Pharm/Tox Flashcards
1
Q
Amiodarone
A
- risk factors for lung tox
- age > 60
- daily dose >=400
- pre-existing lung disease
- high cumulative dose
- can present with
- interstitial pneumonitis
- eosinophilic pneumonia
- fibrosis
- DAH
- foamy macrophages - non specific and are present even with no toxicity
- treat with steroids
2
Q
BCNU
A
- used to treat CNS tumors
- onset many years later
- 1500 mg/m2 dosing - high percent will get Pulm tox
- higher risk
- radiation
- cytoxan
- underlying lung disease
- high mortality
- steroids minimally effective
3
Q
Bleomycin
A
- risk factors for lung tox
- 450-500 units
- oxygen
- radiation
- renal dysfunction
- accumulates in lung and skin
- 10% lung tox
- chronic interstitial fibrosis
- 6 weeks - 6 months after therapy
- treat with steroids
- biopsy - focal type II pneumocyte hyperplasia and intramural alveolar fibrin
4
Q
Methotrexate
A
- hypersensitivity reaction
- folic acid antagonist
- no clear dose relationship
- 10 days - 4 months after starting
- fevers, cough, rash, arthralgias
- blood eosinophilia in 40%
- increased risk with cytoxan
- BAL - lymphocytic
5
Q
Taxane
A
- high incidence of pneumonitis
6
Q
ASA
A
- causes non cardiogenic pulm edema
- diffuse alveolar infiltrate
- resp alkalosis with metabolic acidosis
- alkaline diuresis
- dialysis
7
Q
Nitrofurantonin
A
- acute and chronic
- acute - HP reaction
- chronic - fibrosis
- lavage - lymphocytes
8
Q
Amiodarone
A
- maintenance dose > 400 mg day
- can cause alveolar hypoventilation
- can present as pneumonitis, ARDS, BOOP, DAH, AEP
- age > 60 risk factor
- foamy macrophages
- ## ATII cell hyperplasia
9
Q
Anti-TNF alpha antibody
A
- etanercept, infliximab, adalimumab
- can cause
- granulomatous inflammation
- NSIP
- HP
- fibrosis
- PIE
- does not cause non cardiogenic edema
10
Q
Vinyl Chloride
A
- used to make PVC
- causes ILD with micro nodules
- dissolves bone
- Raynauds
