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143 terms

USMLE Step 1 Drug Side Effects

Courtesy of Dr. Werner
STUDY
PLAY
Acetaminophen (1)
1. glutathione depletion with hepatotoxicity (acetylcysteine is antidote)
Acetazolamide (2)
1. metabolic acidosis
2. hypokalemia
Acyclovir/Ganciclovir (2)
1. crystalline nephropathy (if adequate H2O not provided)
2. seizures
Adenosine (3)
1. hypotension
2. 3rd degree AV block
3. cardiac arrest
Alendronate/Risedronate (2)
1. esophageal erosions
2. osteonecrosis of jaw
Allopurinol (2)
1. may precipitate gouty arthritis
2. rash when given with ampicillin
Alteplase (2)
1. bleeding
2. hemorrhagic stroke
Amikacin (2)
1. nephrotoxic
2. ototoxic
Amiloride (1)
1. hyperkalemia
Amiodarone (5)
1. hyperthyroidism
2. hypothyroidism
3. pulmonary fibrosis
4. prolong QT
5. torsades de pointes (but not as much as Class 1A and other class III meds)
Amoxicillin & Ampicillin (3)
1. rash in pts with EBV
2. pseudomembranous colitis
3. IgE hypersensitivity
Amphotericin B (5)
1. acute renal failure
2. type 1 RTA
3. hypokalemia and hypomagnesiumia
4. fever
5. anemia due to decreased erythropoietin production
Aspirin (4)
1. decreases platelet function for life of platelet (10 days)
2. AG metabolic acidosis + respiratory alkalosis
3. low dose --> decreases uric acid secretion
4. high dose (>3.6 gm/day) --> increases uric acid secretion
Atorvastatin (3)
1. myopathy (esp. w/ gemfibrozil)
2. hepatitis
3. cataracts
Bacitracin (1)
1. allergic contact dermatitis
Bleomycin (1)
1. pulmonary fibrosis
Busulfan (1)
1. pulmonary fibrosis
Captopril/Enalapril (2)
1. increases bradykinin --> cough, angioedema
2. hyperkalemia
Carbamazepine (2)
1. marrow aplasia
2. SIADH (hyponatremia)
Carvedilol (3)
1. AV block
2. CHF
3. bronchospasm
Chloramphenicol (2)
1. aplastic anemia (irreversible in 1/30,000)
2. Gray baby syndrome
Chloroquine (1)
1. retinopathy
Chlorpromazine (2)
1. movement disorders
2. tardive dyskinesia
Chlorpropamide (1)
1. SIADH (hyponatremia)
Cimetidine (3)
1. confusion in elderly
2. loss of libido and gynecomastia
3. increases plasma creatinine concentration
Ciprofloxacin (3)
1. damages growing cartilage
2. arthropathy
3. tendonitis and tendon repture
Cisapride (1)
1. ventricular arrhythmias
Cisplatin (2)
1. nephrotoxicity
2. peripheral sensory neuropathy
Clindamycin (2)
1. clostridium difficile colitis
2. diarrhea
Clofibrate/Fenobibrate (2)
1. hepatitis
2. myopathy
Clonidine (1)
1. rebound HTN upon withdrawal
Codeine (1)
1. constipation
Colchicine (1)
1. diarrhea
Cyclophosphamide (2)
1. hemorrhagic cystitis
2. hematuria
Cyclosporine (3)
1. nephrotoxicity
2. HTN
3. hyperglycemia
Dapsone (1)
1. anemia
Daunorubicin (1)
1. cardiomyopathy
Demeclocycline (1)
1. nephrogenic DI
Diazepam (2)
1. respiratory acidosis
2. CNS toxicity (reversed with FLUMAZENIL)
Digoxin (4)
1. atrial tachycardia with block
2. hyperkalemia
3. serum level increases when administered with Quinidine or Verapamil
4. hypopkalemia precipitates digitalis toxicity
Diphenhydramine (1)
1. urinary retention in males with BPH
Disopyramide (1)
1. precipitates CHF in those with low ejection fraction
Doxorubicin (1)
1. cardiomyopathy
Doxycycline (3)
1. photosensitivity
2. esophagitis
3. stained teeth in children
Dipyridamole (1)
1. myocardial ischemia exacerbation
Ergotamine (3)
1. vasospasm
2. bowel infarction
3. systemic HTN
Erythromycin (1)
1. increases cyclosporine and theophylline levels
Estrogens (3)
1. DVT and PE (increases clotting factors 2, 7, 9, and 10 and decreases anti-thrombin)
2. endometrial hyperplasia
3. HTN
Etanercept (2)
1. increased lymphomas
2. increased URIs
Ethambutol (1)
1. optic neuritis (altered red-green color vision and blurred vision
Fenobibrate (2)
1. myopathy with HMG CoA reductase inhibitors (statins)
2. hepatotoxicity
Finasteride (4)
1. teratogenicity to male fetus - hypospadius
2. gynecomastia
3. erectile dysfunction
4. androgen-sensitive hair growth
Flecainide/Encainide (1)
1. sudden death in patients with myocardial ischemia - proarrhythmic
Fluocinonide (topical steroid) (1)
1. atrophy and thinning of skin
5-Fluorouracil (2)
1. mucositis
2. diarrhea
Fluticasone (inhaled) (1)
1. oral thrush
Furosemide (5)
1. hypokalemia
2. decreases serum Ca2+
3. hyperglycemia
4. hyperuricemia
5. ototoxicity
Gemfibrozil (2)
1. myopathy with HMG CoA reductase inhibitors (statins)
2. hepatotoxicity
Gentamicin (2)
1. nephrotoxic (high-output ATN)
2. ototoxic (vestibular and hearing)
Halothane (3)
1. hepatitis
2. malignant hyperthermia
3. arrhythmias
Haloperidol (3)
1. tardive dyskinesia
2. hyperprolactinemia
3. amenorrhea
Heparin (3)
1. bleeding
2. thrombocytopenia
3. monitor anticoagulant effect with PTT
Hydralazine (1)
1. SLE=like syndrome with arthritis (kidney and brain spaired) + ANA
Hydrochlorothiazide (4)
1. increases serum Ca2+
2. hyperglycemia
3. hyperuricemia
4. hypokalemia
Ibuprofen (NSAIDS) (6)
1. peptic ulcer
2. platelet dysfunction for 2-3 days
3. hepatotoxicity
4. type 4 RTA
5. decreased renal function
6. diuretic resistance
Imipenem (1)
1. seizures in renal failure
Indinavir (2)
1. nephrolithiasis
2. nephrotoxicity
Indomethacin (3)
1. impaired renal function
2. ulcers
3. vertigo limits dosing in gout
Iron (2)
1. abdominal pain
2. bloody diarrhea
Isoniazid (3)
1. hepatotoxicity
2. peripheral neuritis (vit B6)
3. sideroblastic anemia (vit B6)
Isorbide dinitrate (2)
1. headache
2. methemoglobinemia (treat with methylene blue)
Isotretinoin, Tretinoin (4)
1. teratogenic, pregnancy test
2. elevated TG
3. corneal opacities
4. dry skin
Ketoconazole (azoles) (2)
1. elevated liver enzymes
2. rarely hepatitis
Leuprolide (3)
1. hot flashes
2. erectile dysfunction
3. gynecomastia
Levodopa/Carbidopa (3)
1. movement disorders
2. neuroleptic malignant syndrome
3. orthostasis
Levofloxacin (3)
1. QT prolongation
2. arthropathy
3. tendonitis and tendon rupture
Lidocaine (1)
1. seizures
Lindane (1)
1. nephrotoxicity
Lithium (2)
1. nephrogenic DI
2. low T4 and high TSH
Lovastatin (3)
1. hepatotoxicity
2. cataracts
3. myositis
MAOI (1)
1. hypertensive crisis from tyramine
Mefloquine (4)
1. depression
2. psychosis
3. seizures
4. long QT
Metformin (1)
1. lactic acidosis if serum creatinine >2.0
Methadone (1)
1. CNS depression
Methicillin (1)
1. interstitial nephritis
Methimazole (1)
1. agranulocytosis
Methotrexate (3)
1. mucositis
2. diarrhea
3. bone marrow suppression
Methyldopa (1)
1. Coombs positive hemolytic anemia
Methyltestosterone (1)
1. cholestatic jaundice
Methysergide (2)
1. retro-peritoneal fibrosis
2. urinary tract obstruction
Metoclopramide (1)
1. movement disorders (tardive dyskinesia)
Metronidazole (2)
1. disulfiram-like reaction*
2. teratogenic
Minoxidil (2)
1. tachycardia
2. hair growth
Misoprostol (2)
1. miscarriage
2. diarrhea
Morphine (1)
1. hypoventilation with acute respiratory acidosis
Nafcillin (3)
same as ampicillin (more interstitial nephritis)
1. rash in pts with EBV
2. pseudomembranous colitis
3. IgE hypersensitivity
Naproxen (6)
1. peptic ulcer
2. platelet dysfunction for 2-3 days
3. hepatotoxicity
4. type 4 RTA
5. decreased renal function
6. diuretic resistance
Niacin (4)
1. flushing (prevented with aspirin)
2. hepatotoxicity
3. hyperglycemia (acanthosis nigricans)
4. hyperuricemia/gout
Nifedipine (3)
1. edema
2. constipation
3. may precipitate MI in pts with HTN
Nitrofurantoin (1)
1. pulmonary fibrosis or lung nodules
Nitroglycerin (3)
1. syncope when used with Sildenafil
2. orthostatic hypotension
3. headache
Nitroprusside (2)
1. cyanide toxicity
2. methemoglobinemia
Omeprazole (2)
1. B12 deficiency
2. hypergastrinemia
Oxytocin (2)
1. uterine rupture
2. placental abruption
Pentamidine (2)
1. hypoglycemia
2. pancreatitis
Phenytoin (3)
1. lymphadenopathy
2. gum hyperplasia
3. nystagmus
Pioglitazone (2)
1. edema
2. CHF
Praziquantel (1)
1. miningismus and headache if used without steroids for CNS cysticercosis
Prazosin/Terazocin (2)
1. first-dose syncope
2. improves urinary stream in BPH
Prednisone (6)
1. DM
2. cataracts
3. HTN
4. osteoporosis
5. Cushing's syndrome
6. peptic ulcers
Primaquine (2)
1. methemoglobinemia
2. G6PD anemia
Probenecid (1)
1. increases serum level of PCN
Procainamide (2)
1. SLE-like syndrome with +ANA
2. arthritis (brain and kidney spared)
Propafenone (2)
1. QT prolongation
2. torsades de pointes
Propranolol (5)
1. depression
2. claudication
3. bronchospasm
4. CHF
5. masks hypoglycemic symptoms in diabetics
Propylthiouracil (2)
1. agranulocytosis
2. hepatotoxicity
Pyrimethamine/Sulfadoxine (2)
1. Stevens-Johnson syndrome
2. erythema multiforme
Quinidine (4)
1. cinchonism (vertigo, tinnitus, headache, flushing)
2. prolonged QT
3. increases AV node conduction speed
4. increases digitalis levels
Quinine (2)
1. cinchonism (vertigo, tinnitus, headache, flushing)
2. blackwater fever
Raloxifine (3)
1. DVT
2. PE
3. hot flashes
Rifampin (2)
1. red-orange urine and tears
2. hepatotoxicity
Senna (1)
1. melanosis coli (brown pigmentation of colonic mucosa)
Sildenafil (2)
1. syncope when used with NTG
2. MI from hypotension
Spironolactone (4)
1. hyperkalemia
2. gynecomastia
3. metabolic acidosis
4. teratogenicity
SSRIs (1)
1. serotonin syndrome (diarrhea, HTN, hyperthermia, tremor)
Sulfamethoxazole/Trimethoprim (2)
1. macrocytic anemia
2. leukopenia and hepatitis in pts with AIDS
Sumatriptan (2)
1. coronary vasoconstriction
2. arrhythmias
Tamoxifen (3)
1. menopausal symptoms
2. edema
3. endometrial hyperplasia or cancer
Tamsulosin (1)
1. orthostatic hypotension
Terbutaline (2)
1. tremor
2. tachycardia
Tetracycline (3)
1. dark tooth enamel when given during pregnancy or childhood
2. outdated TCN causes Fanconi syndrome
3. photosensitivity
Thalidomide (1)
1. teratogenicity
Thiabendazole (3)
1. causes Ascaris to migrate
2. Stevens-Johnson syndrome
3. hepatotoxicity
Tobramycin (2)
1. nephrotoxicity
2. ototoxicity
Tramadol (2)
1. serotonin syndrome when used with SSRIs
2. constipation
Triamterene (3)
1. hyperkalemia
2. megaloblastic anemia
3. kidney stones
Vancomycin (2)
1. red man syndrome
2. nephrotoxicity
Verapamil (4)
1. AV block
2. decreased contractility
3. increased digoxin levels
4. gingival hyperplasia
Vinblastine (1)
1. bone marrow suppression
Vincristine (3)
1. neurotoxicity
2. areflexia
3. SIADH (hyponatremia)
Warfarin (3)
1. bleeding
2. cutaneous necrosis from protein C deficiency
3. monitor effect with PT
Zidovudine (2)
1. lactic acidosis
2. bone marrow suppression
Foscarnet (3)
1. generalized seizure
2. hypomagnesemia
3. hypocalcemia