Crush Step 2 Pharm
Terms
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- Trazadone SE
- Priapism
- Aspirin SE
- GI bleed, hypersensitivity
- Bleomycin SE
- Pulm fibrosis
- Cyclopyosphate SE
- Hemorrhagic cystitis
- Buproprion SE
- Seizures
- Isoniazid SE
- Vitamin B6 deficiency, lupus, liver tox
- Cyclosporine class and SE
-
anti-inflammatory/immune suppressant
Renal tox - Penicillins SE
- Anaphylaxis, rash with EBV
- ACE inhibitors SE
- cough, can damage fetal kidneys
- Demeclocycline SE
- Diabetes insipidus
- Lithium SE
- Diabetes insipidus, thyroid dyfx
- Methoxyflurane class and SE
-
general anesthetic
Diabetes insipidus - Diabetes Insipidus (3)
- Demeclocycline, Lithium, Methoxyflurane
- Sulfa drugs SE
- Allergies, kernicterus in neonates
- Halothane SE
- Liver necrosis
- Local anesthetic SE
- Seizures
- Phenytoin SE
- folate deficiency, teratogen, hirsutism
-
Vincristine SE
Vinblastine SE -
1) neurotoxicity (areflexia, peripheral neuritis), paralytic ileus
2)blasts bone marrow (suppression) - Amiodarone SE (8)
- Pulmonary fibrosis, corneal deposits, hepatotoxicity, skin deposits leading to photodermatitis, neurologic effects, constipation, CV (bradycardia, heart block, CHF), Thyroid dysfx
- Valproic Acid SE
- Neural tube defects in offspring
- Isotretinoin SE
- terrible teratogen
- Thioridazine SE
- Retinal deposits, cardiac toxicity
- Heparin SE
- Thrombocytopenia, thrombosis
- Vancomycin SE
- Red Man syndrome
- Clofibrate class and SE
-
fibric acid derivative
increased GI neoplasms - Tertracyclines SE
- photosensitivity, teeth staining in children
- Quinolones SE
- Teratogens (cartilage damage)
- Quinine SE
- Cinchonism (tinnitus, vertigo)
- Morphine SE
- Sphincter of Oddi Spasm
- Clindamycin (or any broad spectrum Abx) SE
- Pseudomemnbranous Colitis
- Chloramphenicol class and SE
-
broad spectrum bacteriostatic
Aplastic Anemia, gray baby syndrome - Doxorubicin class and SE
-
onc abx
Cardiomyopathy - Busulfan class and SE
-
alkylating chemo
Pulmonary fibrosis, adrenal failure - MAO inhibitors SE
- Tyramine crisis (wine cheese)
- Hydralazine class and SE
-
vasodilator
Lupus erythematosus - Procainamide class and SE
-
anti-arrhythmic
Lupus erythematosus - Lupus erythematosus (2)
- Hydralazine, procainamide
- Minoxidil class and SE
-
arterial vasodilator
Hirsutism - Aminoglycosides SE
- Hearing loss, renal toxicity
- Acetaminophen
- Liver toxicity (in high doses)
- Chlorpropamide use and SE
-
sufonylurea
SIADH - Oxytocin use and SE
-
(pitocin) - uterine contxn
SIADH - Opiates
- SIADH
- Drugs that cause SIADH (3)
- Chlorpropamide, Oxytocin, Opiates
- Dideoxyinosine (DDI) class and SE
-
nucleoside reverse transcriptatse inhibitor
Pancreatitis, peripheral neuropathy - Halogen anesthetic SE
- Malignant Hyperthermia
- Succinylcholine SE
- Malignant Hyperthermia
- Malignant Hyperthermia
- Halogen, Succinylcholine
- Zidovudine (AZT) SE
- Bone Marrow Suppression
- Digitalis class and SE
-
cardiac glycoside
GI disorders, vision changes, arrhythmias - Acetazolamide class and SE
-
carbonic anhydrase inhibitor (diamox)
Metabolic acidosis - Trimethadioine use and SE
-
anti-convulsant for absence seizures
Terrible teratogen - Clozapine SE
- Agranulocytosis
- SSRIs SE
- Anxiety, agitation, insomnia
- Warfarin SE
- Necrosis, teratogen
- Niacin SE
- skin flushing, pruritis
- HMG CoA reductase SE
- Liver and muscle toxicity
- Ethambutol use and SE
-
TB drug
Optic neuritis - Metronidazole SE
- DIsulfiram like reaction with etoh
- Cisplatin class and SE
-
alkylating agent
Nephrotoxicity - Methyldopa class and SE
-
alpha adrenergic antagonist
hemolytic anemia (coomb's positive) - Thiazides SE
- hyperglycemia, hyperuricemia, hyperlipidemia, hyponatremia, hypokalemic metabolic alkalosis, hypovolemia, calcium retention, SULFA RXN IN SULFA SENSITIVE Pts
- Loop Diuretics SE
- hypokalemic metabolic alkalosis, hypovolemia, ototoxicity, calcium excretion, SULFA RXN (except ethacrynic acid)
- Carbonic Anhydrase inhibitors SE
- metabolic acidosis
- Antihypertensives SE
- sedation, depression (methyldopa esp.), sexual dysfx
- Beta Blockers SE
- bradycardia, heart block, CHF in susceptibles, Asthma, masking of hypoglycemia Sx
- Calcium Channel Blockers SE
- bradycardia, heart block, CHF in susceptibles
- Alpha-one antagonists SE
- severe first dose orthostatic hypotension
- Psych Drugs that cause extrapyramidal SEs
- Haloperidol>>Chlorpromazine, Risperidone or Olanzapine
-
Antipsychotic medications:
High Potency, Low Potency and Atypical - Haloperidol, Chlorpromazine, Risperidone or Olanzapine
- Psych Drugs that cause autonomic SEs
-
Chlorpromazine>>
Risperidone or Olanzapine>
Haloperidol - Extrapyramidal SEs
- Acute dystonia (hours/days), Akathisia(days), Parkinsonism (months), Tardive dyskinesia (yrs), Neuroleptic Malignant Syndrome (any time).
- Acute dystonia: Sx and Tx
-
SX: muscle spasms/stiffness (torticollis, trismus), tongue protusions and twisting, opisthotonos, oculogyric crisis (forced sustained deviation of head and eyes
Tx: antihistamines (diphenhydramine) or anticholinergics (benztropine, trihexyphenidyl) - Akathisia: Sx and Tx
-
subjective restlessness
can try to tx with beta blockers - Parkinsonism: Sx and Tx
-
stiffness, cogwheel rigidity, shuffling gait, mask like facies and drooling
Tx: antihistamines (diphenhydramine) or anticholinergics (benztropine, trihexyphenidyl) - Tardive Dyskinesia: sx and tx
-
sx: perioral movements (darting, protruding tongue, chewing, grimacing, puckering), choreoathetoid movements of the head, limbs and trunk
Tx: none - switch antipsychotic (olanzapine, clozapine) - Neuroleptic Malignant Syndrome:Sx and Tx
-
rigidity, mutism, obtundation, agitation, high fever (up to 107), HIGH CK (>5000), sweating, myoglobinuria
Tx: First d/c antipsychotic,
Second, supportive tx
Third, dantrolene (like in malignant hyperhthermia - Autonomic Side Effects
- anticholinergic (dry mouth, urinary retention, blurry vision, mydriasis), alpha 1 blockade (orthostatic hypotension), and antihistamine effects (sedation)
- Antidote to Acetaminophen Poisoning
- Acetylcysteine
- Antidote to Cholinesterase Inhibitors poisoning
- Atropine, pralidoxime
- Antidote to Quinidine or tricyclic antidepressants poisoning
- Sodium bicarbonate (cardioprotective)
- Antidote to Iron poisoning
- Deferoxamine
- Antidote to Digoxin poisoning
- normalize K+ and other lytes, digoxin Ab
- Antidote to Methanol or ethylene glycol poisoning
- ethanol
- Antidote to Benzodiazepines poisoning
- Flumazenil
- Antidote to Beta blockers poisoning
- glucagon
- Antidote to Lead poisoning
- Edetate
- Antidote to Copper/gold poisoning
- Penicillamine
- Antidote to Opioids poisoning
- Naloxone
- Antidote to Carbon Monoxide Poisoning
- Oxygen (hyperbaric if severe)
- Antidote to Muscarinic receptor blockers poisoning
- Physostigmine
- Drug interactions with MAO inhibitors (2)
-
Meperidine (coma)
SSRIs (SSRI syndrome: hyperthermia, rigidity, myoclonus, autonomic instability) - Drug interaction with Aminoglycosides
- loop diuretics (enhanced ototoxicity)
- Drug interaction with Thiazides
- lithium (lithium tox)