Term
|
Definition
|
|
Term
| Primary determinant of toxicity |
|
Definition
|
|
Term
|
Definition
| known toxicology standards which you compare with drug and/or chemical responses of the patient |
|
|
Term
|
Definition
Emesis inducer
utilized to remove unabsorbed toxicants from the GI tract
contraindications - chemical pneumonitis |
|
|
Term
|
Definition
Emesis inducer
utilized to remove unabsorbed toxicants from the GI tract
contraindications - chemical pneumonitis |
|
|
Term
|
Definition
very large surface area allows for binding of organic toxicants which prevents absorption
often induces emesis |
|
|
Term
|
Definition
antidote that chelates toxicants
used to treat toxins that are AChase inhibitors (often organophosphates)
usually administered with atropine to block muscarininc effects of parasympathetic nervous system |
|
|
Term
|
Definition
CNS and cardiac tissues affected
death in 1-15 minutes
administer amyl nitruite, sodium nitrite and sodium thiosulfate with O2 as antidote |
|
|
Term
|
Definition
Most potent poison known
rapidly absorbed and prevents ACh release from nerve terminals
most common: respiratory depression |
|
|
Term
| Heavy metal poisoning antidote |
|
Definition
| Chelators (BAL, EDTA, DMSA, DMPS, calcium EDTA, deferoxamine) complex with Hg, Pb, As, Fe and/or Ag making them inert and increasing renal excretion |
|
|
Term
| BAL (British Anti-Lewisite) |
|
Definition
| Chelator (heavy metal poisoning antidote) |
|
|
Term
|
Definition
| Treatment of arsenic, mercury and lead poisoning |
|
|
Term
|
Definition
| Treatment of arsenic, mercury and lead poisoning |
|
|
Term
| Trivalent antitoxin for Botulism A, B and E |
|
Definition
|
|
Term
|
Definition
small inhaled dose of amyl nitrite followed by IV sodium nitrite - these nitrites oxidize a portion of the hemoglobin's iron from the ferrous state to the ferric state, converting the hemoglobin into methemoglobin
then administer IV sodium thiosulfate - reacts with the cyanmethemoglobin to give thiocyanate (and sulfite) and hemoglobin |
|
|
Term
|
Definition
Inhibitor of metabolic conversion
Ethylene glycol/methanol/isopropyl alcohol
methanol converted into formaldehyde and formic acid by alcohol dehydrogenase
ethanol administration competitively prevents alcohol dehydrogenase from converting these substances into toxic forms |
|
|
Term
|
Definition
blocks alcohol dehydrogenase
DOC for ethylene glycol poisoning, methanol toxicity and other alcohol poisonings |
|
|
Term
| Carbon monoxide poisoning Tx |
|
Definition
Artificial respiration with pure O2 to promote displacement of CO
hyperbaric oxygen chamber if symptomatic |
|
|
Term
|
Definition
|
|
Term
|
Definition
Competitive receptor antagonist
acts at µ, κ, and δ receptors to competitively block/reverse the effects of opiates
duration of action: ~45 minutes |
|
|
Term
|
Definition
acts at µ, κ, and δ receptors to competitively block/reverse the effects of opiates
Longer duration of action (24-72 hrs) than naloxone |
|
|
Term
| Sympathomimetic toxidrome |
|
Definition
Drugs - cocaine, amphetamines, PCP
Pupils - mydriasis
other - HTN, tremor, hyperthermia |
|
|
Term
| Sedative/Hypnotic toxidrome |
|
Definition
Drugs - alcohol, barbiturates, benzodiazapines
CNS - coma
respiation - decreased
pupils - miosis or mydriasis
other - hypotension |
|
|
Term
|
Definition
drugs - opiates, morphine, codeine, propoxyphene, oxycodone, hydrocodone
CNS - coma (or decreased consciousness)
respiration - depressed
pupils - pinpoint (miosis)
other - "opiate triad" |
|
|
Term
| Anticholinergic toxidrome |
|
Definition
Drugs - anticholinergics, antidepressants
CNS - agitation
pupils - mydriasis
other - fever, dry skin, flushing, urinary retention [hot, dry, mad, red, blind] |
|
|
Term
|
Definition
Drugs - organophosphates, nicotine
Pupils - PPP
other - SLUDE |
|
|
Term
|
Definition
Drugs - TCA (amitriptyline, imipramine, desipramine)
CNS - coma, agitation
pupils - mydriasis
other - dysrhythmia, convulsions, hypotension (due to alpha blockade) |
|
|
Term
|
Definition
Drugs - aspirin
respiration - can increase or normal
other - diaphoresis, tinnitis, agitation, alkalosis (early), acidosis (late), hyperpyrexia |
|
|
Term
| Benzodiazepine toxication |
|
Definition
rarely fatal unless taken with ETOH or other CNS depressant due to synergistic CNS depression
treat with a receptor antagonist - flumazenil |
|
|
Term
|
Definition
signs - (after depletion of glutathione) hepatic necrosis, death due to hepatic failure
treat with n-acetylcysteine |
|
|
Term
|
Definition
signs - cardiac dysrhythmia leading to cardiac arrest
treat with lidocaine |
|
|
Term
| Thyroid hormones and drugs that mimic thyroid hormones have effects on... |
|
Definition
| Metabolism, cardiac function and growth and development |
|
|
Term
| Half lives of thyroid hormones |
|
Definition
very long
T3 = 1.5 days, T4 = 7 days
takes about a month for patients to reach euthyroid levels (4-5 half lives to get to steady state) |
|
|
Term
|
Definition
synthetic T4
treatment of choice for replacement |
|
|
Term
|
Definition
|
|
Term
|
Definition
| fixed-ratio mixture of T3 and T4 |
|
|
Term
|
Definition
Thyroid dysfunction
T4 high, TSH low |
|
|
Term
| Secondary hyperthyroidism |
|
Definition
Pituitary dysfunction
T4 high, TSH high |
|
|
Term
|
Definition
Thyroid dysfunction
T4 low, TSH high |
|
|
Term
|
Definition
Pituitary dysfunction
T4 low, TSH low |
|
|
Term
|
Definition
Autoimmune disorder - Thyroid stimulating IgG
80% of all hyperthyroid cases
Women:men - 9:1 (15-20X incidence in women)
TSH suppressed, iodine uptake elevated, T4 elevated, goiter |
|
|
Term
|
Definition
surgical removal of the thyroid gland
Radioactive iodine (RAI) - half life 5-6 days
Antithyroid agents - iodide salts, thiourea drugs, beta-blockers |
|
|
Term
|
Definition
Inhibitor of peroxidase enzyme
Thiourea drug - antithyroid agent
useful in the treatment of hyperthyroidism - short term fix
PO with effects after 30-60 min
Contraindicated in pregnancy and lactation |
|
|
Term
|
Definition
Inhibitor of peroxidase enzyme
Thiourea drug - antithyroid agent
useful in the treatment of hyperthyroidism - short term fix
PO with effects after 30-60 min
Contraindicated in pregnancy and lactation |
|
|
Term
|
Definition
reduces tachycardia, palpitations and dysrhythmia associated with hyperthyroidism
Immediate action in thyroid storm
Controls symptoms prior to surgery or RAI treatment response |
|
|
Term
| SSKI (saturated solution of potassium iodide) |
|
Definition
Iodide salt
Temporarily suppresses thyroid hormone production and release - short term fix |
|
|
Term
|
Definition
Iodide salt
thyro-block
radiation
contraindicated in pregnancy |
|
|
Term
|
Definition
Iodide salt
for acute management of thyrotoxic crisis
contraindicated in pregnancy |
|
|
Term
|
Definition
delivered orally as a tasteless and colorless liquid
concentrated solely within the thyroid gland
emits β-particles and γ-rays that destroy the thyroid either partially or totally
as thyroid tissue is destroyed, TH levels are reduced over several weeks
because of delayed onset of action, short-term application of β-blockers are often employed for symptomatic treatment
contraindicated in pregnancy |
|
|
Term
|
Definition
| Autoimmune thyroiditis in which mutated T-cells become active against cells of the thyroid gland |
|
|
Term
|
Definition
a severe form of adult hypothyroidism caused by decreased functionality or removal of the thyroid gland
thyroid gland
resolved with replacement therapy |
|
|
Term
| Cretinism (congenital hypothyroidism) |
|
Definition
usually due to RAI exposure in utero
stunted brain and anterior pituitary growth resulting in severely reduced mental activity/ability and dwarfed physical development
If left undiagnosed into childhood macroglossia will ocur |
|
|
Term
|
Definition
Transporter in muscle and adipose tissue
Insulin mediated uptake of glucose |
|
|
Term
|
Definition
B-cell destruction
leads to absolute insulin deficiency
genetic predisposition
immune mediated
idiopathic |
|
|
Term
| Diabetes Mellitus type II |
|
Definition
Insulin resistance and insulin secretory defect
genetic predisposition
obesity
lack of nutrition and physical activity |
|
|
Term
| Diabetes Mellitus type IV |
|
Definition
Gestational diabetes
onset of glucose intolerance usually in the 2nd and 3rd trimester
4% of pregnancies
return to normal glucose tolerance post-delivery
40% of diagnosed women will develop diabetes within the next 10 years |
|
|
Term
| Symptoms of diabetes mellitus |
|
Definition
increased urination
increased thirst
fatigue
weight loss
hunger
frequent infections
slow healing of wounds or sores |
|
|
Term
|
Definition
Mainstay treatment of type I and many type II DM patients
administered IV, IM, inhalation, SCI (most common)
therapeutic goal - FBG 90-120 mg/dL |
|
|
Term
|
Definition
Rapid acting insulin
Amino acid alteration in C-terminal tail of the B peptide preventing insulin complex formation
duration: 3-5 hours |
|
|
Term
|
Definition
Rapid acting insulin
Amino acid alteration in C-terminal tail of the B peptide preventing insulin complex formation
duration: 3-5 hours |
|
|
Term
|
Definition
Rapid acting insulin
Amino acid alteration in C-terminal tail of the B peptide preventing insulin complex formation
duration: 3-5 hours |
|
|
Term
|
Definition
Rapid acting insulin
Amino acid alteration in C-terminal tail of the B peptide preventing insulin complex formation
duration: 3-5 hours |
|
|
Term
|
Definition
Short acting insulin
Identical to human insulin, forms complexes
duration: 4-12 hours |
|
|
Term
|
Definition
Intermediate acting insulin
Protamine-insulin complex
duration: 10-20 hours |
|
|
Term
|
Definition
Long acting insulin
Amino acid substitutions that result in precipitate formation at a more neutral pH in the body
Duration 12-20 hours |
|
|
Term
|
Definition
Long acting insulin
Amino acid substitutions that result in precipitate formation at a more neutral pH in the body
Duration 22-24 hours |
|
|
Term
|
Definition
Oral antidiabetic agent - Biguanide
1st line agent
does not produce hypoglycemia
not dependent upon beta-cell function
MOA - decrease hepatic glucose output
Adverse effect - GI disturbances |
|
|
Term
|
Definition
Endometrium - proliferation
Decrease LDL, increase HDL, increase triglycerides
Menstrual cycle - key regulator during follicular phase |
|
|
Term
|
Definition
Edometrium - differentiation, prepares for implantation, decrease uterine contractions
increase LDL, increase fat deposition
Menstrual cycle - key regulator during luteal phase
Cervical glands - increase cervical mucous viscosity |
|
|
Term
|
Definition
First synthetic non-steroidal estrogen
not used much today
prototype - tested a lot because of previous clinical impact |
|
|
Term
| Pharmacological use of estrogen |
|
Definition
Hypogonadism - increase development of sex organs
Contraception - inhibit ovulation
Acne - inhibit steroidogenesis, decrease free testosterone concentrations
HRT - decrease bone resorption/vasomotor symptoms, urogenital atrophy |
|
|
Term
| Estrogen - adverse effects |
|
Definition
| Nausea, breast tenderness, endometrial hyperplasia, cholestasis, increased blood coagulation, migraine, cancer, bloating |
|
|
Term
| Medroxyprogesterone (MPA) |
|
Definition
Commonly combined with estrogen for HRT
used as a long acting contraceptive (Depo-Provera) |
|
|
Term
|
Definition
Combinational or progestin only hormone contraception
0.5-1 mg/day when combined with estrogen, lower when alone
19-nortestosterone derivative
Nor-QD |
|
|
Term
|
Definition
combinational or progestin only hormone contraception
0.5-1 mg/day when combined with estrogen, lower when alone
19-nortestosterone derivative
Ovrette |
|
|
Term
| Pharmacological use of progestins |
|
Definition
Contraceptive - alone or in combination with estrogen
HRT - decrease risk of endometrial hyperplasia caused by estrogens
dysmenorrhea - decrease endometrial mass and decrease prostaglandin production
endometriosis - decrease endometrial proliferation by regulating ER experession and stimulating differentiation of endometrial cells |
|
|
Term
| Progestins - adverse effects |
|
Definition
Breakthrough bleeding
impaired glucose tolerance
ance
lipid metabolism |
|
|
Term
|
Definition
Hormones - Estrogens and Progestins or progestins only
Treatment duration - monthly, quarterly or yearly
MOA - Supresses LH and FSH surge (inhibits ovulation), alters cervical mucous to create a physical barrier, alters endometrium to inhibit implantation |
|
|
Term
|
Definition
Hormones - Estrogens and Progestins or progestins only (more commonly only progestins)
Treatment duration - monthly or quarterly
MOA - Supresses LH and FSH surge (inhibits ovulation), alters cervical mucous to create a physical barrier, alters endometrium to inhibit implantation |
|
|
Term
| Implantable birth control |
|
Definition
Hormones - Progestins alone
Treatment duration - 3 or 5 years
MOA - Supresses LH and FSH surge (inhibits ovulation), alters cervical mucous to create a physical barrier, alters endometrium to inhibit implantation |
|
|
Term
| Intrauterine device (IUD) |
|
Definition
Hormones - Progestins alone or copper
Treatment duration - 5 years
MOA - Supresses LH and FSH surge (inhibits ovulation), alters cervical mucous to create a physical barrier, alters endometrium to inhibit implantation |
|
|
Term
|
Definition
Hormones - Estrogens and Progestins
Treatment duration - monthly
MOA - Supresses LH and FSH surge (inhibits ovulation), alters cervical mucous to create a physical barrier, alters endometrium to inhibit implantation |
|
|
Term
|
Definition
Hormones - Estrogens and Progestins
Treatment duration - monthly
MOA - Supresses LH and FSH surge (inhibits ovulation), alters cervical mucous to create a physical barrier, alters endometrium to inhibit implantation |
|
|
Term
|
Definition
Injectable birth control
Medroxyprogesterone (MPA)
dosing - IM every 3 months |
|
|
Term
|
Definition
Implantable birth control
Etonogestrel
Implant every 3 years |
|
|
Term
|
Definition
IUD
Levonorgestrel
Implant may remain for 5 years |
|
|
Term
|
Definition
Vaginal ring
Ethinyl estradiol or Etonogestrel
Self-implant for 3 week period (1 week break) |
|
|
Term
|
Definition
Transdermal birth control
Ethinyl estradiol or Norelgestromin
3 week period with patch, replace once a week (1 week break) |
|
|
Term
|
Definition
Emergency birth control
Ethinyl estradiol or Levonorgestrel
Normal 28 day pack, increase dose, repeat after 12 hours |
|
|
Term
|
Definition
Emergency birth control
Levonorgestrel
take within 72 hours post sexual intercourse |
|
|
Term
| Contraindications for estrogen containing contraceptives |
|
Definition
Hx of breast cancer
Thomboembolic disorders
Liver disease
Hx of cardiovascular disease
Smokers 35 yaers of age or older |
|
|
Term
|
Definition
Estrogen receptor partial agonsist
Fertility drug
Adverse effects - multiple births, hot flashes, ovary enlargement, blurred vision |
|
|
Term
|
Definition
| Selective estrogen receptor modulator (SERMS) |
|
|
Term
|
Definition
| Selective estrogen receptor modulator (SERMS) |
|
|
Term
|
Definition
Inhibits estrogen
used for endometriosis and breast fibrocystic disease |
|
|
Term
|
Definition
Inhibits estrogen
Aromatase inhibitor
Used in breast cancer |
|
|
Term
|
Definition
Inhibits estrogen
Aromatase inhibitor
Used in breast cancer |
|
|
Term
|
Definition
Anti-progesterone (progesterone receptor modulator)
Abortifacient
Progesterone antagonist |
|
|
Term
|
Definition
Anti-progesterone (progesterone receptor modulator)
Long acting emergency contraceptive that can be used up to 5 days after intercourse
Progesterone partial agonist |
|
|
Term
|
Definition
ACTH agent - not very antigenic
adjunct in MS, ALS, myasthenia gravis and immunosuppresion |
|
|
Term
|
Definition
Mineralcorticoid agent
activates mineralcorticoid receptor
used in hypoaldosteronism |
|
|
Term
|
Definition
Mineralcorticoid antagonist
Competitive inhibitor of mineralocorticoid binding
used as a K+ sparing diuretic, for HTN, CHF, cirrhosis, hyperaldosteronism and hirsutism
Adverse effect - hyperkalemia |
|
|
Term
|
Definition
Short acting corticosteroid
fast onset |
|
|
Term
|
Definition
Intermediate acting corticosteroid
prodrug - converted to prednisolone by the liver |
|
|
Term
|
Definition
Intermediate acting corticosteroid
anti-inflammatory and immunosuppresion |
|
|
Term
|
Definition
Long acting corticosteroid
does not cross react in cortisol assays |
|
|
Term
| Glucocorticoid pharmacologic actions |
|
Definition
Increased renal excretion of calcium
Decreased osteoblastic activity - indirect stimulation of PTH leads to an increase in osteoclast activity and osteoporosis
Increase in blood pressure |
|
|
Term
|
Definition
Adrenal steroid antagonist
inhibits desmolase activity
used in adrenal hypersecretion and breast cancer |
|
|
Term
|
Definition
Adrenal steroid antagonist
Antimycotic - greater tissue concentrations are required for anti-steroidogenesis
inhibits 11 beta-hydroxylase and 17 alpha-hydroxylase
used in adrenal hypersecretion |
|
|
Term
|
Definition
Adrenal steroid antagonist
inhibits 11 beta-hydroxylase
used for assessing adrenal function and short term hypersecretion |
|
|
Term
|
Definition
Adrenal steroid antagonist
glucocorticoid receptor antagonist
requires greater concentrations than for anti-progestin effects |
|
|
Term
|
Definition
Anabolic steroid
Slow release, depot effect
Slow metabolism, longer duration |
|
|
Term
|
Definition
Anabolic steroid
Increased oral bioavailability
slower metabolism
potential for hepatotoxicity |
|
|
Term
| C-19 modified androgen (nandrolone) |
|
Definition
Anabolic steroid
Less susceptible to peripheral aromatization |
|
|
Term
| Androgens - pharmacodynamic effects |
|
Definition
Nitrogen retention and enhanced protein synthesis
Enhanced erythropoiesis
Increased bone mass, enhanced linear bone growth and closure of epiphyseal plate |
|
|
Term
| Androgens - contraindications |
|
Definition
Carcinoma of the prostate or prostatic hypertrophy
Hepatic disease
CV disease
Renal disease
Polycythemia
Pregnancy |
|
|
Term
| Androgens - therapeutic uses |
|
Definition
Aging - Low T syndrome
Sexual dysfunction
Gynecological disorders/cancer
Anemia
AIDS-associated wasting |
|
|
Term
| Androgens - dosing regimens |
|
Definition
Replacement - 21 mg/day
Performance enhancement - 25-200 mg/day or more |
|
|
Term
| Anti-androgens - therapeutic uses |
|
Definition
Females - hirsutism
Males - precocious puberty, prostatic cancer, alopecia, psychosocial deviance (chemical castration) |
|
|
Term
|
Definition
Androgen receptor antagonist
has a weak progesterone like effect |
|
|
Term
|
Definition
Androgen receptor antagonist
indirectly increases GnRH and LH release leading to gynecomastia |
|
|
Term
|
Definition
Androgen receptor antagonist
indirectly increases GnRH and LH release leading to gynecomastia |
|
|
Term
|
Definition
Anti-androgen
5-alpha-reductase inhibitor |
|
|
Term
|
Definition
Anti-androgen
GnRH agonist
[testosterone] decreases by 90% after one month
administer with flutamide to minimize increased tumor activity |
|
|
Term
|
Definition
androgen
has received a lot of attention as an anti-aging drug |
|
|
Term
|
Definition
Detergent
Anionic wetting agents |
|
|
Term
|
Definition
Detergent
cationic wetting agent
inactivated by anionic compounds |
|
|
Term
|
Definition
| An agent that kills or prevents the growth of microbes when applied to living tissue |
|
|
Term
|
Definition
| agent that prevents infection by the destruction of pathogenic microbes on non-living surfaces |
|
|
Term
|
Definition
Alcohol
Can be used as an antiseptic
Surface effect makes them useful for increasing effectiveness of other agents
Recommended concentration [40-70%] |
|
|
Term
|
Definition
Alcohol
Can be used as an antiseptic (also as a disinfectant)
Surface effect makes them useful for increasing effectiveness of other agents
Causes more local vasodilation (bleeding) beneath the skin after needle puncture |
|
|
Term
|
Definition
Iodophor
skin prep of patient and surgeon
antiseptic on skin, membranes |
|
|
Term
|
Definition
Silver compound
Use - burn treatment |
|
|
Term
|
Definition
Organic mercurial
Antiseptic for surgical prep of skin, mucous membranes and open wounds
DO NOT BANDAGE |
|
|
Term
|
Definition
Oxidizing agent
gas needs to escape, avoid abscess or bandage |
|
|
Term
|
Definition
Substituted phenol
topical antiseptic and hand cleaner
requires repeated daily application
most effective against gram positive |
|
|
Term
|
Definition
Chelating agent
potentiate activity of many antibacterials against gram negative
one of the best antiseptics bc of low incidence of side effects and residual effect after the scrub is over |
|
|
Term
|
Definition
Oxidizing agent
gas needs to escape, avoid abscess or bandage |
|
|
Term
|
Definition
Substituted phenol
topical antiseptic and hand cleaner
requires repeated daily application
most effective against gram positive |
|
|
Term
|
Definition
Chelating agent
potentiate activity of many antibacterials against gram negative
one of the best antiseptics bc of low incidence of side effects and residual effect after the scrub is over |
|
|
Term
|
Definition
Emollient
lubricate, soften and protect skin |
|
|
Term
|
Definition
Astrigent
applied to skin to produce a local and limited protein coagulation effect
dehydrates skin |
|
|
Term
|
Definition
Keratolytic agent
Causes removal of dead skin |
|
|
Term
|
Definition
Keratoplastic agent
Stimulates the epidermis but doesn't produce destruction and desqumation
Lots of potential side effects |
|
|
Term
|
Definition
| Dusting powder - absorbent |
|
|
Term
| Methyl salicyclate (Ben-Gay) |
|
Definition
Counterirritant
relieves pain in viscera, muscles and joints |
|
|
Term
|
Definition
Wound cleaning agent
non-enzymatic cleaner |
|
|
