Drug reactions

Question 1

Coronary vasospasm

Answer 1

amphetamines, cocaine, ergot alkaloids, sumatriptan

Question 2

Cutaneous flushing

Answer 2

vancomycin, adenosine, niacin, nitrates, CCBs, echinocandins (-fungin)

Question 3

DCM

Answer 3

Anthracyclines (doxorubicin, daunorubicin); prevent with dexrazoxane

Question 4

Torsades de pointes

Answer 4

Class IA and III antiarrhythmics, antibiotics (macrolides), antipsychotics (haloperidol), antidepressants (TCAs) and antiemetics (ondansetron) ABCDE!

Question 5

Adrenocortical insufficiency

Answer 5

glucocorticoid WITHDRAWL

Question 6

Diabetes insipidus

Answer 6

lithium, demeclocycline

Question 7

Hot flashes

Answer 7

tamoxifen, clomiphene

Question 8

Hyperglycemia

Answer 8

Tacrolimus, protease inhibitors, niacin, HCTZ, corticosteroids

Question 9

Hypothyroidism

Answer 9

Lithium, amiodarone, sulfonamides

Question 10

SIADH

Answer 10

Carbamazepine, cyclophosphamide, SSRIs

Question 11

Acute cholecystatic hepatitis, jaundice

Answer 11

Erythromycin

Question 12

Diarrhea

Answer 12

Acamprosate, acarbose, cholinesterase inhibitors, colchicine, erythromycin, ezetimibe, metformin, misoprostol, orlistat, pramlintide, quinidine, SSRIs

Question 13

focal to massive hepatic necrosis

Answer 13

Halothane, Amantia phalloides (death-cap mushroom), valproic acid, acetominophen

Question 14

Hepatits

Answer 14

Rifampin, isoniazid, pyrazinamide, statins, fibrates

Question 15

Pancreatitis

Answer 15

Didanosine, corticosteroids, alcohol, valproic acid, azothioprine, furosemide, HCTZ

Question 16

Pill esophagitis

Answer 16

bisphosphonates, ferrous sulfate, NSAIDs, KCl, tetracyclines

Question 17

Pseudomembranous colitis

Answer 17

Ampicillin, cephalosporins, clindamycin, fluoroquinolones (leads to C. difficile)

Question 18

Agranulocytosis

Answer 18

Clozapine, carbamazepine, PTU, methimazole, colchicine, ganciclovir

Question 19

Aplastic anemia

Answer 19

Carbamazepine, methimazole, NSAIDs, benzene, chloramphenicol, PTU

Question 20

Direct Coombs+ hemolytic anemia

Answer 20

Methyldopa, penicillin

Question 21

Drug reaction with eosinophilia and systemic symptoms (DRESS)

Answer 21

Allopurinol, anticonvulsants, antibiotics, sulfa drugs

Potentially fatal, latency 2-8wk; tx: GC

Question 22

Gray baby syndrome

Answer 22

Chloramphenicol

Question 23

Hemolysis in G6PDH deficiency

Answer 23

Isoniazid, sulfonamide, dapsone, primaquine, asprin, ibuprofen, nitrofurantoin

Question 24

Megaloblastic anemia

Answer 24

Hydroxyurea, phenytoin, MTX, Sulfadrugs

Question 25

Thrombocytopenia

Answer 25

Heparin

Question 26

Thromboses

Answer 26

E+P contraceptives, HRT, SERMs (tamoxifen, raloxifene, clomiphene) MEDIATED BY ESTROGEN

Question 27

Fat redistribution

Answer 27

Protease inhibitors, GCs

Question 28

Gingival hyperplasia

Answer 28

Phenytoic, CCBs, cyclosporin

Question 29

Hyperuricemia

Answer 29

Pyrazinamide, thiazides, furosemide, niacin, cyclosporine

Question 30

Myopathy

Answer 30

statins, fibrates, niacin, colchicine, daptomycin, hydroxychloroquine, IFN-alpha, penicillamine, GCs

Question 31

Osteoporosis

Answer 31

CS, depot medroxyprogesterone acetate, GnRH agonists, aromatase inhibitors, anticonvulsants, heparin

Question 32

Photosensitivity

Answer 32

Sulfonamides, amiodarone, tetracyclines, 5-FU

Question 33

Rash (Stevens-Johnson)

Answer 33

Anti-epileptics (esp. lamotrigine), allopurinol, sulfa drugs, penicillin

Question 34

Teeth discoloration

Answer 34

tetracycline

Question 35

Tendonitis, tendon rupture, cartilage damage

Answer 35

fluoroquinolones

Question 36

Cinchonism (tinnitus, hearing/vision loss, psychosis, cognitive impariment

Answer 36

Quinidine, quinine

Question 37

Parkinson-like syndrome

Answer 37

Antipsychotics, reserpine, metoclopramide

Question 38

Seizures

Answer 38

INH (B6 deficiency), buproprion, imipenem/cilastin, tramodol, enflurane

Question 39

Tardive dyskinesia

Answer 39

Antipsychotics, metoclopramide

Question 40

Fanconi syndrome

Answer 40

Cisplatin, ifosfamide, expired tetracyclines, tenofovir

Question 41

Hemorrhagic cystitis

Answer 41

Cyclophosphamide, ifosfamide | Give with mesna

Question 42

Interstitial nephritis

Answer 42

Penicillins, furosemide, NSAIDs, PPIs, sulfa drugs

Question 43

Dry cough

Answer 43

ACEIs

Question 44

Pulmonary fibrosis

Answer 44

MTX, nitrofurantoin, carmustine, bleomycin, busulfan, amiodarone

Question 45

Antimuscarinic

Answer 45

Atropine, TCAs, H1-blockers, antipsychotics

Question 46

Disulfiram-like reaction

Answer 46

1st gen. sulfonuryeals (-mide), procarbazine, cephalosporins, griseofulvin, metronidazole

Question 47

Nephrotox/ototox

Answer 47

Aminoglycosides, vancomycin, loop diuretics, cisplatin, amphotericin B

Question 48

CYP inducers

Answer 48

``` Chronic EtOH St John's wort Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine ```

Question 49

CYP substrates

Answer 49

Anti-epileptics Theophylline Warfarin OCP

Question 50

CYP Inhibitors

Answer 50

``` Sodium valproate Isoniazid Cimetidine Ketoconazole Fluconazole Acute Alcohol Abuse Chloramphenicol Macrolides Sulfonamides Ciprofloxacin Omeprazole Metronizadole ```

Question 51

Sulfa drugs

Answer 51

Sulfonamide antibiotics, sulfasalazine, probenecid, furosemide, acetazolamide, celecoxib, thiazides, solfonylureas Fever, UTI, SJS, hemolytic anemia, thrombocytopenia, agranulocytosis, AIN, urticaria Mild to life-threatening