Therapeutics V Exam 2 AEs

Question 1

what are the adverse effects associated with penicillins?

Answer 1

hypersensitivity, cross allergenicity
tonic clonic seizures in renal insufficiency
Interstitial nephritis (methicillin and nafcillin)
phlebitis (nafcillin)
hypokalemia
sodium overload (ticarcillin and piperacillin)

Question 2

what penicillins are most likely to cause interstitial nephritis?

Answer 2

methicillin and nafcillin

Question 3

what are the adverse effects associated with cephalosporins?

Answer 3

1. hypersensitivity, cross allergenicity
2. precipitation of ceftriaxone with IV calcium products
3. nonconvulsive status epilepticus (with cefepime, ceftazidime, and cefiderocol)

Question 4

what cephalosporins have the MTT side chain?

Answer 4

cefamandole, cefotetan, cefmetazole, cefoperazone, moxalactam

Question 5

what does the MTT side chain do?

Answer 5

can cause hypoprothrombinemia and disulfiram reaction; moxilactam can reduce platelet aggregation

Question 6

what are the adverse effects associated with carbapenems and aztreonam?

Answer 6

1. hypersensitivity
2. CNS: seizures and direct toxic effect (carbapenems)
3. GI N/V/D (aztreonam)

Question 7

what are the major adverse effects associated with vancomycin?

Answer 7

1. red man syndrome (resolves after discontinuation; do not give > 15 mg/min)
2. nephrotoxicity and ototoxicity
3. dermatologic full body rash
4. thrombophlebitis (give into large vein to prevent this)

Question 8

what are the major adverse effects associated with quinupristin-dalfopristin?

Answer 8

venous irritation, myalgias and arthralgias, and rash

Question 9

what are the major adverse effects associated with oxazolidinones?

Answer 9

CNS peripheral & optic neuropathy with linezolid tx > 28d
thrombocytopenia and anemia with treatment of > 2 weeks

Question 10

what are the adverse effects of dapto?

Answer 10

myopathy and CPK elevation, and acute eosinophilic pneumonia (led to FDA BBW)

Question 11

what are the adverse effects of lipoglycopeptides?

Answer 11

red man syndrome, QTc prolongation (telavancin), taste disturbances, nephrotoxicity, BBW pregnancy category C

Question 12

what are the adverse effects of FQ therapy?

Answer 12

c diff colitis, peripheral neuropathy, QTc prolongation, articular damage, and tendonitis/tendon rupture

Question 13

what are the adverse effects of macrolide therapy?

Answer 13

NVD (especially erythromycin), thrombophlebitis, QTc prolongation

Question 14

what are the adverse effects of aminoglycosides?

Answer 14

1. nephrotoxicity (risk factor of prolonged high trough concentrations)
2. ototoxicity (irreversible, must be caught early)

Question 15

what are the adverse effects of tetracyclines?

Answer 15

photosensitivity and pregnancy category D due to divalent and trivalent cations

Question 16

what are the adverse effects of tetracycline analogs?

Answer 16

NVD, flatulence
photosensitivity
pregnancy category D due to divalent and trivalent cations

Question 17

what are the adverse effects of bactrim?

Answer 17

hypersensitivity reactions (RASH)
renal insufficiency
hypokalemia

Question 18

what are the adverse effects of polymyxins?

Answer 18

nephrotoxicity and neurotoxicity

Question 19

what are the adverse effects of clindamycin?

Answer 19

c diff colitis!

NVD and hepatotoxicity

Question 20

what are the adverse effects of metronidazole?

Answer 20

1. GI metallic taste
2. peripheral neuropathy (if any CNS AEs occur, STOP immediately!)
3. mutagenic and carcinogenic (promotion of cancer)
4. may be teratogenic!