OTHERS

Question 1

What is the toxic effect of Penicillin and its treatment?

Answer 1

Toxic Effect: Hypersensitivity (metabolized to Penicilloyl moiety / hapten)

Treatment: Alternative – Erythromycin

Rationale / Concept: Penicillin can act as a hapten, binding to proteins and triggering immune-mediated hypersensitivity reactions. Using erythromycin avoids cross-reactivity.

Question 2

What is the toxic effect of Chloramphenicol and its treatment?

Answer 2

Toxic Effect: Gray Baby Syndrome, Aplastic Anemia, Bone Marrow Suppression

Treatment: Charcoal Hemoperfusion

Rationale / Concept: Chloramphenicol inhibits mitochondrial protein synthesis in neonates (gray baby syndrome) and bone marrow cells in adults. Charcoal hemoperfusion removes the drug from circulation.

Question 3

What is the toxic effect of Vancomycin and its treatment?

Answer 3

Toxic Effect: Red Man Syndrome (Vancomycin infusion reaction)

Treatment: Diphenhydramine, slow infusion
Rationale / Concept: Rapid vancomycin infusion releases histamine → flushing, hypotension. Slowing infusion and antihistamines prevent/reduce symptoms.

Question 4

What is the toxic effect of Isoniazid (INH) and its treatment?

Answer 4

Toxic Effect: Peripheral neuropathy

Treatment: Vitamin B6 (Pyridoxine)
Rationale / Concept: INH depletes pyridoxal phosphate → impaired neurotransmitter synthesis → neuropathy. Supplementation restores B6-dependent pathways.

Question 5

What is the toxic effect of Beta-blockers and its treatment?

Answer 5

Toxic Effect: Heart block

Treatment: Glucagon

Rationale / Concept: Beta-blockers inhibit β1 receptors → reduced cAMP in cardiac cells → bradycardia/heart block. Glucagon bypasses β receptors via Gs → cAMP → restores heart rate.

Question 6

What is the toxic effect of Rofecoxib (Vioxx) and its treatment?

Answer 6

Toxic Effect: Thrombosis

Treatment: None specific

Rationale / Concept: COX-2 selective inhibition reduces prostacyclin → unopposed thromboxane → increased risk of clot formation. No specific antidote exists.

Question 7

What is the toxic effect of Warfarin and its treatment?

Answer 7

Toxic Effect: Cutaneous necrosis, Purple Toe Syndrome, Hemorrhagic Disease of Newborn

Treatment: Vitamin K1

Rationale / Concept: Warfarin inhibits vitamin K epoxide reductase → reduced synthesis of clotting factors → bleeding. Vitamin K1 restores coagulation factor production.

Question 8

What is the toxic effect of Heparin and its treatment?

Answer 8

Toxic Effect: Heparin-Induced Thrombocytopenia (HIT)

Treatment: Protamine Sulfate

Rationale / Concept: Protamine sulfate binds heparin to neutralize its anticoagulant effect and prevent further platelet activation.

Question 9

What is the toxic effect of Succinylcholine and its treatment?

Answer 9

Toxic Effect: Malignant Hyperthermia

Treatment: Dantrolene

Rationale / Concept: Succinylcholine triggers uncontrolled Ca²⁺ release from sarcoplasmic reticulum → hypermetabolism. Dantrolene inhibits Ca²⁺ release → reduces muscle rigidity and hyperthermia.

Question 10

What is the toxic effect of Heparin and its treatment?

Answer 10

Toxic Effect: Heparin-Induced Thrombocytopenia (HIT)

Treatment: Protamine Sulfate

Rationale / Concept: Protamine sulfate binds heparin to neutralize its anticoagulant effect and prevent further platelet activation.

Question 11

What is the toxic effect of Succinylcholine and its treatment?

Answer 11

Toxic Effect: Malignant Hyperthermia

Treatment: Dantrolene
Rationale / Concept: Succinylcholine triggers uncontrolled Ca²⁺ release from sarcoplasmic reticulum → hypermetabolism. Dantrolene inhibits Ca²⁺ release → reduces muscle rigidity and hyperthermia.

Question 12

What is the toxic effect of Tubocurarine / Morphine / Guanethidine and its treatment?

Answer 12

Toxic Effect: Anaphylaxis

Treatment: Epinephrine

Rationale / Concept: IgE-mediated or non-IgE mast cell degranulation → hypotension, bronchospasm. Epinephrine acts on α and β receptors → vasoconstriction and bronchodilation.

Question 13

What is the toxic effect of Nitrous Oxide and its treatment?

Answer 13

Toxic Effect: Diffusional Hypoxia

Treatment: Oxygen supplementation

Rationale / Concept: Rapid N₂O elimination displaces O₂ in alveoli → hypoxia. Administering O₂ prevents tissue hypoxia.