161 cards
Acetaminophen produces analgesia and antipyresis but overdose is dangerous because hepatic CYP2E1 converts it to the toxic metabolite NAPQI, which is normally detoxified by glutathione. In overdose glutathione is depleted and centrilobular hepatic necrosis ensues, so the antidote N-acetylcysteine replenishes glutathion...
Warfarin inhibits vitamin K epoxide reductase, depleting active vitamin K and reducing synthesis of the vitamin K-dependent clotting factors II, VII, IX, and X (mnemonic "1972") along with the anticoagulant proteins C and S. Because proteins C and S have shorter half-lives than the clotting factors, an initial prothrom...
ACE inhibitors reduce blood pressure and provide mortality benefit in heart failure and proteinuric kidney disease but produce a recognizable cluster of side effects: dry cough, angioedema (more common in black patients), hyperkalemia, a small creatinine rise, and teratogenicity. The cough and angioedema stem from brad...
Insulin preparations are categorized by onset and duration: rapid-acting lispro, aspart, and glulisine; short-acting regular insulin; intermediate-acting NPH; and long-acting glargine, detemir, and degludec. Metformin works primarily by reducing hepatic gluconeogenesis through AMPK activation and, importantly, does not...
Aminoglycosides such as gentamicin act via concentration-dependent killing and are limited by nephrotoxicity and ototoxicity, both of which can be reduced by once-daily dosing. Vancomycin infusion reactions, termed red man syndrome, result from histamine release during rapid infusion, producing flushing and pruritus ra...
Antidepressants include SSRIs (fluoxetine, sertraline, escitalopram), SNRIs (venlafaxine, duloxetine), TCAs (amitriptyline, nortriptyline, imipramine, clomipramine, doxepin), MAOIs (phenelzine, tranylcypromine), and atypicals such as bupropion and mirtazapine. SSRIs and SNRIs can cause serotonin syndrome when combined...
Inhaled anesthetic potency is inversely related to the minimum alveolar concentration (MAC), while speed of onset is governed by the blood:gas partition coefficient, with lower values yielding faster onset and nitrous oxide being the prototypical fast agent. Methoxyflurane is rarely used because of fluoride-induced nep...
Cytotoxic chemotherapy spans several mechanistic classes. Cyclophosphamide is an alkylating agent that crosslinks DNA, with signature toxicities of hemorrhagic cystitis (prevented with MESNA), SIADH, myelosuppression, and secondary malignancies including bladder cancer and leukemia. Methotrexate inhibits dihydrofolate...