Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

23 spring: pharm > Test 4: 49 Rx > Flashcards

Test 4: 49 Rx Flashcards

1
Q

how do calcium channel blockers cause toxicity

A

Prevents Ca influx into cell, which prevents contraction.

Effects:
– Hypotension
– Bradycardia, reflex tachycardia
– Pulmonary edema
– Hyperglycemia

verapamil, diltiazem, amlodipine
can be sustained release med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how to treat calcium channel blocker toxicity

A

Calcium gluconate
Vasopressors
Insulin/dextrose - normally the myocardium is fatty acid dependent for energy – however, calcium channel blocker toxicity makes the myocardial cells carbohydrate dependent but at the same time unable to utilize carbohydrates due to the lack of insulin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some common decongestants

A

Pseudoephedrine (PSE)
Phenylephrine (oral)

stimulate ⍺1 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

signs of decongestant overdose

A

Pseudoephedrine (PSE)

  • stimulates both alpha and beta receptors
    • B stimulation results in tachycardia, tachyarrhythmias.
    • Alpha: peripheral vasoconstriction, hypertension
  • Inhibits bladder emptying (stimulates receptors that tighten the bladder sphincter). PSE been used for canine urinary incontinence.

Phenylephrine (oral)

  • hyperactivity, vomiting, mydriasis, hyperthermia, disorientation, tachycardia (and sometimes reflex bradycardia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

species specific for decongestants

A

dogs very senstive

PSE-toxicosis can lead to agitation if mixed with diazepam

narrow therapeutic dose: 1.5 mg/kg 2-3x daily for urinary incontinence in dogs, clinical signs 5-6 mg/kg, death 10-12 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

treatment for decongestant toxicity

A

decontamination and symptomatic supportive care (to manage sx such as tachycardia, bradycardia, excess CNS stimulation).

  • Acepromazine, chlorpromazine or phenobarbital may be preferable to a benzodiazepine to control tremors, seizures and nervousness.

do not use diazepam in dogs can cause agitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are some common antihistamines

A

Chlorpheniramine
Diphenhydramine (po and dermal) Benadryl® 2% cream (2 gm/100gm = 100 mg/5gm tsp)
Meclizine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

clinical signs of antihistamine toxicity

A

CNS depression, dry mucous membranes, ataxia
– Anticholinergic effects (but not meclizine – in piperazine class)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

treatment of antihistamine toxicity

A

decontamination and
symptomatic supportive care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

risk factors for renal toxicity from NSAIDs

A

pre-existing renal disease
hypovolemia (vomiting, dehydration)
hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why can NSAIDs cause renal damage

A

can cause decreases renal blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

clinical signs of NSAID toxicity

A

GI: vomiting, diarrhea, anorexia, hematemesis, melena
hepatic: lethargy, weight loss, liver enzyme elevation
renal failure

Narrow margin of safety in both dogs and cats.

NSAIDs can cause decreased renal blood flow, decreased gastric mucous production and decreased platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cats 2x as sensitive as dogs to NSAIDs due to limited — ability

A

glucuronyl-conjugating

no advil, tylenol(acetaminophen) or bayer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

treatment for NSAID toxicity

A

Decontamination and symptomatic supportive care.

  • GI protectants (avoid bismuth subsalicylate) - Antiulcer meds that have been used: sucralfate, misoprostol, H 2 antagonists
  • Fluids

NSAIDs can cause decreased renal blood flow, decreased gastric mucous production and decreased platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

clinical signs of acetaminophen toxicity

A

can be asymptomatic

vomiting, anorexia, methemoglobinemia, edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

species specific acetaminophen toxicties

A

Dogs are more prone to hepatic necrosis than cats.

Acetaminophen is the most common drug-related cause of Heinz body formation in cats.- methemoglobinuria- liver damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

treatment for acetaminophen toxicity

A

N-acetylcysteine (NAC) - need to give within 8 hrs

Symptomatic treatment (cats with methemoglobinemia may require methylene blue)

  • Although methylene blue is an oxidizing agent, it can be given to cats but at careful low doses.
  • Cimetidine and ascorbic acid(Vit C) are not accepted antidotes for acetaminophen poisoning.
18
Q

Cimetidine and ascorbic acid are not accepted antidotes for —poisoning.

A

acetaminophen

should use NAC within 8 hrs of ingestion

can treat methemoglobinemia in cats with methylene blue

19
Q

what in bengay can cause toxicity

A

aspirin (methyl salicylate)

1 tablespoon= 6.3 grams of aspirin!!

20
Q

what is toxic in pepto bismol

A

bismuth subsalicylate (aspirin)

1 tablespoon= 130 mg of aspirin!

21
Q

clinical signs of aspirin toxicity

A

vomiting, hyperventilation, fever, hypo or hyperglycemia, metabolic acidosis

if pt becomes acidotic ASA can move into the brain and cause seizures

ASA in petobismol and bengay

22
Q

— are more susceptible to ASA poisoning than — due to saturation of elimination pathways

A

Cats

dogs

23
Q

range of toxicity for ASA

A

Dogs

  • Therapeutic dose: 10-20 mg/kg q 48 hrs).
  • Gastric ulcers with 100mg/kg/day for 1-2 weeks

Cats

  • As little as 25 mg/kg can cause acute toxicity
24
Q

treatment for aspirin toxicity

A

Decontamination and symptomatic supportive care

Sodium bicarbonate increases urinary elimination of aspirin and decreases brain concentrations of aspirin. (try to alkanize pt)

25
Q

what are some common ⍺2 agonists

A

clonidine
visine

imidazole decongestant

26
Q

symptoms of imidazole decongestant toxicity

A
  • CNS depression
  • Apnea (not breathing)
  • Bradycardia
  • Hypotension due to central alpha 2 stimulation. But hypertension if peripheral alpha-2 stimulation.
  • Miosis (pupil constricted)

⍺2 agonist: clonidine, visine

27
Q

treatment for imidazoline decongestants

A

decontamination and symptomatic
supportive care

  • Naloxone may be of benefit for ingestions of imidazolines (has been reported to sometimes reverse coma and hypotension in humans)

⍺2 agonist: clonidine, visine

28
Q

clinical signs of antacids toxicity

A

aluminum hydroxide, magnesium
hydroxide, calcium carbonate

minimally toxic

Only symptomatic treatment of the GI effects is needed.

29
Q

clinical signs of fleet enema (sodium phosphate) toxicity

A

hyperphosphatemia, hypernatremia, dehydration and shock.

concern is fluid and electrolyte losses.

30
Q

what causes toxicity in Kaopectate

A

now contains bismuth subsalicylate (aspirin)

pepto bismol also has bismuth subsalicylate
Kaopectate is an antidiarrheal

31
Q

side effects of imodium (loperamide) toxicity

A

can have opioid-like effects (structurally similar to both haloperidol and diphenoxylate).

antidiarrheal med

32
Q

treatment for imodium toxicity

A

Naloxone may be effective

Therapeutic dose in dogs is very small (0.08 - 0.1 mg/kg po q 12 hrs) versus the 2mg capsule available for humans.

33
Q

lomotil toxicity symptoms

A

opioid that contains anticholinergic (try to stop abuse)

antidiarrheal med

34
Q

treatment for antidiarrheal med toxicity

A

decontamination and symptomatic supportive care.

  • Naloxone – for diphenoxylate (Lomotil®) and loperamide (Imodium®)
35
Q

topical zinc oxide toxicity

A

not toxic unless chronic or very large amount without emesis

found in diaper rash ointment, sunscreen, calamine lotion, astringents.

treatment: supportive care (watch and wait)

36
Q

clinical signs of calcipotriene toxicity

A

Synthetic vit D3 Dovonex® (calcipotriene): human psoriasis treatment

– Ingestion: Severe hypercalcemia, renal failure, soft tissue mineralization (in dogs)
– Topical use: only 5-6% is absorbed dermally

vomiting, CNS depression, anorexia, diarrhea, polyuria

Special note: weeks of treatment may be required. Death can occur weeks after an apparent recovery secondary to calcification of cardiac tissue.

37
Q

treatment for calcipotriene toxicity

A
  • Decontamination
  • Supportive care (renal failure).
  • Treat elevated serum calcium and phosphorus
    • Bisphosphonates (Aredia® - pamidronate is used in humans to treat malignancy-related hypercalcemia)

Special note: weeks of treatment may be required. Death can occur weeks after an apparent recovery secondary to calcification of cardiac tissue.

38
Q

clinical signs of 5-fluorouracil toxicity

A

very toxic- 1/2 a tube deadly

Ingestion :

  • severe, intractable seizures,
  • vomiting and GI mucosal sloughing.
  • delayed severe leukopenia (WBC less than 1 x 103)

Topical:

  • toxicity has also occurred following dermal application to dogs and cats

Prognosis is poor since a large % of dogs die from intractable seizures

39
Q

treatment for 5-fluorouracil toxicity

A
  • Seizures rarely respond to diazepam; (success reported in dogs: barbiturates, isoflurane, propofol)
  • Filgrastim (for severe leukopenia)

Weeks of monitoring may be required (delayed leukopenia).

40
Q

list of meds dangerous in small amounts for dogs

A

Dogs
NSAIDS
Pseudoephedrine
Caffeine
Albuterol
Both species
5-fluorouracil
Calcipotriene
Isoniazid

41
Q

list of meds that are toxic in small amounts for cats

A

Both species
5-fluorouracil
Calcipotriene
Isoniazid
Cats
Acetaminophen
Benzocaine
NSAIDS
ASA
In general, oxidant drugs
that induce Heinz body formation (examples: phenols, propofol, phenazopyridine, methylene blue)

23 spring: pharm (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions