Drug reactions Flashcards
Coronary vasospasm
amphetamines, cocaine, ergot alkaloids, sumatriptan
Cutaneous flushing
vancomycin, adenosine, niacin, nitrates, CCBs, echinocandins (-fungin)
DCM
Anthracyclines (doxorubicin, daunorubicin); prevent with dexrazoxane
Torsades de pointes
Class IA and III antiarrhythmics, antibiotics (macrolides), antipsychotics (haloperidol), antidepressants (TCAs) and antiemetics (ondansetron) ABCDE!
Adrenocortical insufficiency
glucocorticoid WITHDRAWL
Diabetes insipidus
lithium, demeclocycline
Hot flashes
tamoxifen, clomiphene
Hyperglycemia
Tacrolimus, protease inhibitors, niacin, HCTZ, corticosteroids
Hypothyroidism
Lithium, amiodarone, sulfonamides
SIADH
Carbamazepine, cyclophosphamide, SSRIs
Acute cholecystatic hepatitis, jaundice
Erythromycin
Diarrhea
Acamprosate, acarbose, cholinesterase inhibitors, colchicine, erythromycin, ezetimibe, metformin, misoprostol, orlistat, pramlintide, quinidine, SSRIs
focal to massive hepatic necrosis
Halothane, Amantia phalloides (death-cap mushroom), valproic acid, acetominophen
Hepatits
Rifampin, isoniazid, pyrazinamide, statins, fibrates
Pancreatitis
Didanosine, corticosteroids, alcohol, valproic acid, azothioprine, furosemide, HCTZ
Pill esophagitis
bisphosphonates, ferrous sulfate, NSAIDs, KCl, tetracyclines
Pseudomembranous colitis
Ampicillin, cephalosporins, clindamycin, fluoroquinolones (leads to C. difficile)
Agranulocytosis
Clozapine, carbamazepine, PTU, methimazole, colchicine, ganciclovir
Aplastic anemia
Carbamazepine, methimazole, NSAIDs, benzene, chloramphenicol, PTU
Direct Coombs+ hemolytic anemia
Methyldopa, penicillin
Drug reaction with eosinophilia and systemic symptoms (DRESS)
Allopurinol, anticonvulsants, antibiotics, sulfa drugs
Potentially fatal, latency 2-8wk; tx: GC
Gray baby syndrome
Chloramphenicol
Hemolysis in G6PDH deficiency
Isoniazid, sulfonamide, dapsone, primaquine, asprin, ibuprofen, nitrofurantoin
Megaloblastic anemia
Hydroxyurea, phenytoin, MTX, Sulfadrugs
Thrombocytopenia
Heparin
Thromboses
E+P contraceptives, HRT, SERMs (tamoxifen, raloxifene, clomiphene) MEDIATED BY ESTROGEN
Fat redistribution
Protease inhibitors, GCs
Gingival hyperplasia
Phenytoic, CCBs, cyclosporin
Hyperuricemia
Pyrazinamide, thiazides, furosemide, niacin, cyclosporine
Myopathy
statins, fibrates, niacin, colchicine, daptomycin, hydroxychloroquine, IFN-alpha, penicillamine, GCs
Osteoporosis
CS, depot medroxyprogesterone acetate, GnRH agonists, aromatase inhibitors, anticonvulsants, heparin
Photosensitivity
Sulfonamides, amiodarone, tetracyclines, 5-FU
Rash (Stevens-Johnson)
Anti-epileptics (esp. lamotrigine), allopurinol, sulfa drugs, penicillin
Teeth discoloration
tetracycline
Tendonitis, tendon rupture, cartilage damage
fluoroquinolones
Cinchonism (tinnitus, hearing/vision loss, psychosis, cognitive impariment
Quinidine, quinine
Parkinson-like syndrome
Antipsychotics, reserpine, metoclopramide
Seizures
INH (B6 deficiency), buproprion, imipenem/cilastin, tramodol, enflurane
Tardive dyskinesia
Antipsychotics, metoclopramide
Fanconi syndrome
Cisplatin, ifosfamide, expired tetracyclines, tenofovir
Hemorrhagic cystitis
Cyclophosphamide, ifosfamide
Give with mesna
Interstitial nephritis
Penicillins, furosemide, NSAIDs, PPIs, sulfa drugs
Dry cough
ACEIs
Pulmonary fibrosis
MTX, nitrofurantoin, carmustine, bleomycin, busulfan, amiodarone
Antimuscarinic
Atropine, TCAs, H1-blockers, antipsychotics
Disulfiram-like reaction
1st gen. sulfonuryeals (-mide), procarbazine, cephalosporins, griseofulvin, metronidazole
Nephrotox/ototox
Aminoglycosides, vancomycin, loop diuretics, cisplatin, amphotericin B
CYP inducers
Chronic EtOH St John's wort Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine
CYP substrates
Anti-epileptics
Theophylline
Warfarin
OCP
CYP Inhibitors
Sodium valproate Isoniazid Cimetidine Ketoconazole Fluconazole Acute Alcohol Abuse Chloramphenicol Macrolides Sulfonamides Ciprofloxacin Omeprazole Metronizadole
Sulfa drugs
Sulfonamide antibiotics, sulfasalazine, probenecid, furosemide, acetazolamide, celecoxib, thiazides, solfonylureas
Fever, UTI, SJS, hemolytic anemia, thrombocytopenia, agranulocytosis, AIN, urticaria
Mild to life-threatening