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Pharmacology – Aweso
Drug side effects and monitoring
| Question | Answer |
|---|---|
| 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
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