Exam aid · Drugs and therapeutics

Signature Adverse Effects

The one adverse effect each drug is famous for. Examiners use these as giveaways.

Tables to memorise

Cover the right-hand column and test yourself before checking.

Drug	Signature effect
ACE inhibitors	Dry cough, angioedema, hyperkalaemia
Amlodipine	Ankle oedema
Amiodarone	Thyroid, lung fibrosis, corneal deposits, blue-grey skin
Digoxin	Yellow-green vision, arrhythmias
Hydralazine	Drug-induced lupus
Minoxidil	Hypertrichosis
Spironolactone	Gynaecomastia, hyperkalaemia
Statins	Myopathy, rhabdomyolysis
Nitrates	Headache, tolerance
Thiazides	Hypokalaemia, hyperuricaemia, hyperglycaemia
Loop diuretics	Ototoxicity, hypokalaemia

Drug	Signature effect
Aminoglycosides	Ototoxicity and nephrotoxicity
Vancomycin	Red man syndrome (rapid infusion)
Chloramphenicol	Grey baby syndrome, aplastic anaemia
Tetracyclines	Tooth staining, photosensitivity
Fluoroquinolones	Tendon rupture, QT prolongation
Metronidazole	Disulfiram-like reaction, metallic taste
Isoniazid	Peripheral neuropathy (give pyridoxine), hepatitis
Rifampicin	Orange-red body fluids, enzyme induction
Ethambutol	Optic neuritis, red-green colour loss
Pyrazinamide	Hyperuricaemia, hepatotoxicity
Amphotericin B	Nephrotoxicity, infusion reactions
Linezolid	Thrombocytopenia, serotonin syndrome

Drug	Signature effect
Phenytoin	Gingival hyperplasia, hirsutism, nystagmus
Valproate	Hepatotoxicity, neural tube defects, weight gain
Carbamazepine	SJS (HLA-B*1502), hyponatraemia
Lithium	Tremor, hypothyroidism, nephrogenic DI
Clozapine	Agranulocytosis, hypersalivation
Typical antipsychotics	Extrapyramidal effects, tardive dyskinesia
Metformin	GI upset, B12 deficiency, lactic acidosis
Sulfonylureas	Hypoglycaemia, weight gain
Pioglitazone	Fluid retention, heart failure
SGLT2 inhibitors	Genital infections, euglycaemic DKA
Bleomycin	Pulmonary fibrosis
Doxorubicin	Cardiotoxicity, red urine
Cisplatin	Nephrotoxicity, ototoxicity, severe emesis
Vincristine	Peripheral neuropathy
Cyclophosphamide	Haemorrhagic cystitis (give mesna)
Bisphosphonates	Oesophagitis, osteonecrosis of the jaw

Drug-induced lupus: hydralazine, procainamide, isoniazid (HIP).
Gingival hyperplasia: phenytoin, ciclosporin, nifedipine.
Ototoxicity: aminoglycosides, loop diuretics, cisplatin, vancomycin.
Agranulocytosis: clozapine, carbimazole, metamizole.
Photosensitivity: tetracyclines, amiodarone, thiazides, fluoroquinolones.
Disulfiram-like reaction: metronidazole, some cephalosporins (MTT side chain), sulfonylureas.

HIP lupus: Hydralazine, Isoniazid, Procainamide cause drug-induced lupus.
Ethambutol = Eyes: Check visual acuity and colour vision before and during ethambutol.

Attempt MCQs on these topics while the sheet is fresh. Anything you get wrong goes to your incorrect list for the next round.