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Step One Pharmacology > Drug Reactions > Flashcards

Drug Reactions Flashcards

(106 cards)

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1
Q

Coronary Vasospasm

A

Cocaine
Sumatriptain (5HT-1b/1d, rx: migraines)
ergot alkaloids

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2
Q

Cutaneous Flushing

A

Vancomycin, Adenosine, Niacin, Ca Ch. blockers

VANC

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3
Q

Dilated Cardiomyopathy

A

Doxorubicin (Adriamycin), Daunorubicin

Gen. free radicals, breaks DNA, rx: solid tumors, leuk/lymph

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4
Q

Torsades de pointes

A

Class III (sotalol) and Class IA (quinidine) antiarrhythmics

[Class IAs (Double Quarter Pounder: Disopyramide, Quinidine, Procainamide)
Class IIIs (AIDS, Amiodarone, Ibutilide, Dofetilide, Sotalol)
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5
Q

Amiodarone

A

Pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroid (40% iodine by weight), corneal deposits, skin deposits (blue/grey) resulting in photodermatitis, neurologic effects, constipation, bradycardia, CHF, heart block

Slows everything down, hypothyroid, pulm fibrosis, constipation, bradycardia, CHF, heart block

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6
Q

Agranulocytosis

A

Agranulocytosis Could Certainly Cause Pretty Major Damage

Clozapine, Carbamazepine, Colchicine, Propylthiouracil, Methimazole

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7
Q

Gray Baby Syndrome

A

Chloramphenicol

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8
Q

Hemolysis in G6PD

A

Hemolysis IS PAIN
Isoniazid, Sulfonamides, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin

also Dapsone

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9
Q

Megaloblastic anemia

A

Having a BLAST with PMS

Phenytoin, Methotrexate, Sulfa drugs

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10
Q

Phenytoin

A

Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, MEGALOBLASTIC ANEMIA, teratogenesis (fetal hydantoin syndrome), SLE-LIKE SYNDROME, P450 inducer, lymphadenopathy, STEVENS JOHNSON RASH, osteopenia

1st line: Tonic-Clonic, Prophylaxis for Status, Increased Na channel inactivation

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11
Q

Carbamazepine

A

Diplopia, atazia, blood dyscrasia (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, P450 inducer, SIADH, Stevens Johnson

1st line: Simple Partial, Complex Partial, Tonic-Clonic
Na channel inactivation

Cross-eyed, shooting CARBINE but just winging people (bone marrow, in the limbs), because he’s holding it like an action hero, hitting himself in the liver, inducing P45, he’s too scared even to pee (SIADH), and he’s all red all over like Stevens Johnson rash

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12
Q

Valproic Acid

A

Gi distress, rare but fatal HEPATOTOXICITY, neural tube defects for fetus, tremor, weight gain.

1st line: Tonic Clonic, Myoclonic
Na inactivation, GABA concentration

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13
Q

Ethosuximide

A

GI distress, fatigue, headache, urticaria, Stevens Johnson

1st line: Absence
T type Ca++

EFGH - Ethosux, Fatigue, GI, Headache

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14
Q

Thrombotic complications

A

OCPs (estrogens)

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15
Q

Cough

A

ACE inhibitors (-pril)

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16
Q

Pulmonary fibrosis

A

hard to BLAB with p.f.

BLeomycin, Amiodarone, Busulfan

Bleomycin - free radicals, DNA strand breaks
rx: Testicular cancer and Hodgkins lymphoma
Busulfan - alkylates DNA; CML

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17
Q

Acute Cholestatic Hepatitis, jaundice

A

Erythromycin

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18
Q

Focal to massive hepatic necrosis

A

Liver HAVAC (Havoc)

Halothane, Amanita phalloides, Valproic Acid, Acetaminophen

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19
Q

Hepatitis

A

INH

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20
Q

Pseudomembranous colitis

A

Clindamycin, ampicillin

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21
Q

Adrenocortical insufficiency

A

Glucocorticoid withdrawal (HPA suppression)

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22
Q

Gynecomastia

A

Some Drugs Create Awkard Knockers

Spironolactone, Digitalis, Cimetidine, chronic Alcohol, estrogens, Ketoconazole

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23
Q

Digoxin

A

CHF patient with non-specific neuro and GI complaints think Dig Toxicity

nausea, vomiting, diarrhea, blurry yellow vision
ECG: +PR, -QT, ST scooping, T-wave inversion, arrhythmia, AV block, hyperkalemia poor prognostic marker

Excreted proximal tubule

Can be for A fib and HF

Antidote: KLAM
Normalize K+, Lidocaine, Anti-dig Fab fragments, Mg2+

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24
Q

Amphotericin B

A

Amphoterrible
Fever/Chills “shake and bake”
hypotension, NEPHROTOXICITY, ARRHYTHMIA, ANEMIA, IV phlebitis.

hydration to reduce nephrotox; supplement K and Mg

Rx serious systemic mycosis (crypto, cocci, blasto, histo, mucor, candida)

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25
Hot flashes
Tamoxifen, clomiphene (SERMs) Tamoxifen (antag breast, ag bone; risk endometrial cancer) Clomiphene (Infertility and PCOS, prevents LH/FSH feedback)
26
Hyperglycemia
Niacin, tacrolimus, protease inhibitors, HCTZ, corticosteroids tacrolimus - like cyclosporine, inhibits calcineurin and secretion of IL2 Navir tease a protease
27
Protease Inhibitors
Navir tease a protease hyperglycemia, GI intolerance (ND), lipodystrophy (cushingoid effect), nephropathy, hematuria ``` N - nephropathy A - Awkward fat distribution V - Vomiting, Nausea, Diarrhea I - Insulin resistance like effect (hyperglycemia) R - RBCs in urine (hematuria) ```
28
NRTIs and NNRTIs
Bone marrow suppression (reversible, G-CSF, EPO), peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), Megaloblastic Anemia (ZDV)
29
Hypothyroid
Lithium, amiodarone, sulfonamides
30
Fat redistribution
Glucocorticoids, protease inhibitors
31
Gingival hyperplasia
Phenytoin, verapamil Very Pink gums (verapamil, phenytoin)
32
Gout
Furosemide, thiazides, niacin, cyclosporine
33
Myopathies
Fish N CHIPS Give you myopathy Fibrates, Niacin, Colchicine, Hydroxychloroquine, Intereron-a, Penicillamine, Statins, Glucocorticoids
34
Osteoporosis
Corticosteroids, heparin
35
Photosensitivity
SAT for a photo Sulfonamides, Amiodarone, Tetracycline
36
Rash (Stevens Johnson)
Bad rash after a PEC SLAPP Penicillin, Ethosuximide, Carbamazepine, Sulfa drugs, Lamotrigine, Allopurinol, Phenytoin, Phenobarbital
37
SLE-like syndrome
its SHIPPE to have lupus (shitty. its shitty to have lupus) Sulfa drugs, Hydralazine, INH, Procainamide, Phenytoin, Etanercept
38
Isoniazid
INH Injures Neurons and Hepatocytes Neurotoxicity (seizures), hepatotoxicity, Lupus. B6 can prevent neurotox Isoniazid, "I say no acid" - inh. mycolic acid synth.
39
Rifampin
RifaMpin - prevents transcription of mRNA 4 R's - RNA polymerase inh., Revs up P450, Red/orange fluids, Rapid resistance if used alone hepatotox, red/orange fluids
40
Ethambutol
Optic neuropathy, red-green color blindness
41
Teeth (kids)
Tetracyclines
42
Tendonitis, tendon rupture, cartilage damage
Fluoroquinolones
43
Diabetes Insipidus
Lithium, demeclocycline
44
Lithium
LMNOP Tremor, sedation, edema, heart block, hypothyroid, polyuria, teratogenesis Fetal cardiac defects include Ebstein anomaly (tricuspid valve displacement), and malformation of great vessels LMNOP - Lithium: Movement (tremor), Nephrogenic di, hypOthyroidism, Pregnancy problems
45
SSRIs
Flashbacks paralyze senior citizens Fluoxetine, paroxetine, sertraline, citalopram GI distress, Sexual dysfunction Serotonin Syndrome: hyperthermia, confusion, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures. Rx: cyproheptadine (5-HT2 antag) (also MAOI, SNRIs, TCAs)
46
Tricyclic Antidepressants
-iptyline, -ipramine, doxepine and amoxapine Sedation, alpha 1 block effects like postural hypotension, atropine-like side effects like tachycardia, urinary retention, dry mouth. Desipramine less sedating and has higher seizure threshold. Tri-C's: Convulsions, Coma, Cardiotoxicity (arrhythmia), also respiratory depression, hyperpyrexia. Antidote for cardiotoxicity: NaHCO3
47
MAOIs
Mao Takes Pride In Shanghai Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline Hypertensive crisis (tyramine intake, wine, cheese).
48
Antipsychotics
haloperidol + "-azines" (Azin is fucking crazy) Extrapyramidal side effects - dyskinesias, dystonia, akisthesia (restless), tardive dyskinesia (mouth stuff), parkinson's like (tremor, bradykinesia) Endocrine - D antagonism, hyperPRLemia, galactorrhea Side effects - muscarinic, alpha and histamine block Dry mouth, constipation, hypotension, sedation Neuroleptic malignant syndrome (NMS) - FEVER Fever, encephalopathy, vitals unstable, Elevated enzymes, Rigidity. also myoglobinuria. Rx Dantrolene, bromocriptine
49
High potency vs Low potency antipsychotics
High potency: Trifluoperazine, Fluphenazine, Haloperidol Try to Fly High - extrapyramidal symptoms (flap your arms and fly, you crazy bastard) Low potency: Chlorpromazine, Thioridazine Cheating Thieves are low non-neuro side effects, anticholinergic, antihistamine, alpha 1 block
50
Fanconi's Syndrome
expired tetracycline loss of bicarb, a.a.'s, glucose, etc in urine instead of being reabsorbed
51
Hemorrhagic Cystitis
Cyclophosphamide, ifosfamide prevent with MESNA coadministration
52
Interstitial nephritis
Methicillin, NSAIDs, furosemide
53
Furosemide
OH DANG! Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout
54
Hydrochlorothiazide
Hypos and Hypers Hypo: -kalemia, -natremia Hyper: -glycemia, -lipidemia, -uricemia, -calcemia. Sulfa allergy
55
SIADH
Carbamazepine, cyclophosphamide
56
Cinchonism
(hearing loss, headache, abd pain, vertigo, dizziness, NV, rash) Quinidine, quinine named for Cinchona bark, the source of quinine
57
Parkinsons-like syndrome
Antipsychotics, reserpine, metoclopramide reserpine - huntington's rx metoclopramide - rx diabetic gastroparesis
58
Seizures
with seizures, I BITE My tongue | INH, Bupropion, Imipenem/cilastatin, Tramadol, Enflurane, Metoclopramide
59
Tardive dyskinesia
Antipsychotics Typical - Haloperidol + "azines" Atypical - its atypical for Old Closets to Whisper Quietly from A to Z Olanzepine, clozepine, risperidone, quietapine, aripiprazole, ziprasidone
60
Antimuscarinic
Atropine, TCA's, H1 blockers, neuroleptics
61
Disulfiram-like reaction
Metronidazole, some cephalosporins, procarbazine, 1st gen sulfonylureas
62
Nephrotoxicity/Ototoxicity
Aminoglycosides, vancomycin, loops, cisplatin
63
Sulfa reaction
fever, UTI, pruritic rash, Steven's Johnson syn, hemolytic anemia, thrombocytopenia, agranulocytosis and urticaria. symptoms vary form mild to life-threatening Popular FACTSSS Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotics, Sulfasalazine, Sulfonylureas
64
Aminoglycosides
Nephrotoxicity, Ototoxity, Neuromuscular blockade, Teratogen
65
Macrolides
MACRO | Motility issues, Arrhythmia via prolonged QT, acute Cholestatic hepatitis, Rash, eOsinophilia
66
Trimethoprim
TMP Treats Marrow Poorly Megaloblastic anemia, Leukopenia, Granulocytopenia Leucovorin rescue (folinic acid)
67
Antibiotics to Avoid in Pregnancy
``` SAFe Children Take Really Good Care. Sulfonamides - kernicterus Aminoglycosides - ototoxicity Fluoroquinolones - cartilage damage Clarithromycin - embryotoxic Tetracyclines - Discolored teeth Ribavarin (antiviral) - teratogenic Griseofulvin (antifungal) - teratogenic Chloramphenicol - Gray Baby ```
68
Ganciclovir
Leukopenia, neutropenia, thrombocytopenia, renal toxicity
69
Cyclosporin
Nephrotoxicity, hypertension, hyperlipidemia, hyperglycemia, tremor, gingival hyperplasia, hirsutism
70
Calcium Channel Blockers
Cardiac depression, AV block, peripheral edema, FLUSHING, dizziness, constipation Vasc. smooth muscle: amlodipine=nifedipine >diltiazem > verapamil Heart: verapamil> diltiazem > amlodipine = nifedipine
71
Hydralazine
Fluid retention, nausea, headache, SLE-like syndrome Reflex tachy --> ci in angina/CAD
72
Statins
Hepatotoxicity, rhabdomyolysis (myalgias, esp with fibrates)
73
Fibrates
Myositis, hepatotoxicity, chol gallstones | myalgia esp with statins
74
Class 1A antiarrhythmics
Double Quarter Pounder Disopyramide - Heart Failure Quinidine - cinchonism: headache, tinnitus Procainamide - reversible SLE-like syndrome thrombocytopenia, TORSADES from increased QT
75
Class 1B antiarrhythmics
Lettuce, Tomato, Mayo Lidocaine, Tocainide, Mexiletine 1B = Is Best post MI Local anesthetic, CNS stimulation/depression, Cardiovascular depression
76
Class 1C antiarrhythmics
More Fries Please Flecainide, Propafenone proarrhythmic esp. post MI. Significantly prolongs refractory period in AV node 1C = Is Contraindicated post MI
77
Class II antiarrhythmics
Beta blockers impotence, astma, bradycardia, AV block (decrease PR interval), CHF, sedation, MASKS HYPOGLYCEMIA metoprolol - dyslipidemia Overdoes Rx: glucagon
78
Class III antiarrhythmics
K Ch. blockers, think Torsades because of increased QT
79
Biguanides
metformin | GI upset, LACTIC ACIDOSIS - ci in renal failure
80
Sulfonylureas
glyburide, glipizide | hypoglycemia
81
Glitazones/thiazolinediones
pioglitazone | Weight gain, edema, hepatotoxicity, heart failure
82
GLP-1 analogs
Exenatide, liraglutide | Nausea, vomiting, PANCREATITIS
83
Propylthiouracil/methimazole
Agranulocytosis, aplastic anemia, rash PTU - liver toxicity MTZ - teratogen
84
H2 blockers
cimetidine, ranitidine Antiandrogenic: PRL release, gynecomastia, impotence Cross BBB: confusion, dizziness, HA decrease renal creatinine excretion
85
PPI's
omeprazole | C Diff risk, PNA, hip fx, low Mg++ chronically
86
Specific Antacid complications
Aluminum hydroxide - "minimum" feces (constipation) Magnesium hydroxide - Mg = must go = diarrhea, hypotension, cardiac arrest Calcium carbonate - hypercalcemia, rebound acid production
87
ADP receptor inhibitors
Ticlopidine | Neutropenia
88
Methotrexate
Myelosuppression reversible with leucovorin Macrovesicular fatty liver change Mucositis Teratogen
89
5-flurorouracil
Myelosuppression, non reversible | Overdose rescue: thymidine
90
6-mercaptopurine, Azathioprine
Bone marrow, GI, Liver toxicity (which are increased with coadministration of allopurinol)
91
Vincristine, Vinblastine
vincristine - neurotoxicity (areflexia, peripheral neuritis), paralytic ileus vinblastine blasts bone marrow (suppression)
92
Cisplatin
Nephrotoxicity, acoustic nerve damage prevent nephrotox with Amifostine and chloride diuresis
93
Trastuzumab
Herceptin for Her-2 (c-erbB2) Cardiotoxicity
94
Bisphosphonates
Alendronate, for osteoporosis/hyperCa/paget's Corrosive esophagitis, osteonecrosis of the jaw
95
Zolpidem
Ataxia, headaches, confusion
96
Halothane
Hepatotoxicity (fulminant), malignant hyperthermia
97
Methoxyflurane
Nephrotoxicity, malignant hyperthermia
98
Enflurane
Proconvulsant, malignant hyperthermia
99
Local anesthetics
CNS excitation, severe cardiovascular toxicity (bupivicaine), hypertension or hypotension
100
Levodopa
Arrhythmias from increased peripheral formation of catecholamines
101
Sumatriptan
Coronary vasospasm (ci in CAD pts/prinzmetals angina)
102
Trazodone
Priapism, sedation, nausea, hypotension
103
Mannitol
Pulmonary edema, dehydration | ci in anuria, CHF
104
ACE inhibitors
Captopril's CATCHH Cough, Angioedema, Teratogen (fetal renal malf), Creatinine increase (reversible decrease in GFR), Hyperkalemia, Hypotension
105
Estrogens
Endometrial cancer, postmenopausal bleeding, clear cell adenocarcinoma of vagina of women exposed to DES in utero, thrombosis risk
106
Antihistamines (1st gen)
sedation antimuscarinic (dry mouth, urinary retention, constipation anti alpha-adrenergic (hypotension) end in -en/ine or -en/ate (chlorpheniramine, diphenhydramine) (2nd gen: loratadine, fexofenadine, desloratadine, end in -adine)

Step One Pharmacology (6 decks)

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