Which of the following drugs is associated with the reaction of Tendon dysfunction?

Question

Options

• ADigitalis
• BNiacin
• CTetracycline
• DFluoroquinolones

• A
  7% (3)
• B
  5% (2)
• C
  17% (7)
• D
  71% (30)

Explanation

Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) carry a well-known risk of tendinopathy and tendon rupture, most commonly affecting the Achilles tendon - this risk is significant enough to warrant an FDA black box warning. The mechanism involves disruption of collagen synthesis and oxidative damage to tendon tissue, and risk is heightened in patients over 60, those on corticosteroids, or those with renal impairment.

Why the distractors are wrong:

• Digitalis (A): A cardiac glycoside; its toxicity manifests as arrhythmias, nausea, and the classic yellow-green visual halos - no tendon involvement.
• Niacin (B): Used for dyslipidemia; causes flushing, hepatotoxicity, and can cause myopathy (muscle damage), but not tendon dysfunction.
• Tetracycline (C): An antibiotic associated with photosensitivity, tooth discoloration in children, and esophageal irritation - not tendon issues.

Memory tip: Think "FLOXed tendons" - FLuoroQuinolones (ending in -floxacin) are the drugs that wreck your tendons. If your patient is on ciprofloxacin and develops Achilles pain, stop the drug immediately.

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