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Flashcards in Pharm Deck (88)
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1

Atropine

+ Organophos/carbamates

2

Bicarbonate

+ Metabolic acidosis:TCA,herbicides,salicylate

--helps w/ membrane depressant effects of BB and CCBs
--displaces TCA drug from Na channels (incr. inward Na)... helps arrhythmia due to TCA toxicity

3

Calcium

+CCB, HF acid

IV Calcium treats depressed cardiac contractility (but less good for peripheral…)

4

d-Penicillamine

+Arsenic, lead, mercury, copper (Wilson's!!!)

Bad ADEs:
major blood penias
lungs, neuro, renal, eyes, ears, GI, derm!

5

Deferoxamine

+Iron only!
(Sx may seem to improve before they get worse again.. like acetominophen)

Red urine
tachycardia, hypoTN, shock; GI sx, fever and flushing

6

Dimercaprol

+Arsenic, lead, mercury
for severe symptoms and encephalopathy

peanut oil=effect chelating agent, but special way to administer b/c risk of IM necrosis…
G-6-PD deficiency
nephrotoxic

7

EDTA

+Lead
mobilizes lead from bones
 DMSA is used subsequently to bind up free lead to keep it from going into the brain
o Serum lead may be increased during treatment as lead is mobilized

8

Flumazenil

+BZDs

9

Glucagon

+ BB, CCB

Most toxic= propranolol (even 2-3x dose can cause probs)

Persistent bradycardia and hypoTN give IV glucagon
• Usual means of raising BP (IV fluids, beta agonists, atropine) are usually ineffective
• Acts on cardiac cells to raise intracellular cAMP levels (like beta agonists) but independently of beta receptors

10

Hydrogen sulfide

~CN “rotten eggs”
+thiosulfate/Colbalmin
(Rx aims to produce methemoglobinemia b/c that form of hemoglobin is better able to bind cyanide… then it is captured by thiosulfate)

11

Hydroxycobalamin

+CN, Hydrogen sulfide

12

Insulin and glucose

+ BB, CCB

can reverse severe cardiotoxicity
• Insulin facilitates myocardial utilization of carbs in times of stress
• Increases lactate uptake
• Increases contractility w/out increasing O2 demand, increases BP, increases metab of carbs rather than fatty acids
 w/ CCBs and BB over dose… there’s a decrease in insulin secretion (b/c blockade of respective channels in pancreas)hyperglycemia, hypoinsulinemia, and acidosis
 insulin shifts K in intracellularly
 increases glucose uptake into cardiac myocytes

13

N-acetylcysteine

+Acetominophen

14

Na thiosulfate + nitrate

+CN, Hydrogen sulfide

15

Nalmefene

+Opioids

16

Naloxone

+Opioids

17

Octreootide

+Sulfonylureas

18

Penicillamine

a

19

Physostigmine

+Anticholinergics

20

Protopam

+Organophos/carbamates

21

Succimer

+Arsenic, lead, mercury
chelator for mild/moderate lead poisoning
LEAD:
 Elevation of erythrocyte protoporphyrin levels!
 Measuring blood concentration of lead after chelation therapy… redistribution in body, so eventually rise in concentration over time if measured serially… so series of successive doses

22

Beta-Sitosterols

good!
+BPH urine flow, no P shrinkage

23

Bitter Orange

+/- cyps: SSRIs CI
inh 3A4

24

Co-Enzyme Q

Antioxidant, lower HTN/ incr. HDL
similar to vit K, so interferes w/ warfarin (monitor!!)
rarely ADE

25

Echinacea

inhibits 1A2, intestinal 3A4
INDUCES 3A4

blocks immunosuppressants

26

Ephedra

CV toxicity!
weight loss aid

27

Garlic

Bleeding!
Anti-platelet, block CYPs
Decreases cholesterol

28

Ginkgo Biloba

Bleeding!
Anti-platelet
inhibits 1A2 and 2D6

helps mental decline, additive to AchE-inhibitor

29

Ginseng

Bleeding!

inhibits 2D6
blocks immunosuppressants

May help immune system, LDL/sugars

30

Kava-Kava

Hepatotoxic, aid sleep/anxiety