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Step 1 Andre > Pharmacology - Toxicities and Side Effects > Flashcards

Pharmacology - Toxicities and Side Effects Flashcards

1
Q

Antidote for acetaminophen toxicity

How?

A

N-acetylcysteine (NAC)

Replenishes glutathione

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2
Q

Antidote for AchE inhibitor (organophosphate) toxicity

How?

A

Atropine + Pralidoxime

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3
Q

Antidote for Amphetamines toxicity

How?

A 
Ammonium Chloride
Protonates amphetamines (basic) to allow renal excretion
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4
Q

Antidote for Antimuscarinic (anticholinergic) toxicity

A

Physostigmine salicylate, control hyperthermia

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5
Q

Antidote for Benzo toxicity

A

Flumazenil

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6
Q

Antidote for beta-blocker toxicity

A

Glucagon

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7
Q

Antidote for CO toxicity

A

100% O2 and hyperbaric O2

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8
Q

Antidote for Cu, As, Au toxicity

A

Penicillamine

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9
Q

Antidote for CN toxicity

A

Nitrite + thiosulfate, hydroxocobalamin

Amyl nitrite

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10
Q

Antidote for digitalis toxicity

A

anti-dig Fab fragments

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11
Q

Antidote for Heparin toxicity

A

Protamine sulfate

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12
Q

Antidote for Iron (Fe) toxicity

A

Deferoxamine, Deferaxirox

De-Fe’s

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13
Q

Antidote for Lead (Pb) toxicity

A
  • EDTA (chelator)
  • Dimercaprol, Succimer (also for mercury toxicity)
  • Penicillamine (also for Cu, As, Au toxicity)
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14
Q

Antidote for Mercury, ethylene glycol (antifreeze) toxicity

A

Di.mer.caprol (BAL), Succi.mer
EDTA

“Mer”

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15
Q

Antidote for Met.hemoglobin toxicity (when Hb has Fe3+ instead of 2+)

A 
Methylene blue (reduces... but oxidizes at very high doses)
Vit C
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16
Q

Antidote for Opioids toxicity

A

Naloxone (short-term, emergency use)

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17
Q

Antidote for Salicylates toxicity

A

NaHCO3 and dialysis to alkalize urine and ionize salicylic acid for renal excretion

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18
Q

Antidote for TCAs toxicity

A

NaHCO3 for plasma alkalinzation

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19
Q

Antidote for tPA, streptokinase, urokinase toxicity

A

Aminocaproic acid

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20
Q

Antidote for warfarin toxicity

A

Vit K, FFP if currently bleeding

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21
Q

Drug reactions: Meds that cause vasospasm (3)

A
  1. cocaine
  2. ergot alkaloids
  3. sumatriptan

“Can Elicit Spasms”

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22
Q

Drug reactions: Meds that cause cutaneous flushing (4)

A
  1. Vanco
  2. Adenosine
  3. Niacin
  4. CaCh blockers

“VANC”

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23
Q

Drug reactions: Meds that cause dilated CM (2)

A
  1. doxorubicin
  2. danunorubicin

D-rubicin drugs cause Dilated CM

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24
Q

Drug reactions: Meds that cause TdP (5)

A
  1. Class III anti-arrhthmic (sotalol)
  2. Class Ia anti-arryhthmic (quinidine)
  3. Macrolides (mainly clarithromycin and erythromycin)
  4. antipsychotics
  5. TCAs
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25
Q

Drug reactions: Meds that cause adrenocortical insufficiency (1)

A

Sudden Glucocorticoid withdrawal leading to HPA suppression

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26
Q

Drug reactions: Meds that cause hot flashes (2)

A
  1. Tamoxifen (SERM)
  2. Clomiphene (SERM)

“Temperature Check”

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27
Q

Drug reactions: Meds that cause hyperglycemia (6)

A
  1. Tacrolimus
  2. Protease inhibitor
  3. Niacin
  4. HCTZ
  5. Beta-blocker
  6. Corticosteroids

“He Takes Pills, Needs Blood Checks”
““H

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28
Q

Drug reactions: Meds that cause Hypothyroidism (3)

A
  1. Amiodarone
  2. Lithium
  3. Sulfonamides

“A Lot of Swimming” will make you cold, like in Hypothyroidism

29
Q

Drug reactions: Meds that cause acute cholestatic hepatitis and jaundice (1)

A

Erythromycin

30
Q

Drug reactions: Meds that cause diarrhea (5)

A
  1. Metformin
  2. Erythromycin
  3. Colchicine
  4. Orlistat (obesity drug to prevent absorption of fat, so osmotic diarrhea)
  5. Acarbose (anti-Diabetes by causing carb locking in GI, so osmotic diarrhea)

“Oh, My Aching Excited Colon”

31
Q

Drug reactions: Meds that cause focal to massive hepatic necrosis (4)

A
  1. Halothane
  2. Amanita phalloides (death cap mushroom)
  3. Depakote Valproic acid
  4. Acetaminophen

Hepatic Death AA!

32
Q

Drug reactions: Meds that cause hepatitis (1)

33
Q

Drug reactions: Meds that cause pancreatitis (6)

A
  1. Didanosine (reverse transcriptase inhibitor anti-retroviral)
  2. Corticosteroids
  3. Alcohol
  4. Valproic Acid
  5. Azathioprine (immunosuppresion via purine analog)
  6. Diuretics (furosemide and HCTZ)

“Drugs Causing A Violent Abdominal Distress”

34
Q

Drug reactions: Meds that cause pseudomembranous colitis (3)

A
  1. Clindamycin
  2. Ampicillin
  3. Cephalosporin

b/c c. dif

35
Q

Drug reactions: Meds that cause Agranulocytosis (6)

A
  1. Dapsone (abx to treat leprosy)
  2. Clozapine (atypical antipsychotic)
  3. Carbamazepine (mood-stabilizer and anticonvulsant)
  4. Colchicine
  5. Methimazole (anti-thyroid drug)
  6. Propylthiouracil (anti-thyroid drug)

“Drugs CCCrush Myeloblasts and Promyelocytes”

36
Q

Drug reactions: Meds that cause Aplastic anemia (6)

A
  1. Carbamazepine (mood-stabilizer and anticonvulsant)
  2. Methimazole (anti-thyroid drug)
  3. NSAIDs
  4. Benzene
  5. Chloramphenicol (abx used for meningitis [strep, neisseia, hflu])
  6. Propylthiouracil (anti-thyroid drug)

“Cannot Make New Blood Cells Properly

37
Q

Drug reactions: Meds that cause direct Coomb’s poitive hemolytic anemia (2)

A
  1. Methyldopa

2. PCN

38
Q

Drug reactions: Meds that cause gray baby syndrome (1)

A

Chloramphenicol (abx for meningitis)

39
Q

Drug reactions: Meds that cause hemolysis in G6PD def (7)

A
  1. INH
  2. Sulfonamides
  3. Dapsone (abx for leprosy)
  4. Primaquine (malaria drug of pneumocystis PNA)
  5. ASA
  6. Ibuprofen
  7. Nitrofurantoin (abx for UTIs resistant to other abx)

Hemolysis “IS D PAIN”

40
Q

Drug reactions: Meds that cause megaloblastic anemia (3)

A
  1. Phenytoin
  2. MTX
  3. Sulfa drugs

have a Blast with PMS

41
Q

Drug reactions: Meds that cause thrombocytopenia (2)

A
  1. Heparin

2. Cimetidine (H2-rec antagonism)

42
Q

Drug reactions: Meds that cause thrombotic complications

43
Q

Drug reactions: Meds that cause fat redistribution (2)

A
  1. Protease inhibitors
  2. GC’s

“Fat PiG”

44
Q

Drug reactions: Meds that cause gingival hyperplasia (4)

A
  1. Phenytoin
  2. Verapamil
  3. Cyclosporine
  4. Nifedipine
45
Q

Drug reactions: Meds that cause hyperuricemia (gout) (5)

A
  1. Pyrazinamide
  2. Thiazide
  3. Furosemide
  4. Niacin
  5. Cyclosporine

Painful Toes and Feet Need Care

46
Q

Drug reactions: Meds that cause myopathy (8)

A
  1. Fibrates
  2. niacine
  3. Colchicine
  4. Hydroxychloroquine
  5. IFN-alpha
  6. Penicillamine
  7. Statins
  8. Glucocorticoids
47
Q

Drug reactions: Meds that cause osteoporosis (2)

A
  1. CS’s

2. Heparin

48
Q

Drug reactions: Meds that cause photosensitivity (4)

A
  1. Sulfonamides
  2. Amiodarone
  3. Tetracycline
  4. 5-FU
49
Q

Drug reactions: Meds that cause Rash (stevens-Johnson) (8)

A
  1. Ethosuximide
  2. Carbamazepine
  3. Lamotrigine
  4. Phenytoin
  5. Phenobarbitol
    - —- antiepileptics —
  6. Allopurinol
  7. Sulfa drugs
  8. PCN
50
Q

Drug reactions: Meds that cause SLE-like syndrome

A
  1. Sulfa drugs
  2. Hydralazine (anti-HTN via activation of VG-KCh on vascular smooth muscle)
  3. INH
  4. Procainamide (Ia anti-arryhthmic)
  5. Phenytoin
  6. Etanercept (TNF inhibitor for inflammatory dz [RA, psoriatic arthritis, anklyosing spondylitis)
51
Q

Drug reactions: Meds that cause teeth discoloration (1)

A

tetracycline

52
Q

Drug reactions: Meds that cause tendonitis, tendon rupture, and cartilage damage (1)

A

fluroquinolones

53
Q

Drug reactions: Meds that cause cinchonism (flushed and sweaty skin, tinnitus, blurred vision, hearing impairment, reversible high freq hearing loss, rashes, vertigo, n/v/d)

A

quinidine

quinine

54
Q

Drug reactions: Meds that cause Parkinson-like syndrome (3)

A
  1. antipsychotics
  2. reserpine (blocker of Dopamine inserting into vesicles)
  3. metoclopramide (dopamine-receptor antagonist for n/v)
55
Q

Drug reactions: Meds that cause seizures (6)

A
  1. INH (2/2 B6 [pyridoxine] deficiency)
  2. Buproprion (antidepressnat/smoking cessation SSRI)
  3. Imipenem/cilastatin (protects imipenem from degradation)
  4. Tramadol (opioid analgesia)
  5. Enflurane (halogenated ether for anesthesia)
  6. Metoclopramide (D-Rec antagonist for n/v)

“I BITE M”y tongue w/seizures

56
Q

Drug reactions: Meds that cause tardive dyskinesia (2)

A
  1. Antipsychotics

2. Metoclopramide (dopamine receptor antagonist for n/v)

57
Q

Drug reactions: Meds that cause diabetes insipidus (2)

A
  1. Lithium (accumulates in collecting tubules and disrupts ADH function)
  2. Demeclocycline (tetracycline derived from Streptomyces aureofaciens)
58
Q

Drug reactions: Meds that cause Fanconi syndrome (1)

A
  1. expired Tetracycline
59
Q

Drug reactions: Meds that cause hemorrhagic cystitis (2)

A
  1. Cyclophosphamide (alklyating agent for chemo and DMARD failure autoimmune disease)
  2. Ifosfamide (alkylating agent for chemo)
60
Q

Drug reactions: Meds that cause interstitial nephritis (2)

A
  1. Methicillin (narrow spectrum PCN)
  2. NSAIDs
  3. Furosemide
61
Q

Drug reactions: Meds that cause SIADH (3)

A
  1. Carbamazepine (anti-convulsant, mood stabilizer)
  2. Cyclophosphamide (alkylating agent)
  3. SSRI’s

“Can’t Concentrate Serum Sodium “

62
Q

Drug reactions: Meds that cause dry cough (1)

63
Q

Drug reactions: Meds that cause pulmonary fibrosis (4)

A
  1. Bleomycin
  2. Amiodarone
  3. Busulfan (alkylating antineoplastic agent - sulfonate)
  4. MTX

“Breating Air Badly with Meds”

64
Q

Drug reactions: Meds that cause multiorgan antimuscarinic syndrome (4)

A
  1. Atropine
  2. TCA
  3. H1-blocker
  4. Antipsychotic
65
Q

Drug reactions: Meds that cause multiorgan disulfiram-like reaction (crappy with alcohol) (5)

A
  1. Metronidazole
  2. Some cephalosporins
  3. Griseofulvin (anti-fungal)
  4. Procarbazine (antineoplastic for Hodgkin’s lymphoma)
  5. 1st gen Sulfonylurea (antidiabetic by increasing insulin release from beta cells)
66
Q

Drug reactions: Meds that cause multiorgan nephrotoxicity/ototoxicity (4)

A
  1. Aminoglycosides
  2. Vanco
  3. Loop diuretics
  4. Cisplatin
67
Q

Arsenic poisoning

  • presentation
  • what does arsenic do
A
  • GI: n/v/d/abd pain
  • AMS
  • tachy
  • garlic breath
  • arsenic binds to sulfhydryl groups of enzymes
68
Q

how to treat arsenic poisoning

A

dimercaprol

69
Q

lithium toxicity

- presentation (6)

A
  • NMJ excitability
  • Irregular coarse tremor
  • fascicular twitching
  • agitation
  • ataxia
  • delirium

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