Clinical Pharmacology and Drug Toxicity — Flashcards

Flashcard 321: What is the proposed mechanism of lithium-induced hyperparathyroidism?

Answer: 1. Raising the set-point of the **Calcium-Sensing Receptor (CaSR)** 2. Activation of the **Wnt/β-catenin pathway** (via inhibition of GSK3β)

Extra: Lithium-induced hyperparathyroidism leads to hypercalcemia and elevated PTH (mimicking primary hyperparathyroidism). Lithium reduces the sensitivity of the CaSR to calcium and inhibits Glycogen Synthase Kinase 3 beta (GSK3β), which stabilizes β-catenin and promotes parathyroid cell function via the Wnt pathway.

Flashcard 322: Zoledronate use has been associated with _____toxicity.

Answer: nephro

Flashcard 323: The most characteristic congenital defect due to warfarin in APLA mothers is _____

Answer: chondrodysplasia punctata

Flashcard 324: _____ is an approved intravenous drug for the treatment of methotrexate toxicity

Answer: Glucarpidase

Flashcard 325: What is the best treatment of delayed emesis associated with cancer chemotherapy?_____

Answer: NK-1 antagonist + 5HT3 antagonist + Corticosteroid

Flashcard 326: Shoulder-hand syndrome is associated with the use of _____.

Answer: Isoniazid

Flashcard 327: Which anti-malarial can deposit in the retina?_____

Answer: Chloroquine

Flashcard 328: Which component of quadruple regimen may cause blackening of stools and black hairy coated tongue?_____

Answer: Bismuth subcitrate

Flashcard 329: Cyclosporine induced cholestasis is due to inhibition of the _____ transporter.

Answer: BSEP (Bile Salt Export Pump) :: or ABCB11

Extra: Cyclosporine-induced cholestasis is primarily due to the inhibition of the **Bile Salt Export Pump (BSEP)**, also known as **ABCB11**. This transporter is responsible for the secretion of bile salts from hepatocytes into the bile canaliculi. Inhibition leads to the accumulation of bile acids within the liver cells, causing cholestasis.

Flashcard 330: Is the agranulocytosis due to clozapine dose dependent?_____

Answer: No