Antibiotic Side Effects

Question 1

Which Antibiotic class has side effects including Ototoxicity (i.e., vestibular damage or auditory damage) and Nephrotoxicity?

Answer 1

Aminoglycosides

Question 2

Which second generation cephalosporin has the unique side effect of hypoprothrombinemia and bleeding due to the methylthiotetrazole group on its structure and can also elicit a disulfiram-like reaction if alcohol is consumed?

Answer 2

Cefotetan

Question 3

Which antibiotic class and specific drug in this class has the unique side effect of displacing bilirubin due to its high affinity for serum album, potentially causing jaundice in neonates?

This drug also has a high affinity for calcium and may lead to biliary peseudolithiasis (i.e., gallstones).

Answer 3

Third generation cephalosporins - Ceftriaxone

Question 4

Which specific antibiotic should be avoided in people with renal impairment due to its potential to cause seizures in people w/ renal failure?

Which class does it belong to?

Answer 4

Imipenem - Carbapenem antibiotic class

Question 5

Which antibiotic class has the unique side effect of causing elevation serum aminotransferases (i.e., hepatotoxicity) w/ occasional skin rashes?

Answer 5

Monobactam class - aztreonam

Question 6

Which antibiotic class must be given IV due to its poor absorption?

Answer 6

Glycopeptides (i.e., vancomycin)

Question 7

Which antibiotic class has the side effect of producing Red Man Syndrome (hypotension, tachycardia, and flushing) and nephrotoxicity?

Answer 7

Glycopeptides - vancomycin

Question 8

Which antibiotic and of what class has the unqiue side effects of:

1) Myelosuppression, and most commonly thrombocytopenia
2) Lactic acidosis, optic neuritis, and peripheral neuropathy
3) Drug-drug interactions w/ adrenergic or serotonergic agents –> Serotonin syndrome

Answer 8

Linezolid - Oxazolidinone class

Question 9

Which antibiotic acts on motilin receptors in the GI tract and can lead to epigrastric distress?

This antibiotic may also cause Hepatotoxicity in the form of cholestatic hepatitis when used for prolonged periods.

Answer 9

Erythromycin of the Macrolide class

Question 10

Which antibiotic class has side effects related to infusion site reactions, which include an arthralgia-myalgia syndrome?

Answer 10

Streptogramins

Question 11

Which antibiotic class can lead to C. difficile associated colitis, permanent brown discoloration of teeth, and affect the formation of fetal bones and teeth?

Answer 11

Tetracyclines

Question 12

Which aminoglycosides are most likely to induce vestibular damage?

Which are most likely to induce auditory damage?

Answer 12

• Gentamicin and streptomicin –> vestibular damage (loss of balance, ataxia, vertigo)
• Amikacin and kanamycin –> auditory damage (high-frequency hearing loss, tinnitus)

Question 13

Which antibiotic class is associated with Achilles tendon rupture?

Which specific drug in this class has the highest risk of QT prolongation inducing a torsades de pointes arrhythmia?

Answer 13

• Fluoroquinolones
• Moxifloxacin (QT prolongation and torsades de pointes arrhythmia)

Question 14

Which antibiotic class can elicit anemia, leukopenia, and granulocytopenia?

Vomiting, photosensitivity, fever, uricaria and rarely Steven-Johnson syndrome?

Answer 14

• Benzylpyrimidine (trimethoprim) –> anemia, leukopenia, and granulocytopenia
• Sulfonamides (sulfamethoxazole) –> SJS

*Are given together TMP/SMX so adverse effects are combined

Question 15

Which antibiotic class can have dose-dependent nephrotoxicity w/ accompanying neurological effects including slurred speech, vertigo, parasthesias, apnea, and muscle weaknss after systemic parenteral administration?

Answer 15

Polymyxins (Polymyxin B and Colistin)