Drug Reactions

Question 1

3 drugs that can cause coronary vasospasm

Answer 1

• cocaine
• sumatriptan
• ergot alkaloids

Question 2

4 drugs that can cause cutaneous flushing

Answer 2

• vancomycin
• adenosine
• niacin
• Ca2+ channel blockers

Question 3

Drugs that can can torsades de pointes

Answer 3

• class Ia (quinidine, procainamide, disopyramide)
• class III (sotalol, ifebutilide, dofebutilide)
• antipsychotics
• TCAs
• macrolide abxs

Question 4

Drugs with negative chronotropic effects (decrease HR)

Answer 4

• b blockers
• non-dihydropyramidine Ca2+ channel blockers (verapamil, dilitazaem)
• cardiac glycosides (digoxin)
• amiodarone, sotalol (class III anti-arrhythmics)
• cholinergic agonists

Question 5

Drugs that can cause hyperglycemia (beware with diabetic pts)

Answer 5

• Tacrolimus (FK508 binder -inhibits calcineurin –> decrease IL-2 transcription)
• Protease inhibitors (-navir)
• Niacin
• HCTZ
• Corticosteroids

Question 6

Drugs that can cause hypothyroidism

Answer 6

• lithium
• amiodarone (can cause hyperthyroidism as well)
• sulfonamides

Question 7

Drugs that cause agranulocytosis (7)

Answer 7

• ganciclovir
• clozapine
• carbamezepine
• colchicine
• methimazole
• propylthiouracil
• dapsone

Question 8

Drugs that cause aplastic anemia (6)

Answer 8

• carbamazepine
• methimazole
• NSAIDs
• benzene
• chloramphenicol
• propylthiouracil

Question 9

Drugs that cause direct Coombs positive hemolytic anemia

Answer 9

methyldopa

penicillin

Question 10

Drugs that cause hemolysis if G6PD deficient

Answer 10

• isoniazid
• sulfonamides
• dapsone
• primaquine
• aspirin
• ibuprofen
• nitrofurantoin (damages bacterial DNA used in UTIs)

Question 11

Drugs that can cause megaloblastic anemia

Answer 11

phenytoin
methotrexate
sulfa drugs

Question 12

Drugs that can cause fat redistribution (2)

Answer 12

glucocorticoids

protease inhibitors

Question 13

drugs that can cause gingival hyperplasia

Answer 13

phenytoin
Ca2+ channel blockers
cyclosporine

Question 14

Drugs that can cause gout

Answer 14

pyrazinamide (for toxoplasmosis)
thiazides furosemide
niacin
cyclosporin

Question 15

Drugs that can cause photosensitivity

Answer 15

sulfonamides
amiodarone
tetracyclines
5-FU

Question 16

Drugs that can cause stevens johnson syndrome

Answer 16

anti-epileptic drugs esp lamotrigine
allopurinol
sulfa drugs
penicillin

Question 17

Drugs that can cause seizures

Answer 17

isoniazid
bupropion
imipenem/cilistatin
enflurane

Question 18

Drugs that can cause tardive dyskinesia

Answer 18

antipsychotics

metoclopramide

Question 19

Drugs that can cause diapetes insipidis vs drugs that can cause SIADH.

Answer 19

Diabetes insipidus due to lithium, demeclocycline

SIADH due to carbamazepine, cyclophosphamide, SSRIs

Question 20

Drugs that can cause pulmonary fibrosis

Answer 20

bleomycin
amiodarone
busulfan
methotrexate

Question 21

Drugs that can cause disulfiram like rxns

Answer 21

metronidazole
certain cephalosporins
griseofulvin
procarbazine
1st generation sulfonylureas

Question 22

Drugs that can nephrotoxicity/otoxicity

Answer 22

aminoglycosides
vancomycin
loop
cisplatin (may respond to amifostine)

Question 23

List the CYP450 inducers

“Chronic alcoholics Steal Phen-Phen and Never Refuse Greasy Carbs”

Answer 23

chronic alcoholism
st johns worts
phenytoin
phenobarbital
nevirapine (NNRTI)
rifampin
griseofulvin
carbamazepine

Question 24

List the CYP450 inhibitors

“AAA RACKS in GQ Magazine”

Answer 24

acute alcohol abuse
ritonavir (protease inhibitor)
amiodarone
cimetidine, ciprofloxacin
ketoconazole
sulfonamides
INH
Grapefruit juice
macrolides (except azithromycin)

Question 25

Drugs that can cause hyperkalemia

Answer 25

• nonselective b blockers
• ACE inhibitors
• angiotensin II receptor blockers
• K+ sparing diuretics
• cardiac glycosides (digoxin)
• NSAIDs