Pharmacology usmle side effects heamatology, renal

summerahmed's version from 2015-07-20 09:30


Question Answer
heparinbleeding, osteoprosis, drug drug interaction, thrombocytopenia (HIT: development of IgG antibodies against heparin bound platelet factor 4 (PF4) antibody-heparin-pf4 activates the platelets leading to thrombosis and thrombocytopenia) antidote is protamine sulfate.
warafrinbleeding, teratogenic, skin and tissue necrosis specially in protein C,S defeciency, small vessel thromboembolism d2 early transient hypercoagulability cause protein S.C have short half life so bridging therapy with heparin is recommended. antidote is vit.K, fresh frozen plasma
apixiban bleeding no reversal agent
rivaroxibanbleeding no reversal agent
alteplase, reteplase, tenecteplase, streptokinasebleeding CI in ptns with active bleeding or hx of intracranial bleeding, surgerym bleeding diathesis, severr htn. ttt of toxicity is with aminocaproic acid to inhibit the fibrinolysis. fresh frozen plasma and cryprecipitate
aspringastric ulcer, tinnitus VIII, renal failure, intersititial nephritis, reye syndrome in children with viral infection, overdose lead to resp alkalosis by rapid beathing and then metabloic acidodid or mixed
adp receptor inhibitors, clopidogrelm prasugrel,ticagrerol(reversable), ticlopedineThrombotic thrombocytopenic purpura, neutropenia (ticlopedine)
cilostazolfacial flushing, headache, hypotension, abdominal pain, nausea
dipyridamolefacial flushing, headache, hypotension, abdominal pain, nausea
GpIIb/IIIa inhibitors, abciximab, tirofiban, epifibatidebleedingm thrombocytopenia
azathioprine, 5mercaptopurine, 6thioguaninemyelosuppresion, GI, liver and increased toxicity with allopurinol or febuxistat d2 both being metabolized by xanthise oxidase
cladribinehairy cell leukeamia. myelosuppression, nephrotoxicity and neurotoxicity
cytarabine, arabinofuranosyl cytidineleucopenia, thrombocytopenia, megaloblastic aneamia
5FUmyelosuppression non reversable with leucoverin
MTXmyelosuppression reversible with leucoverin, hepatotoxicity, mucositis, mouth ulcers, pulmonary fibrosis
bleomycinpulmonary fibrosis, hyperpigmentation, mucositis, mild myelosuppression
dactinomycin, actinomycin Dchildrens tumor(wilms, ewing, rhabdomyosarcome) myelosuppression
doxirubicin, daunirubicindilated cardiomyopathy, alepeciam myelosupression, toxic to tissue following extravasation. tp prevent cardio toxicity give Dexrazoxane which is an iron chelating agent
busulfanCML .sever myelosuppressiom, pulmonary fibrosis, hyperpigmentation
cyclophosphamidesolid tumors, leaukeamia, lymphoma. myelosuppression, hgic cystitis. pfrevented by Mesna that has a thiol group to bind to toxic metabolites
ifosfamidesolid tumors, leaukeamia, lymphoma. myelosuppression, hgic cystitis. pfrevented by Mesna that has a thiol group to bind to toxic metabolites
nitrusureaCNS toxicity, convulsions, ataxia, dizziness
cramustineCNS toxicity, convulsions, ataxia, dizziness
lomustine CNS toxicity, convulsions, ataxia, dizziness
semustinCNS toxicity, convulsions, ataxia, dizziness
paclitaxilovarian and breast cancer. myelosuppression, alopecia, hypersensitivity
vincristinesolid tumors, leaukeamia and NON-hodgkins. neurotoxic, areflexia, peripheral neuritis, paralytic ileus
vinblastinesolid tumors, leaukeamia and hodgkins. blasts bone marrow suppression
streptozocinCNS toxicity, convulsions, ataxia, dizziness
cisplatin, carboplatintesticular, ovarian, lung, bladder cancer. ototoxic, nephrotoxic prevented by AMIFOSTINE scavange the o2 free radicals and chloride saline diuresis
etoposide, teniposidesolid tumor, leaukeamia, lymphoma. myelosuppression, alopecia and GI upset
irimotecin, topotecensever myelosuppression, diarrhea
hyroxyureasever myelosuppression, GI upset
prednisonecushing-like-syndrome, weight gain, central obesity, ms breakdown, cataract, acne, osteoprosis, htn, peptic ulcer, hyperglyceamia, psychosis
bevacizumabanti VEGF. hge, blood clots, impaired wound healing
erlotinibrash. non small cell lung cancer
imatinibCML GI stromal tumor. fluid retention
rituximabnon hodgkins. CLL. IBD. Rheumatoid arthritis. increases the risk of progressive multifocal leuencephalopathy
tamoxifenpartial agonist on endometrium. increases the risk of endometrial cancer. hot flashes
raloxifenno increased rish of endometrial cancer cause its antagonist on endometrium.
vemurafunabmetastatic melanoma.


Question Answer
mannitolpulmonary edema, dehydration, CI in anuria HF
acetazolamidehypochloremic metabolic acidosis, parasthesis NH3 toxicity, sulfaallergy
loop diuretics,furosamide, bumetanide, torsemideototoxicity, hypokalemia, dehyration, allergy intersitial nephritis, gout
ethacrynic acidhyperuriceamia never use to ttt gout, same as loop
thiazide, chlorothiazidem hydrochlorothiazidehypokalemia, metabolic alkalosism hyponatreamia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalceamia, sulfa allergy
K sparing diuretic, spironolactone, elepronone, triametrene, amiloridehyperkalemia, can lead to arrythmia endocrine effects with spironolactone as gynecomastia,antiandrogen effects
ace inhibitors, captopril, enalapril, lisinopril, ramiprilcough angioedema CI in C1 estrase inhibitor dificiency, teratogenic fetal renal malformation, increase creatinine decrrease GFR, hyperkalemiam hypotensionmm avoid in bilateral renal stenosis, because ace inhibitor will further decreaseGFR leading to renal failure
ARB, losartan,candesartan, valsartanhyperkalemia, decrease renal function, hypotension, teratogen
ailskirenhyperkalemia, decrease renal function, hypotension, CI in diabteics taking ACE inhibition or ARBs