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FOM > AM - Side effects/toxicity Lecture 3 > Flashcards

AM - Side effects/toxicity Lecture 3 Flashcards

1
Q

What antimicrobial type most commonly causes allergic reactions?

A

B-Lactams

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2
Q

How common is penicillin hypersensitivity?

A

True penicillin hypersensitivity is rare but alot of patients with other side effects are wrongly labelled as allergic

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3
Q

Are penicillin alleric patients allergic to any other antimicrobials?

A

Around 10% of the truly penicillin alleric patients are also alleric to cephalosporins

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4
Q

What are the 2 types of antimicrobial allergy?

A

Immediate hypersensitivity

Delayed Hypersensitivity

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5
Q

Whats the most extreme form of immediate hypersensitivity?

A

Anaphylactic shock usually following parenteral administration of an antibiotic

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6
Q

What mediates immmediate allergic reactions?

A

IgE

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7
Q

What are the symptoms of immediate hypersensitivity?

A
  • Itching
  • Urticaria
  • Nausea
  • Vomiting
  • Wheezing
  • Shock
  • Laryngeal Oedema
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8
Q

What symptom of immediate hypersensitivity is most commonly fatal?

A

The laryngeal Oedema is often fatal if the airway isnt cleared.

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9
Q

How long does a delayed hypersensitivity reactions take?

A

Hours or Days to occur

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10
Q

What mediates delayed hypersensitivity reactions?

A
  • Immune complexes

- or Cell mediated

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11
Q

What are the symptoms of delayed hypersensitivity?

A

Drug rashes
Drug Fever
Serum Sickness
Erythema Nodosum

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12
Q

Whats erythema nodosum?

A

Red lumps on the skin

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13
Q

Describe the rashes in a delayed hypersensitivity reaction?

A

Rashes are maculopapular

i.e. flat red area of skin covered in small bumps

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14
Q

Whats stevens-johnson syndrome?

A

A form of delayed hypersensitivity where the skin & mucous membranes are both involved.
Its associated with sulphonamides

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15
Q

Whats the common gastrointestinal side effects of antimicrobials?

A

Nausea

Vomiting

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16
Q

What is CDAD?

A

Clostridium Difficile Associated Diarrhoea

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17
Q

Whats CDI?

A

Clostridium Difficile Infection (specifically infection of a dangerous strain no the normal commensal in the gut)

18
Q

Whats an EIA?

A

An Enzyme Immunoassay

19
Q

What happens to C. Diff. when during antibiotic use?

A

It overgrows normal flora in the gut and produces toxins

20
Q

What does C. Diff growth cause during antibiotic use?

A

Anything from mild CDAD or CDI to life threatening pseudomembranous colitis.

21
Q

How do we check fo a CDI?

A

Use an EIA to check the stool for toxins

22
Q

How do we treat a CDI?

A

Oral Vancomycin or metronidazole

IF possible stop all other antibiotic treatment

23
Q

How do we stop spores of the dangerous C Diff strains spreading?

A
  • Isolating patients with CDI

- Hand Washing with soap (resistant to alcohol gel)

24
Q

What antimicrobials cause thrush?

A

Broad Spectrum penicillins & cephalosporins

25
Q

What is Thrush?

A

ORal and/or Vaginal Candidiasis

fungal infection of candida yeast

26
Q

How do antimicrobials cause thrush?

A

Certain antimicrobials cause thrush by suppressing normal flora leading to overgrowth of yeast candida albicans

27
Q

What kind of liver toxicity can be caused by antimicrobials?

A

Varies from transient elevation of liver enzymes al the way to severe hepatitis

28
Q

In what patients are liver toxicity side effects most common?

A

Pregnant patients

Or those with pre-existing liver disease

29
Q

Name some drugs associated with liver toxicicity:

A

Tetracycline
Rifampicin
Flucloxacillin
Isoniazid (anti-TB)

30
Q

Who does nephrotoxiicty effect most?

A

People with pre-exisiting renal disease

31
Q

Why do we monitor the levels of aminoglycosides & vancomycin in the blood?

A

Because they can cause renal toxicity

32
Q

What drugs cause ototoxicity?

A

Aminoglycosides

Vancomycin

33
Q

What drug can cause optic nerve damage?

A

Ethambutol an anti-TB drug can damage the optic nerve

34
Q

What do we monitor during ethambutol treatment?

A

Durin ethambutol treatment we monitor optic nerve function

35
Q

What drugs cause encephalopathy & convulsions?

A

High dose Penicillin
High dose Cephalosporin
Acyclovir (an anti-viral)

36
Q

How do we alter the drug if the pateint has renal impairment?

A

MAy have to reduce the dose proportionally to impairment to avoid toxicity (particularly encephalopathy & convulsion)

37
Q

What drugs can cause peripheral neuropathy?

A

Metronidazole

Nitrofurantoin

38
Q

How does Isoniazid cause peripheral neuropathy?

A

By competetive inhibition wiht pyridoxine (Vitamin B6)

39
Q

In what ways can AMs affect cause marow depression?

A

Selective Depression of one cell line

Unselective depression of all bone marrow elements (pancytopenia)

40
Q

Example of AM that suppresses marrow?

A

Linezolid (an anti-MRSA agent) can cause low platelet counts

41
Q

What haematological side effect can co-trimoxazole cause?

A

Inhibits folic acid synthesis

  • > a folate deiciency
  • > megaloblastic anaemia
42
Q

What antiviral blood levels must be monitored?

A

Zidovudine for HIV

Ganciclovir for CMV

FOM (101 decks)

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