Overdose treatment, common side effects, High Yield Pediatrics, SCREENING, Classification criteria, Inheritance patterns of disease

iliapas97's version from 2018-01-29 06:07

Drug Side Effects

DrugsSide Effects
ACEIs Cough, rash, proteinuria, angioedema, taste changes, teratogenic ef ects.
Amantadine Ataxia, livedo reticularis
Aminoglycosides Ototoxicity, nephrotoxicity (acute tubular necrosis).
Amiodarone Acute AV block, hypotension, bradycardia. Chronic pulmonary fibrosis, peripheral deposition leading to bluish discoloration, arrhythmias, hypo-/hyperthyroidism, corneal deposition.
Amphotericin Fever/rigors, nephrotoxicity, bone marrow suppression, anemia.
Antipsychotics Sedation, acute dystonic reaction, akathisia, parkinsonism, tardive dyskinesia, NMS.
Azoles (eg, fluconazole) Inhibition of P-450 enzymes.
AZT Thrombocytopenia, megaloblastic anemia.
β-blockers Asthma exacerbation, masking of hypoglycemia, impotence, bradycardia, AV block, CHF.
Benzodiazepines Sedation, dependence, respiratory depression.
Bile acid resins Gl upset, malabsorption of vitamins and medications.
Carbamazepine Induction of P-450 enzymes, agranulocytosis, aplastic anemia, liver toxicity.
CCBs Peripheral edema, constipation, cardiac depression.
Chloramphenicol Gray baby syndrome, aplastic anemia.
Cisplatin Nephrotoxicity, acoustic nerve damage.
Clonidine Dry mouth; severe rebound headache and hypertension.
Clozapine Agranulocytosis.
Corticosteroids Mania, hyperglycemia (acute), immunosuppression, bone mineral loss, thinning of skin, easy bruising, myopathy, cataracts (chronic).
Cyclophosphamide Myelosuppression, hemorrhagic cystitis
Digoxin Gl disturbance, yellow visual changes, arrhythmias (eg, junctional tachycardia or SVT).
Doxorubicin Cardiotoxicity cardiomyopathy
Ethyl alcohol Acidosis, renal dysfunction, CNS depression.
Fluoroquinolones Cartilage damage in children; Achilles tendon rupture in adults.
Furosemide Ototoxicity, hypokalemia, nephritis, gout.
Gemfib ozil Myositis, reversible ↑ in LFTs.
Halothane Hepatotoxicity, malignant hyperthermia.
HCTZ Hypokalemia, hyponatremia, hyperuricemia, hyperglycemia, hypercalcemia.
HMG-CoA reductase inhibitorsMyositis, reversible ↑ in LFTs.
Hydralazine Drug-induced SLE.
Hydroxychloroquine Retinopathy.
INH Peripheral neuropathy (prevent with pyridoxine/vitamin B6), hepatotoxicity, inhibition of P-450 enzymes, seizures with overdose, hemolysis in G6PD deficien y.
MAOIs Hypertensive tyramine reaction, serotonin syndrome (with meperidine).
Methanol Blindness, anion-gap metabolic acidosis.
Methotrexate Hepatic fib osis, pneumonitis, anemia.
Methyldopa Coombs test, drug-induced SLE.
Metronidazole Disulfi am reaction, vestibular dysfunction, metallic taste.
Niacin Cutaneous flushin .
Nitroglycerin Hypotension, tachycardia, headache, tolerance.
Penicillamine Drug-induced SLE.
Penicillin/β-lactams Hypersensitivity reactions.
Phenytoin Nystagmus, diplopia, ataxia, arrhythmia (in toxic doses), gingival hyperplasia, hirsutism, teratogenic effects.
Prazosin First-dose hypotension.
Procainamide Drug-induced SLE.
Propylthiouracil Agranulocytosis, aplastic anemia.
Quinidine Cinchonism (headache, tinnitus), thrombocytopenia, arrhythmias (eg, torsades de pointes).
Reserpine Depression.
Rifampin Induction of P-450 enzymes; orange-red body secretions
Salicylates Fever; hyperventilation with respiratory alkalosis and metabolic acidosis; dehydration, diaphoresis, hemorrhagic gastritis.
SSRIs Anxiety, sexual dysfunction, serotonin syndrome if taken with MAOIs.
Succinylcholine Malignant hyperthermia, hyperkalemia.
TCAs Sedation, coma, anticholinergic ef ects, seizures, QRS prolongation, arrhythmias.
Tetracyclines Tooth discoloration, photosensitivity, Fanconi syndrome, GI distress.
Warfarin Skin necrosis with the first week of anticoagulation therapy
Trimethoprim Megaloblastic anemia, leukopenia, granulocytopenia.
Valproic acid Teratogenicity leads to neural tube defects; rare fatal hepatotoxicity.
Vancomycin Nephrotoxicity, ototoxicity, “red man syndrome” (histamine release; not an allergy).
Vinblastine Severe myelosuppression.
Vincristine Peripheral neuropathy, paralytic ileus.

Overdose treatment

Drugs and Electrolyte DisturbancesAntidote
Acetaminophen N-acetylcysteine
TCAs Sodium bicarbonate
Salicylates Sodium Bicarb, activated charcoal, Dialysis
β-blockers Glucagon, insulin, dextrose calcium
Ca channel blockers Glucagon, insulin, dextrose calcium
Black widow bite Calcium gluconate, methocarbamol.
Hyperkalemia.C BIG K: Calcium gluconate (drives potassium intracellularly), Insulin and Glucose , (chronic cases)) Kayexalate
Hypernatremia.Normal Saline. (if unstable vital signs; D5W or ½ NS to replace free-water loss.)
hypercalcemia.IV fluids then Furosemide (excrete excess calcium)
Acid/alkali ingestion Upper endoscopy to evaluate for stricture.
Antimuscarinic (Atropine) Physostigmine.
organophosphates, Anticholinesterases (prevent Ach breakdown leading to Ach toxicity) Atropine (Ach antagonist), pralidoxime.(inhibits anticholinesterase)
Scorpion venom Antivenom, Atropine, Phenobarbital
Opioids Naloxone or Naltrexone
BenzodiazepinesFlumazenil (can precipitate withdrawal, mainly used for acute ingestion)
Carbon monoxide 100% O2, hyperbaric O2.
Copper (Wilson's disease) Penicillamine
Iron Deferoxamine
Lead Succimer or Dimercaprol with EDTA (Severe exposure)
Arsenic Succimer , Dimercaprol
mercury Succimer, Dimercaprol
Cyanide (almond breath) (Old treatment) amyl nitrite/sodium nitrite (converts CN to cyanmetHb) Thiosulfate ((produces thiocyanate, which is excreted)
Cyanide (almond breath)(New treatment) Hydroxycobalamin (VitB12) (forms cyanocobalamin which is nontoxic)
Methemoglobin (Chocolate Blood)Methylene blue.
INH Pyridoxine (VitB6)
Digitalis Normalize K+, avoid giving Ca2+, Mg2+, or lidocaine (for torsades), anti-digitalis Fab.
Heparin Protamine sulfate.
tPA, streptokinaseAminocaproic acid.
Warfarin Vitamin K, FFP.
Methanol Fomepizole followed by Dialysis
ethylene glycol Fomepizole followed by Dialysis


High Yield Pediatrics, SCREENING, Classification criteria, Inheritance patterns of disease

High Yield Pediatrics

Question Answer
Laryngotracheobronchitis CROUP parainfluenza virus, barking cough, Steeple sign, Low fever, Give steroids or epinephrine
Epiglottitis Haemophilus influenza type B, Drooling,Muffled voice, tripod position, Respiratory distress, High fever, Thumbprint sign (on lateral film), Intubate~

Cervical Cancer SCREENING

cervical cancer screening age 21-30Pap smear every 3 years only
cervical cancer screening age 30-65HPV and cytology co-testing every 5 years OR Pap smear every 3 years

Screening mammogram is

Question Answer
women age 50 to 74 start at 50 and repeat every other year
Family history of breast cancer start at 40

AAA screening

Question Answer
Population Men between the ages of 65 and 75 with a smoking history
< 3 cm no follow-up required
3.5-4 cm every 1-2 years
4-4.5 cm every 6 months
> 4.5 cm elective surgery is recommended

Classification criteria= Classification criteria



Question Answer
JNC8 Target blood pressure
< 60 years old < 140/90
> 60 years old < 150/90
> Diabetic patients >130/80
New York Heart Association (NYHA) classificationClassifies heart failure into 4 groups
New York Heart Association (NYHA) Class I heart failure with no limitation
New York Heart Association (NYHA) Class IIsymptoms with strenuous physical activity.
New York Heart Association (NYHA) Class IIIsymptoms with little physical activity
New York Heart Association (NYHA) Class IVsymptoms of heart failure, even at rest.
Debakey SystemClassifies Aortic Dissection by types 3 types (I, II, III)
Type Iinvolves the ascending aorta, arch and descending thoracic aorta.
Type IIAscending Aorta only
Type IIIaIIIa involves the descending thoracic aorta distal to the left subclavian artery and proximal to the celiac artery
Type IIIbinvolves the thoracic and abdominal aorta distal to the left subclavian artery.
Stanford SystemClassifies Aortic Dissection as either type A or B
Type ADissection of the Ascending Aorta
Type BAll others
Rai staging systemused to stage leukemia
Rai stage 0Lmphocytosis greater than 15,000
stage I lymphocytosis + lymphadenopathy
stage IIlymphocytosis + splenomegaly
stage IIIlymphocytosis + anemia
stage IV is lymphocytosis + thrombocytopenia
Ottowa rule Determines of X-ray is needed.
Criteria for X-rayCan't bear weight after injury and on presentation, Tenderness to palpation around medial and lateral malleoli

Inheritance patterns of disease

Pattern of InheritanceDisease
X-linked recessiveFragile X, Duchenne’s muscular dystrophy, hemophilia A and B, Fabry’s disease, G6PD-deficiency, Hunter’s syndrome, and Wiskott-Aldrich syndrome.
Mitochondrialprogressive external ophthalmoplegia and myoclonus
Autosomal recessive cystic fibrosis, albinism, alpha-1 antitrypsin deficiency, phenylketonuria, thalassemias, sickle-cell, glycogen storage diseases, and hemochromatosis.
Autosomal dominantadult polycystic disease, familial hypercholesterolemia (Type IIa), Marfan’s , neurofibromatosis (Types 1 and 2), Von Hippel-Lindau, Huntington’s disease, familial adenomatous polyposis, and hereditary spherocytosis.