Signature Drug Toxicities

Agranulocytosis Clozapine; Indomethacin

Aplastic Anemia Chloramphenicol; NSAIDs; Benzene
Atropine-like Side Effects Tricyclics; Diphenhydramine; Promethazine, Thiorididazine
Cardiotoxicity CHF: Doxorubicin, Daunorubicin
Arrhythmias: Tricyclics, Thioridazine; most Antiarrhythmics!
Collagen dysfunction (children/pregnancy) Fluoroquinolones
Cinchonism Quinidine; Quinine
Cough ACE Inhibitors
Diabetes Insipidus Lithium and more
Disulfiram-like effect Metronidazole; Sulfonylureas (1st generation); cefotetan &
some other cephalosporins
Extrapyramidal Side Effects Antipsychotics (older agents)
Fanconi?s Syndrome (renal) Tetracycline
Gingival Hyperplasia Phenytoin; Dihydropyridine CCAs; Cyclosporin
Gray Baby Syndrome Chloramphenicol
Gynecomastia Cimetidine; Azoles; Spironolactone; Anti-androgens
Hemolytic Anemia in G6PD-deficiency Sulfonamides; Isoniazid; Aspirin; Ibuprofen;
Primaquine, Quinine
Hepatotoxicity Acetaminophen (centrilobular necrosis), Anabolic steroids
(cholestasis), Erythromycin (cholestasis), Halothane (hepatitis, but rare!), Isoniazid
(hepatitis), Valproic acid (necrosis)
Hot Flashes, Flushing Niacin; Tamoxifen; CCAs
Induce Cytochrome P450s Barbiturates; Phenytoin; Carbamazepine; Ethanol;
Rifampin
Inhibit Cytochrome P450s Cimetidine; Azoles; Erythromycin; Ethanol; Indinavir,
Ritonavir
Interstitial Nephritis Methicillin; NSAIDs; Furosemide; Sulfonamides
Maternal-Fetal Toxicity Alcohol; Alkylating agents; Carbamazepine; Coumarins
(Warfarin); DES;
Isotretinoin; Lead; Lithium, Phenytoin; Ribavirin; Tetracyclines; Valproic acid
Osteoporosis Heparin; Corticosteroids
Phototoxicity Sulfonamides, Tetracyclines, FQs, amiodarone, furosemide,
griseofulvin, thiazides
Positive Coombs? Test Methyldopa,
Pulmonary Fibrosis Bleomycin; Busulfan; Procarbazine; Amiodarone; Ergots
Serotonin Syndrome with SSRIs MAOIs, Tricyclics, Selegiline, Meperidine, MDMA
(XTC)
Severe HTN with Tyramine MAOIs
SLE-like Syndrome Procainamide, Hydralazine, Isoniazid & many more (DI-SLE not

gender biased & minimal renal involvement)

Tardive Dyskinesia Phenothiazines, Haloperidol, Thioxanthenes
Tinnitus Aspirin; Quinidine, Antimalarials

Cytochrome P450 Inducer: is Chronic Alcohol

Cytochrome P450 Inhibitor : is Acute Alcohol.

Crystalluria - sulfonamide, acyclovir, ganciclovir, methotrexate

Histamine Releaser - Morphine, Succinylcholine, D-tubocurarine, AmphotericinB
Porphyria precipitants - Pyrazinamide, Griseofulvin, all general inducers mentioned
above