Drug-induced Disorders Research Articles

Impulse control disorders due to cocaine and synthetic stimulants use: a systematic review

The introduction of ICD-11 has opened up new horizons in understanding the impact of modern narcotic substances on mental health, in particular, it has increased the list of possible mental disorders associated with drug use. The purpose of the work is to conduct a systematic review of the literature and describe the features of the pathogenesis, clinical picture, and effectiveness of various types of therapy for impulse control disorders associated with use of cocaine and synthetic stimulants. A systematic analysis of scientific publications was performed in the eLibrary, PubMed, CNKI, and Google Scholar databases according to PRISMA recommendations. 41 publications were selected from the initially found 4,953 articles. The pathogenesis of induced impulse control disorders is associated with the direct effect of stimulant drugs on the brain and consists in the activation of D3 and 5‑HT1A receptors, as well as activation of limbic brain regions and a lack of inhibitory effects of the frontal lobe. Increased impulsivity in users of cocaine and synthetic stimulants has been proven in a large number of neurophysiological and neuroimaging studies. The frequency of occurrence, clinical features, and approaches to therapy of impulse control disorders resulting from the use of drugs with dopaminergic action (drugs for the treatment of Parkinson's disease and hyperprolactinemia, third-generation antipsychotics, and venlafaxine in high doses) have been described in details. At the same time, there is indirect evidence that cocaine and synthetic stimulants should cause impulse control disorders, since they have similar neurotransmitter activity. In addition, there are descriptions of the predominance of individual symptoms of impulse control disorders in this group of drug users. However, at the time of the review, no detailed description of these drug-induced disorders has been found. These are the prospects for further research. The use of fluoxetine and oxcarbazepine (for intermittent explosive disorder) and naltrexone (for kleptomania), as well as comprehensive prevention of drug use relapse and psychotherapy, has the highest degree of evidence as a therapy for impulse control disorders.

Lower Urinary Tract Disorders as Adverse Drug Reactions-A Literature Review.

A potential complication of pharmacotherapy for a given patient is the possibility of various side effects of drugs, which are manifested in many ways and constitute iatrogenic causes of diseases. Among the systemic side effects of drugs, there are also those involving the urinary tract, although these are less reported in the literature. The use of numerous drugs-especially of anticholinergics or drugs with anticholinergic potential, opioid analgesics, non-steroidal anti-inflammatory drugs, antidepressants, first-generation antipsychotics (classic neuroleptics) and selected cardiovascular drugs (beta-blockers, thiazides potassium-sparing diuretics, statins), as well as others-may increase the risk of developing urological disorders, such as urinary retention or incontinence, urinary tract infections, urolithiasis, erectile dysfunction in men and retroperitoneal fibrosis. The purpose of this paper is to characterise the abovementioned drug-induced disorders of the lower urinary tract on the basis of a non-systematic literature review.

Shock Wave Therapy in Patients with Erectile Dysfunction

Erectile dysfunction is a serious medical problem because it directly affects the sex life of a man, but it also has an overall effect on his self-esteem and social behaviour.
 Pathophysiologically, erectile dysfunction may be due to factors of vascular origin, anatomical and structural features, neurological disorders, hormonal problems, drug-induced disorders, or iatrogenic trauma. The so-called psychogenic erectile dysfunction is not uncommon. In addition to the establishedtherapy with phosphodiesterase inhibitors, there are a number of publications that focus on the effect of Shock wave therapy as an alternative for treating erectile dysfunction. However, this issue remains debatable. Extracorporeal shockwave therapy is used as a method of treating erection problems, as itinduces neovascularization and improves blood flow to the cavernous tissue.
 Our goal is to test the efficacy and safety of Shock Wave therapy and to determine its place in the treatment of patients with erectile dysfunction.
 Clinical follow-up included 120 men between the ages of 30 and 75 (mean 55.68) diagnosed with erectile dysfunction. Patients were treated and monitored for a period of two years (January 2017 to April 2019). Detailed anamnestic data was taken, including sexual history, and full laboratory tests were performed.We used the following questionnaires to evaluate the extent of erectile dysfunction: International Index of Erectile Function (IIEF-5), Erection Hardness Score (EHS). All patients underwent shockwave therapy. Course duration was ten weeks, one procedure per week. Extracorporeal shock wave therapy equipment (BTL-5000) was used.
 With regard to the Erection Hardness Score (EHS), there was a significant improvement in penis firmness, immediately after the first procedure, which persisted after the end of treatment until the third month after therapy. Improvement in firmness was mainly observed in patients with moderate and mild erectile dysfunction, while no significant improvement was observed in patients with complete inability to achieve erection.
 With respect to the International Index of Erectile Function (IIEF-5), there is a significant improvement in erectile function, mainly in the groups with mild and moderate erectile dysfunction. The effect of therapy is maintained until the third month of treatment. No improvement in the condition was observed in patients with severe erectile dysfunction.
 The mean value of IIEF-5 increased significantly from 14.54 to 18.85 after the end of treatment, and this value was sustained until the third month after the treatment – 18.55. The procedure was well tolerated by patients, with no side effects reported during and after the procedure.
 The developments in modern technology and in the pharmaceutical industry have fundamentally changed the understanding of erectile dysfunction and the methods of treating it. More and more young people are rejecting the continued use of medication and looking for an alternative to effective treatment. Thus, there is a need for new methods of treating patients with erectile dysfunction. Based on publications in world literature, and on our own results, we have come to the conclusion that extracorporeal shock wave therapy may be an alternative to therapy with Phosphodiesterase 5 inhibitors (PDE5). Following the course of treatment, there was a significant increase in the number of patients without erectile dysfunction, and an increase in the total IIEF-5 score from 14.54 before treatment to 18.55 3 months after the end of therapy. This confirms the assumption of a lasting effect of the therapy 3 months after the end of treatment.

Incidence of and risk factors for alcohol dependence in bipolar disorder: A population-based cohort and nested case-control study.

Although alcohol dependence is highly prevalent in patients with bipolar disorder, the causal relationship is not yet well-established. This study estimated the incidence of alcohol dependence in a nationwide bipolar disorder cohort and examined risk factors for alcohol dependence. Patients aged 15-65 years with consistent bipolar disorder who had their first psychiatric admission between 1999 and 2012 (n = 21,791) were enrolled from the National Health Insurance Research Database in Taiwan. We calculated the adjusted incidence rate ratio of alcohol dependence in the bipolar cohort relative to the general population after stratification by age and sex. In the nested case-control study, we included patients with incident alcohol dependence as cases and four age- and sex-matched controls for each case to analyze health care utilization, comorbidities and concomitant medications between them. We identified 1261 patients with bipolar disorder with incident alcohol dependence. Relative to the general population, the adjusted incidence rate ratio of alcohol dependence was 9.20 in the bipolar cohort. All adjusted incidence rate ratios were high across all age subgroups. Cases had higher psychiatric and nonpsychiatric health care utilization than did controls. Multivariate analysis revealed that cases tended to have cardiovascular disease, diabetes mellitus, chronic hepatic disease, pneumonia and delirium before alcohol dependence diagnosis. Cases had higher psychiatric comorbidities, namely drug-induced mental disorders, anxiety disorder, personality disorder, adjustment disorder and sleep disorder. The bipolar cohort had a higher incidence of alcohol dependence. We identified specific groups with a high risk of alcohol dependence. Additional strategies for early detection, treatment and intervention for alcohol dependence should be developed.

Drug-induced sexual disorders

Drug-induced sexual disorders

Liver-side of inflammatory bowel diseases: Hepatobiliary and drug-induced disorders

Hepatobiliary disorders are among the most common extraintestinal manifestations in inflammatory bowel diseases (IBD), both in Crohn’s disease and ulcerative colitis (UC), and therefore represent a diagnostic challenge. Immune-mediated conditions include primary sclerosing cholangitis (PSC) as the main form, variant forms of PSC (namely small-duct PSC, PSC-autoimmune hepatitis overlap syndrome and IgG4-related sclerosing cholangitis) and granulomatous hepatitis. PSC is by far the most common, presenting in up to 8% of IBD patients, more frequently in UC. Several genetic foci have been identified, but environmental factors are preponderant on disease pathogenesis. The course of the two diseases is typically independent. PSC diagnosis is based mostly on typical radiological findings and exclusion of secondary cholangiopathies. Risk of cholangiocarcinoma is significantly increased in PSC, as well as the risk of colorectal cancer in patients with PSC and IBD-related colitis. No disease-modifying drugs are approved to date. Thus, PSC management is directed against symptoms and complications and includes medical therapies for pruritus, endoscopic treatment of biliary stenosis and liver transplant for end-stage liver disease. Other non-immune-mediated hepatobiliary disorders are gallstone disease, whose incidence is higher in IBD and reported in up to one third of IBD patients, non-alcoholic fatty liver disease, pyogenic liver abscess and portal vein thrombosis. Drug-induced liver injury (DILI) is an important issue in IBD, since most IBD therapies may cause liver toxicity; however, the incidence of serious adverse events is low. Thiopurines and methotrexate are the most associated with DILI, while the risk related to anti-tumor necrosis factor-α and anti-integrins is low. Data on hepatotoxicity of newer drugs approved for IBD, like anti-interleukin 12/23 and tofacitinib, are still scarce, but the evidence from other rheumatic diseases is reassuring. Hepatitis B reactivation during immunosuppressive therapy is a major concern in IBD, and adequate screening and vaccination is warranted. On the other hand, hepatitis C reactivation does not seem to be a real risk, and hepatitis C antiviral treatment does not influence IBD natural history. The approach to an IBD patient with abnormal liver function tests is complex due to the wide range of differential diagnosis, but it is of paramount importance to make a quick and accurate diagnosis, as it may influence the therapeutic management.

Prolonged mannerism as an isolated, interesting, and old symptom in a schizophrenic patient with poor response to clozapine: a clinical image

The concept of catatonia was first described by a German psychiatrist, Kahlbaum, in 1874. Catatonia is a serious neurological disorder associated with a wide range of psychiatric, neurological, medical conditions, and drug-induced disorders. Nevertheless, there is no absolute guideline for treating catatonia patients in whom the cause of the disorder is unknown. Clozapine is the first atypical antipsychotic used for the treatment of catatonia. Our case was a 51-year-old single, right-handed man with schizophrenia and a specific symptom of catatonia. Despite previous studies findings revealing the efficacy of clozapine in relieving catatonia symptoms, our patient did not show a definite response to this medication. Hence, follow-up of these patients to evaluate other treatments and possible incidence or manifest of other catatonic features like waxy flexibility, echo phenomenon, and negativism are suggested.

Coexisting Pediatric Acute Generalized Exanthematous Pustulosis and Staphylococcal Scalded Skin Syndrome

Acute Generalized Exanthematous Pustulosis is a rare drug-induced skin disorder that can present at any age. It is typically noted by swelling and erythema, with numerous facial and/or anogenital nonfollicular pustules that quickly disseminate. Staphylococcal scalded skin syndrome presents with erythema and swelling that similarly favor the head and intertriginous sites with subsequent bullae formation. We present a case of a four-year-old female who presented with SSSS complicated by the development of AGEP and discuss the course of her condition and treatment.

Using administrative health data to estimate prevalence and mortality rates of alcohol and other substance-related disorders for surveillance purposes.

Administrative health databases (AHD) are critical to guide health service management and can inform the whole spectrum of substance-related disorders (SRD). This study estimates prevalence and mortality rates of SRD in administrative health databases. The Quebec Integrated Chronic Disease Surveillance System consists of linked AHD. Analyses were performed on data of all Quebec residents aged 12 and over and eligible for health-care coverage using the International Classification of Diseases (ninth or tenth revision) for case identification. Mortality rate ratios stratified by causes of death were obtained to calculate an excess of mortality. Since 2001-2002, the annual age-adjusted prevalence rate of diagnosed overall SRD remained stable (8.6 per 1000 in 2017-2018). In any given year, the annual prevalence rate was significantly higher in males; adolescents had the lowest rate, while adults 65 years and older the highest. The annual 2017-2018 rate was 2.1 per 1000 for alcohol-induced disorder, 1.9 for other drug-induced disorder, 0.7 for alcohol intoxication and 0.6 for other drug intoxications. Cumulative rate of any diagnosis related to alcohol was 32 per 1000 females and 53 per 1000 males (2001-2018), and 33 per 1000 females and 49 per 1000 males for any diagnosis related to other drugs. There was an excess of all-cause mortality among individuals with SRD compared to the general population. AHD can complement epidemiological surveys in monitoring SRD jurisdiction-wide. Surveillance of services utilisation and interventions, coupled with health outcomes like mortality, could be useful in guiding health services planning.

DRUG-RELATED URINARY TRACT INFECTIONS

Bacterial urinary tract infection (UTI) is the most common infection, both in outpatient treatment and in hospital settings. Clinically, UTIs are classified into lower or upper urinary tract infections and can be either episodic or recurrent, and either uncomplicated or complicated. A severe UTI can lead to urosepsis and septic shock, while recurrent episodes of uncomplicated UTIs are considered to be an important etiological factor for the development of chronic kidney disease. The aim of this paper was to briefly discuss the classification, symptomatology and pathophysiology of a UTI and describe the rationale for the development of some drug-related urinary tract infections. The pathophysiology of a UTI is associated with multiple, anatomical and physiological dysfunctions that predispose infection, but there are also some iatrogenic factors, including the use of certain medications, that contribute to UTI development. Among drugs associated with an increased risk of UTI development one should mention immunosuppressants, agents affecting normal voiding processes and increasing the intravesical volume of residual urine, drugs promoting lithogenesis in the urinary tract with the subsequent favouring of urinary stone formation or drugs that reduce glucose reabsorption in the kidneys, causing glycosuria (“gliflozins”). Conclusions: Therefore, a UTI may also be a specific manifestation of adverse drug reactions and it should be taken into account in the monitoring and diagnosing of druginduced disorders.

Treatment and Diagnostic Considerations in a Complex Psychiatric Case - a Case Report

A patient with a history of autism spectrum disorder and epilepsy was hospitalized for management of acute onset psychosis and agitation. The acuity of his behaviors warranted abrupt shifts in treatment and multiple pharmacologic interventions were ineffective. The atypical nature of his presentation and intense pressure from ancillary staff to consider organic etiologies drove frequent transitions of care within the hospital setting. Multiple diagnoses were considered including a primary psychosis, excited catatonia and antiepileptic drug-induced psychotic disorder. Ultimately the patient was diagnosed with bipolar disorder and effectively treated with quetiapine and valproic acid. The authors suggest that rapid consideration of comorbid bipolar disorder in autism spectrum disorder patients presenting with affective dysregulation may expedite trial of an anticonvulsant with mood stabilizing properties, which would have simplified this patient’s clinical course and limited potential for iatrogenic harm. This course of treatment should especially be considered when a history of epilepsy is present.

A review on drug induced skin disorders: pathophysiology and therapeutics

<p class="abstract"><span lang="EN-US">Drugs are the central part of treatment of various disorders. The consequence of drug use may be either positive outcomes (clinical effect of the drug) or negative outcomes (adverse drug events). That is, it contains both risk and benefit. In recent years multiple disorders treated with many drugs by monotherapy or by fixed-dose therapy existing in the market which leads to increased drug-related problems one among that is drug-induced disorders. Morbidity and mortality have increased due to drug-induced disorders. This study was aimed to describe the various drugs induces skin disorders, its pathophysiology, diagnosis and treatment approach. We completed a review of the current evidence for various drug-induced skin disorders its causative drugs and therapeutic intervention of drug-induced skin disorders. A review through Medline, Embase, Pubmed, Wiley online library and selected studies related to drug-induced skin disorders. This is the comprehensive review of drug- induced skin disorders, designed to address prospectively its etiopathogenesis and clinical management. Penicillin, sulfa, phenyl-butazone, Tetracycline are the most common drug induces various skin disorders. There is not much significant differences in the clinical, histopathological or immuno-pathological features between various skin disorders and drug induced skin disorders. Hence knowing the etiopathology, and differential diagnosis is important to a proper treatment approach.</span></p>

Careful history taking detects initially unknown underlying causes of aspiration pneumonia.

The majority of pneumonia in the elderly is attributed to aspiration. Identifying the cause of aspiration is essential for efficient treatment and prevention. However, the methodology on how to investigate the causes is not established. Therefore, we studied cases that were initially admitted for pneumonia and were newly diagnosed with an underlying cause of aspiration. This is the first study to analyze such cases collectively. This was a retrospective study. Patients aged 65 years or older admitted for pneumonia from October 2012 to November 2018 and were newly diagnosed with a cause of aspiration after admission was included. Patients were excluded if they had hospital-acquired pneumonia, interstitial lung disease, or obstructive pneumonia or were immunocompromised. In total, 4043 patients were admitted for pneumonia and 125 cases who were newly diagnosed with causes of aspiration after admission were included in the study. This constituted 30.7% of suspected aspiration pneumonia cases in which there was no known cause of aspiration on admission. The most common conditions newly identified were neurologic disorders, upper gastrointestinal disorders, drug-induced conditions, and head and neck disease. Some were lethal. The diagnosis enabled treatment of the underlying condition and prevention of aspiration in most cases. The most common sign that lead to the diagnosis was symptoms seen from admission, followed by chronic symptoms. In 30.7% of those with suspected aspiration pneumonia with an unknown cause, a cause of aspiration was newly diagnosed. Careful history taking concerning neurological, gastrointestinal and drug-induced disorders is essential in elderly patients with pneumonia. Geriatr Gerontol Int 2020; 20: 785-790.

High incidence of hepatocellular carcinoma and cirrhotic complications in patients with psychiatric illness: a territory-wide cohort study

BackgroundBecause of high-risk behaviours, sedentary lifestyle and side effects of medications, psychiatric patients are at risk of viral hepatitis, alcohol-related liver disease and non-alcoholic fatty liver disease. We aimed to study the incidence of hepatocellular carcinoma (HCC) and cirrhotic complications in psychiatric patients.MethodsWe identified consecutive adult patients in all public hospitals and clinics in Hong Kong with psychiatric diagnoses between year 2003 and 2007 using the Clinical Data Analysis and Reporting System, which represents in-patient and out-patient data of approximately 80% of the 7.4-million local population. The patients were followed for liver-related events (HCC and cirrhotic complications) and deaths until December 2017. Age- and sex-standardized incidence ratio (SIR) of HCC in psychiatric patients to the general population was estimated by Poisson model.ResultsWe included 105,763 psychiatric patients without prior liver-related events in the final analysis. During a median (interquartile range) follow-up of 12.4 (11.0–13.7) years, 1461 (1.4%) patients developed liver-related events; 472 (0.4%) patients developed HCC. Compared with the general population, psychiatric patients had increased incidence of HCC (SIR 1.42, 95% confidence interval [CI] 1.28–1.57, P < 0.001). The SIR was highest in patients with drug-induced (SIR 3.18, 95% CI 2.41–4.11, P < 0.001) and alcohol-induced mental disorders (SIR 2.98, 95% CI 2.30–3.81, P < 0.001), but was also increased in patients with psychotic disorders (SIR 1.39, 95% CI 1.16–1.65, P < 0.001) and mood disorders (SIR 1.16, 95% CI 1.00–1.34, P = 0.047). Liver disease was the fifth most common cause of death in this population, accounting for 595 of 10,614 (5.6%) deaths. Importantly, 569 (38.9%) patients were not known to have liver diseases at the time of liver-related events. The median age at HCC diagnosis (61 [range 26–83] years) was older and the median overall survival (8.0 [95% CI 5.0–10.9] months) after HCC diagnosis was shorter in this cohort of psychiatric patients than other reports from Hong Kong.ConclusionsHCC, cirrhotic complications, and liver-related deaths are common in psychiatric patients, but liver diseases are often undiagnosed. More efforts are needed to identify liver diseases in the psychiatric population so that treatments and screening for HCC and varices can be provided to patients in need.

Predictors of emergency department visits for suicidal ideation and suicide attempt

ObjectivesThis study investigated predictors of emergency department (ED) visits for suicidal ideation and suicide attempt in 2014–15 among patients at six Quebec emergency departments (ED), using administrative data. MethodsParticipants (n = 11,778) used ED for suicidal ideation (30.4%); suicide attempt (7.0%); or other reasons (61.7%). A multinomial logistic regression was performed using variables described by the Andersen Behavioral Model. ResultsThe odds of ED visits for suicidal ideation or suicide attempt was high for adjustment disorders, personality disorders, and prior ED consultations for mental health (MH) reasons, but lower for schizophrenia spectrum and other psychotic disorders, illness acuity levels 3–5 (low severity), and 3+ consultations with outpatient psychiatrists. The odds of visiting ED for suicidal ideation increased in depressive disorders, and in the 12–17 year age range, but decreased in association with 1–2 outpatient psychiatrist consultations. The odds of suicide attempt also increased with alcohol use disorders and drug-induced disorders, but decreased with specific MH interventions at local community health services centers. Conclusionincreasing access to ambulatory care, and care continuity in outreach programs for acute MH disorders, including substance-related disorders, may reduce ED visits for suicidal ideation and suicide attempt, while improving overall service delivery.

Drug-induced nutritional disorders

Nutritional disorders include malnutrition and inadequate nutrition, overweight and obesity, micronutrient disorders and refeeding syndrome. According to the European Society for Clinical Nutrition and Metabolism, sarcopenia and fragility are nutrition-related conditions with complex and multiple pathogenic infrastructure. Inadequate nutrition is also considered as protein-energy malnutrition and is often accompanied by micronutrient as well as macronutrient deficiencies. Macronutrients such as carbohydrates, proteins, and fats are essential nutrients that provide energy to the body and aid in growth. Micronutrients such as vitamins, minerals, and trace elements are necessary for many special functions in the body. Meanwhile, drug intake can lead to increased morbidity and mortality and decreased quality of life by causing malnutrition through various mechanisms. The pharmacological and pharmaceutical properties of drugs can affect the intake, digestion, absorption, storage, metabolism, and elimination of nutrients, causing imbalance in the amount of nutrients required in the body. Polypharmacy makes this situation even more risky. Many of the patients’ symptoms or complaints received by physicians in their daily practice are associated with drug-induced nutritional disorders. When evaluating symptoms, physicians should also assess whether the symptoms are related to the disease, drug side effects, or drug-induced nutritional disorders. Instead of thinking that the resulting symptoms are simply “part of the disease” or “old age” and starting to take additional medication to resolve them, physicians should focus thoroughly on the event and examine what problems that the drugs used may cause in patients and the underlying reasons for deciding what they can do to eliminate them. This intervention should be investigated. Hence, this review aimed to explore the importance of the subject by mentioning the mechanisms of the negative effects of drugs on nutrition and providing examples of commonly used drugs.

New approaches to pharmacogenetics of drug-induced hyperprolactinemia in patients with schizophrenia

The pathogenesis of the development of drug-induced disorders while taking antipsychotic drugs is not well understood. The aim of the work is to study polymorphic variants of the multidrug resistance protein gene and genes encoding the metabolism and synthesis of dopamine and serotonin enzymes in antipsychotic-induced hyperprolactinemia in schizophrenia patients. As a result of a comprehensive study of 446 patients with schizophrenia and genotyping of 25 polymorphic variants of the MDR1, COMT, MAO-A, MAO-B, TPH1 and TPH2 genes, associations of polymorphisms rs1045642, rs2032582, rs4148739 (MDR1), rs6323 (MAO-А), rs1799836 (MAO-B) were revealed with the development of hyperprolactinemia. Further research is needed to develop personalized approaches to therapy.

Drug-induced psychotic disorder after administration of Vitex agnus castus (chasteberry) medication to treat premenstrual syndrome: a case report

Drug-induced psychotic disorder after administration of Vitex agnus castus (chasteberry) medication to treat premenstrual syndrome: a case report

НЕЙРОПСИХОЛОГІЧНІ КОРЕЛЯТИ МОЗКОВИХ ДИСФУНКЦІЙ У ОСІБ З ОБСЕСИВНО-КОМПУЛЬСИВНИМ РОЗЛАДОМ

У статті розглядається взаємозв’язок між біологічним субстратом обсесивно-компульсивного розладу та його психологічними проявами. Особлива увага приділяється дисфункції кортико-стріато-таламо-кортикальних петель і дизрегуляції базальних гангліїв як причини обсесивно-компульсивної симптоматики. Обсесивно-компульсивний розлад диференціюється від спектру тривожних розладів. Здійснюється порівняльний аналіз етіології компульсивного миття рук і компульсивного перевіряння. Описується альтернативний спосіб навчання і набуття нових навичок у осіб з обсесивно-компульсивним розладом. Інтерпретуються дані когнітивних досліджень з даної теми, зокрема тести на інгібування відповіді. Робляться припущення щодо виникнення «пастки» з обсесивних думок у осіб, що страждають на обсесивно-компульсивний розлад.

Drug-induced bone disorders: A systematic review

Drug-induced bone disorders are a group of disorders characterized by osteomalacia or osteoporosis, with the common denominator being the iatrogenic nature of the disease. Drug-induced bone disorders are either due to the drug directly effecting the bone microarchitecture (osteoblastic or osteoclastic activity) or indirectly by interfering with Vitamin D metabolism, Vitamin D/calcium absorption, and excess calcium loss or due to altered hormone states which promote bone loss (hypogonadism, hyperthyroidism, somatostatin excess states, insulin deficiency, increased systemic inflammation, and oxidative stress). References for this review were identified through searches of PubMed, Medline, and Embase for articles published until July 2019 using the terms “drug induced bone disorders” (MeSH Terms) AND “osteoporosis” (All Fields) OR “osteomalacia” (All Fields). Anti-epileptics, proton pump inhibitors, glucocorticoids, immunosuppressants (calcineurin inhibitors), anticoagulants, glitazones, SGLT2 inhibitors, somatostatin analogs, anticancer medications, and protein kinase inhibitors are some of the commonly used medications associated with bone mineral loss. An increased awareness, minimizing the use of these medications in patients at increased risk of fractures, keeping dosage and duration of therapy to the lowest, ensuring Vitamin D and calcium adequacy either through diet or supplements, and prophylactic use of bisphosphonates (where indicated) can play a major role in preventing morbidity associated with drug-induced bone disorders.