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
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)
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?
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)
What pharmchokinetics of tigecyclin? (3)
super lipophilic, penetration, not highly renally eliminated
What are the adverse effects of tigecycline? (2)
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)
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