Updated: 10/12/2020

Drug Reactions and Side Effects

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Questions
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Evidence
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  • Overview
    • Drug reactions organized by system
      • cardiovascular
      • GI
      • musculoskeletal
      • neurologic
      • renal
      • reproductive/endocrine
      • respiratory
      • multiorgan
    • Type A reactions
      • predictable
      • common
      • mild and self resolving
      • dose-dependent
    • Type B reactions
      • unpredictable
      • rare
      • severe
      • idiosyncratic
      • not dose-dependent
  • Medication Reactions
      • Cardiovascular
      • Reaction
      • Causal Agent
      • Atropine-like side effects
      • TCAs
      • Coronary vasospasm
      • Cocaine
      • Sumatriptan
      • Cutaneous flushing
      • Vancomycin
      • Adenosine
      • Niacin (reduced by co-administration of aspirin)
      • Calcium channel blockers
      • Dilated cardiomyopathy
      • Doxorubicin (Adriamycin)
      • Daunorubicin
      • Trastuzumab
      • Cocaine
      • Torsades de pointes
      • Class IA antiarrhythmic (disopyramide, quinidine, procainamide)
      • Class III antiarrhythmics (amiodarone, sotalol)
      • Lithium
      • Chloroquine
      • Erythromycin, clarithromycin
      • Haloperidol, thioridazine, ziprasidone
      • GI
      • Reaction
      • Causal Agent
      • Acute cholestatic hepatitis
      • Macrolides
      • Troglitazone
      • Focal to massive hepatic necrosis
      • Halothane
      • Valproic acid
      • Acetaminophen
      • Amanita phalloides
      • Carbon tetrachloride
      • Hepatitis
      • INH
      • Phenytoin
      • Methyldopa
      • Pseudomembranous colitis
      • Clindamycin
      • Ampicillin
      • Hematologic
      • Reaction
      • Causal Agent
      • Agranulocytosis
      • Clozapine
      • Carbamazepine
      • Colchicine
      • Propylthiouracil
      • Methimazole
      • Dapsone
      • Cephalosporins
      • Aplastic anemia
      • Chloramphenicol
      • Benzene
      • NSAIDs
      • Propylthiouracil
      • Methimazole
      • Carbamazepine
      • Phenytoin
      • Direct Coombs-positive hemolytic anemia
      • Methyldopa
      • Penicillin
      • Gray baby syndrome
      • Chloramphenicol
      • Hemolysis in G6PD-deficient patients
      • Isoniazid (INH)
      • Dapsone
      • Sulfonamides
      • Primaquine
      • Chloroquine
      • Aspirin
      • Ibuprofen
      • Nitrofurantoin
      • Methylene blue
      • Megaloblastic anemia
      • Phenytoin
      • Methotrexate
      • Sulfonamides
      • 6-mercaptopurine
      • Cytosine arabinoside
      • Thrombotic complications
      • Contraceptives
      • Musculoskeletal
      • Reaction
      • Causal Agent
      • Gingival hyperplasia
      • Phenytoin
      • Cyclosporin
      • Nifedipine
      • Gout
      • Furosemide
      • Thiazides
      • Cyclosporin
      • Levodopa
      • Niacin
      • Osteoporosis
      • Corticosteroids
      • Heparin
      • Proton pump inhibitors
      • Lithium
      • Photosensitivity
      • Sulfonamides
      • Amiodarone
      • Tetracycline
      • Fluoroquinolones
      • Rash (Stevens-Johnson syndrome)
      • Ethosuximide
      • Lamotrigine
      • Carbamazepine
      • Phenobarbital
      • Phenytoin
      • Sulfonamides
      • Fluorquinolones
      • Furosemide
      • Penicillin
      • Allopurinol
      • Rhabdomyolysis
      • Statins
      • SLE-like syndrome
      • Hydralazine
      • INH
      • Procainamide
      • Phenytoin
      • Carbamazepine
      • Tendonitis, tendon rupture, and cartilage damage in children
      • Fluoroquinolones
      • Neurologic
      • Cinchonism
      • Quinidine
      • Quinine
      • Diabetes insipidus
      • Lithium
      • Demeclocycline
      • Parkinson-like syndrome
      • Haloperidol
      • Chlorpromazine
      • Reserpine
      • Metoclopramide
      • MPTP (causes permanent Parkinson's)
      • Clozapine
      • Prochlorperazine
      • Cinnarizine
      • Seizures
      • Bupropion
      • Venlafazine
      • Tramadol
      • Diphenhydramine
      • Imipenem/cilastatin
      • Isoniazid
      • Tardive dyskinesia
      • Antipsychotics (chlorpromazine)
      • Renal/GU
      • Reaction
      • Causal Agent
      • Fanconi's syndrome
      • Expired tetracycline
      • Tenofovir
      • Interstitial nephritis
      • Methicillin
      • NSAIDs
      • Acetominophen
      • Furosemide
      • Allopurinol
      • Hemorrhagic cystitis
      • Cyclophosphamide
      • Ifosfamide (prevented by mesna administration)
      • Reproductive/Endocrine
      • Adrenocortical insufficiency
      • Withdrawal of glucocorticoid therapy
      • Gynecomastia
      • SpironolactoneDigitalisCimetidineClomipheneBusulfan, nitrourea, vincristine (direct testicular injury)
    • Reaction
      Causal Agent
      Hot FlashesTamoxifenClomiphene
      HypothyroidismLithiumAmiodaroneNeck radiation therapy
      Respiratory
      CoughACE inhibitors
      Pulmonary fibrosisBleomycinAmiodaroneBusulfanMethotrexateCyclophosphamideHydralazineTocainide
      Multiorgan
      Disulfiram-like reactionSulfonylureaMetronidazole
      Nephrotoxicity/neurotoxicityPolymyxins
      Nephrotoxicity/ototoxicityAminoglycosides (neomycin)VancomycinLoop diuretics (ethacrynate, furosemide, bumetanide)CisplatinMercuric chloride

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(M1.PH.17.4707) A 32-year-old female presents to her primary care physician with a 4 day history of vaginal odor. When prompted, she says that she has also had some discharge but does not remember details about the discharge. She last had unprotected sex with a new partner 2 weeks prior to presentation. Physical exam reveals minimal inflammation and wet mounts show the cells demonstrated in Figure A. The antibiotic most likely prescribed in this case has which of the following notable side effects?

QID: 108437
FIGURES:

Alcohol intolerance

53%

(173/325)

Aplastic anemia

11%

(35/325)

Ototoxicity

20%

(65/325)

Red man syndrome

3%

(11/325)

Tendon rupture

10%

(34/325)

M 3 C

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(M1.PH.15.75) A 37-year-old female with systemic lupus erythematosus is started on a new regimen of corticosteroids to better control her symptoms. The prescribing physician counsels the patients on the possible side effects including weight gain, hirsutism, and skin changes. The physician goes on to state that corticosteroids can also cause a number of changes on the patients laboratory studies. Which figure correctly identifies the cell type that would be expected to INCREASE as a result of corticosteroid use?

QID: 106846
FIGURES:

Figure A

54%

(109/201)

Figure B

7%

(15/201)

Figure C

19%

(38/201)

Figure D

8%

(17/201)

Figure E

6%

(13/201)

M 1 D

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(M1.PH.14.17) A 75 year-old gentleman presents to the primary care physician with a 2 week history of right sided achilles tendon pain. He states that the pain has had a gradual onset and continues to worsen, now affecting the left side for the past 2 days. He denies any inciting event. Of note the patient performs self-catheterization for episodes of urinary retention and has been treated on multiple occasions for recurrent urinary tract infections. What is the most important next step in management for this patient's achilles tendon pain?

QID: 104902

Refer patient to an orthopedic surgeon

6%

(15/266)

Switch medication and avoid exercise

64%

(169/266)

Place permanent urinary catheter

8%

(20/266)

Perform MRI

12%

(31/266)

Perform CT scan

9%

(23/266)

M 3 D

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(M1.PH.14.54) A 55-year-old man presents to his primary care provider complaining of blood clots in his urine. On further questioning, he also reports suprapubic discomfort and a feeling of bladder fullness with difficulty voiding. The patient reports recently starting treatment for a newly diagnosed non-Hodgkin lymphoma. Vital signs are within normal limits. Physical exam reveals pain on palpation of the suprapubic region. What is the mechanism of action of the drug most likely responsible for the patient’s complaints?

QID: 106368

Alkylating agent

66%

(224/341)

Intercalating agent

9%

(31/341)

Reverse transcriptase inhibitor

4%

(13/341)

Microtubule inhibitor

15%

(51/341)

Folic acid analogue

5%

(17/341)

M 2 D

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(M1.PH.14.21) A 42-year-old female with a history of systemic lupus erythematous (SLE) has a 3-year history of daily prednisone (20 mg) use. Due to long-term prednisone use, she is at increased risk for which of the following?

QID: 101958

Hair loss

5%

(5/105)

Weight loss

2%

(2/105)

Pancreatic insufficiency

7%

(7/105)

Systolic hypertension

19%

(20/105)

Pathologic fractures

62%

(65/105)

M 3 E

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