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 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 Reaction Causal Agent 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 Reaction Causal Agent Adrenocortical insufficiency Withdrawal of glucocorticoid therapy Gynecomastia SpironolactoneDigitalisCimetidineClomipheneBusulfan, nitrourea, vincristine (direct testicular injury) Hot Flashes Tamoxifen Clomiphene Hypothyroidism Lithium Amiodarone Neck radiation therapy Respiratory Reaction Causal Agent Cough ACE inhibitors Pulmonary fibrosis Bleomycin Amiodarone Busulfan Methotrexate Cyclophosphamide Hydralazine Tocainide Multiorgan Reaction Causal Agent Disulfiram-like reaction Sulfonylurea Metronidazole Nephrotoxicity/neurotoxicity Polymyxins Nephrotoxicity/ototoxicity Aminoglycosides (neomycin) Vancomycin Loop diuretics (ethacrynate, furosemide, bumetanide) Cisplatin Mercuric chloride