sideeffect toxicity

Chemo Man - Mnemonic for Chemotherapy Side Effects and Toxicities

#Chemo #Man #Chemotherapy #SideEffects #Mnemonic #diagnosis #oncology

#Chemotherapy #SideEffects ... diagnosis #oncology #toxicity

ABCDEs & 3 P’s of Fluoroquinolone Toxicites

Achilles Tendon Rupture
Acute Aortic Rupture
Blood Glucose Alterations
Central Nervous System
Diarrhea (C

Fluoroquinolone Toxicites ... Fluoroquinolone #Toxicity ... #SideEffects #ABCDEs ... #Toxicites #Pharmacology

Major Chemotherapy Toxicities - AntiNEOPlastic Man Mnemonic

Common Toxicities with Traditional Chemotherapeutic Medications

Originally posted on pharmacologyweekly

#Chemotherapy #Toxicity ... #Toxicities #SideEffects

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Amiodarone Toxicity and Monitoring

Tremor Ataxia
Ocular neuritis
Corneal Microdeposits
Bradycardia
Pulmonary fibrosis
Hepatotoxicity
Blue-gray skin

Amiodarone Toxicity ... #Amiodarone #Toxicity ... #Monitoring #SideEffects

Beta Blocker Side Effects / Toxicity
Cardiac Side Effects:
• Sinus bradycardia, AV block, Heart failure exacerbation,

Side Effects / Toxicity ... BetaBlocker #BB #SideEffects ... #Toxicity #AdverseEffects

Immune Checkpoint Inhibitor Toxicity

Main Toxicities: Colitis,
Pneumonitis, Skin adverse events, Endocrine dysfunction,
Hepatitis,
Myocarditis,

Checkpoint Inhibitor Toxicity ... CheckpointInhibitor #Toxicity ... #Toxicities #SideEffects

Chemotherapy Toxicity Bear Mnemonic - Cumulatively Toxic Drugs and their Rescues
• Asparagine: neurotoxicity
• Cisplatin:

Chemotherapy Toxicity ... #Chemotherapy #Toxicity ... pharmacology #oncology #SideEffects

Carbamazepine Toxicity

Carbamazepine (CBZ) is an antiepileptic drug commonly prescribed for seizure disorders, trigeminal neuralgia, neuropathic pain,

Carbamazepine Toxicity ... Carbamazepine #Toxicity ... Toxicology #Diagnosis #SideEffects

Antidepressant Medications Decision Aid
- The choice of depression medications in primary care is difficult as

across agents' toxicity ... Antidepressants #Comparison #SideEffects

Summary of the adverse effects associated with the use of trimethoprim–sulfamethoxazole

Mnemonic - NOT RISKY?

N - Neurologic

- Reproductive toxicity ... adverse #effects #SideEffects

As a follow up to a previously uploaded infographic delineating indications for the widely-used induction agents

anesthesiology #sideeffects ... propofol-intravenous/details/list-sideeffects ... Halothane Toxicity

Hydroxychloroquine is an antimalarial & DMARD (disease modifying antirheumatic drug). It is currently being discussed as

monitor for retinal toxicity ... (increased BB toxicity ... #Pharmacology #SideEffects

If you haven't seen it, flecainide can cause significant yellowing of the skin and eyes.

#fingernails #toxicity ... #sideeffects #clinical

Almost any type of cardiac arrhythmia is seen in digitalis toxicity. However, type II second-degree atrioventricular

seen in digitalis toxicity ... characteristic of digitalis toxicity ... changes in digitalis toxicity ... #ECG #Digoxin #Toxicity

Acetaminophen toxicity
Emergency Department Workup and Management - Rumack Matthew Nomogram

#Diagnosis #Management #Toxicology #APAP #Acetaminophen #Rumack #Nomogram

Acetaminophen toxicity ... Nomogram #Stages #Toxicity

REBEL Review 96: CCB & BB Toxicity Review and Management via Katrina D'Amore, MD #management #treatment

Review 96: CCB & BB Toxicity ... management #treatment #toxicity

Pathophysiology #SideEffects

Acute Salicylate Toxicity - Diagnosis and Management
#Diagnosis #Management #Toxicology #Salicylate #Aspirin #Toxicity #ALiEM

Acute Salicylate Toxicity ... Salicylate #Aspirin #Toxicity

Cyanide Toxicity after Smoke Exposure - Management Algorithm

By Dr. Kavita Babu @kavitababu

#Cyanide #Toxicity #Smoke #Exposure #Management

Cyanide Toxicity ... kavitababu #Cyanide #Toxicity

Anticholinergic Toxicity - Etiology, Clinical Features and Treatment

#Toxicology #Diagnosis #Management #Anticholinergic #Toxicity

Anticholinergic Toxicity ... Anticholinergic #Toxicity

Medications #Profiles #SideEffects

Aspirin (Salicylate) Overdose and Toxicity

#Aspirin #Salicylate #Overdose #Toxicity #Pathophysiology #Diagnosis

) Overdose and Toxicity ... Salicylate #Overdose #Toxicity

Cyanide Toxicity
Treatment:
1) Hydroxocobalamin + Cyanide = Cyanocobalamin (nontoxic)
or
2) Amyl nitrite

Cyanide Toxicity ... #Cyanide #Toxicity

Flecainide Toxicity on ECG

- Reza Karimianpour, D.O. https://twitter.com/officialdrk12

#Flecainide #Toxicity #ECG #EKG #Electrocardiogram #Cardiology #Clinical #Toxicology

Flecainide Toxicity ... #Flecainide #Toxicity

InfectiousDisease #Hepatology #SideEffects

pulmonary #lungs #sideeffects

Electrocardiographic Features of Digoxin Toxicity
• Virtually any arrhythmia is possible. None specific for digoxin toxicity

Features of Digoxin Toxicity ... specific for digoxin toxicity ... Digoxin #digitalis #Toxicity

#PPI #Adverse #SideEffects

#Propranolol #SideEffects

pathophysiology #sideeffects

#Chemotherapy #SideEffects

#pharmacology #sideeffect

antibiotics #nephrology #sideeffects

Anticholinergic Toxicity

Common toxicities of antifungal agents.
CNS = central nervous system; 5-FC = flucytosine; GI = gastrointestinal;

antifungal #toxicities #SideEffects

Overview of potential mechanisms influencing the risk of obesity in the offspring of obese mothers.

Cardiometabolic #SideEffects

Management #Toxicology #Toxicity

TACROLIMUS - Side Effects Mnemonic

Tremor
Alopecia
Cardiovascular (HTN)
Renal insufficiency
Oncologic (Skin Cancer)
Lipids (hyperlipidemia)
Insulin

Pharmacology #Tacrolimus #SideEffects

Beta-Blocker Overdose/toxicity:

• Bradycardia & hypotension (most common).
• Myocardial depression & cardiogenic shock (severe overdoses).
• Ventricular dysrhythmias (Common with

Beta-Blocker Overdose/toxicity ... • Delayed toxicity ... Beta-Blocker #Overdose #toxicity

$Maculopapular Rashes - THE ALGORITHMIC APPROACH The term maculopapule is a portmanteau, a combination of macule and$

rash and systemic toxicity ... without signs of toxicity ... upon systemic toxicity ... lesions and systemic toxicity

Antipsychotic Side Effect Profiles (Typical / AtypicaI)

Listed by Extrapyramidal Side Effects (EPSE), Weight Gain, Elevated Prolactin

Antipsychotics #SideEffects

Ethylene Glycol Toxicity

Pharmacology, Toxicity

• Vitamin D toxicity

Flecainide Toxicity on ECG

70 year old patient with chronic atrial fibrillation on an antiarrhythmic presented with

Flecainide Toxicity ... #Flecainide #Toxicity

Flapping tremors of Asterixis

DDx
- Decompensated cirrhosis or acute liver failure.
- Renal failure /azotemia.
- Respiratory failure with

carbon dioxide toxicity

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Colchicine Toxicity
Naturally-occurring plant alkaloid [Autumn Crocus and Glory Lilly]
2-24 hrs
• Severe GI distress

Colchicine Toxicity ... #Colchicine #Toxicity

Diagnosis of Serotonin Toxicity

Intravenous Lipid Emulsion (ILE) Therapy

ILE is a treatment for severe toxicity from local anesthetics. In addition,

treatment for severe toxicity ... life-threatening toxicity

Adverse Effects of Antipsychotic Medications - Comparison Table

First Generation: chlopromazine, haloperidol, fluphenazine
Second Generation: aripirazole, asenapine,

Antipsychotics #SideEffects

Causes of Peripheral Weakness without Sensory Changes - Differential Diagnosis Algorithm
No Objective Weakness
• Cardio-pulmonary disease

Hyperreflexia • Lead toxicity ... Dystrophy • Statin Toxicity

Local Anaesthetic Toxicity - Guidelines for Crises in Anaesthesia
Signs of severe toxicity:
• Sudden alteration in

Local Anaesthetic Toxicity ... Signs of severe toxicity ... Local anaesthetic toxicity ... #Anaesthetic #Toxicity

Highland EM Ultrasound - Ultrasound Guided ED Pain Management
#Pharmacology #Local #Regional #Anesthesia #Anesthetics #DosingGuide #MaxDose #Toxicity

DosingGuide #MaxDose #Toxicity

Management of acute beta blocker/calcium channel blocker overdose

#Management #Toxicology #BetaBlocker #CCB #CalciumChannelBlocker #Overdose #Toxicity #Algorithm

CalciumChannelBlocker #Overdose #Toxicity

Toxidromes Compared: Anticholinergic, Cholinergic, Opioid, Sympathomimetic, Sedative-Hypnotic

During your physical exam, look for evidence of some of

acute cholinergic toxicity ... Opioid toxicity

Alkalinization shifts equilibrium toward the plasma and urine and away from the tissues.

#Management #Toxicology #Salicylate #Aspirin

Salicylate #Aspirin #Toxicity

Adverse Effects of NSAIDs
Prostaglandins decreased
- Gastric mucosal damage with ulcer formation, bleeding, and perforation
-

AdverseEffects #SideEffects

TB Man - Mnemonic for Anti-Tuberculosis Medication Toxicities
Isoniazid - peripheral neuropathy, neurotoxicity, hepatotoxicity
Streptomycin - ototoxicity
Ethambutol -

#Medications #Toxicity

Acute Iron Poisoning

There are five classically described phases of toxicity:
Gastrointestinal phase (~6 hours post-ingestion)
-

described phases of toxicity ... absent in severe toxicity ... Iron #Poisoning #Toxicity

The Hot and Altered Patient in the ED - Differential Diagnosis Framework
• Heat Stroke
•

Withdrawal • Lithium Toxicity

Salicylate Toxicity - Diagnosis and Management

Consider if:
1) Patient is hot and altered
2) You see tachypnea with

Salicylate Toxicity ... Salicylate #Aspirin #Toxicity

Causes of Peripheral and Central Vertigo

Peripheral Vertigo:
- Benign Positional Vertigo
- Vestibular Neuronitis
- Meniere's

Disease - Drug Toxicity

Anticoagulation Review. There are other bleeding risk assessment tools, but HAS-BLED is more commonly used. HTN

Assessment #Cardiology #SideEffects

#Testosterone #SideEffects

Hyperkalemia - Differential Diagnosis - Impaired Excretion vs Redistribution

Impaired Urinary Excretion
- Renal failure
-

Succinylcholine - Digoxin toxicity

Primary and Secondary Causes of Cardiomyopathy
(a) Primary cardiomyopathies
- Genetic
- Mixed (genetic/acquired)

- Storage* - Toxicity

Allopurinol and its active metabolite inhibit xanthine oxidase, the enzyme that converts hypoxanthine to xanthine and

druginformation #nephrology #sideeffects

Serotonin-Norepinephrine Reuptake Inhibitors(SNRIs): Mechanisms and Side Effects

Withdrawal: Dizziness, Diarrhea, Insomnia, Nausea, Vomiting
Serotonin Syndrome - Potentially Life

#Pharmacology #SideEffects

Diabetes Medication Choice
-Diabetes Medication Choice decision aid cards provide information on medications commonly used to treat

Medications #Selection #SideEffects

Flutycosine - Antibiotics Class Overview
-
Mechanism: 5-FC interferes with DNA and protein synthesis. Only

Thrombocytopenia) and Hepatic toxicity ... monitored to reduce toxicity

Selective Serotonin Reuptake Inhibitors: Mechanisms and Side Effects
• Serotonin Syndrome:
- Autonomic Hyperactivity:

#Pharmacology #SideEffects

Cerebral Toxoplasmosis
- Most comrnon CNS infection in patients with AIDS
who are not receiving appropriate

pyrimethamine-induced hematologic toxicity

Gamma hydroxybutyrate (GHB) - Toxicology

Clinical presentation
- Symptoms of GHB toxicity include: short term anterograde amnesia,

Symptoms of GHB toxicity ... GHB #Toxicology #Toxicity

Sedative-Hypnotic Visual Decision Aid

What would happen if 100 people over 60 years of age take sleeping

Pharmacology #Benefits #SideEffects

Dizziness - Central and Peripheral Causes - Differential Diagnosis
Central Causes:
• Cerebrovascular: vertebrobasilar, TIA, Wallenburg,

Aminoglycoside toxicity

High Anion Gap Metabolic Acidosis (HAGMA) - Differential Diagnosis - GOLDMARK

Glycols - ethylene and propylene glycol
Oxoproline

Aspirin - salicylate toxicity

Workup for Hyperphosphatemia - Differential Diagnosis Framework
Rule out spurious hyperphosphatemia: paraproteinemia, hyperlipidemia, hemolysis, hyperbilirubinemia, liposomal amphotericin

laxatives, Vitamin D toxicity

Specific considerations for the elderly undergoing steroid treatment
Corticosteroid Adverse Effects - More frequent and/or severe among

AdverseEffects #SideEffects

Quinidine produces the following ECG changes:
1. Prolongation of Q-T interval:
2. Prolongation of QRS complex:
3. Prominent V

Quinidine #Toxicology #Toxicity

Stroke Mimics - Differential Diagnosis - MINT Mnemonic
• Metabolic: Hyper-glycemia, Hypoglycemia, Wernicke's encephalopathy, Mitochondrial Encephalopathy

• Toxins: Drug toxicity

Acyclovir - Pharmacology Summary

• Mechanism of Action: Nucleoside analog - selectively inhibits viral replication of

Resistance • Toxicity

Antifungal Azoles - Antibiotics Class Overview

Mechanism: inhibit ergosterol synthesis (important component of fungal cell membranes)

hepatic, main toxicity

Reported Mechanisms and Toxicity of Investigational Treatments for SARS-COV-2
Chloroquine and Hydroxychloroquine
• Mechanisms: Interference with ligand

Mechanisms and Toxicity ... viral response • Toxicity ... 3 response • Toxicity ... replication • Toxicity ... replication • Toxicity

Retinal / Fundoscopy Surveillance in Hydroxychloroquine (HCQ)
Did you know that retinopathy checkup in asian lupus patients

patterns of retinal toxicity

Radiation Injury
Acute Radiation Toxicity primarily affects rapidly dividing cells based on dosage
Hematopoiteic - Pancytopenia, Infection
•

Acute Radiation Toxicity ... Radiation #Injury #Toxicity

Anticonvulsants as Mood Stabilizers: Mechanism and Side-effect
Examples: Valproate, Carbamazepine, Lamotrigine
• Mild anticholinergic effect -> Drowsiness

MoodStabilizers #Mechanism #SideEffects

Third Generation Antipsychotics: Mechanisms and Side Effects
(Atypical Anti-Psychotics) Example: Aripiprazole
Dopamine D2 Receptor Partial Agonist
• Binds

ThirdGeneration #Mechanisms #SideEffects

Petechial/Purpuric Rashes- THE ALGORITHMIC APPROACH

These rashes can be especially challenging and are
associated with devastating differential

with fever or toxicity ... purpura with fever/toxicity

Non-Resolving Pneumonias: Etiologies
Unusual Infections:
- Immunocompromised patients (e.g.: Mycobacterium, Aspergillosis, Nocardia)
- Endemic Fungi (e.g.: Histoplasmosis,

, CHF) - Drug toxicity

AdverseEffects #SideEffects

Weakness - Differential Diagnosis Framework

Approach To Weakness:
• Non-neuromuscular disorder (Cardiac, pulmonary etc)
• CNS ->

Organophosphate toxicity ... - Carbamate toxicity

Hydroxychloroquine and Chloroquine in COVID19

Dosing:
Hydroxychloroquine:
- 400mg PO BID on the first day, followed by 200mg

agent (increased toxicity

Side Effects of Atypical and Typical Antipsychotics - Comparison Table
Atypical antipsychotics: Risperidone, Quetiapine, Olanzapine, Amisulpride, Ziprasidone

Antipsychotics #SideEffects

Toluene Poisoning - Diagnosis and Management Summary
What is it? Volatile hydrocarbon, Glue or paint-sniffing, Occupational

lipid-soluble, Toxicity

Statin Induced Muscle Toxicity - Summary

Clinical Presentation:
• Elevations of serum creatine kinase with proximal myalgia

Induced Muscle Toxicity ... Statin #muscle #toxicity

Second Generation Antipsychotics: Mechanisms and Side Effects
(Atypical Anti-Psychotics) - Examples: Clozapine, Olanzapine, Quetiapine, Risperidone, Zotepine, Paliperidone,

SecondGeneration #Mechanisms #SideEffects

Mydriasis and Miosis - Differential Diagnosis Framework

Causes of Mydriasis:
Dilated pupils (mydriasis) more than 7mm
• Unilateral

Dopamine, Barbituate toxicity

Thrombotic Microangiopathy - TMAs
1. Not all MAHAs are due to TMAs but (almost) all TMAs cause

TMA (antibody vs toxicity

Radiographic appearances of pulmonary diseases in HIV/AIDS Patients
• Diffuse Interstitial Infiltrates: Pneumocystis jirovecii, M.tuberculosis, Histoplasma

hypersensitivity; Drug toxicity

Metformin Associated Lactic Acidosis (MALA)

Pathophysiology of MALA
- Metformin interferes with the activity of the

LacticAcidosis #Toxicity

Cardiorenal Syndrome (CRS) Types
• Type 1 - Acute CRS: Alteration of renal perfusion is the

induced renal toxicity

Hypoxia and Hypoxemia - Overview
Hypoxia - insufficient oxygen delivered to tissues to meet demands
Hypoxemia - low

(e.g. cyanide toxicity

Check point inhibitors and Side Effects - Immune-related adverse events (IRAEs)

What are the side effects?
-

CheckPointInhibitors #SideEffects

Anastrozole is a Selective non-steroidal aromatase Inhibitor. Used for the treatment of breast cancer in postmenopausal

endocrinology #sideeffects

First Generation Anti-Psychotics: Mechanisms and Side Effects
Typical/Conventional Anti-Psychotics - Examples: Haloperidol, Chlorpromazine

ACh M1 antagonist - Block

FirstGeneration #Mechanisms #SideEffects

Pituitary Mass Effects - Pathogenesis and Clinical Findings
• Pituitary turnors are almost always a benign

#Macroadenoma #SideEffects

Digoxin Pharmacology and Pathophysiology
1) Na/K ATPase Pump - Digoxin works by directly binding to and inhibiting

effect of digoxin toxicity ... limits so digoxin toxicity

Cardiomyopathies

Manifestations of cardiomyopathy (CM) range from microscopic alterations in cardiac myocytes to fulminant Heart Failure

Glycogen storage) • Toxicity

SGLT2 Inhibitors and Euglycemic DKA

Risk factors for euglycemic DKA in those on an SGLT2i include:
•

Euglycemic #DKA #EDKA #Toxicity

N-Acetyl Cysteine (NAC) Therapy Mechanism of Action: The non-toxic route of APAP metabolism gets saturated in

Acetaminophen #Toxicity

Trick of the Trade: Naloxone Dilution for IV Use - Given that many ED overdose patients

reverse opioid toxicity

Pulmonary Complications Following Stem Cell Transplant

For patients in the pre- engraftment period (day 0-30):
-
Pulmonary

syndrome - Drug toxicity

Clinically Significant Cardiovascular Drug-Drug Interactions With OTC Supplements and Herbal Products
Angiotensin-Converting Enzyme Inhibitors (ACEIs)
• Night-blooming

risk of digoxin toxicity ... increasing risk for toxicity

Bradycardia - Differential Diagnosis Framework

BRADI Mnemonic
• BRASH/Hyperkalemia
• Reduced oxygen/Glucose/Temp
• ACS
• Drugs
•

• Flecanide toxicity

Neurological Side Effects of Antipsychotic Drugs
Acute dystonia - Spasm of muscles of tongue, face, neck, back

#Medications #SideEffects

Relapsing Acute Severe Ulcerative Colitis - Management Algorithm
Loss of Response:
• (Re)consult Colorectal Surgery
• Assess

Megacolon, Systemic Toxicity

Transverse lines of the fingernails. (A) Beau’s lines (arrows) of the thumbnail. (B) Mees’ lines (arrowheads)

sign of acute toxicity

Therapeutic Drug Level Monitoring
Carbamazepine - Sample immediately before next dose (trough)
Clozapine - Sample immediately

at anytime if toxicity

Clozapine Toxicology
Clozapine is an atypical antipsychotic most often reserved for use in patients who have treatment-resistant

#Toxicology #Toxicity

Hydroxychloroquine - Risks and Benefits in Lupus
Benefits:
↓ Disease activity, ↓ Flare, ↓ Damage, ↓ Corticosteroid dose,

adverseeffects #sideeffects

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