Errors in First Aid for the USMLE (2007): Pharmacology

As always, comments are welcome.

Pharmacology

  1. P.218, Sympathomimetics
    1. Clonidine and a-methyldopa are centrally acting alpha-2 agonists.  They are listed here as simply “alpha”.
  2. P.223, P-450 interactions
    1. Quinidine is listed as an inducer of P450.  Quinidine is an inhibitor of P450 (BRS 4th ed, P.13)

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9 Responses to Errors in First Aid for the USMLE (2007): Pharmacology

  1. Sanjay Linganna says:

    Page 223 states that Quinide is a p450 inducer.

    However, BRS pharm (4th ed) states that Quinidine is an inhibitor of p450 (pg 13), specifically the CYP 2D6 isoform.

    Baby Katzung agrees with BRS (page 34) as does wikipedia (http://en.wikipedia.org/wiki/Quinidine).

    Golan is silent on the issue (pg 51).

    There remains the possibility that a seperate isoform is induced by Quinidine, but I haven’t seen any evidence supporting this possibility

  2. Brian says:

    Not that more evidence is necessary, but G&G, 11th Ed. states, “Quinidine is a potent inhibitor of CYP2D6.”

  3. GO BLUE says:

    p. 224: St. John’s wort is listed as inhibiting P450. It actually induces P450, as is printed correctly on p. 223.

  4. Holly says:

    p. 209: Pharmacokinetics; half-life entry. It says a drug reaches 94% of steady state after 4 half-lives, but on the table below only shows up to 3.3 half-lives. Also, I saw on a question (shelf or NBME diagnostic, can’t remember which), a question where they asked for 97% of steady-state, which is 5 half-lives, so that might be good to add to the table.

  5. Holly says:

    p. 217, Atropine. They say it blocks “SLUD,” but if you know the mnemonic “DUMBBELS” from anticholinesterase toxicity, then it would make more sense to say that atropine blocks “DUMBBELS.” If you know “SLUDGE” for the anticholinesterases, then the given mnemonic for atropine works.

  6. Fernando says:

    pg. 221. specific antidotes. I think that #10 should not include arsenic. Everywhere I have looked, Dimercaprol (BAL) is the recommended antidote. http://www.atsdr.cdc.gov/MHMI/mmg168.html Also, an arsenic toxicity/antidote question on USMLE World listing both Dimercaprol and Penicillamine as possible answer choices had Dimercaprol as the only correct answer. I didn’t know which to choose because FA listed arsenic under both Dimercaprol (#9) and Penicillamine (#10). Of course, I chose wrong :p

  7. Mark says:

    Fernando, you chose wrong because penicillamine is a backup treatment for arsenic poisoning. First aid did not make that clear enough.

  8. Donald says:

    the 2006 edition lists INH as a drug that causes hemolysis in G6PD deficient pts. Katzung and PharmCards describes such phenomenon occurring in Dapsome, not INH

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