Cardiovascular
A 55‑year‑old man with hypertension develops a persistent dry cough after starting therapy. Which drug class is most likely responsible?
ACE inhibitors (example: Lisinopril)
A hospitalized patient with MRSA develops flushing and pruritus during IV infusion of an antibiotic. Which drug is most likely responsible?
Vancomycin (causing “Red man syndrome”)
A 12‑year‑old boy with generalized tonic‑clonic seizures develops gum overgrowth and coarse facial hair after starting therapy. Which anticonvulsant is most likely responsible?
Phenytoin
A patient with rheumatoid arthritis is started on a drug that inhibits dihydrofolate reductase. Weeks later, they develop mouth ulcers and pancytopenia. Which drug is most likely responsible?
Methotrexate
A patient with gout is started on a drug that inhibits xanthine oxidase to reduce uric acid production. Which medication is this?
Allopurinol
This ARB blocks angiotensin II receptors, is used for hypertension and CHF, and is less likely than ACE inhibitors to cause ________.
Cough or angioedema (drug: Losartan)
This aminoglycoside irreversibly binds the 30S ribosomal subunit, causing misreading of mRNA. It treats severe Gram‑negative infections but can cause ________ and ototoxicity.
Nephrotoxicity (drug: Gentamicin)
This mood stabilizer and anticonvulsant increases GABA activity and blocks sodium channels. It’s used for seizures, bipolar disorder, and migraine prophylaxis, but carries a risk of ________ and neural tube defects.
Hepatotoxicity (drug: Valproic acid)
This alkylating agent cross‑links DNA and is used for solid tumors and autoimmune diseases. A major adverse effect is hemorrhagic cystitis, which can be prevented with ________.
Mesna (drug: Cyclophosphamide)
This microtubule inhibitor reduces neutrophil migration and is used for acute gout flares. A common adverse effect is ________.
Diarrhea (drug: Colchicine)
Which diuretic acts on the distal tubule to inhibit NaCl reabsorption and can cause hypokalemia and hyperuricemia?
A) Furosemide
B) Hydrochlorothiazide
C) Amiodarone
D) Losartan
Hydrochlorothiazide
Which macrolide blocks 50S ribosomal translocation, is used for respiratory infections and atypicals, but can prolong the QT interval?
A) Clindamycin
B) Azithromycin
C) Doxycycline
D) Ciprofloxacin
Azithromycin
Which sodium channel blocker is first‑line for trigeminal neuralgia but can cause agranulocytosis and SIADH? A) Lamotrigine B) Carbamazepine C) Levetiracetam D) Valproic acid
Carbamazepine
Which anthracycline generates free radicals, intercalates DNA, and is notorious for causing cardiotoxicity? A) Imatinib B) Doxorubicin C) Methotrexate D) Cyclophosphamide
Doxorubicin
Which DMARD inhibits dihydrofolate reductase, is used for rheumatoid arthritis and psoriasis, and can cause myelosuppression and hepatotoxicity?
A) Methotrexate
B) Infliximab
C) Allopurinol
D) Colchicine
Methotrexate
This loop diuretic treats pulmonary edema and CHF but can cause ototoxicity in addition to hypokalemia. Name the drug.
Furosemide
This lincosamide antibiotic is effective against anaerobic infections, but its use is limited by a risk of C. diff colitis. Name the drug.
Clindamycin
This anticonvulsant, also used in bipolar disorder, must be titrated slowly to avoid a life‑threatening rash known as Stevens‑Johnson syndrome. Name the drug.
Lamotrigine
This tyrosine kinase inhibitor blocks the BCR‑ABL fusion protein in chronic myelogenous leukemia but can cause fluid retention. Name the drug.
Imatinib
This monoclonal antibody neutralizes TNF‑α and is used for RA, Crohn’s disease, and psoriasis, but increases the risk of infections and TB reactivation. Name the drug.
Infliximab
This Class III antiarrhythmic prolongs repolarization by blocking potassium channels, but carries risks of pulmonary fibrosis, thyroid dysfunction, and hepatotoxicity. What is the drug?
Amiodarone
A hiker develops fever and rash after a tick bite. The antibiotic prescribed blocks the 30S ribosome to prevent tRNA binding, but can cause photosensitivity and teeth discoloration. What is the drug?
Doxycycline
A patient with absence seizures is started on a medication that blocks T‑type calcium channels in the thalamus. What is the drug, and what common side effect should be monitored?
Ethosuximide; GI upset (nausea, vomiting)
A patient with a pulmonary embolism is started on an anticoagulant that activates antithrombin, thereby decreasing thrombin and factor Xa. What is the drug, and what serious complication must be monitored?
Heparin; Heparin‑induced thrombocytopenia (HIT)
A transplant patient develops nephrotoxicity after starting an immunosuppressant that inhibits calcineurin, thereby blocking IL‑2 transcription. Which drug is responsible?
Cyclosporine