Drugs

Question 1

Ipilimumab

Answer 1

• T cell check point receptors
• used in melanoma

SE DUE TO TOXICITY:

• AUTOIMMUNE HEPATITIS
• DIARRHEA
• THYROID ISSUES

TX:

• STOP THE DRUG
• TX WITH STEROIDS

Question 2

Idarucizumab

Answer 2

Reversal agent for dabigatran.
Use in life threatening situations
can be used twice
will decrease the amount of active drug for at least 24 hours

Question 3

Erlotinib

Answer 3

For NSCLC - with EGFR positive

Question 4

Certozinib

Answer 4

For NSCLC - with ALK/ROS2 positive

Question 5

Aromatase Inhibitors

Anastrozole, letrozole, exemestane

Answer 5

For post menopausal women, who have hormone positive Breast cancer
SE: Arthalgias, HLD, bone pain, osteoporosis (due to estrogen inhibition)

Monitoring: DXA q2 years

Should be on for 5-10years if tolerated

Question 6

Tamoxifen

Answer 6

For Premenopausal women following primary cancer treatment in hormone positive cancers.

SE: VTE, endometrial cancer, hot flashes

Question 7

Traztuzumab

Answer 7

For HER2 positive breast cancer
SE: cardiomyopathy

• also test in gastric cancer- can be expressed and treated with traztuzumab with other chemo

Question 8

Denosumab

Answer 8

MOA: NK ligand
Tx when unable to tolerate Bisphosphonate
anti-resorptive

Question 9

Teriparatide

Answer 9

MOA: Synthetic PTH
Indicated: for severe osteoporotic patients with hx of fractures with T-score

Question 10

Calcitonin

Answer 10

Indicated for patients with pain from osteoporosis fractures

Question 11

SLGT-2 inhibiotirs

- risks

Answer 11

• risks of foot amputations
• risks of UTI
• candidia infections
• kidney impairment
• Hypotension
• decreased SU dose if using concomitantly

Question 12

GLP-1 inhibitors (liraglutide, dulaglutide)

Answer 12

Cholestasis/cholelithasis
CKD
pancreatitis

• low risk of hypoglycemia unless with SU
• associated with weight loss
• liraglutide reduces CV risks

Question 13

DPP-4 (saxagliptin)

Answer 13

Pancreatitis
HF exacerbation
Increased risk of infections
nasopharyngitis

• associated with weight loss (less than GLP-1)
• low risk of hypoglycemia unless with SU

Question 14

Thiazolidinediones

Answer 14

Risk of edema- HF exacerbation
Macular edema
Osteoporosis

Bladder cancer with pioglitazone
weight gain

Question 15

Meglitinides (repaglinide, nateglinide)

Answer 15

hypoglycemia

Question 16

Parasuguel

Answer 16

Contraindicated in people with prior strokes or TIA. Can results in ICH.
CI in people with ICH

Question 17

Lithium Toxicity Symptoms

Answer 17

Confusion
Ataxia
Tremor  - coarse, myoclonic jerks 
Nephrogenic DI
Bradycardia 
QT prolongation 
Seizures, coma, encephalopathy

Question 18

Medications that can cause lithium toxicity

Answer 18

• ACE/ARBS
• diuretic
• SSRI
• phenytoin, carbamazapine
• NSAID

Question 19

Indications for GI prophy in NSAID use

Answer 19

If = 2+ of the following :

• Hx of PUD, or GIB due to ulcer
• Concurrent use of aspirin
• Concurrent use of steroid
• Concurrent use of anti-coag
• Age >65yo
• High dose NSAID

Question 20

Clozapine toxicity

Answer 20

Agranulocytosis

• Held if ANC <1000, can restart once >1000
• Discontinued if ANC <500

Question 21

Androgen Deprivation Therapy SE

Answer 21

Osteoporosis
Gynecomastia
Hot flashes 
Anemia 
Sexual Dysfunction

Question 22

Sulfonyureas

Answer 22

weight gain

hypoglycemia

Question 23

Dabigatran

- CI

Answer 23

CI

• CKD with GFR <30
• Any valvular disease
• pregnant patients

Indicated in non-valvular afib
Decreased risk of intracranial hemorrhage compared to warfarin.

Question 24

Methotrexate SE

Answer 24

Hepatotoxicity
Cytopenias
stomatitis

Question 25

Leflunamide

Answer 25

Hepatotoxicity

Cytopenias

Question 26

Hydroxychloroquine

Answer 26

Retinal Toxicity

Question 27

Sulfasalazine

Answer 27

Hemolytic Anemia
Stomatitis
Hepatic Toxicity

Question 28

TNF-a (entanercept)

Answer 28

Demyelination syndromes
Congestive heart failure
Infection risk increased

Question 29

Valproic Acid

Answer 29

Can lead to elevated ammonia levels
therefore can lead to:
- Valproic acid induced Hyper-ammonemic Encephalopathy
* liver enzymes may be normal

Question 30

Bleomycin

TK inhibitors SE

Answer 30

Pulmonary Fibrosis

Question 31

Methotrexate

Answer 31

Hepatic toxicity
renal toxicity (high doses)
hypersensitivity pneumonitis

Question 32

Anthracycline

Tratsuzumab

Answer 32

Cardiotoxicity - dilated cardiomyopathy

Question 33

Cisplatin

Answer 33

Ototoxicity
Nephrotoxicity
peripheral neuropathy

Question 34

Cyclophosphamide

Answer 34

Hemorrhagic cystitis
Bladder toxicity
Gonadal Toxicity

Question 35

5-FU

Answer 35

Diarrhea

Question 36

EGFR (erlotinib)

Answer 36

skin rash

Question 37

PDE’5 Inhibitor SE

Answer 37

hypotension 
priaprism
non-arteritic ischemic optic neuropathy 
bluish discoloration 
flushing, hearing loss, headaches

Question 38

Phenytoin SE and toxicity

Answer 38

Side Effects:

• peripheral neuropathy
• Gingival hyperplasia
• Hypertrichosis
• Vitamin D Def
• Folic Acid Def

Toxicities:

• ataxia
• rash
• Drug induced lupus
• Confusion
• nystagmus
• Coma

IV:

• bradyarrythmias
• Hypotension
• Omeprazole p450 inhibitor other PPI are not

Question 39

Valproic Acid

Answer 39

weight gain, HLD, PCOs, teratogenic

Question 40

topiramate

Answer 40

Dopey

Increased risk of kidney stones

Question 41

Carbamazapine

Answer 41

Interacts with liver enzymes
Hyponatremia
Osteoporosis
HLD

Question 42

Interferon B

Answer 42

Autoimmune hepatitis

test LFTs q 3-6m