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Drug Reactions

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Updated 2009-02-22 20:19

Summary

Memorize adverse reactions to certain medications.

Drug Reactions

Drug reactionCausal agent
Lactic acidosisMetformin
HyperlipidemiaSirolimus
DyslipidemiaMetoprolol
Hematologic toxicity with this post-op analgesicKetorlac (don't use for more than 5 days)
Stevens Johnson syndromeantineoplastics
clinical depressionInterferon (for Hepatitis B)
hyperprolactinemia/galactorrheatricylics (like nortriptylene)
atropine like side effectstricylcics
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Drug reactionCausal agent
cardiac toxicitydoxorubicin (adriamycin), danorubicin
Coronoary vasospasmcocaine
cutaneous flushingniacin, calcium channel blockers, adenosine, vancomycin
Agranulocytosisclozapine, carbamazepine, colchicine
aplastic anemiachloramphenecol, benzene, NSAIDs
Gray baby syndromechloramphenecol inhibits ribosomal peptidyl transferase
Hemolysis in G6PDerssulfonamides, isoniazid (INH), aspirin, ibuprofen, primaquine, nitrofurantoin, dapsone
Thrombotic complicationsOCPs
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Drug reactionCausal agent
coughACE inhibitors
Pulmonary fibrosisbleomycin, amiodarone, busulfan
Acute cholestatic hepatitisMacrolides
Focal to massive hepatic necrosisHalothane, valproic acid, acetaminophen, amanita phalloides
HepatitisINH
Pseudomembranous colitisclindamycin, ampicillin
adrenocortical insufficiencyglucocorticoid withdrawal (HPA Suppression)
gynecomastiaSpirinolactone, Digitalis, Cimetidine, chronic alcohol use, ketoconazole
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Drug reactionCausal agent
hot flashestamoxifen
gingival hyperplasiaphenytoin, verapamil
osteoporosiscorticosteroids, heparin
photosensitivitySulfonamides, amiodarone, tetracyclines
SLE like syndromehydralazine, INH, Procainamide, Phenytoin, chlorpromazine, methyldopa, quinidine
Tendonitis, tendon rupture, and cartilage damagefluoroquinolones (example = ciprofloxacin for gram negatives)
fanconi's syndromeexpired tetracycline
interstitial nephritismethicillin
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Drug reactionCausal agent
hemorrhagic cystitiscyclophosphamide, ifosfamide
cinchonismquinidine, quinine
diabetes insipidus (nephrogenic)lithium, demeclocycline
seizuresbuproprion, imipenem/cilastin
tardative dyskinesiasantipsychotics
disulfiram like reactionmetronidazole, certain cephalosporins, procarbazine, sulfonylureas
Nephrotoxicity/neurotoxicitypolymixins
nephrotoxicity/ototoxicityaminoglycosides, loop diuretics, cisplatin
intrahepatic cholestasis and jaundicebirth control pills, anabolic steroids
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Toxins and Antidotes/Tx

ToxinAntidote/Tx
AcetaminophenN-acetylcysteine
Salicylatesalkanize urine, dialysis
Anticholinesterases, organophosphatesatropine, pralidoxime
antimuscarinic, anticholinergic agentsphysostigmine salicylate
B-blockersglucagon
digitalisstop dig, normalize K+. lidocaine, anti-dig Fab fragments, Mg2+
irondeferoxamine
leadCaEDTA, dimercaprol, succimer ("it SUCKS to be a kid who eats lead."), penicillamine
arsenic, mercury, golddimercaprol (BAL), succimer
copper, arsenic, goldpenicillamine
cyanidenitrate, hydroxocobalamin, thiosulfate
methemoglobinmethelyne blue
carbon monoxide100% O2, hyperbaric O2
methanol, ethylene glycol (antifreeze)ethanol, dialysis, fomepizole
opioidsnaloxone/naltrexone
benzodiazepinesflumazenil
TCAs (tricyclic antidepressants)NaHCO3
Heparinprotamine
Warfarinvit K, fresh frozen plasma
tPA, streptokinaseaminocaproic acid
memorize

Herbal Agents

Agent (clinical use)Toxicities
echinacea (common cold)GI, dizziness, headache (HA)
ephedra (weight loss)CNS and CV stimulation, arrhythmias, stroke, and seizures at high does
feverfew (migraine)GI, mouth ulcers, antiplatelet actions
ginkgo (intermittent claudication)GI, anxiety, insomnia, HA, antiplatelet actions
kava (chronic anxiety)GI, sedation, ataxia, hepatotoxicity, phototoxicity, dermatotoxicity
milk thistle (viral hepatitis)loose stools
saw palmetto (BPH)GI, decreased libido, HTN
St. John's wort (mild to mod depression)GI, phototoxicity, serotonin syndrome with SSRIs, inhibits p-450 system
dehydroepiandroterone (Sx'ic improvement in females with SLE or AIDS)androgenization (premenopausal women), estrogenix effects (postmenopausic women), feminization (young men)
melatonin (jet lag, insomnia)sedation, suppresses midcycle LH, hypoprolactenemia
memorize

 

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