Pharmacology Flashcards
Phenytoin toxicity
Bennett has a big avocado sitting on top of his head + he’s four-eyed + skeletons on either side of him + he’s pushing Rachel in a wheelchair + he’s covered in hair + his hands and feet are in hot water/SE’s – causes folate deficiency + diplopia + increased risk of osteoporosis (increases vitamin D catabolism) + hirsutism + SLE-like syndrome + Stevens-Johnson syndrome + megaloblastic anemia + peripheral neuropathy.
Digoxin toxicity clinical features
- volume depletion from recent illness OR starting new drug that impress clearance Or electrolyte abnormalities + below clinical features
- GI disturbances + neurologic dysfunction + vision changes + electrolyte imbalances + cardiac arrhythmias
- Toxicity does not correlate well with serum digoxin levels so level may be in normal range. Diagnosis is based on clinical findings, NOT level.
SE of thiazides
- hyponatremia
- Mildly increased serum calcium (usually not enough to be symptomatic)
- see database
Treatment of dig toxicity
If arrhythmia, end-organ dysfunction, or hyperkalemia – Dig-antibody fragments
- IV hydration
Bactrim SE’s
- hyperkalemia
- SJS and TEN
- megaloblastic pancytopenia (folate deficiency)
- hyperkalemia
- AKI
- crystalluria
- contraindicated in pregnancy
Management of clozaril-induced agranulocytosis
- IF ANC below 1000 –> hold clozaril until recovery
IF ANC drops below 500 –> stop clozaril indefinitely
Other presentation of antibiotic induced liver injury
- drug-induced cholestasis (intrahepatic cholestasis) (marked hyperbilirubinemia, asymptomatic otherwise)
First step in TCA overdose
ECG (QRS widening or wide complex tachycardia is an indication for IV sodium bicarb)
Other SE’s of valproic acid
- hepatic encephalopathy
SE of high-intensity statin therapy to know
- increased risk of new-onset diabetes
* may also worsen glycemic control in establish diabetes
Other ECG features of early hyperkalemia
- absence of P waves
- shortened QT interval
