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PEBC > Antibiotic DRUG ADRs > Flashcards

Antibiotic DRUG ADRs Flashcards

1
Q

Penicillin Adverse effects. (3)

A

(Well tolerated).
Diarrhea (much higher w/ clavulin.)
Rarely: seizures. Hyperkalemia (with rapid IV Pen G injection).

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2
Q

Penicillin Interactions.

A

Caution in renal impairment (accumulation = seizures). No serious interactions.

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3
Q

Cephalosporin Adverse effects.

A

(Well tolerated).
Diarrhea
Rarely: seizures (in low renal fxn accumulation)

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4
Q

Cephalosporin Interactions.

A

Caution in renal impairment (accumulation = seizures).
Probenecid decreases elimination.
Antacids decrease absorption.

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5
Q

Carbapenem Adverse effects.

A

Caution in renal impairment (accumulation = seizures).
Neutropenia.

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6
Q

Carbapenem Interactions.

A

Cilistatin - decreases renal excretion.

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7
Q

Vancomycin adverse effects.

A

Red man syndrome: histamine relase = redness, pruritis, hypotension.
Ototoxic, nephrotoxic (dose dependant - not time dependant)

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8
Q

Ciprofloxacin adverse effects.

A

Dizziness, headache,seizures
Hepatitis, Photosensitivity, GI upset.
Cartilage toxicity,
QT prolongation

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9
Q

Levofloxacin/Moxifloxacin adverse effects.

A

Dizziness, headache,seizures
Hepatitis, Photosensitivity, GI upset.
Cartilage toxicity,
QT prolongation
Not in Children <18 years

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10
Q

Fluoroquinolone interactions.

A

Metals/ions/antacids decrease absorption.
NSAIDs increase risk of seizure.
Probenecid/cimetidine inhibit excretion - = increased serum levels.
CIPRO = cyp 3A4 inhib watch warfarin/INR

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11
Q

Aminoglycoside adverse effects.

A

Reversible nephrotoxicity
Irreversible ototoxicity
parasthesias

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12
Q

Aminoglycoside interactions.

A

Caution w/ coadminstraiton of other nephrotoxic drugs (vancomycin)
Caution with diuretics - increase risk of renal damage.

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13
Q

SMX-TMP adverse effects.

A

Nausea, vomiting, rash, photosensitivity,
Bone marrow suppression/ hemolytic anemia.
Nephrotoxic (crystalluria)

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14
Q

SMX-TMP interactions.

A

Increase INR with warfarin.
Increase bone marrow suppression w/ MTX

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15
Q

Macrolide adverse effects.

A

QT prolongation (erythro + clarithro)
GI Cramping
(rare) Hepatoxicity(erythromycin estolate) = cholestatic jaundice
(rare) ototoxicity

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16
Q

Macrolide interactions.

A

Clarithro + erythro = cyp 3A4 inhibs - increase warfarin etc.

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17
Q

Clindamycin adverse effects.

A

Diarrhea, pseudomembranous colitis (c.dif!)
Thrombophlebitis if IV
Skin Rash

18
Q

Clindamycin interactions.

A

(none)

19
Q

Tetracyline adverse effects.

A

Nausea, Vomiting, diarrhea, Rash.
Photosensitivity.

20
Q

Tetracycline interactions.

A

Cyp 3A4 subtrate - caution w/ phenytoin, carb,
May increase INR w/ warfarin.
Caution w/ dairy (minimal effect)
Caution w/ aluminum, bismuth, iron, mg absorption.

21
Q

Metronidazole adverse effects.

A

GI upset
Dark or reddish brown discoloration of urine.
Metallic taste.

22
Q

Metronidazole interactions.

A

Disulfiram like reaction w/ alcohol!

23
Q

Rifampin adverse effects

A

Rash, orange discoloration of body fluids (stains contact lens), nausea, vomiting, hepatic toxicity, thrombocytopenia.

24
Q

Rifampin interactions

A

Potent Cyp inducer - decreases levels of warfarin, CNI’s, phenytoin, COC.

25
Q

Isoniazid adverse effects
How to offset.

A

Asymptomatic increase in hepatic ezymes + bilirubin. Hepatitis (wks to months).
Peripheral neuropathy (dose related).
Drug induced lupus
Seizures, drowsiness.
Gynecomastia.
GI Upset
Bone marrow suppression
(Isopropyl - liver toxicity - seizures, drowsiness, - fell and got attacked by dog (lupus) - bled out (bonemarrow suppression) - numbness in leg (peripheral neuropathy.
Prescribe pyridoxine 50mg/day to prevent peripheral neuropathy.

26
Q

Isoniazid interactions

A

Increased hepatotoxicity with other hepatotoxic drugs (alcohol, apap, rifampin)
Increased serum levels of CBZ, phenytoin, theophylline (cyp inhibitor)

27
Q

Pyrazinamide adverse effects

A

Hepatotoxicity -
Arthralgia/ gout
Drug fever
Rash
Bone marrow suppression
Pyrazinamide sets a fire in your joints, your skin, you liver.

28
Q

Pyrazinamide interactions

A

Increases rifampin levels

29
Q

Ethambutolol adverse effects

A

Ocular toxicity - red/greeen color blindness -
skin rash - SJS, TEN.
Bone marrow suppression
Neurologic effects: H/A, dizziness, confusion, hallucinations.
Someone pours boiling alcohol into your eye. Scalds your skin. Then you drink it.

30
Q

Ethambutolol interactions

A

Binds to mg++ separate doses by at least 4 hours

31
Q

TB treatments contraindicated in pregnancy (2)

A

Streptomycin = congenital deafness.
Pyrazinamide - caution - not to be used if can be avoided. (burns fetus?)

32
Q

Which TB drug to switch out in HIV (1)

A

Rifampin —> Rifabutin (less enzyme induction = safer with protease inhibitors)

33
Q

Which TB drugs cause hepatotoxicity. (3)

A

Rifampin. Isoniazid. Pyrazinamide.

34
Q

Antibiotics NOT safe in pregnancy.

A

SMX/TMP - 1st trim = Neural tube defect. 3rd Trim = kernicterus
Tetracyclines - staining of teeth and bone problems
Nitrofurantoin (3rd tim)
Cipro - not in 1st trimester
Macrolides: erythro preferred (just no estolate salt)

35
Q

Antibiotics NOT safe in lactation.

A

All except ciprofloxacin, tetracyclines, and metronidazole are OK in breastfeeding.

36
Q

How does ceftazidime differ from other 3rd generation ceph’s (cefotaxime, ceftriaxone)

A

Increased gram (-) coverage (covers SPACE bugs + Pseudomonas), decreased gram (+) - to basically nothing.

37
Q

Chloroquine adverse effects

A

Non-allergic pruritis in african americans. Vomiting, headache. Bitter taste.
Uncommon: bone marrow suppression, eye problems, hair depigmentation, Rash.
Rare - retinopathy/myopathy.

38
Q

Chloroquine interactions

A

NONE. Retinal toxicity with continuous use. Check eyes q 6-12 months.

39
Q

Mefloquine adverse effects

A

Common: GI sxs. Nightmares, anxiety, personality changes.
Rare: hair loss, skin rash, seizures, psychosis, thobotic purpura.
Kumar - lost hair, went crazy, dark skin.

40
Q

Primaquine adverse effects

A

Hemolysis- G-6-Pd deficiency. Contraindicated in pregnancy (fetus GP6- status is unknown).

41
Q

Mefloquine is contraindicated in patients with.

A

Seizures, depression, anixiety disorders.

PEBC (6 decks)

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