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Table of Contents

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Sheet I
Penicillin G (IV), V (oral) Methicillin, nafcillin, dicloxacillin Ampicillin, amoxicillin Carbenicillin, pipericillin, ticarcillin 1st-gen cephalosporins (cephalothin, cephalexin) 2nd-gen cephalosporins (cefuroxime, cefaclor) 3rd-gen cephalosporins (cefotaxime) 4th generation cephalosporins Aztreonam Imipenem Vancomycin Aminoglycosides (ex: gentamycin, streptomycin) Tetracyclines Macrolides (-thromycins) Chloramphenicol Clindamycin Sulfonamides Trimethoprim Flouroquinolones (-floxacin, ex: Cipro) Metronidazole Polymyxins B and E Isoniazid (INH) Rifampin Amphotericin B Nystatin Azoles Griseofulvin Amantadine Zanamivir Ribavirin Acyclovir Ganciclovir Foscarnet Protease Inhibitors (-navir) AZT (zidovudine) & d4T (stavudine) Didanosine, zalcitabine, lamivudine Nevirapine, delavirdine, efavirenz Interferons Ivermectin

Sheet II
Mebendazole/thiabendazole Praziquantel Pentavalent antimony Primaquine Pentamidine Nifurtimox Suramin Bethanechol Carbachol, pilocarpine Neostigmine, Pyridostigmine Edrophonium Physostigmine, echothiophate Atropine Hexamethonium Pralidoxime Scopolamine Ipratropium Succinylcholine Tubocurarine, pancuronium, etc. Dantrolene Epinephrine Norepinephrine Isoproterenol Dopamine Dobutamine Amphetamine Ephedrine Phenylephrine Albuterol, terbutaline Cocaine Clonidine, a-methyl dopa Phenoxybenzamine, phentolamine Prazosin (-zosins) Yohimbe Propanolol, timolol, nadolol, etc. Metoprolol, atenolol, esmolol

Sheet III
Pheno-/pento-/seco-barbital; thiopental Dia-/lora-/tema-/oxa- zepam; tria-/mida- zolam Haloperidol, thioridazine, fluphenazine, chlorpromazine Clozapine, olanzapine, risperidone Lithium Imi-/desi-/clomi-pramine; ami-/nor-triptyline; doxepin Fluoxetine, paroxetine, sertraline, citalopram Trazodone Buproprion Venlafaxine Mirtazapine Phenelzine, tranylcypromine Selegiline L-dopa Morphine/fentanyl/codeine/heroin/meperidine Sumatriptan Ondansetron Phenytoin Valproate Ethosuximide Lamotrigine Carbamazepine Halothane; en-/iso-/sevo-/methoxy-flurane, NO Bromocriptine Benztropine Ketamine Pro-/co-/tetra-/lido-/bupivi- caine Hydralazine Nifedipine / verapamil / diltiazem Capto-/elana-/lisino- pril Acetazolamide Losartan Furosemide Ethacrinic acid Hydrochlorothiazide Spironolactone Triamterine, amiloride Mannitol Nitroglycerin Digoxin, digitoxin

Sheet IV
Quinidine, Amiodarone, Procainamide, Disopyramide Lidocaine, mexiletine, tocainide Propafenone, flecainide, ecainide Propa-/es-/meto-/ti- molol; atenolol Sotalol, amiodarone, bretylium Adenosine Cholestyramine, cholestipol Lova-/prava-/simva-/atorva- statin Niacin Gemfibrozil, clofibrate Methotrexate 5-Flourouracil 6-Mercaptopurine Busulfan Cyclophosphamide Car-/lo-/se- mustine; streptozocin Cisplatin Doxorubicin (Adriamycin) Bleomycin Etoposide Prednisone Tamoxifen/raloxifene Vincristine / Vinblastine Paclitaxel Dactinomycin Levamisole Sildenafil Clomiphene Mifepristone (RU486) Cime-/rani-/famo-/niza-tidine Omeprazole, lansoprazole Sucralfate Misoprostol Heparin Warfarin Streptokinase, urokinase, tPA, APSAC Clopidogrel, ticlopidine Indomethacin Celecoxib, rofecoxib Acetaminophen

Sheet V
Hydrocorti-/predni-/dexametha-sone Salmeterol Theophylline Ipratropium Cromolyn Beclomethasone, prednisone Zileuton, Zafirlukast Colchicine, indomethacin Prebenecid Allopurinol Tolbutamide, chlorpropamide, glyburide, glipizide Metformin Pioglitazone, rosiglitazone Acarbose, miglitol Leuprolide Propylthiouracil Finasteride Flutamide Cyclosporine Azathioprine Tacrolimus (FK506)

Pharm I
Drug
100%

Class

75%

Mechanism
50%

Use
25%

0%

Toxicity

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sx total count: 0 sx reviewed count: 6 quiz by: date made:

% reviewed: marks in range: PJG 5/1/2003

Item No

Sx Ct Seen

Marked

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28

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4th generation cephalosporins

bactericidal antibiotic

Similar to penicillins, but less susceptible to penicillinases.

Pseudomonas, gram positives

Hypersens. rexns.

28:53 08:18

ues except for the name of the quiz maker and date the quiz was made. 38 1 38 0 38 8

21% 0

Drug Penicillin G (IV), V (oral)

Methicillin, nafcillin, dicloxacillin

Ampicillin, amoxicillin

Carbenicillin, pipericillin, ticarcillin

1st-gen cephalosporins (cephalothin, cephalexin)

2nd-gen cephalosporins (cefuroxime, cefaclor)

3rd-gen cephalosporins (cefotaxime)

4th generation cephalosporins

Aztreonam

Imipenem

Vancomycin

Aminoglycosides (ex: gentamycin, streptomycin)

Tetracyclines

Macrolides (-thromycins)

Chloramphenicol

Clindamycin

Sulfonamides

Trimethoprim

Flouroquinolones (-floxacin, ex: Cipro)

Metronidazole

Polymyxins B and E

Isoniazid (INH)

Rifampin

Amphotericin B

Nystatin

Azoles

Griseofulvin

Amantadine

Zanamivir

Ribavirin

Acyclovir

Ganciclovir

Foscarnet

Protease Inhibitors (-navir)

AZT (zidovudine) & d4T (stavudine)

Didanosine, zalcitabine, lamivudine

Nevirapine, delavirdine, efavirenz

Interferons

elapsed time previous total time date last reviewed

Quiz start time 57:26 Quiz current time 26:19

Elapsed time 28:53

Class

bactericidal antibiotic

bactericidal antibiotic

bactericidal antibiotic

bactericidal antibiotic

bactericidal antibiotic

bactericidal antibiotic

bactericidal antibiotic

bactericidal antibiotic

antibiotic

bactericidal antibiotic

bactericidal antibiotic

bactericidal antibiotic

bacteriostatic antibiotics

bacteriostatic antibiotics

bacteriostatic antibiotics

bacteriostatic antibiotics

bacteriostatic antibiotics

bacteriostatic antibiotics

bactericidal antibiotic

bactericidal antibiotic

antibiotic

antitubercular

antitubercular

antifungal

antifungal

antifungal

antifungal

antiviral

antiviral

antiviral

antiviral

antiviral

antiviral

antiretrovirals

NRTI antiretrovirals

NRTI antiretrovirals

NNRTI antiretrovirals

cytokine

detail 1 detail 2 detail 3 detail 4 detail 5 detail 6

Mechanism
1. Binds penicillin-binding proteins 2. Blocks transpeptidase cross-linking of cell wall 3. Activates autolytic enzymes

1. Binds penicillin-binding proteins 2. Blocks transpeptidase cross-linking of cell wall 3. Activates autolytic enzymes

1. Binds penicillin-binding proteins 2. Blocks transpeptidase cross-linking of cell wall 3. Activates autolytic enzymes

1. Binds penicillin-binding proteins 2. Blocks transpeptidase cross-linking of cell wall 3. Activates autolytic enzymes

Similar to penicillins, but less susceptible to penicillinases.

Similar to penicillins, but less susceptible to penicillinases.

Similar to penicillins, but less susceptible to penicillinases.

Similar to penicillins, but less susceptible to penicillinases.

Monobactam w/ similar mech to penicillins. b-lactamase resistant. Synergistic w/ aminoglycosides.

b-lactamase-resistant carbapenam. Always administered with cilastatin to decrease renal inactivation.

Inhibits cell wall mucopeptide formation.

Inhibit formation of initiation complex & cause misreading of mRNA. Require O2 for uptake.

Bind 30S and prevent amino-acyl tRNA attachment. Doxycycline fecally eliminated; can be used w/ renal pts.

Block translocation by binding to 50S.

Inhibits 50S peptidyl transferase.

Blocks peptide bond formation @ 50S.

PABA antimetabolites inhibit dihydropteroate synthase, in pathway to T, A, and G.

Inhibits bacterial dihydrofolate reductase.

Inhibit DNA gyrase (topoisomerase II).

Forms toxic metabolites in the bacterial cell.

Act like detergents, bind bacterial membranes & disrupt osmotic properties.

Decreases synthesis of mycolic acids

Inhibits DNA-dependent RNA polymerase.

Bind ergosterol, forms membrane pores that disrupt homeostasis

Bind ergosterol, forms membrane pores that disrupt homeostasis

Inhibit ergosterol synth.

Interferes w/ microtubule fxn; disrupting mitosis. Deposits in keratincontaining tissues (nails).

Blocks viral penetration/uncoating by inhibiting M2 protein. Incidentally, increases dopamine release fr. nerves.

Inhibits neuraminidase, preventing sialic acid cleavage fr. host membrane, and thus, budding of new virions.

Inhibits synth of guanine nucleotides by competitively inhibiting IMP dehydrogenase.

Preferentiall inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase.

Phosphorylated by viral kinase, preferentially inhibits CMV DNA polyerase.

Inorganic pyrophosphate analog, inhibits viral DNA polymerase. Does not require activation.

Inhibits assembly of new virus by blocking maturation enzyme.

Inhibit reverse transcriptase in active cells

Inhibit reverse transcriptase in active and latent cells.

Allosterically inhibit reverse transcriptase, prevent viral DNA integration into host DNA.

Human glycoproteins that block various stages of viral RNA and DNA synthesis.

View Status TRUE TRUE TRUE TRUE TRUE TRUE

Use

GPC, GPR, GNC, spirochetes.

S. aureus. Penicillinase resistant.

HELPS: H.influenzae, E.coli, L.monocytogenes, P.mirabilis, Salmonella Not penicillinase resistant; use w/ clavulanic acid. AmOxicillin has better Oral availability.

Pseudomonas. Not penicillinase resistant; use w/ clavulanic acid.

GPC PEcK: Proteus, E.coli, Klebsiella

HEN PEcKS: H.influenzae, Enterobacter aerogenes, Neisseria, Proteus, E.coli, Klebsiella, Serratia

Serious gram negative infections. Meningitis (penetrates BBB), pseudomonas, gonorrhea.

Pseudomonas, gram positives

GNR: Klebsiella, Pseudomonas, Serratia. No activity against grampositives or anaerobes.

GPC, GNR, anaerobes. DOC for Enterobacter.

Serious gram-positive MDR infex, like S. aureus & C. difficile.

Severe GNR infex. Synergistic w/ b-lactams.

VACUUM your BedRoom: V.cholerae, Acne, Chlamydia, Ureaplasma Urealyticum, M.pneumoniae, B.burgdorferi, Rickettsia, tularemia.

URI, pneumonia, STDs, GPC. Mycoplasma, Legionella, Chlamydia, Neisseria. Erythromycin is the DOC for Legionella.

Meningitis

Anaerobes above the diaphragm. Clindamycin "climbs" up to where there's no air (anaerobes).

GP, GN, Nocardia, Chlamydia, simple UTI.

In combo w/ sulfonamides for sequential blockade of folate synth. UTI, Shigella, Salmonella, PCP.

GNR of urinary & GI tracts (Pseudomonas), Neisseria, some gram positives. FLOWroquinolones: for when the GI or UT won't flow fr. all the GNRs.

Antiprotozoal. GET on the metro: Giardia, Entamoeba, Trichomonas, also Gardnerella vaginitis, anaerobes. Part of H.pylori triple therapy.

Resistant gram neg infex. Polymyxin B is administered topically, only.

M.tuberculosis, solo prophylaxis.

M.tuberculosis, leprosy.

Systemic mycoses: Crypto, Blasto, Coccidio, Asper, Histo, Candida, Mucor Crosses neither intestinal wall nor BBB-- insert it where you want it.

Oral candidiasis, only.

Systemic mycoses. Fluco- for crypto. meningitis in AIDS pts, all types of candidal infex. Ketoco- for Blasto, Coccidio, Histo, Candida

Oral tx of superficial infex, esp. dermatophytes.

Influenza A, Parkinson's dz.

Influenza A & B

RSV

HSV, VZV, EBV tx and prophylaxis.

CMV

CMV retinitis

AIDS

AIDS. AZT used also for maternal-fetal prophylaxis.

AIDS

AIDS

Chronic hepatitis B & C, Kaposi's sarcoma.

1 1 1 1 1 1 6

Toxicity

Hypersensitivity rexns, hemolytic anemia

Hypersensitivity rexns. Methicillin: interstitial nephritis

Hypersensitivity rexns. Ampicillin: rash, pseudomembranous colitis

Hypersens. rexns.

Hypersens. rexns.

Hypersens. rexns.

Hypersens. rexns.

Hypersens. rexns.

Non-toxic. No cross-reactivity w/ penicillins.

GI distress, skin rash, seizures

TORN: Thrombophlebitis, Ototoxicity, Red man syndrome, Nephrotoxic

amiNOglycosides: nephrotoxicity (w/ cephalosporins), ototoxicity (w/ loop diuretics). Streptomycin causes vertigo in 75% of pts!

GI distress, discolors teeth, inhibits bone growth, Fanconi's syndrome, photosensitivity.

GI, acute cholestatic hepatitis, eosinophilia, rash.

Anemia, aplastic anemia, grey baby syndrome in premies lacking UDPglucuronyl transferase

Pseudomembranous colitis, fever, diarrhea

Hypersens. rexns. Hemolysis if G6PD deficient. Tubulointerstitial nephritis, kernicterus in infants. Displace other drugs (warfarin) fr. albumin.

Megaloblastic anemia, leukopenia, granulocytopenia.

GI, superinfex, rash, headache, dizziness, damage cartilage/tendons in adults and fetuses.

Disulfiram-like rexn w/ alcohol. Headache.

Neurotoxicity, acute renal tubular necrosis.

INH Injures Neurons & Hepatocytes. G6PD hemolysis, SLE-like syndrome. Pyridoxine can prevent neurotoxicity.

Minor hepatotoxicity. Ramps up P450. Red body fluids.

Fever & chills, hypotension, nephrotoxicity, arrhythmias

Ketoconazole: antiandrogenic, inhibits P450.

Teratogenic, carcinogenic, confusion, headaches, incr. metab by P450 (esp. of Warfarin)

Ataxia, dizziness, slurred speech. Rimantadine has fewer side fx.

Hemolytic anemia

Delirium, tremor, nephrotoxicity.

Leukopenia, thrombocytopenia, renal toxicity. More toxic than acyclovir.

Nephrotoxic

Hyperglycemia, lipodistrophy, GI, thrombocytopenia (indinavir).

Bone marrow suppression, peripheral neuropathy, lactic acidosis. AZT: megaloblastic anemia

Bone marrow suppression, peripheral neuropathy, lactic acidosis.

Bone marrow suppression, peripheral neuropathy, rash.

Neutropenia.

Inactivated Diagnosis

Activated Diagnosis

Unactivated Symptom

Activated Symptom

Pharm II
Drug
100%

Class

75%

Mechanism
50%

Use
25%

0%

Toxicity

Topic Order Sequential Random Items to Quiz All items in range Marked items in range Info topic count: range start: range stop: 37 current #: 1 complete: 3% marked: 0

1 37

all/marked: 1 dx order: 1

Change none of these values except for the name of the quiz maker and date the quiz was m total dx:
range start: range stop:

current dx: 1 current sx: 1

marked: set dx: reviewed:

sx total count: 0 sx reviewed count: 0 quiz by: date made:

% reviewed: marks in range: PJG 5/1/2003

Item No

Sx Ct Seen

Marked

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37

00:00 31:59

ues except for the name of the quiz maker and date the quiz was made. 37 1 37 0 37 1

3% 0

Drug Ivermectin

Mebendazole/thiabendazole

Praziquantel

Pentavalent antimony

Primaquine

Pentamidine

Nifurtimox

Suramin

Bethanechol

Carbachol, pilocarpine

Neostigmine, Pyridostigmine

Edrophonium

Physostigmine, echothiophate

Atropine

Hexamethonium

Pralidoxime

Scopolamine

Ipratropium

Succinylcholine

Tubocurarine, pancuronium, etc.

Dantrolene

Epinephrine

Norepinephrine

Isoproterenol

Dopamine

Dobutamine

Amphetamine

Ephedrine

Phenylephrine

Albuterol, terbutaline

Cocaine

Clonidine, a-methyl dopa

Phenoxybenzamine, phentolamine

Prazosin (-zosins)

Yohimbe

Propanolol, timolol, nadolol, etc.

Metoprolol, atenolol, esmolol

elapsed time previous total time date last reviewed

Quiz start time 57:31 Quiz current time 57:31

Elapsed time 00:00

Class

antiparasitic

antiparasitic

antiparasitic

antiparasitic

antiparasitic

antiparasitic

antiparasitic

antiparasitic

cholinomimetic

cholinomimetic

anticholinesterase

anticholinesterase

anticholinesterase

anticholinergic

anticholinergic

anticholinergic

anticholinergic

anticholinergic

neuromuscular blocker

neuromuscular blocker

sympathomimetic

sympathomimetic

sympathomimetic

sympathomimetic

sympathomimetic

sympathomimetic

sympathomimetic

sympathomimetic

sympathomimetic

sympathomimetic

sympathomimetic

sympatholytic

sympatholytic

sympatholytic

sympatholytic

sympatholytic

detail 1 detail 2 detail 3 detail 4 detail 5 detail 6

Mechanism

Direct ACh agonist. Activates bowel & bladder smooth m.

Direct ACh agonist. Activates ciliary mm of eye (open angle), pupillary sphincter (narrow angle)

Increases endogenous ACh by preventing breakdown in cleft.

Increases endogenous ACh by preventing breakdown in cleft.

Increases endogenous ACh by preventing breakdown in cleft.

antimuscarinic

antinicotinic ggl. blocker

regenerates active cholinesterase

antimuscarinic

antimuscarinic

depolarizing

nondepolarizing

prevents release of Ca++ fr. sarcoplasmic reticulum of skeletal mm.

direct a1, a2, b1, b2 agonist

a1, a2, b1 agonist

b1 = b2 iso means "same", as in same b1 as b2.

D1 = D2 > b > a

b1 > b2 Think "dobutamONE"

Indirect general agonist; releases stored catecholamines.

Indirect general agonist; releases stored catecholamines.

a1 > a2

b2 > b1

indirect general agonist; uptake inhibitor

Centrally-acting a agonist; decreases central adrenergic outflow

non-selective a blockers

selective a1 blockers

selective a2 blocker

non-selective b blockers

selective b1 blockers

View Status TRUE TRUE TRUE TRUE FALSE FALSE

Use

Onchocerciasis (rIVER blindness)

Nematodes

Schistosomiasis, flukes, cysticercosis (taenia solium)

Leishmaniasis

Latent hypnozoite forms of P.vivax, P.ovale

PcPp prophylaxis

Chagas' disease (T. cruzi)

African trypanosomiasis

Postoperative & neurogenic ileus & urinary retention.

Glaucoma

Neo: Postoperative & neurogenic ileus & urinary retention,reversal of NMJ blockade (postoperative). Both: Myasthenia gravis.

Diagnosis of myasthenia gravis. Extremely short-acting.

Both: Glaucoma. Physo: Crosses BBB -->CNS. Useful in atropine overdose.

dilate pupil, reduce acid secretion, reduce urgency in cystitis, decrease GI motility, block SLUDE.

organophosphate exposure treatment

motion sickness

asthma, COPD - reduces airway secretions

surgery

surgery

Tx of malignant hyperthermia fr. use of halothane w/ succinylcholine. Also, neuroleptic malignant syndrome (antipsychotic drugs).

Anaphylaxis, glaucoma (open angle), asthma, hypotension

Hypotension (but decreases renal perfusion)

AV block

Shock - increases renal perfusion; heart failure.

Shock, heart failure

Narcolepsy, obesity, ADD

Nasal congestion, urinary incontinence, hypotension

Pupil dilator, vasoconstrix, nasal decongestion

Asthma

Vasoconstrix & local anesthesia

HTN, esp. w/ renal dz, b/c does not decrease renal blood flow.

Pheochromocytoma

HTN, urinary retention in BPH

impotence (controversial)

HTN, angina, MI, SVT, CHF, glaucoma (timolol)

HTN, angina, MI, SVT, CHF

1 1 1 1 0 0 4

Toxicity

SLUDE

SLUDE

Red as a beet, blind as a bat, mad as a hatter, dry as a bone, hot as hell

Phase I: no antidote, potentiated by anticholinesterases Phase II: antidote: anticholinesterases

Reversal: neostigmine, edrophonium, other anticholinesterases

Orthostatic hypotension, reflex tachycardia

First-dose orthostatic hypotension, dizziness, headache

Impotence, asthma, sedation

Impotence, sedation

Inactivated Diagnosis

Activated Diagnosis

Unactivated Symptom

Activated Symptom

Pharm III
Drug
100%

Class

75%

Mechanism
50%

Use
25%

0%

Toxicity

Topic Order Sequential Random Items to Quiz All items in range Marked items in range Info topic count: range start: range stop: 40 current #: 1 complete: 2% marked: 0

1 40

all/marked: 1 dx order: 1

Change none of these values except for the name of the quiz maker and date the quiz was m total dx:
range start: range stop:

current dx: 1 current sx: 1

marked: set dx: reviewed:

sx total count: 0 sx reviewed count: 0 quiz by: date made:

% reviewed: marks in range: PJG 5/1/2003

Item No

Sx Ct Seen

Marked

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40

00:00 27:59

ues except for the name of the quiz maker and date the quiz was made. 40 1 40 0 40 1

3% 0

Drug Pheno-/pento-/seco-barbital; thiopental

Dia-/lora-/tema-/oxa- zepam; tria-/mida- zolam

Haloperidol, thioridazine, fluphenazine, chlorpromazine

Clozapine, olanzapine, risperidone

Lithium

Imi-/desi-/clomi-pramine; ami-/nor-triptyline; doxepin

Fluoxetine, paroxetine, sertraline, citalopram

Trazodone

Buproprion

Venlafaxine

Mirtazapine

Phenelzine, tranylcypromine

Selegiline

L-dopa

Morphine/fentanyl/codeine/heroin/meperidine

Sumatriptan

Ondansetron

Phenytoin

Valproate

Ethosuximide

Lamotrigine

Carbamazepine

Halothane; en-/iso-/sevo-/methoxy-flurane, NO

Bromocriptine

Benztropine

Ketamine

Pro-/co-/tetra-/lido-/bupivi- caine

Hydralazine

Nifedipine / verapamil / diltiazem

Capto-/elana-/lisino- pril

Acetazolamide

Losartan

Furosemide

Ethacrinic acid

Hydrochlorothiazide

Spironolactone

Triamterine, amiloride

Mannitol

Nitroglycerin

Digoxin, digitoxin

elapsed time previous total time date last reviewed

Quiz start time 57:34 Quiz current time 57:34

Elapsed time 00:00

Class

barbituates

benzos

antipsychotics (neuroleptics)

atypical antipsychotics

mood stabilizer

tricyclic antidepressants

SSRIs

heterocyclic antidepressant

heterocyclic antidepressant

heterocyclic antidepressant

heterocyclic antidepressant

MAOI

MAOI

NT precursor

opioid analgesics

antiepileptic

antiepileptic

antiepileptic

antiepileptic

antiepileptic

inhalational anesthetics

antimuscarinic

arylcyclohexylamine

local anesthetics

antihypertensive

Ca++ channel blockers

ACE inhibitors

CA inhibitor

ARB

Sulfonamide loop diuretic

non-sulfonamide loop diuretic

thiazide diuretic

K+-sparing diuretic

K+-sparing diuretic

osmotic diuretic

vasodilator

cardiac glycosides

detail 1 detail 2 detail 3 detail 4 detail 5 detail 6

Mechanism
Increase duration of Cl- channel opening on GABAA neurons, decreasing neuron firing.

Increase frequency of Cl- channel opening on GABAA neurons, decreasing neuron firing.

Block dopamine D2 receptors

Block 5HT2 and dopamine receptors

Inhibits phosphoinositol cascade?

Block reuptake of norepinephrine & serotonin

Serotonin-specific reuptake inhibitors

Inhibits serotonin reuptake.

mech unknown.

Inhibits serotonin & dopamine reuptake

a2-antagonist (incr. release of norepinephrine & 5HT), 5HT2 receptor antagonist

Non-selective MAO inhibition.

Selectively inhibits MAO-B, increasing dopamine

Crosses BBB, gets converted to dopamine. Use with carbidopa to prevent peripheral metabolism by dopa-decarboxylase.

Agonists at opioid receptors, modulate synaptic transmissions mu: morphine (analgesia, euphoria, resp. depr., miosis, GI decr.) delta: enkephalin kappa: dynorphin (analgesia, disphoria) 5HT1D agonist -> vasoconstrix of cerebral & meningeal aa., inhibit release of neuropeptides & neurotransmitters.

5HT3 antagonist

Use-dependent blockade of Na+ channels

Inhibits metabolism of GABA

Low solubility = quick induction & recovery

Mimics action of dopamine, but not as quickly broken down.

Antagonizes muscarinic receptors in basal ggl.

PCP analog

Block Na+ channels by binding to specific receptors on inner portion of channel. Epinephrine increases duration of effect by constricting local vasculature.

Vasodilation by incr. cGMP --> smooth mm. relaxation. Dilates arterioles > veins, lowering afterload.

Block voltage-dependent L-type Ca++ channels of cardiac & smooth m., reducing contractility. Nifedipine: vasculature Verapamil, diltiazem: heart AV node, decr. veloc., incr. ERP, PR.

Inhibit ACE (duh), decr. Ang II & prevent inactivation of bradykinin (vasodilator). Compensatory incr. in renin fr. loss of feedback cntrl.

Inhibits CA, causing self-limited NaHCO3 diuresis & decr. total-body HCO3- stores. Acts at proximal convoluted tubule.

Antagonizes Ang II receptors.

Inhibits cotransport system (Na+, K+, 2Cl-) of thick ascending limb of loop. Abolishes hypertonicity of medulla, preventing concentration of urine. Increases Ca++ excretion.

Inhibits cotransport system (Na+, K+, 2Cl-) of thick ascending limb of loop. Abolishes hypertonicity of medulla, preventing concentration of urine. Increases Ca++ excretion.

Inhibits NaCl reabsorbtion in early distal tubule, reducing diluting capacity of the nephron. Decreases Ca++ excretion.

Competitive aldosterone receptor antagonist in cortical collecting tubule.

Block Na+ channels in the cortical collecting tubule

Incr. tubular fluid osmolarity--> incr. urine flow

Release NO in smooth mm --> incr. cGMP --> relaxation. Veins >>arteries.

Inhibit Na+/K+/ATPase --> incr. intracellular Na+ --> decr. Na+/Ca++ antiport --> incr. intracellular Ca++

View Status TRUE TRUE TRUE TRUE FALSE FALSE

Use
Axiolytic, seizures, insomnia, induction of anesthesia (thiopental). Anesthetic effect terminated by redistribution fr. CNS.

Anxiolysis, spasticity, detox. Diazepam: status epilepticus Midazolam: IV anesthetic, esp. endoscopy. Amnestic.

Schizophrenia, psychosis positive symptoms. Haloperidol used for PCP overdose. Chorpromazine also used in tx of nausea & vomitting.

Schizophrenia, both positive and negative symptoms. Olanzapine: also OCD, anxiety, depression

Bipolar affective disorder, blocks relapse & manic events.

Endogenous depression Imipramine: bedwetting Clomipramine: OCD Endogenous depression 2-3 weeks to onset of effect, like most antidepressants.

Major depression.

Smoking cessation, depression

Major depression, generalized anxiety disorder

Major depression

Atypical depression (i.e. w/ psychotic or phobic features), anxiety, hypochondria

Parkinsons

Parkinsons

General: pain, acute pulmonary edema Dextrometh: cough Loperamide & diphenoxylate: diarrhea Fentanyl: parenteral only!

Acute migrane, cluster headache

Powerful central-acting antiemetic. Postoperative & for pts. on chemotherapy for cancer.

All seizures except absence seizures. Also a Class IB antiarrhythmic

Absence, tonic-clonic seizures

Absence seizures

Partial seizures, tonic-clonic seizures

Partial seizures, tonic-clonic seizures, trigeminal neuralgia

Parkinsonism unresponsive to L-dopa.

Parkinsonism

IV anesthetic. Cardiovascular stimulant, so used in anesthesia of people w/ weak hearts

Minor surgery, spinal anesthesia

Severe HTN, CHF

HTN, angina, arrhythmia (SVT).

HTN, CHF, diabetic renal dz.

Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness.

HTN, CHF, diabetic renal dz.

Edematous states (CHF, cirrhosis, nephrotic synd, pulmonary edema), HTN, hypercalcemia.

Diuresis in pts. allergic to sulfa.

HTN, CHF, Ca++ stones, nephrogenic diabetes insipidus.

Hyperaldosteronism, K+ depletion, CHF

Hyperaldosteronism, K+ depletion, CHF

ARF, shock, drug OD, elevated ICFor intraocular pressure.

Angina, pulmonary edema

CHF, atrial fibrillation. Digitoxin: Longer name, Longer action, Liver metabolization.

1 1 1 1 0 0 4

Toxicity
Dependence, additive CNS depressive fx w/ alcohol, deadly respiratory & cardio depression. Contraindicated in porphyria. Induce P450! Dependence, additive CNS depressive fx w/ alcohol. Due to specificity of action, little/no risk of deadly respiratory depression. Tx overdose w/ flumazenil, competitive GABA antagonist. EPS: dystonia, akinesia, akathisia (restlessness), tardive diskinesia (facial movements) Neuroleptic Malignant Synd: rigidity, hyperpyrexia, autonomic fx Much less EPS & NMS than regular antipsychotics. Clozapine can cause agranulocytosis. Tremor, hypothyroidism, polyuria (ADH antagonist- remember the swimming baby on Nirvana album?), teratogenic, weight gain. Watch for OD if given w/ NSAIDs, which incr. renal reabsorb. Narrow therapeutic window! Sedation, a-blocking, tachycardia, urinary retention. Mania in bipolar depressives. ANTIMUSCARINIC Tri-Cs: Convusions, Coma, Cardiotoxicity. Also resp.depress., hyperpyrexia, confusion. Much safer than TCAs. CNS stimulation, nausea & vomitting. Serotonine synd w/ MAOIs: hyperthermia, rigidity, CV collapse.

Sedation, nausea, postural hypotension, priapism (think TrazoBONE)

CNS stim, dry mouth, aggravation of psychosis.

CNS stim

Sedation, incr. serum cholesterol, increased appetite

HTN crisis w/ tyramine ingestion & meperidine (an opioid); CNS stim. Contraindicated w/ SSRIs or beta-agonists!

Enhances adverse effects of L-dopa.

Arhythmias if given w/o carbidopa fr. peripheral dopamine conversion. Dyskinesias. Addiction, resp. depression, miosis, constipation. No tolerance develops to miosis & constipation. Tx OD w/ naloxone or naltrexone, opioid receptor antagonists. Chest discomfort, mild tingling. Contraindicated w/ CAD or Prinzmetal's.

Headache, diarrhea.

Gingival hyperplasia, hirsutism, nystagmus, ataxia, lethargy. Rarely, cause malignant hyperthermia. Teratogenic.

GI. Rare but fatal hepatotoxicity. Spina bifida.

GI, lethargy, headache. Stevens-Johnson syndrome!

Stevens-Johnson syndrome!

Liver toxicity, induces P450, blood dyscrasias.

Cardio/resp. depress., nausea/emesis, incr. cerebral blood flow. Halothane: hepatotoxic, malignant hyperthermia Methoxyflurane: nephrotoxic Enflurane: proconvusant.

Disorientation, hallucination, increased cerebral blood flow

Amides metab'd in liver --> toxic if in liver failure Esters metab'd in blood Bupivicaine: severe cardiovasc. toxicity Compensatory tachycardia, fluid retention. Lupus-like syndrome!

Cardiac depression, peripheral edema, flushing, dizziness, constipation.

CAPTOPRIL: Cough, Angioedema, Proteinuria, Taste, hypOtension, Pregnancy probs, Rash, Increased renin, Lower angiotensin II. Oh, and hyperkalemia.

Hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy.

No cough; it ain't an ACE-I.

OH DANG! Ototoxicity, Hypokalemia, Dehydration, Allergy to sulfa, Nephritis, Gout (hyperuricemia). "Loops lose calcium."

OH DN! (No A or G)

HyperGLUC: hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia. Sulfa allergy.

Hyperkalemia, acidosis, antiandrogen effects (used for hirsutism tx)

Hyperkalemia, acidosis

Pulmonary edema, dehydration. Contraindicated in anuria, CHF!

Tachycardia, hypotension, headache, dizziness

NVD, blurry yellow vision, arrhythmia. Toxicity incr. by hypokalemia, renal failure, quinidine (displaces fr. binding sites). Tx: digibind, normalize K+, lidocaine.

Inactivated Diagnosis

Activated Diagnosis

Unactivated Symptom

Activated Symptom

Pharm IV
Drug
100%

Class

75%

Mechanism
50%

Use
25%

0%

Toxicity

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20

21

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30

31

32

33

34

35

36

37

38

39

40

00:00 28:01

ues except for the name of the quiz maker and date the quiz was made. 40 1 40 0 40 1

3% 0

Drug Quinidine, Amiodarone, Procainamide, Disopyramide

Lidocaine, mexiletine, tocainide

Propafenone, flecainide, ecainide

Propa-/es-/meto-/ti- molol; atenolol

Sotalol, amiodarone, bretylium

Adenosine

Cholestyramine, cholestipol

Lova-/prava-/simva-/atorva- statin

Niacin

Gemfibrozil, clofibrate

Methotrexate

5-Flourouracil

6-Mercaptopurine

Busulfan

Cyclophosphamide

Car-/lo-/se- mustine; streptozocin

Cisplatin

Doxorubicin (Adriamycin)

Bleomycin

Etoposide

Prednisone

Tamoxifen/raloxifene

Vincristine / Vinblastine

Paclitaxel

Dactinomycin

Levamisole

Sildenafil

Clomiphene

Mifepristone (RU486)

Cime-/rani-/famo-/niza-tidine

Omeprazole, lansoprazole

Sucralfate

Misoprostol

Heparin

Warfarin

Streptokinase, urokinase, tPA, APSAC

Clopidogrel, ticlopidine

Indomethacin

Celecoxib, rofecoxib

Acetaminophen

elapsed time previous total time date last reviewed

Quiz start time 57:36 Quiz current time 57:36

Elapsed time 00:00

Class

Class IA antiarrhythmics

Class IB antiarrhythmics

Class IC antiarrhythmics

Class II antiarrhythmics

Class III antiarrhythmics

bile acid resins

HMG-CoA reductase inhibitors

vitamin

lipoprotein lipase stimulators

cancer chemo

cancer chemo

cancer chemo

cancer chemo

cancer chemo

nitrosourea cancer chemo

cancer chemo

cancer chemo

cancer chemo

cancer chemo

cancer chemo, immunosuppression

cancer chemo

cancer chemo

cancer chemo

antibiotic cancer chemo

antihelminthic cancer chemo drug

H2 blockers

anticoagulant

anticoagulant

thrombolytics

anticoagulant

NSAID

NSAID

detail 1 detail 2 detail 3 detail 4 detail 5 detail 6

Mechanism
State-dependent Na+ channel block. Decrease slope of phase 4, incr. firing threshold in pacemaker cells. Increase AP duration.

State-dependent Na+ channel block. Decrease slope of phase 4, incr. firing threshold in pacemaker cells. Decrease AP duration.

State-dependent Na+ channel block. Decrease slope of phase 4, incr. firing threshold in pacemaker cells. No effect on AP duration.

Beta-blockers, lower cAMP and Ca++ currents. AV node particularily sensitive. Increase PR.

K+ blockers. Incr. AP duration, ERP, QT.

Bind bile acids in intestine. Lower LDL, slightly incr. TG.

Inhibit cholesterol synth in hepatocytes. Lower LDL, incr. HDL, lower TG

Lowers LDL, incr. HDL, lowers TG.

Decr. LDL, incr. HDL, lower TG

S-phase specific antimetabolite. Folic acid analog the inhibits dihydrofolate reductase--> decr. dTMP-->decr. DNA & protein synth.

S-phase specific antimetabolite. Pyrimidine analog bioactivated to 5FdUMP-->covalently complexes folic acid-->inhibits thymidilate synthase ->decr. dTMP-->decr. DNA & protein synth.

"Caps" purine synthesis.

Alkylates DNA. Most active in G0 but not specific.

Bioactivated by liver. Alkylates DNA by covalent x-linking at guanine N-7.

Bioactivated, alkylate DNA.

Alkylating agent. X-links via hydrolysis of Cl- groups & rexn w/ platinum.

Noncovalently intercalates ("docks") in DNA, creating breaks.

Intercalates in DNA

G2-phase specific inhibitor of topoisomerase II

Triggers apoptosis, even in nondividing cells.

Estrogen receptor mixed agonist/antagonist, blocks binding of estrogen to ER+ cells.

M-phase specific alkaloid that binds tubulin, blocking formation of mitotic spindle.

M-phase specific sap that binds tubulin, preventing breakdown of mitotic spindle, preventing anaphase.

S-phase specific.

Enhances monocyte chemotaxis & phagocytosis.

Inhibits cGMP phosphodiesterase --> incr. cGMP, smooth m. relaxation in corpus cavernosum, incr. blood flow

Partial agonist @ estrogen receptors in pituitary gland. Prevents feedback inhibition on LH & FSH, stimulating ovulation.

Competitive inhibitor of progestins @ progesterone receptors

Reversible block of H2 histamine receptors

Irreversibly inhibits H+/K+ ATPase in stomach parietal cells

Polymerizes in acid environment, selectively binds necrotic ulcer tissue. Requires acidic environment!

PGE1 analog. Increases gastric mucous barrier

Catalyzes activation of antithrombin III

Interferes w/ synth of vit K-dependent factors II, VII, IX, X, C & S. WEPT: Warfarin affects the Extrinsic pathway & prolongs the PT.

Convert plasminogen to plasmin, cleaving thrombin & fibrin clots.

Inhibits platelet aggregation by irreversibly inhibiting ADP pathway of fibrinogen binding.

Reversibly inhibits COX-1 and 2, blocking prostaglandin synth.

Selective COX-2 inhibitors.

Reversibly inhibits cyclooxygenase, mostly in CNS. Inactivated peripherally.

View Status TRUE TRUE TRUE TRUE FALSE FALSE

Use

Atrial & ventricular arrhythmias.

Acute ventricular arrhythmia post MI. Digitalis-induced arrhythmia.

V-tach that progresses to VF; intractable SVT. Last resort drugs.

Suppress abnormal pacemakers

Last resorts.

DOC in diagnosing/abolishing AV nodal arrhythmia

Hyperlipidemia

Hyperlipidemia

Hyperlipidemia

Hyperlipidemia

Leukemia, lymphoma, choriocarcinoma, sarcoma. Also: abortion, ectopic preg., rheumatoid arthritis, psoriasis.

Colon cancer & other solid tumors, basal cell carcinoma (topical). Synergistic with MTX.

Leukemia, lymphomas (except CLL & Hodgkin's)

CML

Non-Hodgkin's, breast & ovarian carcinomas. Used as immunosuppressant.

Brain tumors. The mustines are mustangs, charging across the BBB.

Testicular, bladder, ovary, lung carcinoma.

Part of ABVD for Hodgkin's & myelomas, sarcomas, & solid tumors (breast, ovary, lung)

Testicular, lymphomas

Oat cell carcinoma of lung & prostate, testicular carcinoma.

CLL, Hodgkins (MOPP), immunosuppression in autoimmune dz.

Breast cancer.

Lymphoma (vincristine is the O in MOPP), Wilm's tumor, choriocarcinoma

Ovarian & breast carcinoma

Colon cancer, along with 5-FU.

Erectile dysfunction

Infertility

Abortifacient

Peptic ulcers, gastritis, GERD, Zollinger-Ellison

Peptic ulcers, gastritis, GERD, Zollinger-Ellison

Peptic ulcer

Prevents NSAID-induced peptic ulcer. Maintains PDA

Anticoag for PE, stroke, angina, MI, DVT.

Chronic anticoag.

Early MI

Acute coronary syndrome, coronary stenting. Decreases thrombotic stroke incidence.

Closing a PDA.

Rheumatoid & osteoarthritis, w/ fewer GI fx than other NSAIDs.

Antipyretic, analgesic, but no anti-inflammatory properties.

1 1 1 1 0 0 4

Toxicity
Quinidine: cinchonism, torsades de pointes due to incr. QT Procainamide: SLE-like syndrome

Local anesthetic. CNS stim/depression, cardiovascular depression.

Proarrhythmic.

Impotence, exacerbate asthma, bradycardia, AV block, CHF, CNS fx. May mask hypoglycemia.

Sotalol: torsades de points, beta-block fx. Amiodarone: pulmonary fibrosis, hepatotoxicity, hypothyroidism/hyperthyroidism.

GI discomfort

Reversible incr. LFT, myositis

Red flushed face, ameliorated w/ aspirin or continued use.

Myositis, incr. LFT.

Myelosuppression, reversible w/ leucovorin (folinic acid). Macrovesicular fatty change in liver.

Myelosuppression, NOT reversible w/ leucovorin. Photosens.

Bone marrow, GI, liver. Toxicity incr.'d by allopurinol.

Pulmonary fibrosis: you'll need a "fan" to inflate the fibrosed lungs.

Myelosuppression, hemorrhagic cystitis.

CNS toxicity (dizziness, ataxia)

Nephrotoxic, acoustic nerve damage.

Cardiotoxicity, myelosuppression, alopecia.

Pulmonary fibrosis: Need to blow air into the fibrosed lungs. Skin changes, myelosuppression.

Myelosuppression, GI irritation, alopecia.

Cushing-like symptoms, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis

Partial agonist fx--> incr. risk of endometrial cancer, hot flashes.

Vincristine: neurotoxic, paralytic ileus Vinblastine blasts bone marrow.

Myelosuppression & hypersens.

Flu-like sx, convulsions, metallic taste, altered sense of smell.

Headache, flushing, dyspepsia, blue-green color vision. Life-threatening hyptotension in pts. taking nitrates.

Hot flashes, ovarian enlargement, visual disturbances.

Heavy bleeding, GI fx

Cimetidine: inhibits P450, decreases renal excretion of creatinine, antiandrogenic.

Diarrhea, abortifacient

Follow the PTT. Safe in pregnant women. Bleeding, thrombocytopenia. Tx OD w/ protamine sulfate.

Bleeding, teratogenic. Not for pregnant women!

Bleeding

Neutropenia. Reserved for those who cannot tolerate aspirin.

Renal damage, aplastic anemia, GI fx.

Hepatic necrosis by glutathione depletion & toxic substance formation.

Inactivated Diagnosis

Activated Diagnosis

Unactivated Symptom

Activated Symptom

Pharm V
Drug
100%

Class

75%

Mechanism
50%

Use
25%

0%

Toxicity

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1 21

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range start: range stop:

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marked: set dx: reviewed:

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Item No

Sx Ct Seen

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21

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ues except for the name of the quiz maker and date the quiz was made. 21 1 21 0 21 1

5% 0

Drug Hydrocorti-/predni-/dexametha-sone

Salmeterol

Theophylline

Ipratropium

Cromolyn

Beclomethasone, prednisone

Zileuton, Zafirlukast

Colchicine, indomethacin

Prebenecid

Allopurinol

Tolbutamide, chlorpropamide, glyburide, glipizide

Metformin

Pioglitazone, rosiglitazone

Acarbose, miglitol

Leuprolide

Propylthiouracil

Finasteride

Flutamide

Cyclosporine

Azathioprine

Tacrolimus (FK506)

elapsed time previous total time date last reviewed

Quiz start time 57:39 Quiz current time 57:39

Elapsed time 00:00

Class

glucocorticoids

beta blocker

methylxanthine

corticosteroids

antileukotrienes

sulfonylureas

glitazones

alpha-glucosidase inhibitors

antiandrogen

antiandrogen

immunosuppressant

immunosuppressant

immunosuppressant

detail 1 detail 2 detail 3 detail 4 detail 5 detail 6

Mechanism

Inhibit phospholipase A2 & expression of COX-2 --> decr. LTs & PGs

relaxes bronchial smooth mm.

bronchodilation through phosphodiesterase inhibition (normally degrades cAMP)

Competitive block of muscarinic receptors, preventing bronchoconstrix.

Prevents mediator release fr. mast cells.

Prevent production of leukotrienes fr. arachadonic acid by blocking PLA2.

Zileuton: blocks LT synth by lipoxygenase Zafirlukast: blocks LT receptors

Depolymerizes leukocyte microtubules, impairing chemotaxis & degranulation.

Inhibits reabsorbtion of uric acid in the kidney

Inhibits xanthine oxidase --> decr. conversion of xanthine to uric acid

Close K+ channels in beta-cell membrane -->cell depolarizes --> Ca++ inflow -->insulin secreted

Inhibits gluconeogenesis, increase glycolysis, decreases serum glucose levels

Incr. target cell responsiveness to insulin.

Inhibit brush-border alpha glucosidase-->postprandial hyperglycemia.

GnRH analog w/ both agonist properties (pulsatile) and antagonist properties (continuous).

Inhibits organification & coupling of thyroid hormone synthesis. Also decreases peripheral conversion of T4 to T3.

5 alpha-reductase inhibitor, lowering conversion of testosterone to dihydrotestosterone

Nonsteroidal competitive inhibitor of androgens @ testosterone receptor.

Binds cyclophilins (peptidyl proline cis-trans isomerase), blocking differentiation & activation of T cells by inhibiting production of IL-2 and its receptor.

Antimetabolite derivative of 6-mercaptopurine. Interferes w/ metab. & synth. of nucleic acid. Toxic to proliferating lymphocytes after antigenic stimulus.

Binds FK-binding protein, inhibiting secretion of IL-2 & other cytokines, and thus, activation & prolif of T cells.

View Status TRUE TRUE TRUE TRUE FALSE FALSE

Use

Addison's, inflammation, immune suppression, asthma

Long-acting agent for asthma prophylaxis

Asthma

Asthma

Asthma, prophylaxis only. Not effective in acute attack.

DOC in status asthmaticus, in combo w/ albuterol

Asthma

Acute gout

Chronic gout

Chronic gout

T2DM

Hypoglycemia, w/ or w/o islet cell fxn.

T2DM

T2DM

Infertility (pulsatile) Prostate cancer (continuous) Uterine fibroids

Hyperthyroidism

BPH

Prostate cancer

Suppresses organ rejection. Autoimmune dz.

Kidney transplant, autoimmune dz (esp. glomerulonephritis & hemolytic anemia).

Organ transplant

1 1 1 1 0 0 4

Toxicity

Cushing's syndrome

tremor & arrhythmia

GI fx, esp. if given orally. Indomethacin is less toxic.

Hypoglycemia, disulfiram-like fx (not seen w/ glyburide/glipizide)

Lactic acidosis

Weight gain, hepatotoxic

GI disturbance

Antiandrogen, nausea, vomitting

Rash, agranulocytosis, aplastic anemia

Nephrotoxic, preventable w/ mannitol diuresis. Predisposes pts. to viral infex & lymphoma.

Nephrotoxic, peripheral neuropathy, HTN, pleural effusion, hyperglycemia.

Inactivated Diagnosis

Activated Diagnosis

Unactivated Symptom

Activated Symptom