Drug Reactions

Question 1

Cardiovascular

Answer 1

Coronary vasospasm
Cutaneous flushing
Dilated cardiomyopathy
Torsades de pointes

Question 2

Endocrine/Reproductive

Answer 2

Adrenocortical insufficiency
Hot flashes
Hyperglycemia
Hypothyroidism

Question 3

GI

Answer 3

Acute cholestatic hepatitis, jaundice
Diarrhea
Focal to massive hepatic necrosis
Hepatitis
Pancreatitis
Pseudomembranous colitis

Question 4

Hematologic

Answer 4

Agranulocytosis
Aplastic anemia
Direct Coombs-positive hemolytic anemia
Gray baby syndrome
Hemolysis in G6PD deficiency
Megaloblastic anemia
Thrombocytopenia
Thrombotic complications

Question 5

Musculoskeletal/Skin/CT

Answer 5

Fat redistribution
Gingival hyperplasia
Hyperuricemia (gout)
Myopathy
Osteoporosis
Photosensitivity
Rash (Stevens-Johnson syndrome)
SLE-like syndrome
Teeth discoloration
Tendonitis, tendon rupture, cartilage damage

Question 6

Neurologic

Answer 6

Cinchonism
Parkinson-like syndrome
Seizures
Tardive dyskinesia

Question 7

Renal/Genitourinary

Answer 7

Diabetes insipidus
Fanconi syndrome
Hemorrhagic cystitis
Intersitital nephritis
SIDADH

Question 8

Respiratory

Answer 8

Dry cough

Pulmonary fibrosis

Question 9

Multiorgan

Answer 9

Antimuscarinic
Disulfiram-like reaction
Nephrotoxicity/ototoxicity

Question 10

Cytochrome P450 inducers (+)

9

Answer 10

Chronic alcohol use
Modafinil
St. John's wort
Phenytoin
Phenobarbital
Nevapine
Rifampin
Griseofulvin
Carbamazepine

Question 11

Cytochrome P450 substrates

8

Answer 11

Anti-epileptics
Antidepressants
Antipsychotics
Anesthetics
Theophylline
Warfarin
Statins
OCPs

Question 12

Cytochrome P450 inhibitors (-)

12

Answer 12

Acute alcohol abuse
Gemfibrozil
Ciprofloxacin
Isoniazid
Grapefruit juice
Quinidine
Amiodarone
Ketoconazole
Macrolides
Sulfonamides
Cimetidine
Ritonavir

Question 13

Sulfa drugs

“Popular FACTSSS”

Answer 13

Probenecid
Furosemide
Acetazolamide
Celecoxib
Thiazides
Sulfonamide antibiotics
Sulfasalazine
Sulfonylureas
"Popular FACTSSS"

Question 14

Potential reactions associated with sulfa allergy

Answer 14

Fever, UTI, Stevens-Johnson syndrome, hemolytic anemia, thrombocytopenia, agranulocytosis, urticaria (hives)
Symptoms range from mild to life threatening

Question 15

Coronary vasospasm

Answer 15

Cocaine
Sumatriptan
Ergot alkaloids

Question 16

Cutaneous flushing

“VANC”

Answer 16

Vancomycin
Adenosine
Niacin
CCBs

Question 17

Dilated cardiomyopathy

Answer 17

Doxorubicin

Danorubicin

Question 18

Torsades de pointes

Answer 18

Class III (amiodarone, ibutilide, dofetilide, sotalol) and Class IA (quinidine, procainamide, disopyramide) antiarrhythmics
Macrolide antibiotics
Antipsychotics
TCAs

Prolonged QT interval

Question 19

Adrenocortical insufficiency

Answer 19

HPA suppression secondary to glucocorticoid withdrawal

Question 20

Hot flashes

Answer 20

Tamoxifen

Clomiphene

Question 21

Hyperglycemia

“Taking Pills Necessitates Having Blood Checked”

Answer 21

Tacrolimus
Protease inhibitors
Niacin
HCTZ
B-blockers
Corticosteroids

Question 22

Hypothyroidism

Answer 22

Lithium
Amiodarone
Sulfonamides

Question 23

Acute cholestatic hepatitis, jaundice

Answer 23

Erythromycin

Question 24

Diarrhea

“Might Excite Colon On Accident”

Answer 24

Metformin
Erythromycin
Colchicine
Orlistat
Acarbose

Question 25

Focal to massive hepatic necrosis | "Liver HAVAc"

Answer 25

Halothane Amanita phalloides (death cap mushroom) Valproic acid Acetaminophen

Question 26

Hepatitis

Answer 26

Isoniazid

Question 27

Pancreatitis | "Drugs Causing A Violent Abdominal Distress"

Answer 27

``` Didanosine Corticosteroids Alcohol Valproic acid Azathioprine Diuretics (furosemide, HCTZ) ```

Question 28

Pseudomembranous colitis

Answer 28

Clindamycin Ampicillin Cephalosporins Antibiotics predispose to superinfection by resistant C. difficile

Question 29

Agranulocytosis | "Drugs CCCrush Myeloblasts and Promyelocytes"

Answer 29

``` Dapsone Clozapine Carbamazepine Colchicine Methimazole Propylthiouracil ```

Question 30

Aplastic anemia | "Can't Make New Blood Cells Properly"

Answer 30

``` Carbamazepine Methimazole NSAIDs Benzene Chloramphenicol Propylthiouracil ```

Question 31

Direct Coombs-positive hemolytic anemia

Answer 31

Methyldopa | Penicillin

Question 32

Gray baby syndrome

Answer 32

Chloramphenicol

Question 33

Hemolysis in G6PD deficiency | "Hemolysis IS D PAIN"

Answer 33

``` Isoniazid Sulfonamides Dapsone Primaquine Aspirin Ibuprofen Nitrofurantoin ```

Question 34

Megalobastic anemia | "Having a megaloblast with PMS"

Answer 34

Phenytoin Methotrexate Sulfa drugs

Question 35

Thrombocytopenia

Answer 35

Heparin | Cimetidine

Question 36

Thrombotic complications

Answer 36

OCPs (estrogens)

Question 37

Fat redistribution | "Fat PiG"

Answer 37

Protease inhibitors | Glucocorticoids

Question 38

Gingival hyperplasia

Answer 38

Phenytoin Verapamil Cyclosporine Nifedipine

Question 39

Hyperuricemia (gout) | "Painful Tophi and Feet Need Care"

Answer 39

``` Pyrazinamide Thiazides Furosemide Niacin Cyclosporine ```

Question 40

Myopathy

Answer 40

``` Fibrates Niacin Colchicine Hydroxychloroquine IFN-a Penicillamine Statins Glucocorticoids ```

Question 41

Osteoporosis

Answer 41

Corticosteroids | Heparin

Question 42

Photosensitivity | "SAT For Photo"

Answer 42

Sulfonamides Amiodarone Tetracyclines 5-FU

Question 43

Rash (Stevens-Johnson syndrome) | "Steven Johnson has epileptic Allergy to Sulfa drugs and PCN"

Answer 43

Anti-epileptic drugs (ethosuximide, carbamazepine, lamotrigine, phenytoin, phenobarbital) Allopurinol Sulfa drugs Penicillin

Question 44

SLE-like syndrome | "Having lupus is SHIPP-E"

Answer 44

``` Sulfa drugs Hydralazine INH Procainamide Phenytoin Etanercept ```

Question 45

Teeth discoloration

Answer 45

Tetracyclines

Question 46

Tendonitis, tendon rupture, cartilage damage

Answer 46

Fluoroquinolones

Question 47

Cinchonism

Answer 47

Quinidine | Quinine

Question 48

Parkinson-like syndrome | "Cogwheel rigidity of ARM"

Answer 48

Antipsychotics Reserpine Metoclopramide

Question 49

Seizures | "With seizures, I BITE My tongue

Answer 49

``` INH (vitamin B6 deficiency) Bupropion Imipenem/cilastatin Tramadol Enflurane Metoclopramide ```

Question 50

Tardive dyskinesia

Answer 50

Antipsychotics | Metoclopramide

Question 51

Diabetes insipidus

Answer 51

Lithium | Demeclocycline

Question 52

Fanconi syndrome

Answer 52

Expired tetracycline

Question 53

Hemorrhagic cystitis

Answer 53

Cyclophosphamide Ifosfamide Prevent with mesna

Question 54

Interstitial nephritis

Answer 54

Methicillin NSAIDs Furosemide

Question 55

SIADH | "Can't Concentrate Serum Sodium"

Answer 55

Carbamazepine Cyclophosphamide SSRIs

Question 56

Dry cough

Answer 56

ACE inhibitors

Question 57

Pulmonary fibrosis | "Breathing Air Badly from Medications"

Answer 57

Bleomycin Amiodarone Busulfan Methotrexate

Question 58

Antimuscarinic

Answer 58

Atropine TCAs H1-blockers Antipsychotics

Question 59

Disulfiram-like reaction

Answer 59

``` Metronidazole Certain cephalosporins Griseofulvin Procarbazine 1st generation sulfonylureas (Tolbutamide, Chlorpropamide) ```

Question 60

Nephrotoxicity/Ototoxicity

Answer 60

Aminoglycosides Vancomycin Loop diuretics Cisplatin