Source / episode info

• **Episode:**387
• **Title:**Divine Intervention Episode 387 – Adverse Drug Reactions for Step 2CK/3
• **Published:**2022-04-27
• Source:Episode page

One-liner

This episode reviews critical high-yield drug toxicities, including granulitis (anti-thyroid/anti-seizure), lupus induction (procainamide/methotrexate), pulmonary fibrosis (chemo agents/amiodarone), and various organ-specific ADRs like hepatotoxicity, HIT, megaloblastic anemia, and photosensitivity.

High-yield summary

• Granulitis: Associated with anti-thyroid drugs (PTU, Methimazole), carbamazepine, and chloramphenicol.
• Drug-Induced Lupus (DIL): Classic culprits include procainamide, hydroxychloroquine, isoniazid (INH), and phenytoin.
• Hepatic Toxicity: Common causes include acetaminophen (most common), statins, amiodarone, and anti-tubercular drugs (INH).
• HIT Management: Triggered by heparin products; treatment requires stopping the heparin product and administering a Factor II inhibitor (Bivalirudin).
• Megaloblastic Anemia: Caused by drugs inhibiting folate synthesis (e.g., Methotrexate, Sulfonamides, 5-Fluorouracil) or those interfering with DNA synthesis.
• Photosensitivity: Remember the mnemonic SAD: Phenothiazines, Amiodarone, Tetracyclines.

Learning objectives

• Identify common adverse drug reactions associated with anti-thyroid, anti-seizure, and anti-infective agents.
• Differentiate the mechanisms and management of various types of drug-induced hematologic and hepatic toxicities (e.g., HIT vs. megaloblastic anemia).
• Recognize specific drugs that cause photosensitivity or ototoxicity.
• Understand the pathophysiology behind common adverse reactions like aspirin-exacerbated respiratory disease and methyldopa-induced hemolytic anemia.
• Apply knowledge of drug interactions in high-risk populations (pregnancy, immunocompromised status).