Platinum Hits
This chemotherapeutic class can cause cardiotoxicity and have a lifetime cumulative dose limit due to this.
What are anthracyclines? Doxorubicin, daunorubicin, idarubicin.
This is the maximum time window after symptom onset in which thrombolytics (tPA, TNK) can be administered for an acute ischemic stroke.
What is 4.5 hours?
Name one alternative to Bactrim for PJP prophylaxis in transplant patients with a sulfa allergy.
What is Dapsone or atovaquone or pentamadine?
Combining ACE inhibitors and ARBs with potassium-sparing diuretics like spironolactone can leads to this dangerous electrolyte disturbance.
What is hyperkalemia?
This vitamin increased the absorption of oral iron.
What is vitamin C?
This medication is co-administered with methotrexate to alkalinize the urine and prevent nephrotoxicity (renal crystallization or precipitation of methotrexate).
What is sodium bicarbonate?
After ischemic stroke, high-intensity therapy with this drug class is recommended to lower LDL and reduce recurrence risk.
What are statins?
This commonly used transplant medication can cause birth defects.
What is Mycophenolate?
Concomitant use of antiemetics like ondansetron and antipsychotics such as haloperidol increase the risk of this cardiac adverse effect.
What is QT prolongation or torsades de pointes?
Calculate a CrCl for a 65 year old female patient weighing 150 pounds with a last SCr of 1.2. Use total body weight.
What is 50.3 ml/min?
Cyclophosphamide and ifosfamide share this dose-limiting toxicity affecting the bladder, which can be prevented with adequate hydration and mesna.
What is hemorrhagic cystitis?
Thrombolytics (TPA, TNK) for stroke treatment are contraindicated if a patient’s blood pressure is greater than this value at the time of administration.
What is 185/110 mmHg?
Dapsone is contraindicated in patients with THIS type of deficiency (bonus if you know what it causes).
What is G6PD and hemolytic anemia?
Combining beta-blockers like carvedilol with non-DHP calcium channel blockers (nifedipine, diltiazem) can cause this cardiovascular adverse effect.
What is bradycardia or heart block?
A 58-year-old female is admitted and started on IV linezolid. Her medication list includes sertraline 100 mg daily for depression, methadone 10 mg TID scheduled for cancer pain, and tramadol as needed for pain.What serious drug interaction–related adverse effect is this patient at risk for?
What is serotonin syndrome?
This “rescue” medication is given after high-dose methotrexate to prevent severe myelosuppression, mucositis, kidney and liver damage, etc.
What is leucovorin (folinic acid)?
Patients with a cardioembolic stroke due to atrial fibrillation are treated with this class of medications for secondary prevention.
What are oral anticoagulants (e.g., warfarin or DOACs)?
This antiviral is used for HIGH risk CMV patients post-transplant (bonus if you can name the other agent used in combination with it).
What is Letermovir/Prevymis (main answer) + acyclovir?
These SSRI medications inhibits CYP2D6 and can increase serum levels of beta-blockers like metoprolol, leading to bradycardia and hypotension.
What is fluoxetine (or paroxetine)? SSRIs that inhibit CYP2D6 include fluoxetine, paroxetine, sertraline, and duloxetine. The degree of inhibition varies, with fluoxetine and paroxetine being potent inhibitors, while sertraline is a moderate to significant inhibitor and duloxetine is a moderate inhibitor.
This IV colloid solution is used after large-volume paracentesis (>5 L removed) to prevent paracentesis-induced circulatory dysfunction.
What is albumin?
Name a chemotherapy agent that can cause pulmonary toxicity.
What is bleomycin and/or busulfan?
A patient presenting with an ischemic stroke is NOT eligible for thrombolytics (tPA, TNK) if their INR is greater than this value while on warfarin.
What is 1.7?
Name one of the two additional prophylactic medications pancreas transplant patients need in addition to the typical Bactrim + Valcyte (Can name the drugs or the type of coverage).
What is fluconazole (fungal) and Augmentin or fluoroquinolone (enteric)?
What is simvastatin (or lovastatin)?
A patient receiving IV heparin for acute AFib is to be transitioned to apixaban at discharge. The pharmacist should ensure that this step occurs when the heparin infusion is discontinued to prevent overlap or gap in therapy.
What is starting apixaban at the time of heparin discontinuation (no overlap required)?