Adverse Effects Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
Hydralazine | Lupus-like Syndrome |
Clonidine | DOC for HTN in pt on dialysis |
Meperidine | Normeperidine is an active metabolite that builds up during renal dysfunction-causes seizures |
Carbapenems (imipenim) | Seizures |
carbamazepine | aplastic anemia agranulocytosis hepatotoxicity Stevens Johnson Syndrome |
Valproic Acid | hepatotoxicity teratogenicity pancreatitis |
topiramate | oligohydrosis glaucoma weight loss Kidney stones |
zonisamide | oligohydrosis stevens johnson syndrome Kidney stones |
lamotrigine | toxic epidermal necrosis (esp with VA) |
vigabatrin | permanent vision loss |
methyldopa | DOC for HTN in pregnancy |
Ribavirin | Hemolytic Anemia teratogenicity |
exenatide (byetta)and liraglutide (victoza) | pancreatitis, dose limiting SE is nausea |
Pancreatitis | byetta, victoza, valproic acid stavudine, didanosine |
oligohydrosis | topiramate, zonisamide |
hepatotoxicity | valproic acid, carbamazepine, NNRTIs |
Nevirapine (Viramune) | NNRTI-induces own metabolism |
Protease Inhibitors | Fat maldistribution, hypertriglyceridemia, hyperglycemia, hyperlipidemia, nephrolithiasis |
NRTIs | lactic acidosis and severe hepatomegaly |
"D" NRTIs | Didanosine, Zalcitabine, Stavudine (cause pacreatitis, peripheral neuropathy, and lactic acidosis) |
Lamivudine (Epivir) | Bone Marrow Suppression NRTI |
Zidovudine (Retrovir) | BMS (neutropenia, and anemia)NRTI |
Abacavir (Ziagen) | patients must be tested for HLA-B 5701 to determine risk for hypersensitivity. ANY rxns (rash, cough, N/V, fatigue)- D/C!!!!!! |
What is in Combivir? | Zidovudine and Lamivudine (both NRTIs) |
What is in Trizivir? | Zidovudine, Lamivudine, and Abavavir (All NRTIs) |
HIV and pregnancy | avoid efavirenz, avoid combining stavudine and didanosine, and consider starting tx after the 1st trimaster |
omalizumab (Xolair) | Anti IgE therapy indicated for severe persistent asthma patients who have frequent trips to the ER. SQ q 2-4 weeks. Most serious ADRs are malignancies and anaphylaxis. Injection site rxn 45% of the time because solution is viscous. |
What should be inhaled swiftly? | DPIs- Pulmicort (budesonide) Flovent Diskus, Advair Diskus, Asmanex, Foradil (Formoterol) and Serevent (salmeterol) |
Use bronchodilator and ICS. Which should you use first? | Use the bronchodilator first, wait several minutes then use the ICS-this will allow better penetration of the steroid |
Therapeutic goal of theophylline? | 5-15mcg/ml (<15= no toxicity, >20 60% toxic and >30 80% toxic) SMOKING induces liver enzymes and will cause theophylline levels to decrease!! |
Sx of methylxanthine toxicity | N/V, seizures, hyperactivity, ventricular arrhythmias (severe toxicity is not necessarily preceded by milder sx) |
Zileuton (Zyflo) | hepatotoxicity (leukotriene modifier) |
Amantadine (Symmetrel) | livedo reticularis (red mottling of the skin-affects 80% of patients)Increase dopaminergic transmission by unknown mechanism |
Selegiline | Selective MAO-B inhibitor at doses <10mg/day-can decrease levodopa dose by 10-30% (after third dose) |
Pramipexole (Mirapex)and Ropinirole (Requip) | Falling asleep during ADLs |
Apomorphine (Apokyn) | SC only (IV admin can cause pulmonary embolism) Will cause emesis-must pretreat with Trimethobenzamide or Domperidone-Start 3 days prior to use- NOT HT3 ANT-hypotension and loss of consciousness |
Fluorouracil (Adrucil) | GI and diarrhea |
Chemotherapy drugs with low risk of BMS | Asparaginase (Elspar), Vincristine (Oncovin), bleomycin and busulfan |
Bleomycin (Blenoxane) and busulfan (Busulfex) | Pulmonary fibrosis, SOB; hyperpigmentation of skin |
Cyclophosphamide (Cytoxan) | Metabolized to acrolein causes hemorrhagic cystitis at doses >1g/m2 ; give mesna at doses >1g/m2 |
Cytarabine (ara-C) | Keratitis, conjunctivitis; severe CNS toxicity in doses >1g/m2 |
Cisplatin (Platinol) | Ototoxicity, and CNS toxicity; acute and related emesis; nephrotoxicity (les with carbo; give IV fluids or amifostine) |
Daunorubicin (Cerubidine), doxorubicin (Adriamycin), epirubicin (Ellence), idarubicin (Idamycin) | Cardiac toxicity if cumulative doses >400mglm2 for daun/dox but less for idarubicin and more for epirubicin; extravasation risk |
Dexrazoxane | Used to Prevent cardiac toxicity during doxorubicin treatment or treat extravasation |
Dactinomycin (Cosmegen) | Extravasation risk |
Ixabepilone (Ixempra) | Peripheral neuropathy |
Ifosfamide (Ifex) | Metabolized to acrolein causing hemorrhaguc cystitis; give mesna |
Irinotecan (Camptosar; CPT11) | Severe acute and delayed diarrhea |
Methotrexate | Mucositis; liver toxicity/fibrosis; leucovorin can be used for toxicity |
Mechlorethamine (Mustargen) | Extravasation risk |
Oxaliplatin (Eloxatin) | Oral pharyngeal paraesthia; peripheral neuropathy; avoid exposure to cold stimulus to avoid exacerbation |
Streptozocin (Zanosar) | Insulin dependent diabetes (historically used to treat pancreatic cancer) |
Docetaxel (Taxotere), Paclitaxel (Taxol) | Peripheral neuropathy (mainly paclitaxel); edema/fluid retention (mainly docetaxel) |
Vinblastine (velban), vincristine (oncovin), vinorelbine (navelbine) | Peripheral neuropathy (vincristine>>vinblastine); extravasation risk; vincristine has less risk of BMS |
Contraindications for Lithium | renal disease, severe cardiovascular disease, hx of leukemia, first trimaster of pregnancy |
Monitoring parameters for Lithium | Thyroid (Lithium may cause hypothyroidism), SCr and BUN, CBC w/ diff (may cause leukocytosis or reactivate leukemia), electrolytes, ECG (may cause flattened or inverted T waves), urinalysis (may decrease specific gravity) |
Lithium steady state levels | 4-5 days (half life=24h) maintenance: 0.8-1 mEq/L (draw the level weekly for 4 weeks and then monthly for 3 months |
Lithium toxicity | 1.5-2.0mEq/L N/V, diarrhea, muscle weakness, fatigue, fine hand tremor, difficulty w/conc &memory 2-2.5mEq/L ataxia,lethargy,nyastgmus, worsening confusion, severe GI upset, coarse tremors, increase DTR >3.0mEq/L coma,seizures, respir complic/death |
Pernicious anemia- What deficiency causes this? | B12 (cyanocobalamin)-lack of intrinsic factor in stomach- vegetables have no B12-VEGANS HAVE 12 PROBLEMS-animal derived foods are rich in B12 |
Dose of cyanocobalamin | to treat prenicious anemia: 1000 mcg IM qd x 7 days then 1mg weekly for 1-2 months (until H/H return to normal) then once monthly |
Thiamine deficiencys | (B1) leads to beriberi and Wernicke's encephalopathy |
Niacin deficiency | Pellagra- rash sore mouth, diarrhea, mental deterioration |
Vitamin D deficiency | rickets |
Vitamin C deficiency | Scurvy-red spots on skin, gums hemorrhage, teeth fall out, hemorrhaging occurs in cells through out the body |
Daily need for fluid and TBW | 30-35ml/kg; Females (60%) Males (50%) |
Chromium (what does it do) | essential for incorporation of glucose into the cells and the intracellular metabolism of glucose-refractory hyperglycemia (check for chromium deficiency) |
Non-isotonic solutions hurt the most when they are injected how? | SQ-in contact the longest and close to nerves |
HEPA filters | remove 99.97% of air particles 0.3 microns or larger |
Microdrip set | 60 drops/min (normal drip set is 15-20 drops/min) |
Drugs that must be protected to light during administration | amphotericin, BiCNU (carmustine), furosemide, nitroprusside, vinblastin (velban), vincristine (oncovin) |
Reopro (Abciximab) | Antiplatelet agent used for PCI |
Benzyl Alcohol as solvent in injectables | causes a fatal syndrome "gasping syndrome" in premature infants |
3 drugs that are used in propylene glycol for injection | phenytoin, valium, and digoxin |
SE of propylene gylcol for injection | hypotension, CV collapse, CNS depression (will cause gel formation with other solvents) |
Only po DMARD? | Arava (leflunomide) |
Leflunomide (arava) | hepatotoxicity, TEN/ SJS, immunosupp, CI in women of child bearing age, use cholestyramine for fasting elimination (8g tid) otherwise stays in body for up to 2 years |
hydroxychloroquine (Plaquenil) | retinopathy- used as antimalaria and RA |
entanercept (Enbrel) | 50mg SQ weekly- Anti-TNF- watch for infections and neutropenia |
Inlfiximab (Remicade) | IV q 2-8 weeks (anti TNF)-watch for TB |
Adalimab (Humira) | SC qoweek (anti TNF)- watch for TB |
rifmapin | used to tx TB with INH-May impart a red-orange color to urine, feces, saliva, sputum, sweat, skin & teeth - will permanently discolor soft contact lenses. hepatotoxicity |
ethambutol (Myambutol) | Never use alone-used with other TB drugs to prevent the development of other resistant strains (decreases visual activity), MAY PRECIPITATE GOUT |
TPN in vein should next exceed what percent of glucose? | 10-12.5% peripheral 20-40% central |
Amino Acid requirement | 1-1.5g/kg/d -AA are 16% N |
Calcium Phosphate incompatibility | ALWAYS ADD Ca LAST! Can result in massive pulmonary emboli and death! |
Pulmonary disease and TPN | avoid excess carbs-carbs cause higher CO2 production |
Felbamate (Felbatol) | Aplastic anemia and hepatic failure |
fenofibrates | gall stones, rhabdo, absolute CI in severe renal and hepatic dx |
Niacin | hyperuricemia, decrease insulin sensitivity, rhabdo |
long term effects of heparin | hyperkalemia, alopecia, and osteoporosis |
Black box warning for LMWHs | Spinal/epidural hematoma formation |
Created by:
lukaszewiczj
Popular Pharmacology sets