Pharm Flashcards
Hydroxycholoroquine s/e
Retinal toxicity
Methotrexate s/e*
Macrocytic anemia ==> pancytopenia
Cyclophosphamide s/e*
Hemorrhagic cystitis & bladder cancer (2/2 acrolein metabolite ==> take MESNA)
Myelosuppression
Digitalis / digoxin interactions, s/e*
Verapamil increases digoxin levels
GI upset (common!) Hyperkalemia 2/2 displacing K+ binding sites
Carbonic anhydrase inhibitor name, mechanism, s/e
Acetazolamide
Block CA @ proximal limb ==> block Na+ reabsorption & H+ secretion ==> increase Na+/H20 excretion
Metabolic acidosis
Sulfa allergy
Osmotic agent names, mechanism, s/e
Mannitol, urea
Pull fluid into tubules
Backfire: anuria, pulmonary edema
Loop diuretic names, mechanism, s/e*
Furosemide, -ides, ethacrynic acid
Block Na/K/2Cl transport @ ascending Henle ==> increase Na/H20 excretion
Ototoxicity
Sulfa allergy (except ethacrynic)
Metabolic alkalosis (2/2 increased DCT Na+ increases HCO3 reabsorption)*
Hypokalemia (2/2 increase Na/K exchange @ DCT)*
Hypocalcemia ==> calcium stones
Thiazide names, mechanism, s/e*
-thiazides
Block DCT Na/Cl cotransporter & activate Ca transporter ==> increase Na/H20 excretion
Pancreatitis
Hypercalcemia
Hyponatremia
Sulfa allergy (except ethacrynic)
Metabolic alkalosis (2/2 increased DCT Na+ increases HCO3 reabsorption)
Hypokalemia* (2/2 increase Na/K exchange @ DCT)
K+ sparing diuretic names, mechanism, s/e*
Spironolactone: block aldosterone receptor ==> block ENAC (Na+ reabsorption) /ROM-K (K+ secretion) exchange
Triamterene/amiloride: block ENAC channel
Hyperkalemia* Metabolic acidosis Antiandrogenic effects (gynecomastia)
IV acyclovir risk, tx*
Supersaturation & crystallization in DCT ==> renal failure
Aggressive hydration
Anticholinergic meds, s/e*
Diphenhydramine
Amitryptiline
Urinary retention 2/2 detrussor inability to contract & urinary sphincter inability to relax
Rifampin s/e*
Red-orange discoloration of body fluids
Metformin mechanism, s/e, contraindications*
Inhibits hepatic gluconeogenesis
Increases peripheral insulin sensitivity
Weight neutral
GI upset
Elderly > 80 y/o
Renal, hepatic, or heart failure patients
Renal failure ==> worsens lactic acidosis*
Sepsis
Cyclosporin mechanism, s/e**
IL-2 transcription inhibitor, especially lymphocytes
Nephrotoxic: azotemia, hyperkalemia, hyperuricemia, hypertension
Neurotoxic: tremor, seizure
Gingival hypertropy & hirsuitism
Malignancy, infection, GI intolerance, hyperglycemia
Tacrolimus mechanism, s/e**
IL-2 transcription inhibitor
*Same as cyclosporin except no hirsuitism or gingival hypertrophy
Nephrotoxic
Neurotoxic
Diarrhea & glucose intolerance
Azathioprine mechanism, s/e**
Inhibits purine synthesis
Diarrhea
Hepatotoxicity
Leukopenia
Mycophenolate mechanism, s/e**
Inhibits purine synthesis
MARROW SUPPRESSION
ACE-inhibitor mechanism, s/e*
___
Angioedema: perioral, periorbital etc. ==> can occur ANYTIME, not just upon starting meds
Tetracyclines names, mechanisms, s/e*
Photosensitivity
Rosiglitazone, piaglitazone name, mechanism, s/e, contraindications*
TZD
Increase insulin sensitivity
Weight gain
Hepatotoxicity
Bone loss
Contraindicated in heart failure patients
Levothyroxine name, mechanism, interactions*
L-thyroxine
Oral estrogen: increases thyroxine binding globulin (TBG), thus more T4 is bound requiring increased level of levothyroxine
Pregnancy: increases thyroxine binding globulin ==> requires increased levothyroxine
Sildinafil mechanism, contraindications*
Phosphodiesterase inhibitor
Give >4 hours apart with alpha-blocker (doxazosin) to avoid hypotension
Do not give with nitrates
Do not give with priapism conditions (sickle cell)
Erythromycin and cimetidine prolong it
Methimazole and propylthiouracil s/e*
Rare but serious: agranulocytosis ==> discontinue if any fever / sore throat ==> permanently discontinue if WBC<1000
Sulfonylurea names, mechanism, s/e, contraindications*
Weight gain
Hypoglycemia
Beta-2 agonists names, mechanisms
Albuterol: short acting bronchial smooth muscle relaxation
Salmeterol: long acting bronchial smooth muscle relaxation
Muscarinic antagonists names, mechanism
Ipratroprium: blocks muscarinic bronchoconstriction
Cromolyn mechanism
Blocks vasoactive MAST cell release
Antileukotriene names
Zileuton
Monteleukast
Amiodarone s/e*
Interstitial lung disease
Heparin mechanism
Bind and enhance antithrombin 3
Warfarin mechanism
Inhibit vitamin K dependent clotting factors 2, 7, 9, 10
Unfractionated heparin alternatives (e.g. enoxaparin etc.) contraindication*
Renal failure
GFR < 30
Glucorticoid s/e*
Neutrophilia 2/2 increasing marginalization
Leukopenia & eosinophilopenia
Theophylline toxicity signs*
TRIAD, 2/2 cirrhosis, illness, or competing drugs
CNS stimulation: headache, seizure
GI upset
Cardiac: arrhythmia
