Adverse Effects Flashcards
PCNs
Generally well tolerated Diarrhea Allergic Rxn - Rash, anaphylaxis, increased LFTs, interstitial nephritis Seizures with high doses Neutropenia, Thrombocytopenia Thrombophlebitis (Nafcillin)
Amox/Amp
Maculopapular rash with mono infection (65-90%), CLL (90%), Allopurinol (15-20%) - not true PCN allergy
Clavulanic Acid
Diarrhea commonly
Cephalosporins
Generally well tolerated Hypersensitivity - cross-reactivity with PCNs. Est to be 2%. Do not use in pts w/anaphylaxis or hives to PCN Diarrhea Neutropenia, Thrombocytopenia Platelet dysfunction
Cephalosporin Contraindications
Hypersensitivity to any Cephalosporin
Type 1 allergy to PCNs
Ceftriaxone - use in neonates with increased bilirubin secondary to kernicterus risk
Carbapenems
Allergy - rash, anaphylaxis. Cross sensitivity with Beta-lactam anaphylaxis
Seizures (Imipenem primarily) - generally occurred in pts predisposed to seizure. Do not use in meningitis.
GI problems.
Carbapenem contraindications
Carbapenem hypersensitivity and Type 1 Beta-Lactam allergy. Do not use in meningitis.
Monobactam
Rash; N/V/D
Rare cross-sensitivity to PCNs and Cephalosporins
Vancomycin
Nephrotoxicity - less common with newer preparations
Ototoxicity - more common when adm with aminoglycosides (also ototoxic). More common with sustained trough levels over 20
Red neck/man syndrome - rash on neck, face, back due to rapid infusions. Infuse over at least 60 min.
Fluoroquinolone
Use should be limited in children (less than 18) and avoided in pregnancy. Bone/Joint/Cartilage erosion in young animals
GI problems - 2-10% - usually Nausea and diarrhea
CNS - 1-7%. Dizziness, lightheadedness, HA, insomnia
Decreased absorption with metal cations
Interacts with Theophylline (cipro), Warfarin. Avoid combination with other meds that prolong QT interval (Moxi)
Trimethoprim-Sulfamethoxazole
15% sulfa allergy.
GI upset (N/V, anorexia) and Rash most common; Photosensitivity
Rare, life-threatening rxns - Stevens-Johnson, Toxic Epidermal Necrolysis. Blood dyscrasia (Leukopenia, Neutropenia). Hepatotoxic rxns.
Rare crystalluria that leads to renal toxicity.
Hyperkalemia - esp with ACEI, ARB, K sparing diuretic, K supplement; High dose or decreased CrCl.
Trimethoprim-Sulfamethoxazole Contraindications
Hypersensitivity to any sulfa drug or TMP; folate deficiency anemia; infants less than 2 months; marked hepatic or renal dysfunction; pregnancy at term or lactation.
Aminoglycosides
Ototoxicity (often irreversible) - Vestibular - dizziness, impaired vision, nystagmus, vertigo, n/v, balance and walking. Cochlear - tinnitus, hearing impairment.
Nephrotoxicity - (usually reversible) - acute tubular necrosis
Tetracyclines
Teeth and bones - gray-brown to yellow permanent discoloration of teeth in children less than 8.
GI upset; photosensitivity; diarrhea (tetracycline); Vertigo (minocycline only); Rare hypersensitivity - serum-sickness like reactions, drug-induced lupus, hepatic injury, nephrotoxicity.
Tetracycline Contraindications
Do not use in ages less than 8; pregnancy or lactation