STEP 2 Rapid Review Drug Side Effects

Cough, rash, proteinuria, angioedema, taste changes, teratogenic effects

Ataxia, livedo reticularis

Ototoxicity, nephrotoxicity (ATN)

• Acute: AV block, hypotension, bradycardia
• Chronic: pulm fibrosis, peripheral deposition leading to bluish discoloration, arrhythmias, hypo/hypertyroidism, corneal deposition

Fever/rigors, nephrotox, bone marrow suppression, anemia

Sedation, acute dystonic reaction, akathisia, parkinsonism, tardive dyskinesia, NMS

Inhibition of P450 enzymes

Thrombocytopenia, megaloblastic anemia

Asthma exacerbation, masking of hypoglycemia, impotence, bradycardia, AV block, CHF

Sedation, dependence, respiratory depression

GI upset, malabsorption of vitamins/medications

Peripheral edema, constipation, cardiac depression

Induction of P450, agranulocytosis, aplastic anemia, liver toxicity

Gray baby syndrome, aplastic anemia

Nephrotoxicity, acoustic nerve damage

Dry mouth; severe rebound headache and hypertension

Agranulocytosis

Mania, hyperglycemia, immunosuppression, bone mineral loss, thinning of skin, easy bruising, myopathy, cataracts (chronic)

Myelosuppression, hemorrhagic cystitis

GI disturbance, yellow visual changes, arrhythmias (junctional tachycardia or SVT)

Cardiotoxicity (cardiomyopathy)

Renal dysfunction, CNS depression

Cartilage damage in children; Achilles tendon rupture in adults

Ototoxicity, hypokalemia, nephritis, gout

Myositis, reversible increase in LFTs

Hepatotoxicity, malignant hyperthermia

Hypokalemia, hyponatremia, hyperuricemia, hyperglycemia, hypercalemia

Myositis, reversible increase in LFTs

Drug-induced SLE

Retinopathy

Peripheral neuropathy (prevent with pyridoxine/Vit B6), hepatotoxicity, inhibition of P450, seizures with overdose, hemolysis in G6PD

Hypertensive tyramine reaction, serotonin syndrome (with meperidine)

Blindness

Hepatic fibrosis, pneumonitis, anemia

+ Coombs test, drug-induced SLE

Disulfiram reaction, vestibular dysfunction, metallic taste

Cutaneous flushing

Hypotension, tachycardia, headache, tolerance

Drug induced SLE

Hypersensitivity reactions

Nystagmus, diplopia, ataxia, arrhythmia (in toxic doses) gingial hyperplasia, hirsutism, teratogenic effects

First-dose hypotension

Drug-induced SLE

Agranulocytosis, aplastic anemia

Cinchonism (headache, tinnitus) thrombocytopenia, arrythmias (e.g. torsades de pointes)

Depression

Induction of P-450 enzymes; orange-red body secretions

Fever; hyperventilation with respiratory alkalosis and metabolic acidosis; dehydration, diaphoresis, hemorrhagic gastritis

Anxiety, sexual dysfunction, serotonin syndrome if taken with MAOIs

Malignant hyperthermia, hyperkalemia

Sedation, coma, anticholinergic effects, seizures, and arrythmias

Tooth discoloration, photosensitivity, Fanconi's syndrome, GI distress

Megolblastic anemia, leukopenia, granulocytopenia

Teratogenicity leads to neural tube defects; rare fatal hepatotoxicity

Nephrotoxicity, ototoxicity, "red man syndrome" (histamine release; not an allergy)

Severe myelosuppression

Peripheral neuropathy, paralytic ileus