Adverse Effects of Antibiotics Flashcards by Rebecca Evatt

ADRs of Nafcillin?

neurotoxicity
bone marrow suppression
neutropenia
agranulocytosis
C. diff

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drugs that cause C. diff

Nafcillin
Zosyn
Azobactam 
Daptomycin
Clindamycin
FQs
Doxycycline
Tygacycline

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ADRs of Unasyn?

seizures at high doses
hepatic dysfunction
rash

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all ß-lactams have the potential for this ADR:

hypersensitivity reaction/anaphylaxis (allergy)

therefore, monitor for signs of anaphylaxis with the first dose for all ß-lactams

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Most injectables have this ADR:

local pain at site of injection

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Most antibiotics in general have this ADR:

GI upset

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Antibiotics that interact with warfarin:

Unasyn
Zosyn
all cephalosporins
azactam
Flagyl
Bactrim
Rifampin
Doxycycline

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ADRS of Zosyn

FATAL hypersensitivity
SJS
TEN
C. diff
electrolyte abnormalities (Na, K)
Hematologic effects

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ADRS of Keflex and Ancef

SJS
TEN
increased seizure risk
thrombocytopenia

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Antibiotics that interact with phenytoin:

Ancef
Flagyl
Bactrim
Rifampin

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ADRs of Cefuroxime?

same as ß-lactams in general:

anaphylaxis; GI upset

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Ceftin can increase the levels of _________ and __________.

Aminoglycosides and warfarin

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Keflex may increase the levels of _________ and __________.

Metformin and warfarin

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Separate these antibiotics from antacids/H2RAs

Ceftin

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ADRS of Rocephin?

skin tightness, induration (skin hardening) at injection site
hyperbilirubinemia in neonates

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ADRs of 3rd generation cephalosporins?

thrombocytopenia

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Which antibiotic can cause hyperbilirubinemia in neonates?

Rocephin

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3rd gen cephs may increase the levels of _________ and __________.

AGs and warfarin (minor)

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Separate Rocephin from _________.

calcium supplements

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Cefepime can increase the levels of ________ and ________.

Aminoglycosides and warfarin

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ADRs of Telflaro?

hemolytic anemia

probenecid may increase the concentrations of ______

cephalosporins and penicillins

What antibiotics may cause a false positive direct Coombs test?

cefepime; meropenem and imipenem/cilastatin

major ADR of carbapenema?

SEIZURES

what are some ADRs of imipenem/cilastatin?

increased serum AST and ALT decreased Hct and Hgb eosinophilia

Imipenem is __________, so it must always be given with cilastatin.

nephrotoxic

Carbapems can decrease the serum concentration of _________.

valproic acid

ADRs of Azobactam:

* Common: neutropenia, increased serum transaminases, pain at injection site, fever * Life-threatening: TEN, anaphylactic reaction, C. diff

Azobactam is very similar to what other antibiotic?

ceftazidime (same spectrum, same side chain, same allergy)

ADRs of vancomycin?

· IV: hypotension & flushing, erythematous rash on face and upper boy (red man syndrome) · Oral: abdominal pain, bad taste, nausea · Nephrotoxicity, ototoxicity, neutropenia, extravasation

ADRs of televancin?

``` · CNS: insomnia, psychiatric disturbance, HA · GI: metallic taste, nausea, vomiting · Genitourinary: proteinuria · Renal: ↑ serum creatinine · Nephrotoxicity (more so than vanc) · Red man syndrome · FOAMY urine ```

major drug interaction with televancin?

QT PROLONGATING AGENTS

name some drugs that are HIGH risk QT prolonging agents that may interact with televancin.

``` § Quinidine § Sotolol § Methadone § Lithium § Thorazine § Ziprasidone § Chlorpromazine ```

name some drugs that are MODERATE risk QT prolonging agents that may interact with televancin.

amiodarone cipro haldol

name some drugs that are indeterminate risk QT prolonging agents that may interact with televancin.

benadryl Zofran fluconazole

What agents interact with the typhoid vaccine?

vanc and televancin

ADRs of daptomycin:

``` · N/V/D/C · Anemia · Eosinophilic pneumonia · Hypersensitivity reactions and anaphylaxis · MYOPATHY (rhabdo) · Peripheral neuropathy · C. diff · Drug fever ```

What antibiotic should you NOT give to treat pneumonia or other URTI's because the surfactant in the lungs binds to it and makes it ineffective?

daptomycin

ADRs of clindamycin

diarrhea, rash, SJS, C. diff

ADRs of linezolid after 2 weeks of therapy? after prolonged therapy?

myelosuppression—most commonly thrombocytopenia (tends to occur after 2 or more weeks of therapy and warrants monitoring); peripheral neuropathy and lactic acidosis can occur after prolonged therapy (months) because of toxicity to mitochondria

major drug interaction with linezolid

SEROTONIN SYNDROME

ADRs of azithromycin?

QT prolongation

ADRs of flagyl?

· Systemic: HA, N, vaginitis, peripheral neuropathy · Topical: candida overgrowth & candidiasis, vaginal discharge · QT prolongation

Common ADRs of Bactrim:

· Common: RASH & urticaria (from hypersensitivity), HA, GI upset, swollen tongue, insomnia, dizziness, photosensitivity, fatigue

Life-threatening ADRs of Bactrim:

``` · Life-threatening: o SJ syndrome o TEN o Fulminant hepatic necrosis o Agranulocytosis o Aplastic anemia o Blood dyscrasias o Anaphylaxis o Renal failure (crystalluria or AIN) -- Can occur in any patient taking Bactrim + dehydration ```

Life-threatening ADRs of FQs:

Life-threatening: o Bone marrow depression o Pancytopenia o QT prolongation/arrhythmias o Hepatic failure

Common ADRs of FQs

tendonitis dysgycemias QT prolongation

Common ADRs of rifampin?

``` Increased LFTs Discolored bodily fluids (red/orange) dizziness fatigue flatulence HA lack of appetite ```

Doxycycline ADRs

GI (nausea & esophageal irritation) photosensitivity discoloration of developing teeth in children C. diff

Tygacycline ADRS

``` DEATH GI upset allergic rxn C. diff permanent discoloration of teeth (if used in ```

ADRs of Gentamicin:

``` · Nephrotoxicity · Ototoxicity · injection site reaction · neuromuscular blockade can cause therapeutic paralysis (most often in pts with underlying neuromuscular disorder or paralyzed in ICU) · hypersensitivity ```