Pharm Drug SFx (from DIT)

Question 1

Cardiovascular SFx

Answer 1

Flushing, coronary vasospasm, torsades de pointes

Question 2

Blood disorder SFx

Answer 2

Thrombocytopenia, agranulocytosis, aplastic anemia, gray baby syndrome, hemolysis in G6PD deficiency, thrombosis

Question 3

Respiratory SFx

Answer 3

Pulmonary fibrosis, cough

Question 4

GI SFx

Answer 4

Pseudomembranous colitis, hepatic necrosis, hepatitis, tertiary adrenal insufficiency

Question 5

Endocrine SFx

Answer 5

Gynocomastia, hot flashes, hypothyroidism

Question 6

MSK SFx

Answer 6

Gout, gingival hyperplasia, osteoporosis, photosensitivity, Stevens-Johnson syndrome, drug-induced lupus, tendinitis/cartilage damage

Question 7

Renal SFx

Answer 7

Interstitial nephritis, diabetes insipidus, Fanconi syndrome, hemorrhagic cystitis

Question 8

Neuro SFx

Answer 8

Parkinson-like syndrome, cinchonism, seizures, tardive dyskinesia

Question 9

Multi-organ SFx

Answer 9

Disulfiram-like reaction, nephrotoxicity + neurotoxicity, nephrotoxicity + ototoxicity, anticholinergic effects

Question 10

SFx - flushing

Answer 10

vancomycin (red man syndrome)
niacin
adenosine
Dihydropyridine calcium channel blockers

Question 11

SFx - coronary vasospasm

Answer 11

cocaine
amphetamines
-triptans
ergotamine

Question 12

SFx - dilated cardiomyopathy

Answer 12

anti-CA drugs: (+ bone marrow suppression)
doxorubicin
daunorubicin

Question 13

SFx - torsades de pointes

Answer 13

potassium channel blockers (class III)
sodium channel blockers (class IA)
macrolides
haloperidol
chloroquine
protease inhibitors (HIV)

Question 14

SFx - thrombocytopenia

Answer 14

heparin (HIT)

cimetidine (H2 blocker)

Question 15

SFx - agranulocytosis (the 3 C’s)

Answer 15

clozapine, carbamazepine, colchicine
propylthiouracil (PTU), methimazole (anti-thyroid)
dapsone

Question 16

SFx - aplastic anemia

Answer 16

chloramphenicol
benzene
NSAIDs
propulthiouracil (PTU)
methimazole

Question 17

SFx - gray baby syndrome

Answer 17

Sx: cyanosis, CV issues

chloramphenicol (inactivates UGT)

Question 18

SFx - hemolysis in G6PD deficiency

Answer 18

isoniazid
sulfonamides
primaquine
ASA (high-dose)
ibuprofen
nitrofurantoin (tx UTI)
dapsone
fava beans
naphthalene

Question 19

SFx - thrombosis

Answer 19

oral contraceptives (esp: smoker, F, over 35yo, on OCPs)

Question 20

SFx - pulmonary fibrosis

Answer 20

amiodarone (tx afib - labs: LFTs, PFTs, TFTs)
bleomycin
busulfan

Question 21

SFx - cough

Answer 21

ACE inhibitors (via inc bradykinin)
(sub ARBIs = no cough)

Question 22

SFx - pseudomembranous colitis

Answer 22

clindamycin

amoxicillin/ampicillin

Question 23

SFx - hepatic necrosis

Answer 23

halothane
acetaminophen
valproic acid
amanita phalloides

Question 24

SFx - hepatitis

Answer 24

isoniazid (P450 inhibitor)

Question 25

SFx - tertiary adrenal insufficiency

Answer 25

corticosteroid withdrawal (asthma, RA, OA)

Question 26

SFx - gynecomastia "STACKED knockers"

Answer 26

``` Spironolactone***** THC (marijuana) Alcohol (chronic use) Cimetidine Ketoconazole******* Estrogens Digoxin Note - if it causes gynocomastia, likely is anti-androgen (ex: keto, spironolactone) ```

Question 27

SFx - hot flashes

Answer 27

tamoxifen, clomiphene (selective Estrogen R modulator)

Question 28

SFx - hypothyroidism

Answer 28

amiodarone, lithium, sulfonamides

Question 29

SFx - gout (right 1st toe)

Answer 29

diuretics (loop and thiazide) niacin (tx low HDL) cyclosporine pyrazinamide

Question 30

SFx - gingival hyperplasia

Answer 30

phenytoin | verapamil

Question 31

SFx - osteoporosis

Answer 31

corticosteroids | heparin

Question 32

SFx - photosensitivity "SAT for photo"

Answer 32

Sulfonamides Amiodarone Tetracycline

Question 33

SFx - Stevens-Johnson syndrome "CLAPPPERS"

Answer 33

``` Carbamazepine* Lamotrigine* Allopurinol Phenytoin* Phenobarbital* Penicillin Ethosuximide* RASH (sx no rx) Sulfa drugs *indicate seizure drugs ```

Question 34

SFx - drug-induced lupus "SHIPP"

Answer 34

``` Sulfonamides Hydralazine Isoniazid Procainamide Phenytoin ```

Question 35

SFx - tendinitis/cartilage damage

Answer 35

fluoroquinolones

Question 36

SFx - interstitial nephritis

Answer 36

NSAIDs furosemide antibiotics

Question 37

SFx - diabetes insipidus

Answer 37

lithium demeclocycline (tx with amiloride or HCTZ)

Question 38

SFx - Fanconi syndrome (proximal tubular defect)

Answer 38

tetracycline (expired) | *also caused by heavy metal exposure, Wilson Dz

Question 39

SFx - hemorrhagic cystitis

Answer 39

cyclophosphamide, ifosfamide

Question 40

SFx - parkinsonian-like syndrome

Answer 40

metoclopramide (tx gastric emptying Ds) antipsychotics reserpine (NE packaging blocker)

Question 41

SFx - cinchonism (dizziness, headache, vision changes, tinnitus)

Answer 41

quinidine | quinine

Question 42

SFx - seizures

Answer 42

``` bupropion imipenem/cilastatin isoniazid tramadol metoclopramide benzodiazepine/alcohol withdrawal ```

Question 43

SFx - tardive dyskinesia

Answer 43

antipsychotics | metoclopramide

Question 44

SFx - disulfram-like reaction

Answer 44

``` metronidazole certain cephalosporins procarbazine first-gen sulfonylureas disulfram ```

Question 45

SFx - nephrotoxicity + neurotoxicity

Answer 45

aminoglycosides cisplatin polymixins

Question 46

SFx - nephrotoxicity + ototoxicity

Answer 46

aminoglycosides vancomycin loop diuretics cisplatin

Question 47

SFx - anticholinergic effects

Answer 47

*atropine* TCAs H1 blockers (diphenhydramine) low-potency neuroleptics (thioridazine, chlorpromazine) (*don't give anti-chol to patients with urinary issues, dementia, BPH)

Question 48

SFx - Acute Interstitial Nephritis "Drug induced Nephritis"

Answer 48

``` Abx: Penecillins, Cephalosporins Ciprofloxacin Rifampin Sulfonamides \\ NSAIDs Diurretics Proton Pump Inhibitors Cimetidine Allopurinol ```