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Understanding drug-induced endocrine and reproductive side effects is essential for USMLE Step 1. Below is a detailed guide with causal agents, mnemonic aids, and clinical notes.
Condition | Causal Agents | Notes | Mnemonic |
---|---|---|---|
Adrenocortical Insufficiency | HPA suppression due to glucocorticoid withdrawal | Results from abrupt cessation of long-term glucocorticoid therapy. | — |
Diabetes Insipidus | Lithium, demeclocycline | Central or nephrogenic DI, characterized by polyuria and polydipsia. | — |
Hot Flashes | Selective Estrogen Receptor Modulators (SERMs): tamoxifen, clomiphene, raloxifene | Often reported during therapy for breast cancer or ovulation induction. | — |
Hyperglycemia | Tacrolimus, Protease inhibitors, Niacin, Hydrochlorothiazide (HCTZ), Corticosteroids | Monitor blood glucose levels in at-risk patients. | The People Need Hard Candies |
Hyperprolactinemia | Typical antipsychotics (e.g., haloperidol), atypical antipsychotics (e.g., risperidone), metoclopramide, methyldopa, reserpine | Causes hypogonadism (e.g., infertility, amenorrhea, erectile dysfunction) and galactorrhea. | — |
Hyperthyroidism | Amiodarone, iodine | Thyrotoxicosis may occur due to excessive thyroid hormone synthesis or release. | — |
Hypothyroidism | Amiodarone, Sulfonamides, Lithium | Presents as fatigue, weight gain, and lethargy. | I AM SUddenly Lethargic |
SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion) | Carbamazepine, Cyclophosphamide, SSRIs | Results in hyponatremia and concentrated urine due to excessive ADH secretion. | Can’t Concentrate Serum Sodium |