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165 Cards in this Set
- Front
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Side effects of:
ACEI |
rash
cough taste changes teratogenic proteinuria angioedema |
|
Side effects of:
amantidine |
Livido reticularis (skin appears mottled L>UE)
ataxia |
|
Side effects of:
aminoglycosides |
ototoxicity
nephrotoxicity (ATN) |
|
Amiodarone
|
pulm fibrosis
peripheral deposition causing bluish discolouration arrhythmias hypo/hyperthyroidism corneal deposition |
|
Side effects of:
amphotericin |
fever/chills
nephrotoxicity bone marrow suppression anemia |
|
Side effects of:
antipsychotics |
tardive dyskinesia
sedation acute dystonic rxn akathisia parkinsonism neuroleptic malignant syndrome |
|
acute dystonia
|
involuntary m cont/spasm - torticollis, oculogyric crisis)
Rx anticholinergic (benztropine) or diphenhydramine Prevent prophylatic benztropine |
|
akathisia
|
subjective/objective restlessness
Rx ↓neuroleptic βblocker (propranolol) +/- benzos, anticholinergics |
|
dyskinesia
|
pseudoparkinsonism
Rx anticholinergic (benztropine) or DA agonist (amantidine) ↓neuroleptic or d/c |
|
tardive dyskinesia
|
stereotypic oral-facial mvts
likely d/t DA receptor sensitization 50% irreversible Rx ↓neuroleptic or d/c or change drugs giving anticholinergics or ↓neuroleptic may initially WORSEN TD |
|
Neuroleptic Malignant syndrome
|
fever
muscle rigidity autonomic instability clouded consciousness ↑CPK, WBCs Rx stop neuroleptic dantrolene/bromocriptine IV fluids |
|
Evolution of EPS
|
4 hours
acute dystonia 4 days akathisia 4 weeks akathisia 4 months tardive dyskinesia |
|
Side effects of:
-azoles (fluconazole) |
inhibition of P450
|
|
P450 inducers
|
carbamazepine
EtOH glucocorticoids griseofulvin omeprazole 1A2) phenobarbital phenytoin primidone quinine rifampin |
|
P450 inhibitors
|
amniodarone
cimetidine erythromycin grape fruit INH ketoconazole metronidazole omeprazole (2C8) quinidine sulfonamides |
|
Side effects of:
AZT |
TCP
megaloblastic anemia |
|
Side effects of:
β-blockers |
asthma exacerbation
masking of hypoglycemia impotence |
|
Side effects of:
benzos |
sedation
dependence respiratory depression |
|
Side effects of:
Bile acid resins |
GI upset
malabsorption of vitamens & medications |
|
Side effects of:
CCBs |
peripheral edema
constipation cardiac depression |
|
Side effects of:
carbemazepine |
P450 induction
agranulocytosis aplastic anemia |
|
Side effects of:
choramphenicol |
grey baby syndrome
aplastic anemia |
|
Side effects of:
Cisplatin |
nephrotoxicity
acoustic nerve damage |
|
Side effects of:
Clonidine |
dry mouth
severe rebound h/a rebound HTN |
|
Side effects of:
clozapine |
agranulocytosis
|
|
Side effects of:
Corticosteroids |
mania (acute)
thin skin easy bruising immunosuppression bone mineral loss cataracts myopathy (late) |
|
Side effects of:
cyclophosphamide |
myelosuppression
hemorrhagic cystitis* |
|
Side effects of:
Digoxin |
GI disturbances
yellow visual changes arrhythmias - junctional SVT |
|
Side effects of:
Doxorubicin |
cardiotoxicity - cardiomyopathy
|
|
Side effects of:
ethyl alcohol |
renal dysfunction
|
|
Side effects of:
fluoroquinolones |
cartilage damage in kids
achilles tendon rupture in adults |
|
Side effects of:
furosemide |
ototoxicity
hypokalemia nephritis |
|
Side effects of:
gemfibrozil |
myositis
reversible ↑LFTs |
|
Side effects of:
Gold |
renal dysfunction
leukopenia rash |
|
Side effects of:
halothane |
hepatotoxicity
malignant hyperthermia* |
|
Side effects of:
HMG-CoA reductase inhibitors |
myositis
reversible ↑LFTs |
|
Side effects of:
hydralazine |
drug induced SLE
|
|
Side effects of:
HCTZ |
hypokalemia
hyperuricemia hyperglyemia |
|
Side effects of:
hydroxychloroquine |
retinopathy
|
|
Side effects of:
INH |
peripheral neuropathy - prevent with Vit B6
inhibits P450 hepatotoxicity seizures with OD |
|
Side effects of:
MAOIs |
hypertensive tyramine rxn
serotonin syndrome (with meperidine) |
|
Serotonin syndrome
|
MAOIs used with meperidine, SSRIs, TCAs, and indirect sympathomimetics (in main OTC cold remedies)
|
|
Serotonin syndrome S/S
|
Triad:
1. altered MS 2. autonomic dysfunction 3. neuromuscular abnormalities restlessness confusion lethargy euphoria - feeling drunk & dizzy rapid eye mvt hyperreflexia myoclonus hypertonicity clumsiness |
|
Common symptoms of NMS and Sertonin syndrome
|
excitement
diaphoresis rigidity hyperthermia ↑HR, BP |
|
Neuroleptic malignant syndrome
|
severe muscular rigidity
hyperthermia autonomic instability - diaphoresis, incontinence, labile BP, ↑HR LOC changes shufling gait leukocytosis ↑CPK |
|
Side effects of:
methanol |
blindness
|
|
Side effects of:
MTX |
hepatic fibrosis
pneumonitis anemia |
|
Side effects of:
methyldopa |
+ve Coomb's test
drug induced SLE |
|
Coombs' test
|
direct
measures presence of Ab on RBC SURFACE - detects autoAb against RBCs Indirect measures presence of Ab to RBCs in BLOOD - detects Ab in blood capable of attaching to RBCs (other than ABO & Rh) |
|
+ve direct Coombs' test DDx
|
autoimmune hemolytic anemia
drug-induced hemolytic anemia (procainamide, quinidine, methyldopa) infectious mono mycoplasma infection syphilis CLL SLE transfusion rxn |
|
+ve Indirect Coomb's test DDx
|
incompatible xmatched blood (test in blood bank)
Erythroblastosis fetalis |
|
Side effects of:
metronidazole |
disulfuram rxn
vestibular dysfunction metallic taste* |
|
Side effects of:
Niacin |
cutaneous flushing
|
|
Side effects of:
Nitroglycerin |
hypotension
h/a ↑HR tolerance |
|
Side effects of:
Penicillins/βLactams |
hypersensitivity rxns
|
|
Side effects of: penicillamine
|
drug induced SLE
|
|
Side effects of:
phenytoin |
nystagmus
diplopia gingival hyperplasia* ataxia hirsutism |
|
Side effects of:
Prazosin |
1st dose hypotension
|
|
Side effects of:
Procainamide |
Drug induced SLE
|
|
Side effects of:
PTU |
agranulocytosis
|
|
Side effects of:
Quinidine |
Cinchonism - h/a, tinnitus
TCP arrhythmias (torsade) |
|
Side effects of:
Reserpine |
depression
|
|
Side effects of:
rifampin |
induction of P450
red-orange secretions |
|
Side effects of:
salicylates |
fever
hyperventilation with resp alkalosis and met acidosis* dehydration diaphoresis hemorrhagic gastritis |
|
Side effects of:
SSRIs |
anxiety
sexual dysfunction* |
|
Side effects of:
Succinylcholine |
Malignant hyperthermia
|
|
Side effects of:
tetracyclines |
tooth discolouration
photosensitivity Fanconi's syndrome |
|
Fanconi's syndrome
|
polyuria, polydipsia, dehydration
dilute urine proteinuria hypokalemia hypophosphatemia hyperchloremic metabolic acidosis Rickett's (defect in Vit D conversion) FTT* variable mode of inheritance |
|
Side effects of:
TCAs |
sedation coma
anticholinergic effects seizures arrhythmias |
|
Side effects of:
valproic acid |
NTD
|
|
Side effects of:
Vancomycin |
nephrotoxicity
ototoxicity "red man syndrome" - histamine release (not allergy) |
|
Side effects of:
Vinblastine |
severe myelosuppression
|
|
Side effects of:
Vincristine |
peripheral neuropathy
|
|
EtOH withdrawl syndrome
|
Mild withdrawl (6-24h from last drink)
tremor, anxiety, N/V, insomnia Major Withdrawl (10-72h) visual/auditory hallucinations, whole body tremor, vomiting, diaphoresis,↑BP Withdrawl seizures - 6-48hrs DTs - 2-7d severe autonomic instability/hyperactivity (↑HR, BP) delerium, confusion, agitation, hallucinations fever positional nystagmus death - mortality 15-20% |
|
EtOH withdrawl Rx including DTs
|
benzos* (DOC)
haloperidol for hallucinations clonidine, BBs for hyperadrenergic state thiamine, folate, vitamens replace lytes IV fluids |
|
Barbituate withdrawl
|
anxiety
seizures delerium tremor cardiac & resp depression Rx benzos |
|
Benzodiazepine withdrawl
|
rebound anxiety
seizures tremor instability Rx benzos |
|
Cocaine/amphetamine withdrawl
|
depression
hyperphagia hypersomnolence Rx supportive avoid BBs (results in excess uninhibited cardiac activation) |
|
Opioid withdrawl
|
anxiety
insomnina flu-like symptoms* sweating piloerection fever rhinorrhea stomach cramps diarrhea mydriasis Rx clonidine +/or buprenorphine for mod withdrawl methadone for severe naltrexone in pts drug-free for 7-10d |
|
metabolism by P450 enzymes
|
benzos
amide anaesthetics metoprolol, propranolol nifedipine phenytoin quinidine theophylline warfarin barbituates |
|
induction of P450
|
barbituates
phenytoin carbamazepine rifampin |
|
inhibition of P450
|
cimetidine
ketoconazole INH |
|
increasing risk of digoxin toxicity
|
quinidine
cimetidine amniodarone CCB |
|
competition for albumin binding sites
|
warfarin
ASA phenytoin |
|
drug induced blood dyscrasias
|
ibuprophen
quinidine methyldopa chemo agents |
|
Drug induced hemolysis in G6PD deficiency
|
sulfonamides
INH primaquine ASA ibuprofen nitrofurantoin |
|
drug induced gynecomastia
|
cimetidine
spironolactone ketoconazole |
|
Drug induced Steven Johnson syndrome
|
ethosuximide
sulphonamides penicillins phenytoin carbamazepine barbituates |
|
Steven Johnson syndrome
|
= erythma multiforme major
immune-complex mediated hypersensitivity disorder 3-15% mortality |
|
Steven Johnson syndrome S/S
|
non-specific URTI 1-14d prodrome (fever, pharyngitis, chills, h/a, malaise +/- V/D)
abrupt onset non-pruritic mucocutaneous rash (most often truncal) - begins as macules → papules, vesicles, bullae, urticarial plaques or confluent erythema "target lesion" pathognomonic involvement of: oral, nasal, eye, vaginal, urethral, GI, lower resp |
|
Steven Johnson syndrome causes
|
1. infectious
2. drug induced 3. malignancy related 4. idiopathic |
|
drug induced photosensitivity
|
tetracycline
amniodarone sulphonamides |
|
Drug induced SLE
|
procainamide
penicillamine hydralazine INH |
|
Name the antidote:
Acetominophen |
N-acetylcystine
|
|
Name the antidote:
anticholinesterases, organophosphates |
atropine
pralidoxime |
|
Name the antidote:
antimuscarinic, anticholinergic agents |
physostigmine
|
|
Name the antidote:
black widow bite |
Ca gluconate
|
|
Name the antidote:
Iron |
defuroximine
|
|
Name the antidote:
methanol, ethylene glycol |
EtOH
fomepizole dialysis |
|
Name the antidote:
Lead |
Succimer
CaEDTA dimercaprol penicillamine |
|
Name the antidote:
arsenic Hg Gold |
succimer
dimercaprol |
|
Name the antidote:
Copper arsenic lead gold |
penicillamine
|
|
Name the antidote:
cyanide |
Na thiosulfate
nitrate |
|
Name the antidote:
salicylates |
alkalinize urine
dialysis activated charcoal |
|
Name the antidote:
heparin |
protamine sulfate
|
|
Name the antidote:
methemoglobin |
methylene blue
|
|
Name the antidote:
opioids |
naloxone
|
|
Name the antidote:
benzos |
flumazenil
|
|
Name the antidote:
barbituates |
alkalinize urine
dialysis activated charcoal |
|
Name the antidote:
TCAs |
benzos for seizures
cardiac monitor NaHCO3 for QRS prolongation |
|
Name the antidote:
warfarin |
FFPs
Vit K |
|
Name the antidote:
carbon monoxide |
hyperbaric/100% O2
|
|
Name the antidote:
tPA, streptokinase |
aminocaproic acid
|
|
Name the antidote:
Digitalis |
digitalis specific Fab
lidocaine for torsades stop dig normalize K+ |
|
Name the antidote:
Beta-blockers |
glucagon
|
|
Name the antidote:
PCP |
NG suction
|
|
Name the antidote:
theophylline |
activated charcoal
|
|
Name the antidote:
acid/alkali ingestion |
upper endoscopy to evaluate for strictures
|
|
S/S of Deficiency of:
Vitamin A |
night blindness
dry skin |
|
S/S of Deficiency of:
B1 (thiamine) |
Beriberi
polyneuritis, DCM, high-output CHF, edema Wernicke-Korsakoff |
|
S/S of Deficiency of:
B2 (riboflavin) |
angular stomatitis
corneal vascularization cheilosis |
|
S/S of Deficiency of:
B3 (niacin) |
Pellagra
3d's diarrhea dermatitis dementia |
|
S/S of Deficiency of:
B5 (pantothenate) |
dermatitis
enteritis adrenal insufficiency alopecia |
|
S/S of Deficiency of:
B6 (pyridoxine) |
convulsions
irritability given prophylactically with INH |
|
S/S of Deficiency of:
B12 (cobalamin) |
macrocytic, megaloblastic anemia
glossitis neuro symp optic neuropathy, subacute combined degeneration, P/N |
|
S/S of Deficiency of:
Vitamen C |
Scurvy
swollen gums bruising anemia poor wound healing |
|
S/S of Deficiency of:
Vitamin D |
Ricketts
bending bones Osteomalacia soft bones hypocalcemic tetany |
|
S/S of Deficiency of:
Vitamin E |
Increased fragility RBCs
|
|
S/S of Deficiency of:
Vitamin K |
neonatal hemorrhage
↑PT, PTT N bleeding time |
|
S/S of Deficiency of:
Biotin |
dermatitis
enteritis Can be caused by eating RAW EGGS |
|
S/S of Deficiency of:
Folic acid |
Most common Vitamin deficiency
macrocytic, megaloblastic anemia without neuro signs sprue |
|
S/S of Deficiency of:
Magnesium |
weakness
muscle cramps exacerbation of hypocalcemic tetany CNS hyperirritability leading to: tremors choreoathetoid mvt +ve Babinski |
|
S/S of Deficiency of:
Selenium |
Keshan's syndrome (dilated cardiomyopathy)
|
|
Aortic disruption CXR
|
widened mediastinum
pleural cap loss of aortic knob deviation of trachea to R depression of L main stem bronchus Always suspect with R1-2#s aortography - gold standard |
|
Arrhythmia Rx:
asystole |
epi
atropine |
|
Arrhythmia Rx:
Vfib |
desynchronized shock → epi or vasopressin → shock → lido or amio → shock → procainamide or Mg
|
|
Arrhythmia Rx:
VTach |
if unstable/pulseless - desynchronized shock
if stable - lido or amio |
|
Arrhythmia Rx:
PEA |
identify & Rx underlying
+/- epi +/or atropine |
|
Arrhythmia Rx:
Afib/flutter |
if unstable shock at 100J
If stable - control rate (CCB, dig, BB) - +/- rhythm conversion - anticoagulate |
|
Arrhythmia Rx:
SVT |
Control rate
valsalva, carotid sinus massage, cold stim - adenosine (procainamide) |
|
Arrhythmia Rx:
bradycardia |
if symptomatic consider atropine
if Mobitz II/AVB pace Acutely, unstable - atropine/dopamine/dobutamine or transvenous pacing |
|
hypovolemic shock
|
↓CO
↓PCWP ↑PVR |
|
cardiogenic shock
|
Causes:
tension PTX cardiac tamponade arrhythmia structural hrt dz MI ↓CO ↑PCWP ↑PVR |
|
Septic shock
|
↑CO
↓PCWP ↓PVR |
|
anaphylactic shock
|
↑CO
↓PCWP ↓PVR |
|
Rx for malignant HTN
|
nitroprusside
|
|
test to r/o urethral injury
|
retrograde cystourethrogram
|
|
Radiographic indications for Sx in pts with acute abd
|
free air under diaphragm
extravasation of contrast severe bowel distension SOL mesenteric occlusion (angiography) |
|
Cannon a waves
|
complete AVB
|
|
signs of neurogenic shock
|
hypotension
bradycardia |
|
Cushing's triad
|
Signs of ↑ICP
HTN bradycardia abnormal respirations |
|
Signs of air embolism
|
pt with chest truma previously stable suddenly dies
|
|
Organims/Rx of strep pharyngitis
|
Org
GAS, S. pneumo Rx Pen V Amoxicillin erythromycin |
|
Organisms causing sinusitis
|
S. pneumo
H. flu M. catarrhalis GAS anaerobes S. aureus |
|
Rx for sinusitis
|
1st line - Amoxicillin
(TMP-SMX if pen allergic) 2nd line - Amox/clav 3rd line clarithromycin |
|
Acute OM pathogens
|
Viral
S. pneumo H. flu M. catarrhalis |
|
Name the antidote:
cyanide |
Na thiosulfate
nitrate |
|
Name the antidote:
salicylates |
alkalinize urine
dialysis activated charcoal |
|
Name the antidote:
heparin |
protamine sulfate
|
|
Name the antidote:
methemoglobin |
methylene blue
|
|
Name the antidote:
opioids |
naloxone
|
|
Name the antidote:
benzos |
flumazenil
|
|
Name the antidote:
barbituates |
alkalinize urine
dialysis activated charcoal |
|
Name the antidote:
TCAs |
benzos for seizures
cardiac monitor NaHCO3 for QRS prolongation |
|
Name the antidote:
warfarin |
FFPs
Vit K |