Pharmacology Flashcards
1
Q
Unique/common side effect of trazodone?
A
Priapism
2
Q
Unique/common side effect of aspirin?
A
GI bleeding, hypersensitivity
3
Q
Unique/common side effect of bleomycin?
A
Pulmonary fibrosis
4
Q
Unique/common side effect of cyclophosphamide?
A
Hemorrhagic cystitis
5
Q
Unique/common side effect of buproprion?
A
Seizures
6
Q
Unique/common side effect of isoniazid?
A
Vitamin B6 deficiency, lupus-like syndrome, liver toxicity
7
Q
Unique/common side effect of cyclosporine?
A
Renal toxicity
8
Q
Unique/common side effect of penicillins?
A
Anaphylaxis, rash with EBV
9
Q
Unique/common side effect of ACEI?
A
Cough, angioedema
10
Q
Unique/common side effect of demeclocycline?
A
Diabetes insipidus
11
Q
Unique/common side effect of lithium?
A
Diabetes insipidus, thyroid dysfunction
12
Q
Unique/common side effect of methoxyflurane?
A
Diabetes insipidus
13
Q
Unique/common side effect of sulfa drugs?
A
Allergies, kernicterus in neonates
14
Q
Unique/common side effect of halothane?
A
Liver necrosis
15
Q
Unique/common side effect of local anesthetic?
A
Seizures
16
Q
Unique/common side effect of phenytoin?
A
Folate deficiency, teratogen, hirsutism
17
Q
Unique/common side effect of vincristine?
A
Peripheral neuropathy
18
Q
Unique/common side effect of amiodarone?
A
Thyroid dysfunction, pulmonary toxicity
19
Q
Unique/common side effect of valproic acid?
A
Neural tube defects in offspring
20
Q
Unique/common side effect of isoretinoin?
A
Terrible teratogen
21
Q
Unique/common side effect of thioridazine?
A
Retinal deposits, cardiac toxicity
22
Q
Unique/common side effect of heparin?
A
Thrombocytopenia, thrombosis
23
Q
Unique/common side effect of vancomycin?
A
Red man syndrome
24
Q
Unique/common side effect of clofibrate?
A
Increased GI neoplasms
25
Unique/common side effect of tetracyclines?
Photosensitivity, teeth staining in children
26
Unique/common side effect of quinolones?
Teratogens (cartilage damage)
27
Unique/common side effect of quinine?
Cinchonism (tinnitus, vertigo)
28
Unique/common side effect of morphine?
Sphincter of Oddi spasm
29
Unique/common side effect of clindamycin?
Pseudomembranous colitis (can be caused by any broad-spectrum antibiotic)
30
Unique/common side effect of chloramphenicol?
Aplastic anemia, gray-baby syndrome
31
Unique/common side effect of doxorubicin?
Cardiomyopathy (dilated)
32
Unique/common side effect of busulfan?
Pulmonary fibrosis
33
Unique/common side effect of monoamine oxidase inhibitors?
Tyramine crisis (after eating cheese or wine)
34
Unique/common side effect of hydralazine?
Lupus-like syndrome
35
Unique/common side effect of procainamide?
Lupus-like syndrome
36
Unique/common side effect of minoxidil?
Hirsutism
37
Unique/common side effect of aminoglycoside?
Hearing loss, renal toxicity
38
Unique/common side effect of acetaminophen?
Liver toxicity (in high doses)
39
Unique/common side effect of chlorpropamide?
SIADH
40
Unique/common side effect of oxytocin?
SIADH
41
Unique/common side effect of opiates?
SIADH
42
Unique/common side effect of didanosine (ddI)?
Pancreatitis, peripheral neuropathy
43
Unique/common side effect of halogen anesthesia?
Malignant hyperthermia
44
Unique/common side effect of succinylcholine?
Malignant hyperthermia
45
Unique/common side effect of zidovudine (AZT)?
Bone marrow suppression
46
Unique/common side effect of digitalis?
GI disorders, vision changes, arrhythmias
47
Unique/common side effect of acetazolamide?
Metabolic acidosis
48
Unique/common side effect of clozapine?
Agranulocytosis
49
Unique/common side effect of SSRIs?
Anxiety, agitation, insomnia, sexual dysfunction
50
Unique/common side effect of warfarin?
Necrosis, teratogen
51
Unique/common side effect of niacin?
Skin flushing, pruritus
52
Unique/common side effect of HMC Coa reductase inhibitors?
Liver and muscle toxicity
53
Unique/common side effect of ethambutol?
Optic neuritis
54
Unique/common side effect of metronidazole?
Disulfiram-like reaction with alcohol
55
Unique/common side effect of cisplatin?
Nephrotoxicity
56
Unique/common side effect of methyldopa?
Hemoytic anemia (Coombs test-positive)
57
What are the side effects of thiazide diuretics?
Calcium retention, hyperglycemia, hyperuricemia, hyperlipidemia, hyponatremia, hypokalemic metabolic alkalosis, hypovolemia
They are sulfa drugs - watch out for sulfa allergy!!
58
What are the side effects of loop diuretics?
Hypokalemic metabolic alkalosis, hypovolemia (more potent than thiazides), ototoxicity, calcium excretion
With the exception of ethacrynic acid, they are sulfa drugs
59
What are the side effects of carbonic anhydrase inhibitors?
Metabolic acidosis
60
What are the side effects of potassium-sparing diuretics (e.g. spironolactone)?
Hyperkalemia
61
What are the side effects of beta blockers?
Sedation, depression, and sexual dysfunction. Also bradycardia and heart block in susceptible patients. can precipitate asthmatic attacks and mask symptoms of hypoglycemia (avoid in asthmatics/COPD and diabetics).
Beta1-selective beta blockers (atenolol, metoprolol) or combined beta and alpha blocker (carvedilol) is preferred if beta locker is needed to treated another condition such as heart disease.
62
What class of antihypertensive agents is best known for severe, first-dose orthostatic hypotension.
Alpha1-antagonists
63
What antihypertensive is best known for causing depression?
Methyldopa. Beta blockers may also cause depression.
64
What is the antidote for overdose or toxic exposure to acetaminophen?
Acetylcysteine
65
What is the antidote for overdose or toxic exposure to cholinesterase inhibitors?
Atropine, pralidoxime
66
What is the antidote for overdose or toxic exposure to quinidine or TCAs?
Sodium bicarbonate (cardioprotective)
67
What is the antidote for overdose or toxic exposure to iron?
Deferoxamine
68
What is the antidote for overdose or toxic exposure to digoxin?
Normalize potassium and other electrolytes; digoxin antibodies
69
What is the antidote for overdose or toxic exposure to methanol/ethylene glycol?
Ethanol
70
What is the antidote for overdose or toxic exposure to benzodiazepines?
Flumazenil
71
What is the antidote for overdose or toxic exposure to beta blockers?
Glucagon
72
What is the antidote for overdose or toxic exposure to lead?
Edetate (EDTA); use succimer in children
73
What is the antidote for overdose or toxic exposure to copper or gold?
Penicillamine
74
What is the antidote for overdose or toxic exposure to opioids?
Naloxone
75
What is the antidote for overdose or toxic exposure to carbon monoxide?
Oxygen (hyperbaric in cases of severe poisoning)
76
What is the antidote for overdose or toxic exposure to muscarinic blockers?
Physostigmine
77
What may happen if you give an MAO inhibitors plus meperidine?
Coma
78
What may happen if you give an aminoglycoside plus loop diuretic?
Enhanced ototoxicity
79
What may happen if you give a thiazide plus lithium?
Lithium toxicity
80
What may happen if you give an MAO inhibitor plus SSRI?
Serotonin syndrome (hyperthermia, rigidity, myoclonus, and autonomic instability)
81
What prophylactic medication should be given to contacts of a patient with neisserial meningitis?
Rifampin, ciprofloxacin, ceftriaxone, or azithromycin
82
Name 3 medications that cause hepatic enzyme induction
Classic enzyme inducers: barbiturates, antiepileptics, and rifampin
83
Name 3 medications that cause hepatic enzyme inhibition
Classic enzyme inhibitors: cimetidine, erythromycin, and ketoconazole
84
True or false: If a patient responds to placebo, a psychosomatic condition can be diagnosed.
False. Response to placebo means only that the patient responded to placebo. Normal people with real diseases often have an improvement in symptoms with a placebo medication or treatment.
85
Describe the mechanism of action for aspirin and other NSAIDs. How do they differ?
Inhibit cyclooxygenase centrally and peripherally, causing anti-inflammatory, antipyretic, analgesic, and antiplatelet effects.
Aspirin binds to and inhibits cyclooxygenase irreversibly. One dose can cause antiplatelet effects for the entire life of the platelet, whereas the effects of other NSAIDs last only for several hours.
86
How is acetaminophen different from aspirin and other NSAIDs?
Thought to inhibit cyclooxygenase primarily in the brain; it does not act well in the periphery of the body. Thus it has analgesic and antipyretic effects but no antiplatelet or significant anti-inflammatory effects.
87
What are the side effects and toxic effects of aspirin?
Causes GI upset and bleeding - most important preventable risk factor for development of gastric ulcers. Can also cause renal damage or aggravate gout.
Toxic doses of aspirin can cause tinnitus, vertigo, respiratory alkalosis and metabolic acidosis, hyperthermia, coma, and death. Severe overdoses can be removed by dialysis.
88
What are the side effects of non-aspirin NSAIDs?
GI upset, bleeding, and ulcers. May cause renal damage (interstitial nephritis, acute tubular necrosis and/or papillary necrosis), esp. in patients with preexisting renal disease.
89
What is phenylbutazone and why should it not be used chronically?
NSAID that can cause fatal aplastic anemia/agranulocytosis
90
What development in NSAID therapy may reduce GI and bleeding complications?
New combos of NSAIDs with PGE1 and COX2 inhibitors. Normal NSAIDs inhibit COX1 (in addition to COX2), which is thought to be the main culprit in causing GI problems. PGE1 protects the stomach by supplying what NSAIDs take away. COX2 inhibitors avoid the problem altogether, but may not be as protective against GI bleeding as originally thought. 2/3 COX2 inhibitors initially approved in the U.S. have been removed from the market due to adverse CV effects.
91
What happens with an overdose of acetaminophen?
Liver toxicity due to depletion of glutathione. Treat with acetylcysteine to decrease liver injury.
92
What age group should not be given aspirin?
Children younger than 15 y/o (esp. with fever or viral infection) because of concern for Reye syndrome.
93
What finding on physical exam is a contraindication to aspirin use?
Nasal polyps because hypersensitivity reactions involving an asthmatic attack are extremely common. Also, people with asthma may have an asthma attack after aspirin even in the absence of nasal polyps.
94
What is the relationship between aspirin and MI?
Low-dose aspirin has been proven to be of benefit in reducing the risk of MI in patients with previous MI or those with stable or unstable angina. It is also recommended for all diabetics with CV disease and for primary prevention in those with 1 or more risk factors.
95
Discuss the relationship between aspirin and strokes.
Low-dose aspirin is of proven benefit in reducing strokes in patients with transient ischemic attacks and/or known carotid artery stenosis.
96
True or false: Patients should be given an aspirin as soon as possible in the ED for a suspected MI or unstable angina.
True, but beware the patient who presents with chest pain and ends up having an aortic dissection (aspiring should be avoided then).
97
True or false: In the setting of an acute neurologic deficit, you should give aspirin before ordering brain imaging.
False. You do not know whether they are having a stroke or TIA. TIA is a retrospective diagnosis made once symptoms clear. First order a CT or MRI to rule our hemorrhagic stroke and potentially locate an area of infarct, which is a contraindication to aspirin. If the CT is negative for blood, the patient should be given aspirin 325 mg within 24-48 hrs of TIA or stroke onset.
