Clinical Pharmacology and Drug Toxicity — Flashcards

Flashcard 401: Drug of choice for ventricular premature beats (VPC) due to digitalis toxicity is:

Answer: Lidocaine (Lignocaine)

Extra: Management of Digitalis-induced arrhythmias: - **Lidocaine**: Drug of choice (DOC) for ventricular arrhythmias (e.g., VPCs, Ventricular Tachycardia). - **Phenytoin**: Traditionally considered DOC for digitalis-induced arrhythmias in general, especially supraventricular ones (e.g., Paroxysmal Atrial Tachycardia with AV block). - **Digoxin-specific antibody fragments (Digibind)**: The definitive antidote for life-threatening digitalis toxicity (e.g., severe hyperkalemia, hemodynamically unstable arrhythmias). - **Potassium**: Administered if hypokalemia is present, but contraindicated if AV block or hyperkalemia is present.

Flashcard 402: Drug of choice for Epilepsy in pregnancy is -

Answer: Lamotrigine

Flashcard 403: The drug of choice for **early-onset (muscarinic)** mushroom poisoning is _______.

Answer: Atropine

Extra: Early-onset mushroom poisoning (e.g., *Inocybe*, *Clitocybe*) is characterized by muscarinic (SLUDGE) symptoms and is treated with **Atropine**. Late-onset mushroom poisoning (e.g., *Amanita phalloides*) causes hepatotoxicity due to amatoxins. Management includes **multidose activated charcoal (MDAC)** to interrupt enterohepatic circulation, and specific agents like **Silibinin** (Silymarin) or Penicillin G.

Flashcard 404: Drug of choice in intractable hiccups is:

Answer: Chlorpromazine

Extra: Chlorpromazine is the only FDA-approved drug for intractable hiccups and is traditionally considered the drug of choice in medical examinations. Other medications used in management include: - Baclofen (often preferred clinically due to fewer side effects) - Gabapentin - Metoclopramide - Haloperidol