Pharmacology and Toxicology

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Questions and Answers

What is the primary use of sodium bicarbonate in medical treatment?

To treat cinchonism

To treat hemolytic anemia

To treat metabolic acidosis and alkalinize the urine in salicylate poisoning (correct)

To treat morphine overdose

What is the primary side effect of mefloquine?

Neutropenia

Dizziness and vertigo (correct)

Cardiotoxicity

Hemolytic anemia

What is the primary use of amantadine?

To treat viral infections and Parkinson's disease (correct)

To treat metabolic acidosis

To treat cinchonism

To treat hemolytic anemia

What is the primary treatment for cardiotoxicity caused by quinidine poisoning?

Sodium bicarbonate Signup and view all the answers

What is the primary enzyme inhibited by trimethoprim?

Dihydrofolate reductase Signup and view all the answers

What is the primary use of dantrolene?

To treat neuroleptic malignant syndrome Signup and view all the answers

What is the primary treatment for methemoglobinemia?

Methylene blue Signup and view all the answers

What is the primary treatment for hypotension caused by chloroquine and aminoquinoline?

Epinephrine Signup and view all the answers

Which of the following is a commonly used treatment for hypoprothrombinemia?

Vitamin K Signup and view all the answers

What is the toxic metabolite of acetaminophen primarily formed in the liver?

N-acetyl-p-benzoquinone imine Signup and view all the answers

Which of the following is a TRUE statement regarding acetaminophen poisoning?

N-acetylcysteine is a precursor of cysteine, which is necessary for glutathione synthesis. Signup and view all the answers

What is the primary mechanism of action of N-acetylcysteine in treating acetaminophen overdose?

Promoting the detoxification of the toxic metabolite of acetaminophen. Signup and view all the answers

What is the clinical significance of elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in the blood?

They are markers of liver damage. Signup and view all the answers

What is the most effective treatment for chronic intoxication of salicylates?

Hemodialysis Signup and view all the answers

Which of the following is TRUE regarding the role of cytochrome P-450 enzymes in acetaminophen metabolism?

Chronic alcohol consumption induces the activity of CYP2E1, increasing the formation of the toxic metabolite of acetaminophen. Signup and view all the answers

Which of the following is an appropriate treatment for mild surgical procedures as an alternative to morphine?

Ketorolac Signup and view all the answers

What is a condition characterized by a decrease in blood pH due to an increase in acid production, a decrease in acid excretion, or a loss of bicarbonate?

Metabolic acidosis Signup and view all the answers

Which of the following is a neuropsychiatric syndrome resulting from liver dysfunction and the subsequent accumulation of neurotoxic substances in the bloodstream?

Hepatic encephalopathy Signup and view all the answers

Which of the following is a technique used to remove toxic substances from the bloodstream by passing blood through an adsorbent material?

Hemoperfusion Signup and view all the answers

Which of the following is a plasma protein produced in the liver in the presence of vitamin K and converted into thrombin by blood coagulation?

Prothrombin Signup and view all the answers

Which of the following statements about prothrombin time is true?

An increase in prothrombin time indicates impaired liver function, as the liver is responsible for producing clotting factors. Signup and view all the answers

What is a rare but serious condition that causes swelling in the liver and brain which affects children with viral infection that use aspirin?

Reye’s syndrome Signup and view all the answers

How much acetaminophen can cause severe hepatotoxicity with centrilobular necrosis?

15 g Signup and view all the answers

Which of the following statements about salicylate is true?

Acute ingestion of 150-200 mg/kg/day of salicylate will produce mild intoxication. Signup and view all the answers

What happens to a drug that is extensively distributed into body tissues?

Dialysis is less effective in clearing it from the body. Signup and view all the answers

What is the dose range that can lead to severe toxicity from isoniazid?

80-150 mg/kg Signup and view all the answers

Which condition is caused by the metabolism of dapsone?

Sulfhemoglobinemia Signup and view all the answers

Which drug is used to prevent or mitigate the risk of peripheral neuropathy associated with isoniazid?

Pyridoxine Signup and view all the answers

What is the lethal dose range for chloroquine in an adult?

3-4 g Signup and view all the answers

What is the function of glucose-6-phosphate dehydrogenase in the body?

Protects red blood cells from damage Signup and view all the answers

What is the role of leucovorin in treating toxic effects on rapidly dividing cells?

Restores normal folate levels Signup and view all the answers

Severe chloroquine overdose can result in which of the following conditions?

Hyperkalemia Signup and view all the answers

Study Notes

Analgesic Drugs

Metabolic Acidosis: Decrease in blood pH caused by increased acid production, decreased acid excretion, or loss of bicarbonate.
Respiratory Alkalosis: Elevated blood pH due to excessive loss of CO2 from the lungs.
Hepatic Encephalopathy: Neuropsychiatric syndrome caused by liver dysfunction and accumulation of neurotoxic substances.
Prothrombin: Plasma protein produced in the liver with the aid of vitamin K; it's converted to thrombin during blood coagulation.
Reye’s Syndrome: Serious condition affecting children with viral infections who take aspirin, causing liver and brain swelling.
Hemoperfusion: Technique to remove toxic substances from the bloodstream by passing blood through an adsorbent material.
Acetaminophen Toxicity:
- Acute ingestion >140 mg/kg in children or >6 g in adults can be hepatotoxic.
- Severe hepatotoxicity can occur at doses above 15 g.
Metoclopramide: Antiemetic drug used to manage vomiting before administration of antidotes and activated charcoal.
Chronic Alcohol Consumption: Increases activity of cytochrome P-450 enzymes (CYP2E1), elevating risk of acetaminophen toxicity due to enhanced conversion of acetaminophen to toxic metabolites.
Vitamin K: Utilized in treating hypoprothrombinemia by assisting in prothrombin synthesis.
N-acetylcysteine: Precursor of cysteine necessary for synthesizing glutathione, used in acetaminophen overdose treatment.
Glutathione: Antioxidant in the liver that detoxifies acetaminophen metabolites through conjugation.
Sodium Bicarbonate: Treats metabolic acidosis and alkalinizes urine in salicylate poisoning.

Chemotherapeutic Drugs

Activated Charcoal: Not recommended for isoniazid poisoning due to risk of rapid onset of coma and seizures.
Cinchonism: Condition characterized by tinnitus, headache, nausea, dizziness, and visual disturbances associated with quinine use.
Hemolytic Anemia: Condition involving rapid destruction of red blood cells surpassing their production rate.
Amantadine: Medication with antiviral and antiparkinsonian properties.
Methylene Blue: Used for treating methemoglobinemia.
Dantrolene: Muscle relaxant for neuroleptic malignant syndrome, alleviating muscle rigidity and hyperthermia.
Leucovorin: Also known as folinic acid; mitigates the effects of drugs that inhibit folate metabolism.
Amodiaquine and Mefloquine: Antimalarial drugs; Amodiaquine can cause fatal neutropenia, while Mefloquine may induce dizziness and vertigo.
Trimethoprim and Sulfamethoxazole: Components of co-trimoxazole, with trimethoprim inhibiting dihydrofolate reductase.
Lethal Dose of Chloroquine: 30-50 mg/kg for adults; minimum toxic dose of quinine is 3-4 g.
Isoniazid Toxicity: Severe toxicity can occur at doses of 80-150 mg/kg.
Sulfhemoglobinemia: Occurs when dapsone metabolites sulfate hemoglobin; irreversible condition with no antidote.
Pyridoxine: Prevents peripheral neuropathy, a common side effect of isoniazid.
Glucose-6-Phosphate Dehydrogenase: Enzyme that protects red blood cells from damage and destruction.
Stellate Ganglion Block: Medical procedure to block sympathetic nerves at C6 or C7 vertebrae using a local anesthetic.
Chloroquine Overdose: Severe overdose typically results in hypokalemia, not hyperkalemia.

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Test your knowledge of various medications and their effects. Identify the primary uses and side effects of different drugs, as well as their interactions and treatments.