Overview Drug reactions organized by system cardiovascular GI hematologic 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 Reaction Causal Agent Cardiovascular 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 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 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 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 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 Spironolactone Digitalis Cimetidine Clomiphene Busulfan, nitrourea, vincristine (direct testicular injury) Chronic alcohol use Estrogens Ketoconazole Finasteride Hot Flashes Tamoxifen Clomiphene Hypothyroidism Lithium Amiodarone Neck radiation therapy Respiratory Cough ACE inhibitors Pulmonary fibrosis Bleomycin Amiodarone Busulfan Methotrexate Cyclophosphamide Hydralazine Tocainide Multiorgan Disulfiram-like reaction Sulfonylurea Metronidazole Nephrotoxicity/neurotoxicity Polymyxins Nephrotoxicity/ototoxicity Aminoglycosides (neomycin) Vancomycin Loop diuretics (ethacrynate, furosemide, bumetanide) Cisplatin Mercuric chloride
QUESTIONS 1 of 11 1 2 3 4 5 6 7 8 9 10 11 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (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? Tested Concept QID: 108437 FIGURES: A Type & Select Correct Answer 1 Alcohol intolerance 53% (160/303) 2 Aplastic anemia 11% (34/303) 3 Ototoxicity 20% (61/303) 4 Red man syndrome 3% (10/303) 5 Tendon rupture 11% (32/303) M 3 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review tested concept Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (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? Tested Concept QID: 106846 FIGURES: A B C D E Type & Select Correct Answer 1 Figure A 56% (92/163) 2 Figure B 7% (12/163) 3 Figure C 20% (32/163) 4 Figure D 6% (10/163) 5 Figure E 7% (11/163) M 1 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review tested concept (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? Tested Concept QID: 104902 Type & Select Correct Answer 1 Refer patient to an orthopedic surgeon 3% (7/220) 2 Switch medication and avoid exercise 68% (149/220) 3 Place permanent urinary catheter 7% (15/220) 4 Perform MRI 11% (25/220) 5 Perform CT scan 9% (20/220) M 3 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review tested concept (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? Tested Concept QID: 106368 Type & Select Correct Answer 1 Alkylating agent 65% (178/273) 2 Intercalating agent 10% (27/273) 3 Reverse transcriptase inhibitor 4% (11/273) 4 Microtubule inhibitor 16% (43/273) 5 Folic acid analogue 4% (11/273) M 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review tested concept (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? Tested Concept QID: 101958 Type & Select Correct Answer 1 Hair loss 0% (0/39) 2 Weight loss 3% (1/39) 3 Pancreatic insufficiency 8% (3/39) 4 Systolic hypertension 23% (9/39) 5 Pathologic fractures 64% (25/39) M 3 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review tested concept Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK