Which of the following drugs is associated with the reaction of extreme photosensitivity?

Question

Options

• ADigitalis
• BNiacin
• CTetracycline
• DFluoroquinolones

• A
  6% (3)
• B
  2% (1)
• C
  84% (41)
• D
  8% (4)

Explanation

Tetracycline is well-known for causing extreme photosensitivity, a phototoxic reaction where UV light triggers an exaggerated sunburn response in the skin. This occurs because tetracycline accumulates in skin cells and absorbs UV radiation, generating reactive oxygen species that damage tissue.

Why the distractors are wrong:

• A. Digitalis - a cardiac glycoside used for heart failure/arrhythmias; its toxicities include visual disturbances (yellow-green halos), arrhythmias, and GI effects - not photosensitivity.
• B. Niacin - causes flushing, pruritus, and hepatotoxicity; not associated with photosensitivity.
• D. Fluoroquinolones - while fluoroquinolones can cause mild photosensitivity, it is far less pronounced and not the textbook "extreme" reaction. Tetracyclines are the classic high-yield association for this adverse effect.

Memory tip: Think "Tet = Tan gone wrong" - tetracyclines make you hypersensitive to the sun, so patients must be counseled to avoid sun exposure and use sunscreen. The mnemonic TETС (Teeth staining, Esophagitis, Tetracycline + sun = burn, Chelation with divalents) covers its major adverse effects together.

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