counseling on the patents with insulin-induced weight gainReview for changes in diet
☆Ask about hypoglycemic symptoms(may cause patients to attempt to suppress feelings of hypoglycemia)
halothane
toxicity→ histology, labs(remains one of the most commonly used inhaled anesthetics worldwide)
hepatotoxicity (fulminant hepatitis with a 50% fatality rate)
→ causes the liver to rapidly atrophy and appears ☆shrunken on autopsy
(histologically, centrilobular necrosis is indistinguishable from acute viral hepatitis)
Characteristic of pyrazinamidePyrazinamide is an essential anti-tuberculous drug that is activated into pyrazinoic acid. This conversion is best achieved at an acidic pH, such as that found within host macrophage phagolysosomes.
colchicine
mechanism, adverse effectBinds and stabilizes tubulin to inhibit microtubule polymerization, disrupting ☆cytoskeletal dependent function such as ☆neutrophil chemotaxis, phagocytosis, and degranulation.
It also reduces the formation of leukotriene B4.
muromomabused to prevent organ transplant rejection
It binds to CD3 receptors on T cells to trigger apoptosis, reducing T-lymphocyte count and IL-2 activity.
There is no direct effect on B lymphocytes, but B lymphocyte activity decreased due to the reduced activation by T lymphocyte. immunologypharmacology HirotoShishido
patiromer
mechanism, clinical use, adverse effecta nonabsorbable cation exchange resin that binds colonic potassium in exchange for calcium, trapping potassium within the resin where it is then excreted in the feces.
often used for treatment of ★chronic hyperkalemia. (however, onset of action takes several hours, so it is not recommended as monotherapy in acute hyperkalemia)
GI disturbance, hypercalcemia, hypokalemia, hypomagnesemia
induce mast cell degranulation by activating of protein kinase A and PI3 kinase
Because red man syndrome(RMS) is not IgE mediated,it is not a true allergic reaction, so vancomycin infusion can be resumed at a slower rate once symptoms resolve. immunologypharmacologyUWorld HirotoShishido
why does acyclovir have only a minimal effect on EBV, CMVEBV and CMV do not produce thymidine kinase(TK) which ☆phosphorylate acyclovir into acyclovir monophosphate(rate limiting step in acyclovir activation) microbiologypharmacologyUWorld HirotoShishido
toxins which can be treated with bicarbonate☆salicylate, TCAs
Salicylate is lipophilic and readily passes into the tissues. Therefore, sodium bicarbonate helps treat salicylate toxicity in two ways.
①bicarbonate binds to free hydrogen ions, facilitating the conversion of lipophilic salicylic acid to lipophobic salicylate ion which are trapped within the bloodstream
②bicarbonate alkanizes the urine, increasing lipophobic salicylate which ☆reduces renal tubular reabsorption pharmacologyUWorld HirotoShishido
