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Black Box Warnings

100

I am an anti-seizure medication with anti-dysrhythmic properties. I cannot be given at an IV push rate higher than this, and I am only compatible with Normal Saline. Who am I, and what is the rate? 

Phenytoin, 50mg/min max 

200

I rhyme with a classic Dolly Parton song. I am a direct acting neuromuscular drug and my black box warning contains this toxicity, and this demographic is at greater risk. 

Dantrolene, 

Liver toxicity, females over 35

300

What are the 3 cardiovascular drugs that cause an increased risk of myocardial infarction and angina when abruptly stopped? 

Metoprolol, Atenolol, Propranolol 

400

I am an anti-dysrhythmic. I block a specific ion channel, but I affect all the anti-dysrhythmic classes. My black box warning includes pulmonary toxicity, optic nerve toxicity, and liver toxicity. Who am I? 

Amiodarone 

500

I am an anti-platelet that is primarily given for stent thrombus prophylaxis. If you are an individual who does this poorly, I may not be activated or effective. 

Clopidogrel, metabolism/liver metabolism 

Teaching/ Patient education

100

What foods may you instruct a patient to avoid when taking Phenelzine? 

Tyramine 

found in beer/wine, aged meats, smoked fish, liver, soy sauce, cheeses, milk, yogurt, bananas, fava beans, chocolate, figs, yeast, avocados 

200

When educating a patient how to take Nitroglycerin, what is the teaching you may include? (Both transdermal and sublingual)

Take sublingual Nitroglycerin every 5 minutes, up to 3 doses. If 1st dose isn't effective, call 911 while taking the 2nd dose

We can build tolerance to Nitroglycerin, it is important to teach a patient that you should take a patch off for 12 hours in the evening, and place it in the morning 

300

If you are an individual taking this drug, you may specifically want to keep it out of reach of children due to its black box warning pertaining to fatal poisoning/overdose. 

Ferrous Sulfate

400

When taking Zolpidem, you may include that the best time to take this drug is at this time of day 

Night time/ before bed time. 

500

You cannot take grapefruit juice with these medications: 

Nifedipine, Verapamil, Amiodarone 

Values

100

What is the therapeutic range for Lithium? What is the range where we see toxicity? 

0.6-1.2 (therapeutic) 

over 1.5 (toxicity) 

200

To decrease the risk of adverse cardiovascular events, your daily sodium intake should be below this: 

1500 mg daily 

300

This number or over, plus targeted organ damage is the definition of hypertensive crisis 

180/120

400

What are the hold parameters for Beta Blockers? 

A heart rate below 60 and/or systolic blood pressure below 100 

500

What is the goal PTT time when taking Heparin? 

46-75

Drug time frames

100

I am an anti-platelet drug used for stent thrombus prophylaxis. I must be discontinued this many days before surgery. 

Clopidogrel, 5 days before procedures 

200

I am an anti-coagulant, and Vitamin K antagonist. I'm usually taken after Heparin, what is my name and time of onset? 

Warfarin 

5-7 days 

300

I am our primary drug used for anxiety. I may not be taken long term due my risk of causing dependence. Who am I? 

Lorazepam 

400

What is the onset length for Chlorpromazine?

6-12 weeks 

500

My onset time is only 30 minutes and my antidote is protamine. Who am I? 

Heparin 

Toxicity

100

A patient comes in with psychosis and visual blurring in the form of halos, what toxicity are they likely suffering from? 

Digoxin 

(visual changes such as blurring or halos), delirium, psychosis, anorexia, dysrhythmias) 

200

What type of toxicity may you expect to see in an individual taking medications for ADHD? 

Atomoxetine and Methylphenidate both cause liver toxicity 

300

Liver toxicity and these other two serious symptoms are seen in patients taking Hydralazine 

Lupus, Leukopenia 

400

A patient with a potassium level of 2.5 may increase the toxicity levels of this drug

Digoxin 

500

Not necessarily toxicity, but I am a lifelong vitamin supplement that individuals with this condition must take. I also can cause this electrolyte abnormality: 

Pernicious Anemia, Cyanocobalamin, Hypokalemia