

Vd = Drug in body / plasma concentration

Question 26

Etanercept

Answer 26

TNF-antagonist (2 TNF receptors + 1 human IgG Fc)