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Flashcards in Pharm Deck (10):

HIV ppx

CD4 < 200 trimethoprim sulfamethoxazole for PCP
CD4 < 150 itraconazole for histo (if risk factors)
CD4 < 100 trimethoprim sulfamethoxazole for toxo
CD4 < 50 azythromycin for MAC



Heparin = mostly ATIII (10a, 2a), intrinsic, PTT
Warfarin = vit K (10,9,7,2), extrinsic, PT/INR
Enoxaparin (LMWH) = mostly 10a, avoid in ESRD
Argatroban, bivalirudin, dabigatran = direct thrombin inhibitors
Contraindications: GI bleed, ICH, surgery <72hrs



Absorption reduced by PPIs, cholestyramine
TBG reduced by androgens, steroids
TBG increased by estrogen, SERMs, heroin
Clearance increased by rifampin, phenytoin, carbamazepine


Antipsychotics side effects

Both 1st and 2nd gen may cause asymptomatic LFTs elevation
1st gen (haloperidol, perphenazine, chlorpromazine) have higher risk of extrapyramidal symptoms, hyperprolactinemia (along with risperidone)
2nd gen may cause metabolic syndrome (monitor BMI, fasting glucose and lipids, BP, weight)
clozapine may cause agranulocytosis (weekly CBCs)


MAOIs adverse rxns

Phenelzine, tranylcypromine, used in atypical depression
Serotonin syndrome - with SSRIs, meperidine
hyperreflexia, myoclonus, confusion, hyperthermia, death
Hypertensive crisis - with tyramine rich foods (wine, cheese)
high BP, headache, ICH


Acetaminophen toxicity

Glutathione depletion and fulminant liver failure
especially with EtOH, high INR, asterixis, ammonemia
Tx with n-acetylcysteine
less nephrotoxicity than ibuprofen


Ibuprofen toxicity

AKI due to AIN, ATN, or papillary necrosis
GI ulcers and bleeding
especially with hypovolemia


2nd line antidepressants

First line SSRI, then add drug with diff mechanism of action:
Atypical antipsychotics - metabolic side effects
Bupropion - no metabolic or sexual side effects
Avoid MAOIs


Anti arrhythmics

Atropine for bradycardia
Rate control with CCBs, BBs, adenosine, digoxin (may affect AV node conduction)
procainamide (Na channel) or amiodarone, ibutilide (K channel) can be used for Afib with WPW, ventricular arrhythmias
lidocaine for ventricular arrhythmias



Pulmonary fibrosis (PFTs)
also order LFTs, thyroid labs
inhibits warfarin metabolism
Peripheral neuropathy, corneal deposits
QT prolongation