Drugs Flashcards
Ipilimumab
- T cell check point receptors
- used in melanoma
SE DUE TO TOXICITY:
- AUTOIMMUNE HEPATITIS
- DIARRHEA
- THYROID ISSUES
TX:
- STOP THE DRUG
- TX WITH STEROIDS
Idarucizumab
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
Erlotinib
For NSCLC - with EGFR positive
Certozinib
For NSCLC - with ALK/ROS2 positive
Aromatase Inhibitors
Anastrozole, letrozole, exemestane
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
Tamoxifen
For Premenopausal women following primary cancer treatment in hormone positive cancers.
SE: VTE, endometrial cancer, hot flashes
Traztuzumab
For HER2 positive breast cancer
SE: cardiomyopathy
- also test in gastric cancer- can be expressed and treated with traztuzumab with other chemo
Denosumab
MOA: NK ligand
Tx when unable to tolerate Bisphosphonate
anti-resorptive
Teriparatide
MOA: Synthetic PTH
Indicated: for severe osteoporotic patients with hx of fractures with T-score
Calcitonin
Indicated for patients with pain from osteoporosis fractures
SLGT-2 inhibiotirs
- risks
- risks of foot amputations
- risks of UTI
- candidia infections
- kidney impairment
- Hypotension
- decreased SU dose if using concomitantly
GLP-1 inhibitors (liraglutide, dulaglutide)
Cholestasis/cholelithasis
CKD
pancreatitis
- low risk of hypoglycemia unless with SU
- associated with weight loss
- liraglutide reduces CV risks
DPP-4 (saxagliptin)
Pancreatitis
HF exacerbation
Increased risk of infections
nasopharyngitis
- associated with weight loss (less than GLP-1)
- low risk of hypoglycemia unless with SU
Thiazolidinediones
Risk of edema- HF exacerbation
Macular edema
Osteoporosis
Bladder cancer with pioglitazone
weight gain
Meglitinides (repaglinide, nateglinide)
hypoglycemia
Parasuguel
Contraindicated in people with prior strokes or TIA. Can results in ICH.
CI in people with ICH
Lithium Toxicity Symptoms
Confusion Ataxia Tremor - coarse, myoclonic jerks Nephrogenic DI Bradycardia QT prolongation Seizures, coma, encephalopathy
Medications that can cause lithium toxicity
- ACE/ARBS
- diuretic
- SSRI
- phenytoin, carbamazapine
- NSAID
Indications for GI prophy in NSAID use
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
Clozapine toxicity
Agranulocytosis
- Held if ANC <1000, can restart once >1000
- Discontinued if ANC <500
Androgen Deprivation Therapy SE
Osteoporosis Gynecomastia Hot flashes Anemia Sexual Dysfunction
Sulfonyureas
weight gain
hypoglycemia
Dabigatran
- CI
CI
- CKD with GFR <30
- Any valvular disease
- pregnant patients
Indicated in non-valvular afib
Decreased risk of intracranial hemorrhage compared to warfarin.
Methotrexate SE
Hepatotoxicity
Cytopenias
stomatitis
Leflunamide
Hepatotoxicity
Cytopenias
Hydroxychloroquine
Retinal Toxicity
Sulfasalazine
Hemolytic Anemia
Stomatitis
Hepatic Toxicity
TNF-a (entanercept)
Demyelination syndromes
Congestive heart failure
Infection risk increased
Valproic Acid
Can lead to elevated ammonia levels
therefore can lead to:
- Valproic acid induced Hyper-ammonemic Encephalopathy
* liver enzymes may be normal
Bleomycin
TK inhibitors SE
Pulmonary Fibrosis
Methotrexate
Hepatic toxicity
renal toxicity (high doses)
hypersensitivity pneumonitis
Anthracycline
Tratsuzumab
Cardiotoxicity - dilated cardiomyopathy
Cisplatin
Ototoxicity
Nephrotoxicity
peripheral neuropathy
Cyclophosphamide
Hemorrhagic cystitis
Bladder toxicity
Gonadal Toxicity
5-FU
Diarrhea
EGFR (erlotinib)
skin rash
PDE’5 Inhibitor SE
hypotension priaprism non-arteritic ischemic optic neuropathy bluish discoloration flushing, hearing loss, headaches
Phenytoin SE and toxicity
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
Valproic Acid
weight gain, HLD, PCOs, teratogenic
topiramate
Dopey
Increased risk of kidney stones
Carbamazapine
Interacts with liver enzymes
Hyponatremia
Osteoporosis
HLD
Interferon B
Autoimmune hepatitis
test LFTs q 3-6m
