Miscellaneous (32, 35, 36, 39, 43)

Question 1

Chemo S/E

Answer 1

SE: bone marrow suppression, thrombocytopenia
-Check for mucositis before airway manipulation

Question 2

Anthracyclines Chemo drugs

Answer 2

doxorubicin (adriamycin), idarubicin = impair myocytes by forming free radicals
that interfere w/ mitochondrial activation = lipid peroxidation (cardiotoxic)

Question 3

Vincristine S/E

Answer 3

reversible paresthesias in hands and feet

Question 4

Bleomycine considerations

Answer 4

= pulmonary toxicity, FiO2 < 30%

Question 5

Cisplatin S/E

Answer 5

can be nephrotoxic

Question 6

Statins MOA

Answer 6

inhibits HMG-CoA reductase = ↓cholesterol production

Question 7

Statins S/E and interactions

Answer 7

GI upset, fatigue, HA, peripheral neuropathy, hepatic dysfunc, myopathy, paresis,
myalgias (↑CK), rhabdo (rare)
- Teratrogenic

Question 8

Bile-acid binding resins MOA

Answer 8

bind up bile acids = liver makes more from cholesterol

Question 9

Bile-acid binding resin S/E

Answer 9

abd pain, constipation, hyperchloremic acidosis

Question 10

Water soluble B-Complex vitamins MOA

Answer 10

inhibits VLDLs synthesis, inhibits FA release,
↑lipoprotein lipase activity

Question 11

Water soluble B-Complex vitamins S/E

Answer 11

flushing, hepatic dysfunc, reactive PUD,

Question 12

Water soluble B-Complex vitamins interactions

Answer 12

HoTN w/ antiHTN, myopathy w/ statins

Question 13

Fibrates MOA

Answer 13

↑activity of lipoprotein lipase

Question 14

Fibrates S/E and interactions

Answer 14

SE: Abd pain, N, HA, ↑cholesterol content of bile, ↓WBC
Interactions: ↑warfarin effect, avoid in liver/renal dz (↑liver transaminase)

Question 15

Herbal remedies: bleeding risks

Answer 15

-garlic (7 days)
-gingko (36 h)
-ginseng (7 days)
-ginger (no data)

Question 16

Herbal: MAOI Interactions

Answer 16

serotonin syndrome = ephedra, St. John’s wort

Question 17

Herbal remedies: Prolongs anesthetic agents

Answer 17

Prolong anesthetic agents = valerian, kava kava, St. John’s wort

Question 18

Herbal remedies: Warfarin interactions

Answer 18

ginger, garlic, feverfew, St. John’s wort

Question 19

Fat soluble vitamins

Answer 19

A, D,E,K

Question 20

Water Soluble Vitamins

Answer 20

B1, B2, B3 B6, B12, C, biotin, pantothenic acid, folacin

Question 21

Licorice Interactions

Answer 21

pseudoaldosteronism

Question 22

Ephedra Sinica (Mu huang)

Answer 22

for weight loss; SE: palpitations, MI, death (banned)

Question 23

Steroids S/E

Answer 23

moon face, acne, hirsutism, buffalo hump, truncal obesity, ↓K, ↑Na, ↑glucose, gynecomastia, muscle atrophy, osteoporosis, irritable, immunosuppression, avascular necrosis

Question 24

Relative potency of common steroids

Answer 24

Harry potter must die & 20 = 5 x 4 x 1
-Hydrocortisone: 20
-prednisone/prednisolone: 5
-methylprednisolone: 4
-dexamethasone: 0.75

Question 25

When to stress dose steroids

Answer 25

> 20mg for >3wks
5-20mg for >3weeks

Question 26

Receptor location of mineral and corticosteroids

Answer 26

Mineralocorticoid receptors: distal renal tubules & hippocampus
Glucocorticoid receptors: widely distributed

Question 27

daily secretion of cortisol

Answer 27

20mg

Question 28

Contrast dyes: Prevention of contrast induced nephropathy

Answer 28

Prevention of contrast-induced nephropathy (CIN):
○ Use nonionic, iso- or low-osmolar instead of hyperosmolar contrast
○ Use lowest volume of contrast needed
○ Withhold other nephrotoxic drugs (aminoglycosides, NSAIDs, piperacillin)

○ Hydrate w/ 0.9%NaCl before admin
○ NaHCO3 injection or infusion
○ N-acetylcysteine is a free radical scavenger (uncommon)

Question 29

IV Dye: S/E

Answer 29

HA, N/V, feeling hot, dizziness, rash/hives, pruritus, erythema, dyspnea, anaphylaxis