Adverse effects

Question 1

Lower seizure threshold

Answer 1

Bupropion, Buspirone, Enflurane, Theophylline, many narcotics, psychostimulants; Isoniazid (B6 deficiency)

Question 2

Withdrawal causes seizures

Answer 2

Benzos, Barbiturates, Alcohol, Anticonvulsants

Question 3

Stevens-Johnson syndrome

Answer 3

Anticonvulsants (Lamotrigine esp; ethosuximide, carbamazepine, phenobarbital, phenytoin)
Antibiotics (penicillins, sulfa drugs)
Allopurinol

Question 4

Cyp450 inducers (speed up drug metabolism)

Answer 4

[Ken(ytoin) rides shotgun in Barbie’s girlie car]

Phenytoin, Rifampin, St. John’s Wort, Barbiturates, Griseofulvin, Carbamazepine

Question 5

Cause depression

Answer 5

Sedatives (alcohol, benzos, antihistamines)
Methyldopa
Typical antipsychotics
Anti-nausea drugs (metoclopramide, prochlorperazine), Glucocorticoids
Interferon alfa
Stimulant withdrawal, insufficient thyroid replacement (hypothyroidism)

Question 6

Cause psychosis

Answer 6

Hallucinogens (LSD, PCP)
Stimulants (cocaine, amphetamine)
Withdrawal from benzos, barbiturates, alcohol
Glucocorticoids
Anabolic steroids

Question 7

Check G6PD deficiency to r/o risk of hemolytic anemia

Answer 7

Dapsone

Question 8

Amiodarone

Answer 8

K channel blocker and Na channel blocker (antiarrhythmic medication)
Check PFTs, LFTs, TFTs before use
(Continue to check PFTs - can cause pulmonary fibrosis)

Question 9

Disulfiram like reaction if combined w/ alcohol

Answer 9

Metronidazole

Question 10

Drug-induced lupus

Answer 10

SHIPP
Sulfa drugs (esp sulfasalazine)
Hydralazine
Isoniazid
Phenytoin
Procainamide
(also methyldopa, quinidine, chlorpromazine)

Question 11

Sulfa drugs

Answer 11

Thiazide diuretics
Loop diuretics (except ethacrynic acid)
Acetazolamide

Question 12

Anti-HTN w/ first dose orthostatic HoTN

Answer 12

Alpha blockers

Question 13

Anti-HTN w/ hypertrichosis

Answer 13

Minoxidil

Question 14

Anti-HTN w/ dry mouth, sedation, severe rebound HTN

Answer 14

Clonidine

Question 15

Anti-HTN w/ reflex tachycardia

Answer 15

Vasodilators (hydralazine, minoxidil, nitroprusside)

Question 16

Anti-HTN w/ bradycardia, impotence, asthma exacerbation

Answer 16

Non-selective BB

Question 17

Anti-HTN w/ cough

Answer 17

ACE

Question 18

Anti-HTN w/ angioedema

Answer 18

ACE (maybe ARB)

Question 19

Anti-HTN w/ cyanide toxicity

Answer 19

Nitroprusside (vasodilator)

Question 20

Anti-HTN w/ azotemia, hyperkalemia (C/I)

Answer 20

ACE/ARB

Question 21

Anti-HTN w/ peripheral edema

Answer 21

NDP and DHP CCB (eg amlodipine)

Question 22

Anti-HTN w/ increased intracranial pressure

Answer 22

Nitroprusside (vasodilator)

Question 23

Cyclosporine

Answer 23

(Immunosuppressant)

Nephrotoxicity

Question 24

Azathioprine

Answer 24

(Immunosuppressant)
Leukopenia
Metabolized by XO (so avoid allopurinol)

Question 25

Tacrolimus

Answer 25

(Immunosuppressant) | Nephrotoxicity

Question 26

Muromonab-D3

Answer 26

(Immunosuppressant) One time cytokine release (leukopenia, fever) Short-term therapy

Question 27

Rapamycin

Answer 27

(Immunosuppressant) Thrombocytopenia Hyperlipidemia

Question 28

Mycophenolate

Answer 28

``` (Immunosuppressant, lupus nephritis) Leukopenia GI toxicity Lymphoma Teratogen ```

Question 29

Antithymocyte globulin

Answer 29

(Immunosuppressant) Serum sickness Short-term therapy

Question 30

Hydroxychloroquine

Answer 30

(Immunosuppressant, SLE, RA) | Visual disturbances

Question 31

Theophylline

Answer 31

Tachycardia, seizures, hypotension, drug interactions

Question 32

Gynecomastia

Answer 32

``` STACKED Spironolactone (K sparing ald antagonist + anti-androgen) THC (marijuana) Alcohol (chronic use) Cimetidine (H2 blocker) Ketoconazole Estrogens Digoxin Also risperidone (atypical antipsychotic) ```

Question 33

Diuretics causing hypokalemia

Answer 33

Acetazolamide Loops Thiazides

Question 34

Diuretics causing hyperkalemia

Answer 34

K sparing aldosterone antagonists (spironolactone, eplerenone) K sparing other (amiloride, triamterene)

Question 35

Carbonic anhydrase inhibitor (acetazolamide)

Answer 35

Mild metabolic acidosis Hypokalemia Nephrolithiasis Sulfa drug

Question 36

Osmotic agent (mannitol)

Answer 36

Dilutional hyponatremia initially then Relative hypernatremia Hyperosmolarity Pulmonary edema

Question 37

Loop diuretics

Answer 37

Ototoxicity Hyperuricemia Hypokalemia Hypocalcemia (Hypercalciuria; avoid w/ calcium stones)

Question 38

Thiazide diuretics

Answer 38

Hypokalemia Hyperuricemia Hypercalcemia Hyponatremia

Question 39

K sparing aldosterone antagonists

Answer 39

Hyperkalemia | Gynecomastia, menstrual irregularity (spironolactone)

Question 40

K sparing non aldosterone antagonists

Answer 40

Hyperkalemia

Question 41

Cause interstitial nephropathy (AIN)

Answer 41

``` NSAIDs (MC) Antibiotics (MC) (aminoglycosides, B-lactams, sulfonamides) Also: allopurinol diuretics PPIs ```

Question 42

Abx causing photosensitivity

Answer 42

Tetracycline

Question 43

Isotretinoin

Answer 43

``` Hepatotoxicity Major teratogen Dry skin/eyes Hyperlipidemia Depression/suicidal ideation ```