TOXICITIES AND SIDE EFFECTS Flashcards
These drugs cause Coronary vasospasm
Cocaine, Amphetamines, Sumatriptan, Ergot alkaloids (CASE)
causes Cutaneous flushing
Vancomycin, Adenosine, Niacin, Ca2+ channel blockers, Echinocandins, Nitrates (flushed from VANCEN)
rate-dependent infusion reaction to vancomycin causing widespread pruritic erythema due to histamine release. Manage with diphenhydramine, slower infusion rate.
Red man syndrome
causes Dilated cardiomyopathy
Anthracyclines (eg, Doxorubicin, Daunorubicin); prevent with Dexrazoxane
Cause Torsades de pointes
Agents that prolong QT interval: antiArrhythmics (class IA, III), antiBiotics (eg, macrolides), anti“C”ychotics (eg, ziprasidone), antiDepressants (eg, TCAs), antiEmetics (eg, ondansetron) (ABCDE)
Cause Adrenocortical
insufficiency
HPA suppression 2° to glucocorticoid withdrawal
Causes Diabetes insipidus
Lithium, demeclocycline
Causes Hot flashes
SERMs (eg, tamoxifen, clomiphene, raloxifene)
Causes Hyperglycemia
Tacrolimus, Protease inhibitors, Niacin, HCTZ,
Corticosteroids
cause Hyperprolactinemia
Typical antipsychotics (eg, haloperidol), atypical antipsychotics (eg, risperidone), metoclopramide, methyldopa, reserpine
Presents with hypogonadism (eg, infertility, amenorrhea, erectile dysfunction) and
galactorrhea
cause Hyperthyroidism
Amiodarone, iodine
cause Hypothyroidism
AMiodarone, SUlfonamides, Lithium
cause SIADH
Carbamazepine, Cyclophosphamide, SSRIs
Causes Acute cholestatic
hepatitis, jaundice
Macrolides (eg, erythromycin)
Cause Diarrhea
Acamprosate,
antidiabetic agents (acarbose, metformin, pramlintide),
colchicine,
cholinesterase inhibitors,
lipid-lowering agents (eg, ezetimibe, orlistat),
macrolides (eg, erythromycin), SSRIs,
chemotherapy (eg, irinotecan)
cause Focal to massive hepatic necrosis
Halothane, Amanita phalloides (death cap mushroom), Valproic acid, Acetaminophen
causes Hepatitis
Rifampin, isoniazid, pyrazinamide, statins,
fibrates
cause Pancreatitis
Didanosine, Corticosteroids, Alcohol, Valproic acid, Azathioprine, Diuretics (eg, furosemide, HCTZ)
cause Pill-induced esophagitis
Bisphosphonates, ferrous sulfate, NSAIDs, potassium chloride, tetracyclines
Pseudomembranous colitis
Ampicillin, cephalosporins, clindamycin, fluoroquinolones, PPIs
drugs that cause Agranulocytosis
Dapsone, Clozapine, Carbamazepine,
Propylthiouracil, Methimazole, Colchicine,
Ganciclovir
cause Aplastic anemia
Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol, Propylthiouracil
Direct Coombs ⊕ hemolytic anemia
Penicillin, methylDopa, Cephalosporins
drugs that cause Drug reaction with eosinophilia and
systemic symptoms
(DRESS)
Allopurinol, anticonvulsants, antibiotics, sulfa drugs
Causes Gray baby syndrome
Chloramphenicol
Cause Hemolysis in G6PD
deficiency
Isoniazid, Sulfonamides, Dapsone, Primaquine,
Aspirin, Ibuprofen, Nitrofurantoin
Cause Megaloblastic anemia
Hydroxyurea, Phenytoin, Methotrexate, Sulfa drugs
Cause Thrombocytopenia
Heparin, vancomycin, linezolid, quinidine,
indinavir, ganciclovir, abciximab
cause Thrombotic
complications
Combined oral contraceptives, hormone replacement therapy, SERMs (eg, tamoxifen)
cause Drug-induced lupus
Methyldopa, Minocycline, Hydralazine, Isoniazid, Phenytoin, Sulfa drugs, Etanercept, Procainamide
Cause Fat redistribution
Protease inhibitors, Glucocorticoids
Drugs that cause Gingival hyperplasia
Cyclosporine, Ca2+ channel blockers, Phenytoin
drugs that cause Hyperuricemia (gout)
Pyrazinamide, Thiazides, Furosemide, Niacin, Cyclosporine
cause Myopathy
Statins, fibrates, niacin, colchicine, daptomycin,
hydroxychloroquine, interferon-α, penicillamine, glucocorticoids
drugs that cause Osteoporosis
Corticosteroids, depot medroxyprogesterone
acetate, GnRH agonists, aromatase inhibitors,
anticonvulsants, heparin, PPIs
cause Photosensitivity
Sulfonamides, Amiodarone, Tetracyclines, 5-FU
cause Rash (Stevens-Johnson syndrome)
Anti-epileptic drugs (especially lamotrigine), allopurinol, sulfa drugs, penicillin
causes Teeth discoloration
Tetracyclines
causes Tendon/cartilage
damage
Fluoroquinolones
causes Cinchonism
Quinidine, quinine
Can present with tinnitus, hearing/vision loss, psychosis, and cognitive impairment
Parkinson-like
syndrome
Antipsychotics, Reserpine, Metoclopramide
Peripheral neuropathy
Isoniazid, phenytoin, platinum agents (eg, cisplatin), vincristine
Idiopathic intracranial
hypertension
Growth hormones, tetracyclines, vitamin A
cause Seizures
Isoniazid, Bupropion, Imipenem/cilastatin,
Tramadol, Enflurane
drugs that cause Tardive dyskinesia
Antipsychotics, metoclopramide
drugs that cause Visual disturbance
Topiramate (blurred vision/diplopia, haloes), Digoxin (yellow-tinged vision), Isoniazid (optic neuritis), Vigabatrin (bilateral visual field defects), PDE-5 inhibitors (blue-tinged vision), Ethambutol (color vision changes)
cause Fanconi syndrome
Cisplatin, ifosfamide, expired tetracyclines, tenofovir
cause Hemorrhagic cystitis
Cyclophosphamide, ifosfamide
Prevent by coadministering with mesna
Interstitial nephritis
Remember the 5 P’s Diuretics (Pee), NSAIDs (Pain-free), Penicillins and cephalosporins, PPIs, rifamPin, and sulfa drugs
causes Dry cough
ACE inhibitors
drugs that cause Pulmonary fibrosis
Methotrexate, Nitrofurantoin, Carmustine, Bleomycin, Busulfan, Amiodarone
cause Antimuscarinic effects
Atropine, TCAs, H1-blockers, antipsychotics
Disulfiram-like reaction
1st-generation Sulfonylureas, Procarbazine, certain Cephalosporins, Griseofulvin, Metronidazole
cause Nephrotoxicity/
ototoxicity
Loop diuretics, Aminoglycosides, cisPlatin,
Vancomycin, amphoTERicin B
Drugs that increase pupil size (dilation)
Anticholinergics (eg, atropine, TCAs,tropicamide, scopolamine, antihistamines)
Drugs of abuse (eg, amphetamines, cocaine, LSD), meperidine
Sympathomimetics
Drugs that decrease pupil size (constrict)
Sympatholytics (eg, α2-agonists)
Drugs of abuse (eg, heroin/opioids)
Parasympathomimetics (eg, pilocarpine),
organophosphates