Adverse Effects

Question 1

Organ directed toxicity: GI

Answer 1

Aspirin

Question 2

Organ directed toxicity: Kidneys

Answer 2

Aminoglycosides

Question 3

Organ directed toxicity: Liver

Answer 3

Acetominophen

Question 4

Organ directed toxicity: Heart

Answer 4

Doxorubicin

Question 5

Fetal toxicity directly toxic effects: sulfonamide

Answer 5

induced kernicterus

Question 6

Fetal toxicity directly toxic effects: Chloramphenicol

Answer 6

Gray baby syndrome

Question 7

Fetal toxicity that are directly toxic: Bone growth

Answer 7

Tetracycline

Question 8

Fetal toxicity: teratogens

Answer 8

Thalidomide
Antifolates
Phenytoin
Warfarin
Isotretinoin
Lithium
Valproic Acid
Fetal alcohol syndrome

Question 9

Drug Allergies: Hypersensivity. Most drugs are not by themselves immunogenic. When they bind covalently to a macromolecule or alter structure of macromolecule to become an immunogenic ______

Answer 9

hapten

Question 10

Drug toxicity hypersensitivities target organs type I

Answer 10

GI
Skin
Lung
Vasculature

Question 11

Drug toxicity hypersensitivities target organs type II

Answer 11

Circulating Blood cells

Question 12

Drug toxicity hypersensitivities target organs type III

Answer 12

Blood Vessels
Skin
Joints
Kidney

Question 13

Drug toxicity hypersensitivities target organs type IV

Answer 13

Skin
Lungs
Central Nervous System

(Stevens-Johnson Syndrome)

Question 14

Hypersensitivity reaction type I involves IgE that release

Answer 14

histamine, leukotrienes, prostaglandins

Question 15

Drugs associated with Type I reactions

Answer 15

Beta-lactam anti-bacterials

Neuromuscular blockers

Quinolones

Platinum-basid cytotoxic drugs (cis-platin)

Foreign Proteins

Question 16

Drugs associated with Type I reactions

Answer 16

Beta-lactam anti-bacterials

Neuromuscular blockers

Quinolones

Platinum-basid cytotoxic drugs (cis-platin)

Foreign Proteins

Question 17

Drugs associated with hemolytic anemia and thrombocytopenia

Answer 17

Beta-lactam

NSAID

Quinine-quinidine

Question 18

drugs associated w/ thrombocytopenia

Answer 18

Beta-lactam

NSAID

Quinine-quinidine

Heparin
Abciximab
Sulfonamides
Carbamazepine
Propylthiouracil

Question 19

Type III hypersensitivity require longer or short exposure?

Answer 19

Longer (high dose, and/or long duration therapy)

Question 20

Type IV cell-mediated or delayed hypersensitivity caused by

Answer 20

Topical drugs, also metals and jewelry, poison ivy

Stevens-Johnson from sulfonamides, lamotrigine, allopurinol

Interstitial nephritis from acetominophen, NSAIDs, PPIs, Anti-bacterials, anti-virals

drug-induced hepatitis from Acetominophen, NSAIDs, steroids (anabolic, BCP), statins

Question 21

Drug idiosyncrasies: Abnormal serum cholinesterase develop ______ when given normal doses of succinylcholine

Answer 21

apnea

Question 22

Drug idiosyncrasies: Abnormal serum cholinesterase develop apnea when given normal doses of ________

Answer 22

succinylcholine

Question 23

Isoniazid involves genetic aberrations related to

Answer 23

fast and slow acetylation

Question 24

Glucose-6-phosphate dehydrogenase elicits hemolytic anemia elicited by ________

Answer 24

Primaquine
Sulfonamide
Nitrofurantoin

Question 25

Barbiturates can cause porphyria because it mimics part of the heme structure and in some people is can block the portion of the heme site that regulates what enzyme that converts succinyl to porphobilinogen

Answer 25

ALA synthetase

Question 26

Alkalinization of urine via sodium bicarbonate will enhance the excretion of

Answer 26

weak organic acids

Question 27

Acidification of the urin via ammonium chloride enhances the excretion of

Answer 27

weak organic bases

Question 28

What drug blocks tubular secretion of for example

Answer 28

Probenicid

Question 29

Valium and ethanol have a ______effect on one another

Answer 29

synergistic

Question 30

Propanolol and isoproterenol have ______ effects as well as nalaxone and morphine

Answer 30

opposing

Question 31

Animal testing is done in how many species to confirm efficacy, selectivity, and mechanism? This leads to IND judgement

Answer 31

2 species

Question 32

Clinical testing involves 3 phases, which phases tests whether a drug works, involves 1000-6000 patients (multicenter testing) and is tested in a double-blind trial

Answer 32

Phase 3

Question 33

IND stands for

Answer 33

Investigational new drug. Follow animal testing

Question 34

NDA occurs after the 3 phases of clinical trials and stands for

Answer 34

New drug application

Question 35

Phase 4 occurs after NDA and involves

Answer 35

postmarketing surveillance; is after the drug is on the market

Question 36

``` Animal testing--> IND--> Clinical trial Phases 1-3--> NDA --->Phase 4 post market surveillance ```

Answer 36

general set up for drug testing

Question 37

Phase ___finds the maximum tolerated dose, characterizes adverse effects, and defines the pharmacokinetics and is never double blind

Answer 37

1

Question 38

Phase ___ attempts to determine clinical effectiveness of test agent

Answer 38

2

Question 39

Phase ___ is extensive testing of a drug's efficacy and toxicity and is usually carried out by physicians in private practice

Answer 39

Phase 3

Question 40

Informed consent is required for Phases 1-3 but only needs to be in writing for phases ____

Answer 40

1 and 2