S15C200 - Antimicrobial toxicity

Question 1

Penicillin Toxicity

Answer 1

• seizures (>50million units IV)

- tx: benzo

Question 2

Amoxicillin

Answer 2

• crystalluria, hematuria, AKI

- tx: IV hydration

Question 3

Cephalosporins

Answer 3

• encephalopathy, seizures

- tx: benzo

Question 4

Chloramphenicol

Answer 4

• cardiovascular collapse

- tx: HD

Question 5

Fluoroquinolones

Answer 5

• seizures

- tx: benzo

Question 6

Macrolides

Answer 6

• long QT, torsades

- tx: MgSO4-

Question 7

Vancomycin

Answer 7

• red man syndrome

- tx: slow/stop infusion, antihistamines

Question 8

Isoniazid

Answer 8

• inhibition of GABA, funtional deficiency of pyridoxine, seizures
• nausea, AMS, ataxia (seen 30mins post-ingestion)
• 3 classic features of OD: seizures, metabolic acidosis, protracted coma
• tx: benzos, pyridoxime (Vit B6 - 5g IV)

Question 9

Quinine

Answer 9

• Na/K channel blockade, alpha adrenergic antagonist, hypoglycemia, ototoxicity
• tx: NaHCO3-, dextrose, octreotide

Question 10

Chloroquine

Answer 10

• seizures, wide QRS, long QT, HoTN, hypokalemia

- tx: epinephrine, diazepam

Question 11

Primaquine

Answer 11

• methemoglobinemia

- tx: methylene blue