Apex- Antibiotics

Question 1

What is the most common side effect of prophylactic antibiotics?

Answer 1

Pseudomembranous colitis

Question 2

T/F: Allergic reactions are most commonly caused by beta-lactam antibiotics

Answer 2

True

Question 3

why is there a convern about cross-reactivity between PCN and cephalosporins?

risk? (%)

which generation cephalosporins are associated with the lowest rate of cross-reactivity?

Answer 3

bc they share a beta-lactam ring

<1%

3rd and 4th generation

Question 4

If a patient reports an allergy to PCN - they can receive a cephalosporin if the reaction was not…. _____ mediated and did not produce what

what would be the 2 alternatives?

Answer 4

was not IgE mediated
& didn’t produce exfolative dermatitis

vanco or clinda

IgE mediated (anaphylaxis, bronchospasm, urticaria)
exfolative dermatitis (stevens-Johnson syndrome)

Question 5

dose and rate that vanco should be infused and why?

Answer 5

10-15ml/kg over 1 hour

*histamine release and hypotension

Question 6

Which 4 antibiotics are contraindicated during pregnancy?

Answer 6

1. Chloramphenicol (whatever that is)
2. Erythromycin
3. Fluoroquinolones
4. Tetracyclines

1. chloroprep lol
2. macrolide
3. cipro, levofloxacin, moxifloxacin
4. doxycycline

Question 7

Aminoglycosides (2)
Risks (3)

Answer 7

Gent and Streptomycin

ototoxicity, nephrotoxicity, skeletal muscle weakenss*

*caution with NMB

Question 8

What class antibiotics is doxycycline?

2 risks associated

Answer 8

Tetracycline

hepatotoxicity and nephrotoxicity

Question 9

Fluroquinolones (3)

2 associated risks

Answer 9

1. ciprofloxacin
2. levofloxacin
3. moxifloxacin

F - Fluroquinolonin; F- Floxacin

GI upset & tendonitis/trendon rupture

Question 10

What class is erythromycin?

risks?

Answer 10

Macrolide

P450 inhibition
prolonged duration of drugs metabolized by P450 system

Question 11

3 risks of vanco

Answer 11

1. hypotension with rapid infusion (histamine relaease)
2. red-man syndrome
3. stevens-johnson

Question 12

2 risks with metronidazole

Answer 12

peripheral neuropathy and alcohol intoelrance

Question 13

What 2 antibiotics cause skeletal muscle weakness where you should be mindful of your NMB dosing

Answer 13

Aminoglycosides (Gent and streptomycin)
& Clindamycin

Question 14

which abx is stronly associated with etoh intolerance?

Answer 14

metronidazole

Question 15

which abx is associated with peripheral neuropathy?

Answer 15

metronidazole

Question 16

Which abx is associated with steven johnson syndrome?

Answer 16

vancomycin

Question 17

which abx is associated with histamine release

Answer 17

vanco

-hypotension with rapid infusion
-red man syndrome

Question 18

which abx CLASS is associated with p450 inhibition

which drug is in that class

Answer 18

macrolides

erythormycin

Question 19

which abx class is associated with tendonitis and tendon rupture?

Answer 19

fluroquinolones

-ciprofloxacin, levofloxacin, moxifloxacin

Question 20

which drug class is associated with nephrotoxicity? (2)

Answer 20

1. aminoglycocides (gent and steptomycin)
2. tetracyclines (doxycycline)

Question 21

which abx class is assoicated with hepatotoxicity?

Answer 21

tetracycline

doxycycline

Question 22

how do cephalosporins work?

what other drug works in this way?

Answer 22

they distrupt bacterial cell wall synthesis (peptidoglycan)

vanco

Question 23

how often should cephazolin be redosed

Answer 23

q4h

Question 24

what is the abx of choice for pts with active MRSA

Answer 24

vanco

Question 25

Which are the beta-lactams? (3)

Answer 25

1. PCN
2. Cephalosporins
3. ampicilin