Antibiotic and Antifungal Drug Adverse Reactions

Question 1

Mild nausea/vomiting, diarrhea, ‘non-allergy” maculopapular rash, Allergic urticarial rash

Answer 1

Penicillins

Question 2

Nausea/vomiting, diarrhea most common, hypersensitivity

Answer 2

Cephalosporins

Question 3

Hypersensitivity and seizures (rare)

Answer 3

Carbapenems

Question 4

Ototoxic and nephrotoxic, permanent auditory/vestibular impairment possible

Answer 4

Vancomycin or Gentamycin

Question 5

GI irritation, photosensitivity, deposition in developing bones and teeth (discoloration/impaired growth), should not be taken with divalent cations

Answer 5

Doxycycline

Question 6

Generally safe, GI irritation, prolonged Q-T interval increases risk of arrythmias

Answer 6

Azithromycin

Question 7

Diarrhea, C. diff. colitis is a major concern

Answer 7

Clindamycin

Question 8

Myelosuppression, peripheral and optic neuropathy, lactic acidosis, concomitant use with anti-depressants causes serotonin syndrome

Answer 8

Linezolid

Question 9

Peripheral neuropathy (drug-induced deficiency in pyridoxine), hepatotoxicity, hepatitis (potentially fatal hepatic necrosis), Pyridoxine is used to treat side effects

Answer 9

Isoniazid (INH)

Question 10

Hepatotoxicity (jaundice and hepatitis), red-orange urine, sweat, saliva, tears, strong induction of many CYP isoforms

Answer 10

Rifampin

Question 11

Optic neuritis

Answer 11

Ethambutol

Question 12

Hyperuricemia

Answer 12

Pyrazinamide

Question 13

Tendonitis/tendon rupture, CNS effects, peripheral neuropathy, prolonged QT interval, photosensitivity, makes MG worse

Answer 13

Ciprofloxacin (fluoroquinalones)

Question 14

Headache, GI disturbances, dark urine, carcinogenic (in animals), neuropathy, disulfiram-like rxn in combination with alcohol

Answer 14

Metronidazole

Question 15

Kernicterus in neonates (bilirubin induced brain dysfunction), hypersensitivity (rash and Stevens-Johnson syndrome/Toxic Epidermal Necrolysis), Hemolytic anemia in patients with G6PD deficiency

Answer 15

Sulfamethoxazole (SMX)

Question 16

Bone marrow suppression in folate-deficient patients, hyperkalemia

Answer 16

Trimethoprim (TMP)

Question 17

Myopathy (muscle pain/weakness), Eosinophilic pneumonia

Answer 17

Daptomycin

Question 18

Nephrotoxicity, neurotoxicity (weakness)

Answer 18

Colistin

Question 19

Well tolerated topically or orally, infusion related effects: cytokine storm (fever, chills, rigors, hypotension), Renal toxicity, Hematologic toxicity

Answer 19

Amphotericin B

Question 20

Hematologic (direct myelosuppression/ monitor CBC), Hepatotoxicity

Answer 20

Flucytosine

Question 21

Headaches are common but resolve with continuous use, photosensitivity reactions

Answer 21

Griseofulvin

Question 22

Dermal irritation and hypersensitivity, taste disturbances, hepatotoxicity

Answer 22

Terbinafine

Question 23

Gi upset (most common), drug interactions due to inhibition of human CYPs (can result in severe toxicity), hepatotoxicity, avoid during pregnancy

Answer 23

Fluconazole

Question 24

Almost none! Infusion reactions

Answer 24

Caspofungin