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250 SEcTIoN II Pharmacology ` PHARMACOLOGY—TOXICITIES ANd SIdE EFFECTS Pharmacology ` PHARMACOLOGY—TOXICITIES ANd SIdE EFFECTS

Drug reactions—hematologic
dRUG REACTION CAUSAL AGENTS NOTES
Agranulocytosis Dapsone, Clozapine, Carbamazepine, Drugs Can Cause Pretty Major Collapse of
Propylthiouracil, Methimazole, Colchicine, Granulocytes
Ganciclovir
Aplastic anemia Carbamazepine, Methimazole, NSAIDs, Can’t Make New Blood Cells Properly
Benzene, Chloramphenicol, Propylthiouracil

Direct Coombs ⊕ Penicillin, methylDopa, Cephalosporins P Diddy Coombs
hemolytic anemia
Drug reaction with Allopurinol, anticonvulsants, antibiotics, sulfa Potentially fatal delayed hypersensitivity reac-
eosinophilia and drugs tion. Latency period (2- 8 weeks), then fever,
systemic symptoms morbilliform skin rash, frequent multiorgan
(DRESS) involvement. Treatment: withdrawal of offend-
ing drug, corticosteroids
Gray baby syndrome Chloramphenicol
Hemolysis in G6PD Isoniazid, Sulfonamides, Dapsone, Primaquine, Hemolysis IS D PAIN
deficiency Aspirin, Ibuprofen, Nitrofurantoin

Megaloblastic anemia Hydroxyurea, Phenytoin, Methotrexate, Sulfa drugs You’re having a mega blast with PMS
Thrombocytopenia Heparin, vancomycin, linezolid, quinidine,
indinavir, ganciclovir, abciximab
Thrombotic Combined oral contraceptives, hormone Estrogen-mediated side effect
complications replacement therapy, SERMs (eg, tamoxifen)

Drug reactions—musculoskeletal/skin/connective tissue
dRUG REACTION CAUSAL AGENTS NOTES
Drug-induced lupus Methyldopa, Minocycline, Hydralazine, Lupus Makes My HIPS Extremely Painful
Isoniazid, Phenytoin, Sulfa drugs, Etanercept,
Procainamide
Fat redistribution Protease inhibitors, Glucocorticoids Fat PiG
2+
Gingival hyperplasia Cyclosporine, Ca channel blockers, Phenytoin Can Cause Puffy gums
Hyperuricemia (gout) Pyrazinamide, Thiazides, Furosemide, Niacin, Painful Tophi and Feet Need Care
Cyclosporine
Myopathy Statins, fibrates, niacin, colchicine, daptomycin,
hydroxychloroquine, interferon-α,
penicillamine, glucocorticoids
Osteoporosis Corticosteroids, depot medroxyprogesterone
acetate, GnRH agonists, aromatase inhibitors,
anticonvulsants, heparin, PPIs
Photosensitivity Sulfonamides, Amiodarone, Tetracyclines, 5-FU SAT For Photo
Rash (Stevens-Johnson Anti-epileptic drugs (especially lamotrigine), Steven Johnson has epileptic allergy to sulfa
syndrome) allopurinol, sulfa drugs, penicillin drugs and penicillin
Teeth discoloration Tetracyclines Teethracyclines
Tendon/cartilage Fluoroquinolones
damage

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