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What are the common adverse effects of penicillins? (6)

allergic reaction, acute interstitial nephritis (AIN), bone marrow suppression, seizures, contact dermatitis, GI

what are the DDIs of penicillins? (1 and state affects)

gout medication probenecid can block renal excretion and prolong half life

What are the side effects of cephalosporins specific to the drugs? (2)

ceftriaxone-bilinary sludging in neonates; (cefotetam, cefetazole, cefoperazone) causes bleeding, nausea, vomiting in patients taking alcohol

bilinary sludging in neonates can caused by __________


bleeding, nausea, vomiting in patients taking alcohol is caused by ________ (3)

cefotetam, cefetazole, cefoperazone

Side effect of ceftriaxone (1)

bilinary sludging in neonates

side effect of cefotetam, cefetazole, cefoperazone

bleeding, nausea, vomiting in patients taking alcohol

What are the side effects of carbapenems? (1)


What Two beta lactams do you not dose adjust for renal fuction?

ceftriaxone and Anitstaphylococcal

Can aminoglycosides be used alone?

ONlY for urinary tract infections because they highly concentrate in the urine

What are the adverse effects of aminoglycosides? (3)

nephrotoxicity, vestibular/ototoxicity, neuromuscular blockade

What drugs have the potential to cause nephrotoxicity (3)

aminoglycosides and vancomyocin and telavancin

What drug class has the potential to cause vestibular/ototoxicity


What drug class has the potential to cause neuromuscular blockade


What are three pharmokinetic facts about fluroquinolones?

All except norfloxacin are readily absorbed allowing for PO instead of IV, higly lipophilic this can be used for infection in bodily sites, renaly eliminated requiring dose adjustment for all except moxifloxacin

What are two pharmacokinetics facts about aminoglycosides?

poor oral absorption and hydrophillic so poor tissue concentration

What is the one fluroquinolones that is not dose adjusted?


What are the side effects of fluroquinolones? (5)

CNS toxicity resulting in headaches, dizzy, insomnia, damage to growing cartilage a problems for infants, TENDON RUPTURE, dysglycemia, cardiac arrhythmias

What drug interactions are know for fluroquinolones?

chelation with divalent cations like Ca, Mg, Fe cause reduced absorption

What are the side effects of vancomycin? (2)

Nephrotoxicity, ototoxicity, rash (red man's syndrome)

Why does vancomycin cause a rash (red man's syndrome)?

rapid infusion causes histamine response

What are the pharmocological problems of telavancin? (3)

toxicity is higher that vancomycin, interference with coagulation tests, can't be used in pregnant patient

What are some of the clinical issues of daptomycin? (5)

**DO not use for pneumonia** b/c it will irreversibly bind to surfactant, some cross resistance seen with MRSA that have elevated vanc MICs, CPK elevations and rhabdomyolysis especially when used with statins

What are the pharmacokinetics? (2)

great absorption PO=IV, not renally eliminated,

What are the side effects of linezolid? (2)

**thromocytopenia**(14 days into treatment), peripheral/optic neuropothy

What are the DDIs or linezolid? (1)

linezolid is a weak MAOI and may lead to serotonin syndrome if patient in on SSRI or if tyramine is given

What are the side effects of macrolides (erythromycin (IV/PO); clarithromycin (IV/PO) azithromycin (IV/PO)) (1)

GI erthyro>clarithro>azithro,

What are the pharmokinetic factors of macrolides? (2)

for azithromycin IV dose=PO dose, inhibitors and substrates of CYP3A4 (can create toxicity) erthyro>clarithro>azithro

Why is telithromycin not used?

serious hepatotoxicity

What are the pharmokinetics of tetracyclines? (3)

lipophlic, penetration, not highly renally eliminated

What are the adverse effects of tetracyclines? (2)

binding into growing teeth (avoid for those under 8 y/o), photosensitization

What are possible tetracyline DDIs? (1)

chelation possible

What pharmchokinetics of tigecyclin? (3)

super lipophilic, penetration, not highly renally eliminated

What are the adverse effects of tigecycline? (2)

nausea/vomiting, pancreatic

What are the side effects of lincosamide (clindamycin)?

diarrhea including c difficile diarrhea

What are the side effects of TMP/SMX? (4)

sulfa-(**reflex hypersensitivity**, rash and VERY severe skin reaction) trimethoprim-HYPERkalemia and inc INR when given with warfarin

What are the adverse drug effects of metronidazole? (3)

peripheral neuropathies, metallic taste, disulfiram reaction with ethanol

What are the pharmokinetic effects of metronidazole? (2)

100% bioavaliable, min renal elimination

What are the DDI effects of metronidazole?

inc INR with warfarin

What are the pharmokinetics of rifampin? (2)

100% bioavaliable, IV=PO

What are the side effects of rifampin? (2)

hepatotoxicity, **discolored fluids**,

What are the drug effects of rifampin? (2)

***strong inducer of CYP 450 and CYP3A4 (can dec levels of other drugs)

What are the adverse effects of polymixins? (2)

nephrotoxicity, neurotoxicity

Nitrofurantoin: use, one problem, cannot use if

lower UTI, rare inflammatory lung process, cannot use if GFR is depressed

Dapsone: MOA, clin use, 2 side effects

antagonist of PABA, treat PCP pneumonia in patients that can't have TMP/SMX, hemolysis in patients with G6PD deficiency

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