Act as Internalist 👨🏻‍⚕️🫀🩺

The idea in this post is that each of these drugs causes a specific syndrome through a different pathological and physiological mechanism, and some of them are very important clinically because understanding the mechanism helps you anticipate symptoms and avoid complications.. 🩺 *Vancomycin → Red Man Syndrome.* Vancomycin Infusion Reaction.. It is not a true allergy, but it often occurs due to giving vancomycin too quickly, which leads to direct release of histamine from mast cells.. Which leads to ⬇️ : Vasodilation and severe redness especially of the face and neck with itching and hypotension may occur. And this reaction is traditionally known as ➿️Red Man Syndrome➿️ 🩺 Amiodarone → Blue-Gray Skin Discoloration. The drug may deposit in the skin with chronic sun exposure, causing photosensitivity. And deposition of pigments in the skin leads to ⬇️ : Appearance of a blue-gray color especially in sun-exposed areas. And it is sometimes referred to as ➿️Blue Man Syndrome➿️ although this term is less common in medical references.. 🩺 Chloramphenicol → Gray Baby Syndrome Newborns have deficiency in liver enzymes UDP-glucuronyl transferase So they cannot metabolize the drug ⬅️ it accumulates and causes mitochondrial inhibition and circulatory collapse ⬅️ pallor, grayness, and asphyxia. 🩺 Aspirin → Reye’s Syndrome Giving aspirin to children during a viral infection leads to severe mitochondrial dysfunction in liver and brain → fatty liver + cerebral edema → vomiting and altered consciousness and may be fatal. And these are the signs of Reye’s Syndrome.. 🩺 Tamsulosin → Floppy Iris Syndrome Alpha-1 receptor blocker ⬅️ relaxation of iris dilator muscle ⬅️ during cataract surgery the iris becomes floppy and unstable. 🤩 Corticosteroids → Iatrogenic Cushing Syndrome Exogenous cortisone raises glucocorticoids level in the body ⬅️ ↑ gluconeogenesis ↑ fat redistribution ↑ protein breakdown → the known Cushingoid appearance. 💊 Warfarin → Purple Toe Syndrome Warfarin may cause bleeding inside atherosclerotic plaques cholesterol plaques → release of cholesterol emboli to the toes ⬅️ cyanosis and pain. 💊 Phenytoin → Purple Glove Syndrome Often with IV administration; it causes irritation and vascular leakage with vasoconstriction, so swelling and purple discoloration occurs and may progress to necrosis. 💊 Hydralazine, Procainamide, Isoniazid, Methyldopa, Quinidine, phenytoin, TNF inhibitors → SLE-like Syndrome → Drug-induced lupus.. Some drugs alter the immune response and lead to formation of autoantibodies especially anti-histone antibodies → symptoms similar to lupus. 💊 Isoniazid → Pellagra-like Syndrome Isoniazid may lead to disturbed metabolism of pyridoxine Vitamin B6 and niacin Vitamin B3, which may cause symptoms similar to Pellagra such as dermatitis, diarrhea, and neurological disorders.. 💊 SSRIs/SNRIs/MAOIs/Tramadol → Serotonin Syndrome Excessive increase of serotonin inside the CNS → hyperthermia + agitation + clonus + autonomic instability. Dangerous especially when combining more than one serotonergic drug. 💊 Antipsychotics → Neuroleptic Malignant Syndrome Severe blockade of dopamine D2 receptors → rigidity + hyperthermia + autonomic dysfunction + ↑ CK. Similar to serotonin syndrome but different mechanism.. 💊 Tetracyclines, Aminoglycosides, Tenofovir… → Fanconi Syndrome These drugs may cause injury to the proximal renal tubules → loss of glucose, phosphate, amino acids and bicarbonate in urine.. And expired tetracycline is a classic example associated with this syndrome.. 💊 SSRIs, Carbamazepine, Cyclophosphamide…→ SIADH Either increase ADH secretion or increase kidney sensitivity to it leading to ⬅️ water retention and hyponatremia. 💊 Mebendazole + Metronidazole, Lamotrigine + valproic acid, Sulfonamides, Allopurinol → Stevens-Johnson Syndrome A severe cytotoxic immune reaction against keratinocytes → apoptosis and separation of skin and mucosa, therefore it is considered a very dangerous emergency condition. 💙💙💙