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USLME Step 1 > Drug Toxicities - First Aid 2014 > Flashcards

Drug Toxicities - First Aid 2014 Flashcards

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1
Q

What is the antidote for acetaminophen?

A

N-acetylcysteine (replenishes glutathione)

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2
Q

What is the antidote for AChE inhibitors/organophosphates?

A

Atropine (blocks effects of excess ACh) followed by pralidoxime (regenerates AChE).

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3
Q

What is the antidote for Amphetamines?

A

Weak base so give NH4Cl (acidify urine)

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4
Q

What is the antidote for anti-muscarinic/anti-cholinergic agents?

A 
Physostigmine salicylate (goes into CNS), control hyperthermia.
Overheating from loss of sweating. Unclear whether there is blocking of anterior hypothalamus (keeping body cool through parasym).
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5
Q

What is the antidote for benzodiazepines?

A

Flumazenil (competitive antagonist at GABA benzo receptor).

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6
Q

What is the antidote for beta-blockers?

A

Glucagon (it also activates cAMP through non-adrenergic pathway G protein receptors…therefore bypassing Beta blockade)

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7
Q

What is the antidote for carbon monoxide?

A

100% O2, hyperbaric O2.

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8
Q

What is the antidote for copper?

A

Penicillamine.

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9
Q

What is the antidote for cyanide?

A

Nitrite (converts hemoglobin to methemoglobin, which binds cyanide better) + thiosulfate (binds the cyanide-globin complex and is excreted in the urine) or hydroxocobalamin (has high affinity for cyanide).

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10
Q

What is the antidote for digitalis?

A

anti-dig Fab fragments

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11
Q

What is the antidote for Heparin?

A

Protamine sulfate (very cationic peptide that binds to negatively charged heparin and allows for urinary excretion)

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12
Q

What is the antidote for iron?

A

DeFERoxamine, deFERrasirox.

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13
Q

What is the antidote for Lead?

A

EDTA, dimercaprol, succimer, penicillamine.

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14
Q

What is the antidote for Mercury?

A

diMERCaprol (BAL), succimer.

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15
Q

What is the antidote for arsenic/gold?

A

Penicillamine, dimercaprol (BAL), succimer

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16
Q

What is the antidote for methanol, ethylene glycol (antifreeze)?

A

Fomepizole (competitive inhibitor of alcohol dehydrogenase) > ethanol, dialysis

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17
Q

What is the antidote for methemoglobin?

A

Methylene blue (converts methemoglobin back to hemoglobin, decreasing half life of toxin from hours to minutes), Vitamin C.

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18
Q

What is the antidote for opioids?

A

Naloxone

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19
Q

What is the antidote for salicylates?

A

it’s a weak acid so NaHCO3 (alkalinize urine), dialysis

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20
Q

What is the antidote for TCAs?

A

it’s a weak acid so NaHCO3 (plasma alkalinization)

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21
Q

What is the antidote for tPA, streptokinase, urokinase?

A

Aminocaproic acid (lysine analogue that inhibits plasmin).

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22
Q

What is the antidote for warfarin?

A

Vitamin K, plasma (if bleeding to restore clotting factors)

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23
Q

Which drugs cause coronary vasospasm?

A

Cocaine, Sumatriptan, Ergot alkaloids

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24
Q

Which drugs cause cutaneous flushing?

A

Vancomycin, Adenosine, Niacin, Ca+2 channel blockers

VANC

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25
Which drugs cause dilated cardiomyopathy?
Doxorubicin, daunorubicin
26
Which drugs cause torsades de pointes?
Class III (e.g. sotalol) and class IA (e.g. quinidine) antiarrhythmics, macrolide antibiotics, antipsychotics, TCAs.
27
Which drugs cause Adrenocortical insufficiency?
HPA suppression secondary to glucocorticoid withdrawal.
28
Which drugs cause hot flashes?
Tamoxifen, clomiphene.
29
Which drugs cause hyperglycemia?
Tacrolimus, Protease inhibitors, Niacin, Hydrochlorothiazide, B-blockers, Corticosteroids. Taking Pills Necessitates Having Blood Checked
30
Which drugs cause hypothyroidism?
Lithium, amiodarone, sulfonamides
31
Which drugs cause acute cholestatic hepatitis, jaundice?
Erythromycin
32
Which drugs cause diarrhea?
Metformin, Erythromycin, Colchicine, Orlistat (lipase inhibitor...meant for obesity treatment), Acarbose Might Excite Colon On Accident.
33
Which drugs cause focal to massive hepatic necrosis?
Halothane, Amanita phalloides (death cap mushroom), Valproic Acid, Acetaminophen (HAVAc).
34
Which drugs cause hepatitis?
isoniazid (INH)
35
Which drugs cause pancreatitis?
Didanosine, Corticosteroids, Alcohol, Valproic acid, Azathioprine, Diuretics (foresomide, HCTZ). Drugs Causing A Violent Abdominal Distress.
36
Which drugs cause pseudomembranous colitis?
Clindamycin, ampicillin, cephalosporins. | Antibiotics predispose to superinfection by resistant C. difficile.
37
Which drugs cause agranulocytosis?
Dapsone, Clozapine, Carbamazepine, Colchicine, Methimazole, Propylthiouracil. Drugs CCCrush Myeloblasts and Promyelocytes.
38
Which drugs cause aplastic anemia?
Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol, Propylthiouracil. Can't Make New Blood Cells Properly.
39
Which drugs cause Direct Coombs-positive hemolytic anemia?
Methyldopa, penicillin.
40
Which drugs cause gray baby syndrome.
Chloramphenicol
41
Which drugs cause hemolysis in G6PD deficiency?
Izoniazid, Sulfonamides, Dapsone, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin. Hemolysis IS D PAIN.
42
Which drugs cause megaloblastic anemia?
Phenytoin, Methotrexate, Sulfa drugs Having a BLAST with PMS
43
Which drugs cause thrombocytopenia?
Heparin, cimetidine
44
Which drugs cause thrombotic complications?
OCPs (e.g. estrogens)
45
Which drugs cause fat redistribution?
Protease Inhibitors, Glucocorticoids | FAT PIG.
46
Which drugs cause gingival hyperplasia?
Phenytoin, verapamil, cyclosporin, nifedepine.
47
Which drugs cause hyperuricemia (gout)?
Pyrazinamide, Thiazides, Furosemide, Niacin, Cyclosporine. | Painful Tophi and Feed Need Care.
48
Which drugs cause myopathy?
Fibrates, niacin, colchine, hydroxychloroquine, interferon-alpha, penicillamine, statins, glucocorticoids.
49
Which drugs cause osteoporosis?
Corticosteroids, heparin
50
Which drugs cause photosensitivity?
Sulfonamides, Amiodarone, Tetracyclines, 5-FU. | SAT For PHOTO.
51
Which drugs cause Rash (Stevens-Johnson Syndrome)
Anti-epileptic drugs (ethosuximide, carbamazepine, lamotrigine, phenytoin, phenobarbital), Allopurinol, Sulfa drugs, Penicillin. Steven Johnson has Epileptic ALLergy to Sulfa drugs and Penicillin.
52
Which drugs cause SLE-like syndrome?
Sulfa drugs, Hydralazine, Isoniazid, Procainamide, Phenytoin, Etanercept. Having lupus is SHIPP-E. Note: apparently also alpha-methyldopa
53
Which drugs cause teeth discoloration?
Tetracyclines
54
Which drugs cause tendonitis, tendon rupture, and cartilage damage?
Fluoroquinolones.
55
Which drugs cause Cinchonism?
Quinidine (class 1A anti-arrhythmic), quinine (for malaria). Remember: symptoms include flushed and sweaty skin, ringing of ears, blurred vision, impaired hearing, confusion, headache, abdominal pain, rashes, vertigo, nausea, vomiting, diarrhea. Cardiotoxicity and shock in large doses.
56
Which drugs cause Parkinson-like syndrome?
Antipsychotics, Reserpine, Metoclopramide. | Cogwheel rigidity of ARM.
57
Which drugs cause seizures?
Isoniazid (Vitamin B6 deficiency), Bupropion, Imipenem/cilastatin, Tramadol, Enflurane, Metoclopramide. With seizures, I BITE My tongue
58
Which drugs cause tardive dyskinesia?
Antipsychotics, metoclopramide.
59
Which drugs cause diabetes insipidus?
Lithium, demeclocycline.
60
Which drugs cause Fanconi syndrome?
Expired tetracycline.
61
Which drugs cause hemorrhagic cystitis?
Cyclophosphamide, ifosfamide. | Prevent by coadministering with mesna (thiol group of mesna binds toxic metabolites).
62
Which drugs cause interstitial nephritis?
Methicillin, NSAIDs, furosemide
63
Which drugs cause SIADH?
Carbamazepine, Cyclophosphamide, SSRIs. | Can't Concentrate Serum Sodium.
64
Which drugs cause Dry Cough?
ACE inhibitors
65
Which drugs cause pulmonary fibrosis?
Bleomycin, Amiodarone, Busulfan, Methotrexate. | Breathing Air Badly from Medications.
66
Which drugs cause anti-muscarinic effects?
Atropine, TCAs, H1-blockers, anti-psychotics.
67
Which drugs cause disulfiram-like reaction?
Metronidazole, certain cephalosporins, griseofulvin, procarbazine, 1st-generation sulfonylureas. remember: it involves severe flushing, tachycardia, hypotension
68
Which drugs cause nephrotoxicity/ototoxicity?
Aminoglycosides, vancomycin, loop diuretics, cisplatin.
69
What are the inducers of cytochrome P-450?
``` Inducers: Chronic alcohol use Modafinil St. John's wort Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine ``` Mnemonic: chronic alcohol Mona steals phen-phen and never refuses greasy carbs.
70
What are the inhibitors of the cytochrome P-450 system?
``` Inhibitors: Acute alcohol abuse Gemfibrozil Ciprofloxacin Isoniazid Grapefruit juice Quinidine Amiodarone Ketoconazole (all azoles: fluconazole, itraconazole, voriconazole) Macrolides Sulfonamides Cimetidine Ritonavir ``` A cute gentleman Cipped iced Grapefruit juice quickly and kept munching on soft cinammon rolls
71
What are the substrates for P450 metabolism?
``` Anti-epileptics Anti-depressants Anti-psychotics Anesthetics Theophylline Warfarin Statins OCPs ``` Always, Always, Always, Always Think When Starting Orders.
72
Which are the sulfa drugs and what do they cause?
Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Suflonamide antibiotics, Sulfasalazine, Sulfonylureas. Popular FACTSSS. Patients with sulfa allerges may develop: fever, UTI, Stevens-Johnson syndrome, hemolytic anemia, thrombocytopenia, agranulocytosis, and urticaria (hives). Symptoms range from mild to life threatening.

USLME Step 1 (7 decks)

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