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Pharmacology – Aweso

Drug side effects and monitoring

QuestionAnswer
What to check before starting infliximab or rituximab? PPD, Hep C IgG, and Hep B
Side effects of gouty arthritis (joints) gouty arthritis, aspirate chocolate from the nodule
what drugs can cause hypersensitivity pneumonitis? methotrexate, rituximab, nitrofurantoin
what would you expect to see in CBC with rituximab? lymphopenia
what would you expect to see in lungs with rituximab? hypersensitivity pneumonitis, interstitial lung fibrosis
taking minocycline for 1-2 years - what side effects? drug induced lupus and autoimmune hepatitis, weird because you take it for mild lupus
Side effects of hydroxychloroquine give for mild lupus, esp for malar rash, side effects is loss of accommodation reflex
Drugs that increase the metabolism of other drugs (want to get rid of other drugs quickly) - jealous drugs St. John's Wort, Rifampin, tocilizumab, phenytoin
benign side effects of minocycline dizziness / vertigo, very lipophilic so easily affects CNS
what to consider when considering use of leflunomide? check UPreg because drug is teratogenic up to one year after end of use. If using, then wait > 1 year to have baby, or use cholestyramine x11d to wash away metabolites
what are the side effects of tocilizumab? diverticular rupture, OCP failure, hyperlipidemia
Drugs that decrease the metabolism of other drugs (want other drugs to stick around and party with them) - happy drugs Bactrim (increases level of warfarin especially), quinolones (levo, cipro), grapefruit juice, Norvir, flu/ketoconazole
How to follow a patient you'd started on methotrexate? CBC, Cr, AST q2-4 weeks x 3; then 8-12 w x3, then q12 wks
what to give prior to starting DMARDs pneumococcal and flu vaccines (no live vaccines); place PPD, test for Hep B/C
Pyrazinamide side effects can cause hyperuricemia and gout by inhibiting renal tubular excretion of uric acid. Other potential side effects include hepatitis, rash, and gastrointestinal upset.
what drug can cause toxic epidermal necrolysis? Lamotrigine - best drug for seizures in elderly
what drug causes Ca Phos kidney stones? topriamate
What type of RTA does topiramate cause? RTA 2
You would expect high or low K as side effect of Bactrim? high K (TMP blocks the ENaK channel so will have decreased Na absorption and increased K retention)
proximal muscle wasting and weakness - what drug can cause this? what disease? excess glucocorticoids or Cushings
need lipid profile to monitor cholesterol levels, associated with leukopenia, thrombocytopenia, and elevated serum aminotransferase levels tocilizumab - Tocilizumab also is associated with increases in serum cholesterol levels, a concern given the increased risk for premature cardiovascular disease associated with rheumatoid arthritis
what is tocilizumab used for FDA approved to treat patients with rheumatoid arthritis who have experienced an inadequate response to tumor necrosis factor α inhibitors
what drug can't you use Allopurinol and febuxostat with and why? Allopurinol and febuxostat block urate prod by inhibiting xanthine oxidase, an enzyme that converts xanthine to urate. Can't use w azathioprine because it is metabolized by xanthine oxidase, so using these drugs together will cause azathioprine toxicity.
what is probenecid a medication for? promotes renal urate excretion and is efficacious in patients who underexcrete uric acid (documented by a 24-hour urine collection) in the setting of a normal estimated glomerular filtration rate (GFR)
in which patients would you NOT want to give probenecid to? it may increase the risk of kidney stones; therefore, patients taking probenecid must hydrate aggressively and may need to alkalinize their urine, pts with high risk for stones (for example, a history of stones or tophaceous gout) should avoid it
which drugs should you check for G6PD in? Rasburicase, Dapsone
how to treat TCA overdose. How do people usually die from TCA overdose? Sodium bicarbonate infusion. Most deaths due to TCA overdose are caused by cardiovascular collapse with refractory hypotension or lethal arrhythmias such as ventricular tachycardia or ventricular fibrillation
big side effect of Natalizumab - also, what does it treat, how to treat the side effect treats MS, side effect is JC virus PML, MRI repeated- if any PML lesions, LP for JC virus PCR; immediately stop natalizumab if PML is diagnosed and then to use plasmapheresis to remove unbound circulating antibody.
mitoxantrone - what does it treat and what is the side effect MS, Dose-dependent cardiotoxicity
interferon beta treatment of MS - what are the side effects Worsening of underlying depression and flu-like sxs
what side effect do you see for glatiramer acetate Treats MS, Skin lipoatrophy is commonly seen at frequent injection sites
Amiodarone side effects pulmonary toxicity, including chronic interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, and a solitary pulmonary mass.
oxcarbazapine causes what Hyponatremia
What medication can cause a subclinical metabolic acidosis, kidney stones, weight loss, and acute angle closure glaucoma Topiramate
what labs should you be monitoring for a patient on a few weeks of nafcillin, oxacillin, and carbapenems? CBC for bone marrow suppression, liver enzyme tests, serum creatinine.
What labs should you be monitoring for patients on cefepime? CBC, LFTs, serum creatinine, serum potassium
Created by: christinapham