Adverse effects Flashcards
Lower seizure threshold
Bupropion, Buspirone, Enflurane, Theophylline, many narcotics, psychostimulants; Isoniazid (B6 deficiency)
Withdrawal causes seizures
Benzos, Barbiturates, Alcohol, Anticonvulsants
Stevens-Johnson syndrome
Anticonvulsants (Lamotrigine esp; ethosuximide, carbamazepine, phenobarbital, phenytoin)
Antibiotics (penicillins, sulfa drugs)
Allopurinol
Cyp450 inducers (speed up drug metabolism)
[Ken(ytoin) rides shotgun in Barbie’s girlie car]
Phenytoin, Rifampin, St. John’s Wort, Barbiturates, Griseofulvin, Carbamazepine
Cause depression
Sedatives (alcohol, benzos, antihistamines)
Methyldopa
Typical antipsychotics
Anti-nausea drugs (metoclopramide, prochlorperazine), Glucocorticoids
Interferon alfa
Stimulant withdrawal, insufficient thyroid replacement (hypothyroidism)
Cause psychosis
Hallucinogens (LSD, PCP) Stimulants (cocaine, amphetamine) Withdrawal from benzos, barbiturates, alcohol Glucocorticoids Anabolic steroids
Check G6PD deficiency to r/o risk of hemolytic anemia
Dapsone
Amiodarone
K channel blocker and Na channel blocker (antiarrhythmic medication)
Check PFTs, LFTs, TFTs before use
(Continue to check PFTs - can cause pulmonary fibrosis)
Disulfiram like reaction if combined w/ alcohol
Metronidazole
Drug-induced lupus
SHIPP Sulfa drugs (esp sulfasalazine) Hydralazine Isoniazid Phenytoin Procainamide (also methyldopa, quinidine, chlorpromazine)
Sulfa drugs
Thiazide diuretics
Loop diuretics (except ethacrynic acid)
Acetazolamide
Anti-HTN w/ first dose orthostatic HoTN
Alpha blockers
Anti-HTN w/ hypertrichosis
Minoxidil
Anti-HTN w/ dry mouth, sedation, severe rebound HTN
Clonidine
Anti-HTN w/ reflex tachycardia
Vasodilators (hydralazine, minoxidil, nitroprusside)
Anti-HTN w/ bradycardia, impotence, asthma exacerbation
Non-selective BB
Anti-HTN w/ cough
ACE
Anti-HTN w/ angioedema
ACE (maybe ARB)
Anti-HTN w/ cyanide toxicity
Nitroprusside (vasodilator)
Anti-HTN w/ azotemia, hyperkalemia (C/I)
ACE/ARB
Anti-HTN w/ peripheral edema
NDP and DHP CCB (eg amlodipine)
Anti-HTN w/ increased intracranial pressure
Nitroprusside (vasodilator)
Cyclosporine
(Immunosuppressant)
Nephrotoxicity
Azathioprine
(Immunosuppressant)
Leukopenia
Metabolized by XO (so avoid allopurinol)
Tacrolimus
(Immunosuppressant)
Nephrotoxicity
Muromonab-D3
(Immunosuppressant)
One time cytokine release (leukopenia, fever)
Short-term therapy
Rapamycin
(Immunosuppressant)
Thrombocytopenia
Hyperlipidemia
Mycophenolate
(Immunosuppressant, lupus nephritis) Leukopenia GI toxicity Lymphoma Teratogen
Antithymocyte globulin
(Immunosuppressant)
Serum sickness
Short-term therapy
Hydroxychloroquine
(Immunosuppressant, SLE, RA)
Visual disturbances
Theophylline
Tachycardia, seizures, hypotension, drug interactions
Gynecomastia
STACKED Spironolactone (K sparing ald antagonist + anti-androgen) THC (marijuana) Alcohol (chronic use) Cimetidine (H2 blocker) Ketoconazole Estrogens Digoxin Also risperidone (atypical antipsychotic)
Diuretics causing hypokalemia
Acetazolamide
Loops
Thiazides
Diuretics causing hyperkalemia
K sparing aldosterone antagonists (spironolactone, eplerenone)
K sparing other (amiloride, triamterene)
Carbonic anhydrase inhibitor (acetazolamide)
Mild metabolic acidosis
Hypokalemia
Nephrolithiasis
Sulfa drug
Osmotic agent (mannitol)
Dilutional hyponatremia initially then
Relative hypernatremia
Hyperosmolarity
Pulmonary edema
Loop diuretics
Ototoxicity
Hyperuricemia
Hypokalemia
Hypocalcemia (Hypercalciuria; avoid w/ calcium stones)
Thiazide diuretics
Hypokalemia
Hyperuricemia
Hypercalcemia
Hyponatremia
K sparing aldosterone antagonists
Hyperkalemia
Gynecomastia, menstrual irregularity (spironolactone)
K sparing non aldosterone antagonists
Hyperkalemia
Cause interstitial nephropathy (AIN)
NSAIDs (MC) Antibiotics (MC) (aminoglycosides, B-lactams, sulfonamides) Also: allopurinol diuretics PPIs
Abx causing photosensitivity
Tetracycline
Isotretinoin
Hepatotoxicity Major teratogen Dry skin/eyes Hyperlipidemia Depression/suicidal ideation