Chapter 30

Pharmacology

1 On the USMLE, bizarre, unique, and fatal side effects are tested as well as common side effects of common drugs. Cover the right-hand column and name the side effects of the listed drugs

DRUG	SIDE EFFECT
Trazodone	Priapism
Aspirin	Gastrointestinal (GI) bleeding, hypersensitivity
Bleomycin	Pulmonary fibrosis
Cyclophosphamide	Hemorrhagic cystitis
Bupropion	Seizures
Isoniazid	Vitamin B6 deficiency, lupus-like syndrome, liver toxicity
Cyclosporine	Renal toxicity
Penicillins	Anaphylaxis; rash with Epstein-Barr virus (EBV)
Angiotensin-converting enzyme (ACE) inhibitors	Cough, angioedema
Demeclocycline	Diabetes insipidus
Lithium	Diabetes insipidus, thyroid dysfunction
Sulfa drugs	Allergies, kernicterus in neonates
Halothane	Liver necrosis
Local anesthetic	Seizures
Phenytoin	Folate deficiency, teratogen, hirsutism
Vincristine	Peripheral neuropathy
Amiodarone	Thyroid dysfunction, pulmonary toxicity
Valproic acid	Neural tube defects in offspring
Isotretinoin	Terrible teratogen
Thioridazine	Retinal deposits, cardiac toxicity
Heparin	Thrombocytopenia, thrombosis
Vancomycin	Red man’s syndrome
Clofibrate	Increased GI neoplasms
Tetracyclines	Photosensitivity, teeth staining in children
Quinolones	Teratogens (cartilage damage)
Quinine	Cinchonism (tinnitus, vertigo), thrombocytopenia, QT prolongation
Morphine	Sphincter of Oddi spasm
Clindamycin	Pseudomembranous colitis (can be caused by any broad-spectrum antibiotic)
Chloramphenicol	Aplastic anemia, gray-baby syndrome
Doxorubicin	Cardiomyopathy
Busulfan	Pulmonary fibrosis
Monoamine oxidase (MAO) inhibitors	Tyramine crisis (after eating cheese or wine)
Hydralazine	Lupus-like syndrome
Procainamide	Lupus-like syndrome
Minoxidil	Hirsutism
Aminoglycoside	Hearing loss, renal toxicity
Acetaminophen	Liver toxicity (in high doses)
Chlorpropamide	Syndrome of inappropriate antidiuretic hormone (SIADH)
Oxytocin	SIADH
Opiates	SIADH
Didanosine (ddI)	Pancreatitis, peripheral neuropathy
Halogen anesthesia	Malignant hyperthermia
Succinylcholine	Malignant hyperthermia
Zidovudine (AZT)	Bone marrow suppression
Digitalis	GI disorders, vision changes, arrhythmias
Acetazolamide	Metabolic acidosis
Clozapine	Agranulocytosis
Selective serotonin reuptake inhibitors (e.g., fluoxetine)	Anxiety, agitation, insomnia, sexual dysfunction
Warfarin	Necrosis, teratogen
Niacin	Skin flushing, pruritus
HMG CoA reductase inhibitors (e.g., simvastatin)	Liver and muscle toxicity
Ethambutol	Optic neuritis
Metronidazole	Disulfiram-like reaction with alcohol
Cisplatin	Nephrotoxicity
Methyldopa	Hemolytic anemia (Coombs test-positive)

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