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Step 1 2019 First Aid Flashcards > Pharm FA II Tox & SE p247 - 253 > Flashcards

Pharm FA II Tox & SE p247 - 253 Flashcards

1
Q

acetaminophen

A

N-acetylcysteine (replenishes glutathione)

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2
Q

AChE inhibitors, organophosphates

A

Atropine > pralidoxime

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3
Q

Antimuscarinic, anticholinergic agents

A

Physostigmine, control hyperthermia

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4
Q

Arsenic

A

Dimercaprol, succimer

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5
Q

Benzodiazepines

A

Flumazenil

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6
Q

Beta Blockers

A

Atropine, glucagon, saline

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7
Q

Carbon monoxide

A

100% Oxygen, hyperbaric oxygen

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8
Q

Copper

A

“penny” cillamine ( penicillamine), trientine

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9
Q

Cyanide

A

Nitrite +thiosulfate, hydroxycobalamin

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10
Q

Digitalis ( digoxin)

A

Digoxin-specific antibody fragments

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11
Q

Heparin

A

protamine sulfate

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12
Q

iron

A

deferoxamine, deferasirox, deferiprone

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13
Q

Lead

A

Calcium disodium EDTA, dimercarprol, succimer, penicillamine

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14
Q

mercury

A

dimercaprol, succimmer

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15
Q

methanol, ethylene glycol ( antifreeze)

A

fomepizole >ethanol, dialysis

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16
Q

Methemoglobin

A

methylene blue, Vitamin C ( reducing agent)

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17
Q

opioids

A

naloxone

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18
Q

salicylates

A

NaHCO3- ( alkaline urine) dialysis

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19
Q

TCAs

A

NaHCO3- ( stabilizes cardiac membrane)

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20
Q

warfarin

A

Vitamin K ( delayed effect), PCC/FFP ( immediate effect)

PCC - prothrombin complex concentrate

FFP - fresh frozen plasma

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21
Q

Coronary vasospasm

A

Cocaine, Amphetamines, Sumatriptan, Ergot alkaloids (CASE)

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22
Q

Cutaneous flushing

A

Vancomycin, Adenosine, Niacin, Ca2+ channel blockers, Echinocandins, Nitrates (flushed from VANCEN [dancing])

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23
Q

Red man syndrome?

A

rate-dependent infusion reaction to vancomycin causing widespread pruritic erythema. Manage with diphenhydramine, slower infusion rate.

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24
Q

Dilated cardiomyopathy?

A

Anthracyclines (eg, Doxorubicin, Daunorubicin); prevent with Dexrazoxane

Use Dex for Dox Dilated cardiomyopathy

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25
Q

Prevent Rx induced dilated cardiomyopathy?

A

prevent with Dexrazoxane

Use Dex for Dox Dilated cardiomyopathy

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26
Q

Torsades de pointes

A

Agents that prolong QT interval: antiArrhythmics (class IA, III), antiBiotics (eg, macrolides), anti“C”ychotics (eg, haloperidol), antiDepressants (eg, TCAs), antiEmetics (eg, ondansetron) (ABCDE)

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27
Q

Adrenocortical insufficiency

A

HPA suppression 2° to glucocorticoid withdrawal

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28
Q

Diabetes insipidus

A

Nephrogenic DBI

Lithium, demeclocycline (ADH antagonist)

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29
Q

Hot flashes

A

SERMs (eg, tamoxifen, clomiphene, raloxifene

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30
Q

Hyperglycemia

A
  • Tacrolimus ((-) IL2 transcription by blocking calcineurin)
  • Protease inhibitors
  • Niacin
  • HCTZ,
  • Corticosteroids
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31
Q

Hyperprolactinemia

A
  • Typical antipsychotics - Haloperidol, pimozide, trifluoperazine, fluphenazine, thioridazine, chlorpromazine.
  • atypical antipsychotics - Aripiprazole, asenapine, clozapine, olanzapine, quetiapine, iloperidone, paliperidone,
    risperidone, lurasidone, ziprasidone.
  • metoclopramide, (anti-emetic)
  • methyldopa
  • reserpine (stops resorption of catecholamines into vesicle in neuron VMAT)
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32
Q

Hyperthyroidism

A

Amiodarone, thyroid replacement therapy, iodine

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33
Q

Hypothyroidism

A

AMiodarone, SUlfonamides, Lithium

I AM SUddenly Low

34
Q

SIADH

A

SIADH:

Carbamazepine, Cyclophosphamide, SSRIs

Can’t Concentrate Serum Sodium

35
Q

Acute cholestatic hepatitis, jaundice

A

Macrolides (eg, erythromycin)

36
Q

Diarrhea

A
  • Acamprosate - dec desire for alcohol
  • antidiabetic agents (acarbose, metformin, pramlintide),
  • colchicine,
  • cholinesterase inhibitors,
  • lipid-lowering agents (eg, ezetimibe, orlistat),
  • macrolides (eg, erythromycin),
  • SSRI
37
Q

Focal to massive hepatic necrosis

A

Halothane, Amanita phalloides (death cap mushroom), Valproic acid, Acetaminophen

Cause HAVAc to Liver

38
Q

Hepatitis

A

Rifampin, isoniazid, pyrazinamide, statins, fibrates

TB rx and Chol lowering rx.

RIP FuckS Liver

39
Q

Pancreatitis

A
  • *D**idanosine (NRTI - HIV rx) , Corticosteroids, Alcohol, Valproic acid, Azathioprine ( dec purine synthesis (+) by HGPRT), Diuretics (eg, furosemide, HCTZ)
  • *D**rugs Causing A Violent Abdominal Distress
40
Q

Pill-induced esophagitis

A
  • Bisphosphonates
  • ferrous sulfate,
  • potassium chloride
  • NSAIDs,
  • Tetracyclines

Caustic effect minimized with upright posture and adequate water ingestion

41
Q

Pseudomembranous colitis

A

Ampicillin, cephalosporins, clindamycin, fluoroquinolones
Antibiotics predispose to superinfection by resistant C difficile

FACC!! I’m shitting from C diff

42
Q

Agranulocytosis

A
  • Dapsone - leprosy
  • Clozapine - atypical antipsych
  • Carbamazepine - anti epileptic
  • Propylthiouracil - hyperthyroid
  • Methimazole - hyperthyroid
  • Colchicine - gout
  • Ganciclovir - CMV

Drugs Can Cause Pretty Major Collapse of Granulocytes

43
Q

Aplastic anemia

A

Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol, Propylthiouracil

Can’t Make New Blood Cells Properly

44
Q

Direct Coombs positive hemolytic anemia

A

Penicillin, methylDopa, Cephalosporins

P Diddy Coombs

45
Q

Drug reaction with eosinophilia and systemic symptoms (DRESS)

A

Allopurinol, anticonvulsants, antibiotics, sulfa drugs

DRESS is a potentially fatal delayed hypersensitivity reaction. Latency period (2–8 weeks) followed by fever, morbilliform skin rash, and frequent multiorgan involvement.

Treatment: withdrawal of offending drug, corticosteroids

46
Q

Grey Baby syndrome

A

Chloramphenicol

47
Q

Hemolysis in G6PD deficiency

A

Isoniazid, Sulfonamides, Dapsone, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin

Hemolysis IS D PAIN

48
Q

Megaloblastic anemia

A

Hydroxyurea, Phenytoin, Methotrexate, Sulfa drugs

U’re having a mega blast with PMS

49
Q

Thrombocytopenia

A
  • *H**eparin, Vancomycin, Linezolid
  • *H**elp! Very Low platelets
50
Q

Thrombotic complications

A

Combined oral contraceptives, hormone replacement therapy, SERMs (eg, tamoxifen, raloxifene, clomiphene)
Estrogen-mediated side effect

51
Q

Drug-induced lupus

A

Methyldopa, Minocycline, Hydralazine, Isoniazid, Phenytoin, Sulfa drugs, Etanercept, Procainamide

Lupus Makes My HIPS Extremely Painful

52
Q

Fat redistribution

A

Protease inhibitors, Glucocorticoids
Fat PiG

53
Q

Gingival hyperplasia

A
  • *C**yclosporine, Ca2+ channel blockers, Phenytoin
  • *C**an Cause Puffy gums
54
Q

Hyperuricemia (gout)

A
  • *P**yrazinamide, Thiazides, Furosemide, Niacin, Cyclosporine
  • *P**ainful Tophi and Feet Need Care
55
Q

Myopathy

A
  1. Statins
  2. fibrates
  3. niacin
  4. colchicine
  5. daptomycin
  6. hydroxychloroquine
  7. interferon-α
  8. penicillamine
  9. glucocorticoid
56
Q

Osteoporosis

A
  1. Corticosteroids
  2. depot medroxyprogesterone acetate
  3. GnRH agonists
  4. aromatase inhibitors
  5. anticonvulsants
  6. heparin
  7. PPIs
57
Q

Photosensitivity

A
  • *Sulfonamides, Amiodarone, Tetracyclines, 5-F**U
  • *SAT** For Photo
58
Q

Rash (Stevens-Johnson syndrome)

A

Anti-epileptic drugs (especially lamotrigine), allopurinol, sulfa drugs, penicillin
Steven Johnson has epileptic allergy to sulfa drugs and penicillin

59
Q

Teeth discoloration

A

Tetracyclines
Teethracyclines

60
Q

Tendon and cartilage damage

A

Fluoroquinolones

61
Q

Sx of Cinchonism

A

tinnitus, hearing/vision loss, psychosis, and cognitive impairment

62
Q

Parkinson-like syndrome

A

Antipsychotics, Reserpine, Metoclopramide

Cogwheel rigidity of ARM

63
Q

Peripheral neuropathy

A

Isoniazid, phenytoin, platinum agents (eg, cisplatin), vincristine

64
Q

Idiopathic intracranial hypertension

A

Growth hormones, tetracyclines, vitamin A

65
Q

Seizures

A
  • Isoniazid (vitamin B6 deficiency),
  • Bupropion
  • Imipenem/cilastatin
  • Tramadol
  • Enflurane

With seizures, I BITE my tongue

66
Q

Tardive dyskinesia

A

Antipsychotics, metoclopramide

67
Q

Visual disturbance

A
  • Topiramate (blurred vision/diplopia, haloes), - anti-epileptic
  • Digoxin (yellow-tinged vision),
  • Isoniazid (optic neuropathy/color vision changes),
  • Vigabatrin (bilateral visual field defects), - anti-epileptic
  • PDE-5 inhibitors (blue-tinged vision), - sildenafil etc. ED/pulm HTN
  • Ethambutol (color vision changes)

These Drugs Irritate Very Precious Eyes

68
Q

Fanconi syndrome

A

Cisplatin, ifosfamide, expired tetracyclines, tenofovir (NRTI)

CITT Fanconi

Fanconi - Generalized reabsorption defect in PCT –> excretion of amino acids, glucose, HCO3–, and PO43–, and all substances reabsorbed by the PCT
May lead to metabolic acidosis (proximal RTA), hypophosphatemia, osteopenia

69
Q

Hemorrhagic cystitis

A

Cyclophosphamide, ifosfamide

70
Q

Interstitial nephritis

A

Diuretics (Pee), NSAIDs (Pain-free), Penicillins and cephalosporins, PPIs, rifamPin, and sulfa drugs

Remember the 5 P’s

71
Q

Pulmonary fibrosis

A
  • Methotrexate
  • Nitrofurantoin,
  • Carmustine (DNA alkylating agent),
  • Bleomycin,
  • Busulfan,
  • Amiodarone

My Nose Cannot Breathe Bad Air

72
Q

Antimuscarinic

A

Atropine, TCAs, H1-blockers, antipsychotics

73
Q

Disulfiram-like reaction

A

1st-generation Sulfonylureas, Procarbazine ( Cell cycle phase–nonspecific alkylating agent, brain and hodgkins), certain Cephalosporins, Griseofulvin, Metronidazole

Find diSulfiraM with a GPS

74
Q

Nephrotoxicity/ ototoxicity

A
  • *Loop diuretics, Aminoglycosides, cisPlatin, Vancomycin, amphoTER**icin B
  • *Listen And Pee Very TERriB**ly
75
Q
A
76
Q

p450 (+)’rs

A
  • Chronic alcohol use
  • St. John’s wort
  • Nevirapine - anti HIV
  • Rifampin - anti TB
  • Griseofulvin - anti fungal
  • Carbamazepine - anti epileptic
  • Phenytoin - anti epileptic
  • Phenobarbital - barb
  • Modafinil - for narcolepsy - GABA (-)’n, Glu (+)’n

Most chronic alcoholics Steal Phen-Phen and Never Refuse Greasy Carb

77
Q

Substrates for p450

A

Warfarin
Anti-epileptics
Theophylline
OCPs

War Against The OCPs

78
Q

p450 (-)’rs

A
  • Acute alcohol abuse
  • Grapefruit juice
  • Fluconazole - anti fungal
  • Isoniazid - anti-TB
  • Ketoconazole - anti fungal
  • Ciprofloxacin - antibiotic (flouroquinolone)
  • Chloramphenicol - antibiotic
  • Clarithromycin - antibiotic (macrolides)
  • Erythromycin - antibiotic (macrolides)
  • Metronidazole - antibiotic
  • Sulfonamides - antibiotic
  • Cimetidine - H+ blocker
  • Omeprazole - PPI
  • Amiodarone - class III anti arrythmic (K+ ch blocker)
  • Sodium valproate - anti-epileptic

AGH!!! FIK CChEMS (chemical) ChAOS with p450 (-)’rs

79
Q

Ex of Sulfa rx?

A
  • Sulfonamide antibiotics,
  • Sulfasalazine,
  • Probenecid,
  • Furosemide,
  • Acetazolamide,
  • Celecoxib,
  • Thiazides,
  • Sulfonylureas.

Scary Sulfa Pharm FACTS

80
Q

SE of Sulfa drugs

A

Patients with sulfa allergies may develop fever, urinary tract infection, StevensJohnson syndrome, hemolytic anemia, thrombocytopenia, agranulocytosis, acute interstitial nephritis, and urticaria (hives).

Step 1 2019 First Aid Flashcards (63 decks)

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