This is my 38th powerpoint.. It deals with the pathophysiological mechanisms involved in ADRs, the roles of drugs involved in specific ADRs(in alphabetical order "A") In future slides, i will present the remaining ADRs, and causative drugs, in alphabetical order...! Happy reading!!! @RxVichu-alwz4uh! :)

1. ADRs- THEIR
MECHANISMS, & ROLE
OF DIFFERENT
DRUGS(PART ‘A’)
PRESENTED TO: DR. EMILL JAME DAVID
PRESENTED BY:
VISHNU.R.NAIR,
FIFTH YEAR PHARM.D,
NATIONAL COLLEGE OF PHARMACY.

2. GENERAL INTRODUCTION:
• In clinical practice  more than 1 drug is prescribed/administered
• In case of occurrence of an adverse reaction  the doctor has 2 responsibilities:
a. To treat the adverse reaction caused
b. To identify the offending drug(s) & advise their discontinuation/modification.
• Some drugs that are prescribed to alleviate certain signs & symptoms can in fact, aggravate
the same
• PROMETHAZINE(anti-emetic)  given to children  can cause restlessness & irritation in
some children
• In most cases  offending drug often escapes notice, and the problem is considered as A
DIFFERENT CAUSE.

3. • Consider the following examples:
a. METOCLOPRAMIDE(Anti-emetic)  causes both HYPOTENSION & HYPERTENSION
b. PALONOSETRON(Anti-emetic)  causes both BRADYCARDIA &TACHYCARDIA
c. ONDANSETRON(Anti-emetic) , ATENOLOL(Anti-hypertensive) & BISOPROLOL(Anti-
hypertensive)  cause both DIARRHEA & CONSTIPATION
d. AMIODARONE(Anti-arrhythmic)  causes both HYPOTHYROIDISM &
HYPERTHYROIDISM.
• In this work, I will present a precise version of the mechanisms of different ADRs on organ
systems & the commonADRs(along with the culprit drugs involved).
HAPPY READING!!

4. DEFINITION:
• According toWHO  ADR is defined as “A response to a drug, that is
NOXIOUS & UNINTENDED, and which occurs at doses, normally
used in man for the prophylaxis, diagnosis or therapy of disease, or
for the modification of physiological function/s”.

5. PATHOPHYSIOLOGICAL
MECHANISMS OF ADRs

6. EFFECTS ON GIT:
• GI disorders contribute to approx. 20% of the documentedADRs overall
• GIADRs can show impact on:
1. MOUTH:
Different disorders include:
A. TASTE DISORDERS:
- Chemosensory nerves  mediate senses of taste & smell
- During GI ADRs  taste may be distorted, blunted/ lost completely
- Usually occur when the patient has been taking the drug for a long time
- Increased ZINC LOSS  contributes to taste disturbances.

7. B. GINGIVAL DISORDERS:
- Gingival enlargement due to drugs  occurs within 1-3 months of drug usage
- Severity enhances in areas of PLAQUE ACCUMULATION.
C. PIGMENTATION IN MOUTH:
- Accumulation of melatonin, iron/ drug metabolite in the mucosa  can lead to pigmentary
changes inside the mouth.
D. DRY MOUTH:
- Secretion of saliva  regulated by ANS
- Parasympathetic nervous system  regulates volume of saliva secretion
- Sympathomimetic nervous system  regulates salivary composition

8. - Anticholinergic medications  act against M3 muscarinic receptors  cause
XEROSTOMIA.
E. STOMATITIS/ MOUTH ULCERS:
- Irritant/ allergic substances  come into contact with oral mucosa  contact dermatitis
can occur
- Mouth ulcers are mostly caused by local trauma/stress.

9. EFFECTS ON ESOPHAGUS:
• Patients with drug-induced esophageal injury  may have a history of taking their
medicationsWITH LITTLE/ NOWATER, JUST BEFORE ORWHILE LYING DOWN.
• Potential contributing factors for drug-induced esophageal injury include:
a. Presence of gastroesophageal reflux
b. Pre-existing esophageal stricture
c. Pre-existing enlarged left atrium  increase risk by blocking the passage of bolus
d. Alcohol  impairs esophageal function.

10. - Mechanism is poorly understood
- It is believed that most drugs cause the above problem by showing effects on CTZ / the
vomiting center.
NAUSEA & VOMITING:

11. EFFECTS ON STOMACH :
- Drugs that alter gastric motility  can cause a variety ofADRs
- Gastric emptying can be delayed by OPIOIDS & ANTICHOLINERGICS
- Gastric emptying can be enhanced by PROKINETICS, like METOCLOPRAMIDE.
• Drugs that delay gastric emptying  may cause symptoms like BLOATING
• Increased rate of gastric absorption  can lead to acute adverse effects, which is directly
proportional to plasma concentration(Eg: DROWSINESS, with CNS DEPRESSANTS)
• Most important upper GI ADR is PEPTIC ULCERATION, caused frequently by NSAIDs.

12. EFFECTS ON SMALL INTESTINE:
• Drug-induced intestinal/ pseudo-intestinal obstruction is rare, but significant
• Mechanisms involving drug-induced intestinal obstruction include:
a. Physical obstruction within the small bowel lumen
b. Bowel dysmotility(due to drug effects on smooth muscles)
c. Obstruction from outside the gut wall(due to vascular occlusion/ peritoneal fibrosis)
• Neural control of gut  occurs via SYMPATHETIC & PARASYMPATHETIC NERVOUS
SYSTEMS
• OPIOIDS, ANTICHOLINERGICS & CCBs  have role in intestinal effects
• Secondary effects can also result in the same(Eg: ELECTROLYTE IMBALANCES due to
DIURETICS)

13. EFFECTS ON COLON:
• Drugs affect colonic function in 4 ways:
1. Drugs  affect motility  Cause constipation/diarrhea
2. Drugs  affect the colonic contents, by disturbing microflora
3. Drugs  act on mucosa  cause colitis
4. Drugs  act on vascular supply  cause ischemic colitis.
• ANTIMICROBIALS  contribute to approx. 25% of drug-induced diarrhea

14. • Mechanisms of DRUG-INDUCED DIARRHEA include:
1. Intraluminal osmotic change
2. Increased secretion
3. Impaired fluid absorption
4. Motility change
5. Overflow diarrhea from constipation
6. Colitis-induced diarrhea.

15. EFFECTS ON PANCREAS:
• Drug-induced pancreatitis is uncommon(<2% cases reported)
• Drugs involved include:
a. Didanosine
b. Sodium valproate
c. 5-aminosalicylates
d. Estrogen, etc.

16. HEPATIC DISORDERS:
• Drug-induced hepatotoxicity  accounts for approx. 2% of cases of I.P JAUNDICE
• Liver is involved in 3-10% of all ADRs
• Upto 50% of ACUTE LIVER FAILURE cases(with a mortality rate as high as 90%)  are
believed to be drug-induced
• HEPATOTOXICITY  Major cause of fatal ADRs  leads to worldwide withdrawal of drugs
from market
• Culprit drugs involved include:
a. Paracetamol d. MTX g. INH, etc.
b. Salicylates e. CPZ
c. Tetracyclines f. Halothane

17. EFFECTS OF DRUGS ON RESPIRATORY
SYSTEM:
• Drugs  can cause a variety of thoracic effects & responses
• Drug-induced pulmonary toxicity can occurs via the following mechanisms:
1. OXIDANT INJURY:
- Plays significant role in most of the drug-related pulmonary diseases
- Oxidant molecules formed within phagocytic cells(eg: monocytes, macrophages &
neutrophils)  participate in redox reactions  results in FATTY-ACID OXIDATION 
Causes membrane instability  leads to cytotoxicity
- Examples include:
a. Chronic reactions with NTU usage
b. Chemotherapeutic drug-induced pulmonary changes.

18. B. PULMONARYVASCULAR DAMAGE:
- Mechanisms involved include:
1. Increased microvascular hydrostatic pressure
2. Increased permeability of vascular endothelium
3. Vascular occlusion, by:
i. Direct activation of inflammatory & immune mechanisms
ii. Indirectly, by stimulation of intravascular coagulation(PULMONARY EMBOLISM)
4. Impaired homeostasis(caused by AMIODARONE).

19. C. IMMUNE-SYSTEM MEDIATED INJURY:
- Drugs  act as potential antigens/ haptens  induce immune cascade  leads to immune-
mediated lung toxicity
- Deposition of antigen-antibody complexes  trigger inflammatory response  leads to
pulmonary edema & interstitial lung disease
- Drug-induced SLE is also a classical example of immune-mediated lung damage.
D. CNS DEPRESSION:
- An acute neurological crisis, characterized by significant increase in intracranial pressure 
stimulates hypothalamus & vasomotor centers of medulla  initiates massive autonomic
discharge  leads to neurogenic pulmonary edema
- Eg: MTX(given intrathecally), & cytarabine.

20. E. DIRECTTOXIC EFFECTS:
- Chemotherapeutic drugs  can cause direct toxic reactions to the lungs
- Eg: Bleomycin.

21. EFFECTS OF DRUGS ON CVS:
• Cellular targets for drugs that produceADRs  can be categorized into a number of sites,
that include:
1. Cell-membrane bound receptors
2. Second messenger system
3. Ionic channels
4. Ionic pumps
5. Intracellular organelles
- Interference with neuronal input to the heart can also lead to ADR manifestations
- Drug  modifies function of an ION CHANNEL at plasma membrane level  leads to
abnormal repolarization / depolarization of cardiac cells  causes disruption in rhythm 
leads to dysfunction in contraction/relaxation of myocytes.

22. EFFECTS OF DRUGS ON URINARY
SYSTEM:
• Mechanisms include:
A. ALTERED INTRAGLOMERULARR HEMODYNAMICS:
- Drugs with ANTIPROSTAGLANDIN ACTIVITY (NSAIDs) / those with ANTI-ANGIOTENSIN II
ACTIVITY (ACEIs, ARBs)  interfere with kidney’s ability to autoregulate glomerular
pressure  cause reduction in GFR
- CYCLOSPORINE,TACROLIMUS  cause dose-dependant vasoconstriction of afferent
arterioles  leads to renal impairment
B.TUBULAR CELLTOXICITY:
- Drugs  Impair mitochondrial function  interfere with tubular transport  increase
oxidative stress  cause formation of FREE RADICALS  leads to toxicity reactions.
- Eg: Aminoglycosides, AMB, Anti-retrovirals, cisplatin, contrast dyes.

23. C. INFLAMMATION:
- Drugs cause inflammatory changes in the glomerulus, renal tubular cells & surrounding
interstitium  leads to RENAL SCARRING/ FIBROSIS
- Drugs that cause GLOMERULONEPHRITIS include:
1. Gold therapy
2. Hydralazine
3. Lithium
4. NSAIDs
5. PTU
6. Pamidronate.

24. - Drugs  bind to antigens in kidney/ act as antigens  deposited in the interstitium 
induces immune reaction  lead to INTERSTITIAL NEPHRITIS
- Drugs that causeACUTE INTERSTITIAL NEPHRITIS include:
1. Allopurinol
2. Sulphonamides
3. Rifampicin
4. Antivirals
5. Diuretics
6. NSAIDs
7. Phenytoin
8. Omeprazole.

25. - Drugs that cause CHRONIC INTERSTITIAL NEPHRITIS include:
1. Cyclosporine
2. Tacrolimus
3. Lithium.
D. CRYSTAL NEPHROPATHY:
- Drugs  produce crystals, that are insoluble in human urine  can lead to renal
impairment
- Crystals  precipitate within distal tubular lumen  obstructs urine flow  cause
interstitial reactions
- Eg: Ampicillin, sulfonamides, acyclovir, MTX, triamterene.

26. E. RHABDOMYOLYSIS:
- In rhabdomyolysis  MYOGLOBIN is released  cause renal injury by the following
mechanisms:
1. Direct toxicity reactions
2. Tubular obstruction
3. Alterations in GFR
- Eg include:
1. Statins
2. Ketamine
3. Methamphetamine.

27. F.THROMBOTIC MICROANGIOPATHY:
- Organ damage can be caused by PLATELETTHROMBI in MICROCIRCULATION
- Eg:
1. Clopidogrel
2. Ticlopidine
3. Cyclosporine
4. Quinine.

28. EFFECTS OF DRUGS ON NERVOUS
SYSTEM:
• Drug-induced neurotoxicity can be classified as:
1. DIRECT/PRIMARY REACTIONS:
- Caused by breech of BBB , & retrograde axonal transport
2. INDIRECT/ SECONDARY REACTIONS:
- Caused due to changes in other organs/ systems.

29. DRUG-INDUCED CUTANEOUS ERUPTIONS:
• Account for approx. 2-3& of all ADRs
• Mechanisms include:
1. Allergic reactions
2. Toxicity
3. Drug-drug interactions
4. Exacerbation of pre-existing dermatologic diseases
5. Direct release of mast cell mediators
6. Activation of complement system.
* Aspirin & other NSAIDs  alter arachidonic acid metabolism  can induce anaphylactic
type reactions, without formation of antibodies.

30. EFFECTS OF DRUGS ON HEMATOPOIETIC
SYSTEM:
• Numerous medications can cause adverse drug reactions affecting RBCs, platelets/
neutrophils
• May be the result of drug/ dose dependent toxicity reactions, while others may be
idiosyncratic/ immune-mediated
• Drug-induced hematological disorders include:
1. APLASTIC ANEMIA
2. AGRANULOCYTOSIS
3. HEMOLYTIC ANEMIA
4. MEGALOBLASTIC ANEMIA
5. THROMBOCYTOPENIA.

31. DRUGS, CAUSING
ABDOMINAL DISTENSION

32. • Include:
1. Acarbose 11.Tolbutamide
2. Alendronic acid 12.Voglibose.
3. Clomiphene
4. Disopyramide
5. Dydrogestrone
6. Glycopyrronium bromide
7. Loperamide
8. Mesalazine
9. Metolazone
10. Morphine

33. DRUGS, CAUSING
ABDOMINAL PAIN

34. • Include:
1. 8-hydroxy quinolines 12. Artemether
2. Abacavir 13. Artesunate
3. Acarbose 14. Atorvastatin
4. Adefovir 15. Azithromycin
5. Alendronic acid 16. Bicalutamide
6. Allopurinol 17. Bezafibrate
7. Aminophylline 18. Bisoprolol
8. Amlodipine 19. Cabergoline
9. Aripiprazole 20. Calcitonin
10. Arteether 21. CBZ

35. 22. Carboprost 34. clindamycin 46. Efavirenz
23. Cefadroxil 35. clofazimine 47. Esomeprazole
24. Cefazolin 36. clomiphene 48. Ezetimibie
25. Cefpodoxime 37. colchicine 49. Loperamide
26. Cefdinir 38. dactinomycin 50. Mefenamic acid
27. Cefixime 39. desmopressin 51. PAS
28. Celecoxib 40. didanosine 52. Rosuvastatin
29. Cetirizine 41. dinoprostone 53.Voglibose
30. Ciprofloxacin 42. disodium hydrogen citrate 54. Zaleplone
31. Cisapride 43. disopyramide 55. Zidovudine, etc.
32. Citalopram 44. divalproex
33. Clarithromycin 45. Doxazosin

36. DRUGS, CAUSING
ABNORMAL DREAMS

37. • Include:
1. Butorphanol tartarate
2. Efavirenz
3. Ketamine
4. Mirtazapine
5. Montelukast
6. Paroxetine
7. Propranolol
8. Selegiline.

38. DRUGS, CAUSING
ABNORMAL GAIT

39. • Include:
1. Antipsychotics
2. Clarithromycin
3. Oxcarbazepine
4. Topiramate
5. Metoclopramide(less frequent), etc.

40. DRUGS, CAUSING ACIDOSIS

41. • Includes:
1. Metformin(causes lactic acidosis)
2. Calcitriol
3. Lamivudine
4. Linezolid
5. Tenofovir
6. Topiramate, etc.

42. DRUGS, CAUSING
ACNEIFORM

43. • Includes:
1. Betamethasone
2. Dactinomycin
3. Danazol
4. Deflazacort
5. Gefitinib
6. Hydroxyprogresterone caproate
7. Leuprorelin
8. Methylprednisolone
9. Nandrolone
10. Stanozol
11. Norethisterone, etc.

44. • DRUGS, CAUSING ACTIVATION OF PEPTIC ULCER: NIACIN(Vitamin B3)
• DRUGS, CAUSING ACUTE DYSTONIA: CHLORPROMAZINE
• DRUGS, CAUSING ADDISON’S DISEASE: XIPAMIDE
• DRUGS, CAUSING ACID REBOUND: CALCIUM CARBONATE(on prolonged
use)

45. DRUGS, CAUSING
AGGRESSION

46. • Includes:
1. Chlordiazepoxide
2. Lamotrigine
3. Montelukast
4. Nitrazepam
5. Topiramate
6. Venlafaxine
7. Zopiclone, etc.

47. DRUGS, CAUSING AGITATION

48. • Include:
1. Acyclovir
2. Allopurinol
3. Barbiturates
4. Bupropion
5. Fluvoxamine
6. Mirtazapine
7. Montelukast
8. Nitrazepam
9. Olanzapine
10. Paroxetine
11. procyclidine

49. 12. Risperidone
13. Sertraline
14.Topiramate
15. Butorphanol tartarate, etc.

50. DRUGS, CAUSING
AGRANULOCYTOSIS

51. • Include:
1. Amoxapine
2. Clozapine
3. Carbimazole
4. Cefepime
5. Colchicine
6. Cotrimoxazole
7. Dapsone
8. Etanercept
9. Flupenthixol
10. Furazolidone
11. Gentamicin

52. 12. Levamisole
13. Loxapine
14. Metoclopramide
15. Mirtazapine(reversible agranulocytosis observed)
16. Penicillamine
17. Quinidine
18. Sulphadiazine
19. NTU
20. Metformin, etc.

53. • DRUGS, CAUSING AKATHISIA(Inability to sit still, with motor restlessness):
- Aripiprazole
- Olanzapine
- Ziprasidone.
• DRUGS, CAUSING ALCOHOL INTOLERANCE: Bromocriptine
• DRUGS, CAUSING ALKALOSIS:
- CaCO3
- Disodium hydrogen citrate
- Indapamide
- Sodium bicarbonate.

54. DRUGS, CAUSING ALOPECIA

55. • Include:
1. Albendazole(reversible alopecia observed)
2. Alkylating agents
3. Allopurinol
4. Anastrozole
5. Antimetabolites
6. Antithyroid drugs
7. Bleomycin
8. Bicalutamide
9. Carboplatin
10. Chloroquine
11. Cimetidine

56. 12. Colchicine
13. Dactinomycin
14. Doxorubicin
15. Etoposide(reversible alopecia observed)
16. 5-FU
17. HCQ
18. Indinavir
19. Interferon-alpha 2B
20. Ketoconazole
21. L-dopa
22. Metoprolol(reversible alopecia observed(
23. NTU

57. 24. Roxatidine
25. Sodium valproate
26. Sulfasalazine
27.Tamoxifen
28. Heparin
29.Vinca alkaloids
30. Hydroxyurea , etc.

58. DRUGS, CAUSING
ABNORMAL BEHAVIOUR

59. • Include:
1. Divalproex 12. Zaleplone
2. Escitalopram 13. Zolpidem.
3. Ketamine
4. Metronidazole
5. Olanzapine
6. Paroxetine
7. Ribavirin
8. Sodium cromoglycate
9. Stavudine
10. Topiramate
11. Triamcinolone

60. DRUGS, CAUSING ALTERED
TASTE

61. • Include:
1. Allopurinol
2. Captopril
3. Enalapril
4. Clofazimine
5. L-dopa
6. Levamisole
7. Linezolid
8. Ornidazole
9. Penicillamine
10. Paroxetine
11. Terbinafine

62. 12. Ritonavir
13. Propafenone
14. Imitinib
15. Etoricoxib, etc.

63. DRUGS, CAUSING
AMENORRHEA

64. • Include:
1. Amisulpiride
2. Busulfan
3. Chlorambucil
4. CPZ
5. Glycopyrrolate
6. Danazol
7. Droperidol
8. Epirubicin
9. Fluphenazine
10. Haloperidol
11. Loxapine

65. 12. Mitomycin
13. Norethisterone
14. Prochlorperazine
15.Vincristine.

66. • DRUGS, CAUSING ALVEOLITIS: Lornoxicam
• DRUGS, CAUSING AMBYLOPIA:
- Etodolac
- Gefitinib
- Palonosetron
- Tamsulosin, etc.

67. DRUGS, CAUSING AMNESIA

68. • Include:
1. Alprazolam (transient)
2. Atropine
3. Clonazepam
4. Diazepam
5. Digoxin
6. Efavirenz
7. Gabapentin
8. Levetiracetam
9. Metoprolol(Transient)
10. Oxazepam
11. Paroxetine

69. • Zolpidem
• Zaleplone
• Zopiclone, etc.

70. • DRUGS, CAUSING ANAL ULCERS: Cytarabine
• DRUGS, CAUSING ANURIA: Sulfadiazine
• DRUGS, CAUSING APATHY: Zuclopenthixol
• DRUGS, CAUSING ARACHNOIDITIS: Methotrexate

71. DRUGS, CAUSING
ANAPHYLAXIS

72. • Include:
1. Abacavir
2. AMB
3. Ampicillin
4. Anastrozole
5. Penicillin G
6. Bleomycin
7. Carboplatin
8. Cefepime
9. Cefaclor
10. Cefalexin
11. Cefotaxime

73. 12. Cefpodoxime
13. Ceftriaxone
14. Chlorzoxazone
15. Cisplatin
16. Cloxacillin
17. Cytarabine
18. Dacarbazine
19. Doxycycline
20. Ketorolac
21. Leflunomide
22. Lincomycin
23. Mecobalamine(when given parenterally)

74. 24. Montelukast
25. Melphalan
26. Meropenem
27. Nitrazepam
28. NTU
29. Oxcarbazepine
30. Parenteral iron
31. Piperacillin
32. Sodium hyaluronate
33.Thiopental sodium
34.Vancomycin
35.Tobramycin, etc.

75. DRUGS, CAUSING ANGINA

76. • Include:
1. 5-FU
2. Bicalutamide
3. Adrenaline
4. Carvedilol
5. Clozapine
6. Ergotamine
7. DHE
8. Felodipine
9. L-thyroxine
10. Selegiline, etc.

77. DRUGS, CAUSING
ANGIONEUROTIC EDEMA/
URTICARIA ERYSIPELAS

78. • Include:
1. ACTH
2. Allopurinol
3. Ampicillin
4. Aspirin
5. Barbiturates
6. Benzyl penicillin
7. Capreomycin
8. Captopril
9. Cephalosporins
10. Chloramphenicol
11. CPZ

79. 12. Clomiphene 24. Streptokinase
13. Desferrioxamine 25.Tobramycin, etc.
14. DEC
15. Disulfiram
16. Griseofulvin
17. Indomethacin
18. NTU
19. Parenteral iron
20. Phenothiazines
21. Streptomycin
22. Sucralfate
23.Tetracyclines

80. DRUGS, CAUSING ANOREXIA

81. • Include:
1. Abacavir
2. Acetazolamide
3. Alprazolam
4. Atorvastatin
5. Biguanides
6. Calcitonin
7. Clobazam
8. Clindamycin
9. Haloperidol
10. HCTZ
11. Interferon alfa-2B

82. 12. DEC 24.Venlafaxine
13. Divalproex 25.Tinidazole, etc.
14. Famotidine
15. Metformin
16. Mecobalamine
17. Glucosamine
18. Phenytoin
19. NTU
20. Paroxetine
21.Topiramate
22.Terbinafine
23. Zonisamide

83. • DRUGS, CAUSING ANTIMUSCARINE EFFECTS:
1. Chlorpheniramine
2. TCAs
3. Diphenhydramine
4. Tripolidine
5. Procainamide
6. Disopyramide
7. CPZ
8. Clozapine
9. Flavoxate
10.Tolterodine
11.Methocarbamol, etc.

84. DRUGS, CAUSING ANXIETY

85. • Include:
1. Adrenaline
2. Aminophylline
3. Aripiprazole
4. Butorphanol tartarate
5. Cefdinir
6. Clarithromycin
7. Dapsone
8. Efavirenz
9. Haloperidol
10. INH
11. Mephentermine

86. 12. Moclobemide
13. Phenobarbital
14. Ritonavir
15. Selegiline
16.Tizanidine
17.Tolterodine
18.Topiramate
19. Paroxetine
20. Risperidone, etc.

87. DRUGS, CAUSING APLASTIC
ANEMIA

88. • Include:
1. Allopurinol
2. CBZ
3. Carbimazole
4. Chloramphenicol
5. CQ
6. Clindamycin
7. Colchicine
8. Co-trimoxazole
9. Etanercept
10. HCQ
11. Indomethacin

89. 12. Mefenamic acid
13. Phenylbutazone
14. NTU
15. Penicillamine, etc.

90. • DRUGS, CAUSING APNEA:
1. Colistin sulphate
2. Fentanyl citrate
3. Meropenem
4. Midazolam
5. Propofol
6. Succinylcholine
7. Vecuronium bromide, etc.

91. DRUGS, CAUSING
ARRHYTHMIAS/
DYSRRHYTHMIAS

92. • Include:
1. 5-FU
2. Adrenaline
3. Aminophylline
4. Amoxapine
5. Astemizole(causes ventricular arrhythmias, at HIGH DOSES)
6. Bupivacaine
7. Desferrioxamine
8. Dicyclomine
9. Dobutamine
10. Domperidone
11. Doxorubicin

93. 12. Fentanyl citrate
13. Halothane
14. Ketamine
15. Levodopa
16. Neostigmine
17. Xylometazoline HCl
18. Selegiline
19. Sumatriptan
20. Quinidine, etc.

94. DRUGS, CAUSING
ARTHRALGIA

95. • Include:
1. Allopurinol
2. Carbimazole
3. Carvedilol
4. Cimetidine
5. DEC
6. Fenofibrate
7. Imatinib
8. Ivermectin
9. Lamivudine
10. Lamotrigine
11. Letrozole

96. 12. MTX 24. Sildenafil citrate
13. Mianserin 25. Stavudine,etc.
14. Mirtazapine
15. Parenteral iron
16. Pamidronate
17. Pindolol
18. Raloxifene
19. Moxifloxacin
20. Ciprofloxacin
21. Montelukast
22. NTU
23. Nicotine

97. • DRUGS, CAUSING ASCITES:
- Dactinomycin
- Urofollitropin, etc.
• DRUGS, CAUSING ATRIAL FIBRILLATION:
- Pamidronate

98. DRUGS, CAUSING ASTHENIA

99. • Include:
1. Adefovir
2. Alfuzosin
3. Amlodipine
4. Butorphanol tartrate
5. Capecitabine
6. Ebastine
7. Interferons
8. Triptans
9. Lamotrigine
10. Leuprorelin
11. Olanzapine

100. 12. Ziprasidone
13.Venlafaxine
14. Ritonavir
15.Tizanidine, etc.

101. DRUGS, CAUSING ATAXIA

102. • Include:
1. Amikacin
2. Amiodarone
3. Atropine
4. Bromocriptine
5. CBZ
6. Clomipramine
7. Efavirenz
8. Gabapentin
9. Lamotrigine
10. Phenytoin
11. Midazolam

103. 12. Glycopyrrolate
13. Lamotrigine
14. Levetiracetam
15. Streptomycin
16. Spironolactone
17. Metronidazole
18. Zolpidem
19. Nitrazepam
20. Piperazine, etc.

104. • DRUGS, CAUSING AV BLOCK:
1. Bisoprolol
2. Carvedilol
3. Donepezil
4. Imipramine
5. Mefloquine
6. Neostigmine
7. Primaquine
8. Pyridostigmine
9. Quinidine
10.Sildenafil
11.Verapamil, etc.

105. • DRUGS, CAUSING AZOOSPERMIA/ OLIGOSPERMIA:
1. Busulfan
2. Chlorambucil(in high dose)
3. Sulphasalazine
4. Testosterone
5. Vincristine
6. Vinblastine, etc.

106. SUMMMARY/ CONCLUSION:
• So, this is my first powerpoint on the major study onADRs, and drugs causing the same
• In this ppt, I have explained the general mechanisms of ADR occurrences
• I have mentioned the ADRs(starting with letter “A”), and the drugs causing the same
• Do note that all drugs causing respective ADRs have NOT BEEN MENTIONED HERE
• I have just provided a precise insight into the different ADRs, and the culprit drugs involved!
• Do refer more..and learn more!!

107. THANK YOU!!!!!   