Drug Toxicities (from FA)

Question 1

Foscarnet

Answer 1

hypocalcemia (pyrophosphate analog that chelates Ca) and hypomagnesemia (nephrotoxic wasting)

Question 2

Gancyclovir

Answer 2

severe neutropenia (esp. together with antiretrovirals

Question 3

Carbamazepine

Answer 3

bone marrow suppression, hepatotoxicity, and SIADH

Question 4

Drugs famous for causing seizures

Answer 4

Bupropion, INH (given w/o B6), and Imipenem/Cilastatin

Question 5

TCA (tricyclic antidepressant)

Answer 5

CV tox (ARRYTHMIAS!), Convulsions, Coma; urinary retention, orthostatic hypotension

Question 6

Clozapine

Answer 6

agranulocytosis and seizures

Question 7

MAOI

Answer 7

hypertensive crisis (w/ tyramine, sympathomimetics), serotonin syndrome (w/ SSRI, meperidine)

Question 8

Trazodone

Answer 8

priapism

Question 9

Olanzapine

Answer 9

weight gain

Question 10

Ziprasidone

Answer 10

prolonged QT

Question 11

Chlorpromazine

Answer 11

Corneal deposits

Question 12

Thioridazine

Answer 12

Retinal deposits

Question 13

Phenytoin

Answer 13

Gingival hyperplasia

Question 14

Phenytoin

Answer 14

Pseudolymphoma (generalized LAD)

Question 15

Valproic acid

Answer 15

Fatal hepatotoxicity (measure LFTs)

Question 16

Lamotrigine

Answer 16

Stevens-Johnson syndrome

Question 17

Phenytoin

Answer 17

Fetal hydantoin syndrome

Question 18

Halothane

Answer 18

Massive hepatic necrosis

Question 19

Mechanism of TCA cardiotoxicity

Answer 19

Blocking cardiac fast Na+ channels

Question 20

Vancomycin

Answer 20

Red man syndrome (cutaneous flushing) dt rapid infusion

Question 21

Methyldopa

Answer 21

direct Coombs-positive hemolytic anemia

Question 22

Chloramphenicol

Answer 22

Gray baby syndrome

Question 23

Megaloblastic anemia

Answer 23

Phenytoin, Methotrexate, Sulfa drugs (PMS)

Question 24

Pulmonary fibrosis

Answer 24

Bleomycin, Amiodarone, Busulfan

Question 25

Acute cholestatic hepatitis

Answer 25

Macrolides

Question 26

INH

Answer 26

Hepatitis

Question 27

Pseudomembranous colitis

Answer 27

Clindamycin, ampicillin, cephalosporins

Question 28

Hypothyroidism

Answer 28

Lithium, amiodarone

Question 29

Atropine-like side effects

Answer 29

TCA's, antihistaminics

Question 30

Coronary vasospasm

Answer 30

Sumatriptan

Question 31

Dilated cardiomyopathy

Answer 31

Doxorubicin, Daunorubicin

Question 32

Heparin

Answer 32

Osteoporosis

Question 33

Photosensitivity

Answer 33

Sulfonamides, Amiodarone, Tetracycline (SAT)

Question 34

SLE-like syndrome

Answer 34

Hydralazine, IHN, Procainamide, Phenytoin (HIPP)

Question 35

Tendonitis/rupture

Answer 35

Fluoroquinolones

Question 36

Expired tetracycline

Answer 36

Fanconi's syndrome

Question 37

Interstitial nephritis

Answer 37

Methicillin, furosemide, NSAIDs

Question 38

Cyclophosphamide

Answer 38

Hemorrhagic cystitis

Question 39

Quinidine

Answer 39

Cinchonism

Question 40

Reserpine

Answer 40

Depression, suicidality, parkinsonism (blocks vesicular storage of monoamines)

Question 41

Disulfiram-like rxn

Answer 41

Metronidazole, procarbazine, cephalosporins, sulfonylureas

Question 42

Nephrotoxicity/Neurotoxicity

Answer 42

Polymixins

Question 43

Nephrotoxicity/Ototoxicity

Answer 43

Aminoglycosides, Vancomycin, Cisplatin, Loop diuretics

Question 44

Cimetidine

Answer 44

Gynecomastia, P-450 inhibitor

Question 45

Ethylene glycol

Answer 45

Oxalic acid-->Calcium-oxalate crystals, metabolic acidosis, nephrotoxicity

Question 46

Methanol

Answer 46

Formaldehyde and formic acid-->Retinal damage, acidosis

Question 47

Ethanol

Answer 47

Acetaldehyde-->HA, N/V, hypotension

Question 48

Sulfa drugs (w/o sulfa in names)

Answer 48

Celecoxib, furosemide, thiazides, probenecid, acetazolamide

Question 49

Teratogenesis: alkylating agents

Answer 49

Absence of digits, etc.

Question 50

Teratogenesis: cocaine

Answer 50

Fetal addiction, placental abruption

Question 51

Teratogenesis: Diethylstilbestrol

Answer 51

Vaginal clear cell carcinoma

Question 52

Teratogenesis: Lithium

Answer 52

Ebstein's anomaly (atrialized RV)

Question 53

Teratogenesis: maternal diabetes

Answer 53

Caudal regression syndrome, Sirenomelia

Question 54

Teratogenesis: smoking

Answer 54

Preterm labor, IUGR, ADHD, placental problems

Question 55

Teratogenesis: alcohol

Answer 55

Developmental retardation, microcephaly, holoprosencephaly, facial and limb abnormalities, heart and lung fistulas

Question 56

Teratogenesis: valproate

Answer 56

Neural tube defects (inhibits intestinal folate absorption)

Question 57

Teratogenesis: Vitamin A

Answer 57

SAB, birth defects (cleft palate, cardiac)

Question 58

Teratogenesis: Warfarin

Answer 58

Bone deformities, fetal hemorrhage, SAB

Question 59

Gynecomastia

Answer 59

Spironolactone, Digitalis, Cimetidine, Alcohol, Ketoconazole

Question 60

Testosterone

Answer 60

Gonadal atrophy, premature closure of epiphyseal plates, elevated LDL, lowered HDL

Question 61

Oral contraceptives

Answer 61

Elevated triglycerides, hypercoag, HTN, depression, wt gain

Question 62

Sildenafil

Answer 62

Impaired blue-green color vision, HA, flushing, dyspepsia, life-threatening hypotension with nitrates

Question 63

Common agents with antimuscarinic effects

Answer 63

Atropine, TCA, H1 antagonists, neuroleptics, and drugs for PD

Question 64

Ethambutol

Answer 64

Optic neuritis (red-green color blindness, central scotoma, decreased visual acuity)

Question 65

Peripheral edema and flushing

Answer 65

Amlodipine