Question
A 33-year-old man is diagnosed with essential hypertension. He is started on a blood pressure medication, and after 6 weeks, he notes fatigue, rash over his face, joint aches, and effusions. A serum antinuclear antibody (ANA) test is positive. Which of the following is the most likely agent
| A. |
Hydralazine
|
| B. |
Propranolol
|
| C. |
Thiazide diuretic
|
| D. |
Nifedipine
|
Show Answer
|
Correct Answer � A
Explanation
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|
Answer A)
- Prolonged treatment may cause a syndrome similar to lupus, which can become fatal if the symptoms are not noticed and drug treatment stopped.
- Hydralazine is within the top three drugs that is known to induce systemic lupus and this adverse drug event is dose dependent yet significant.
- Very common (>10% frequency) side effects include headache, tachycardia, and palpitations.
- Common (1–10% frequency) side effects include flushing, hypotension, anginal symptoms, aching or swelling joints, muscle aches, positive tests for atrial natriuretic peptide, stomach upset, diarrhea, nausea and vomiting, and swelling (sodium and water retention)
- Many medications are notorious for causing positive ANA tests, and some can cause drug-induced Lupus. A few examples are hydralazine, hydrochlorothiazide, antibiotics (minocycline, isoniazid), methyldopa, procainamide
