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Flashcards in ABX Paxton Pearls Deck (24)
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1

Oral contraceptives

Recommend back-up BC while on ALL abx

Rifampin is a potent CYP inducer

2

Warfarin

Avoid concomitant use if possible or monitor INR more frequently.

INC INR:
1. all macrolides, TTC, FQ
2. Metronidazole (2-4x)*
3. TMP-SMX (2-4x)*

DEC INR:
1. rifampin*

3

Dysrhythmia

1. macrolides (generally all agents); we hate this drug, it's a drug of desperation
2. FQs

4

Ototoxicity

1. AGs (gentamicin >> vancomycin)
- permanent sensorineural hearing loss
2. minocycline
- transient vestibular dysfunction (dizziness, N/V)

5

Nephrotoxicity

1. AGs --> acute tubular necrosis
- gentamicin*
2. Vancomycin
- problem combined w/other nephrotoxic agent or overweight pt
3. PCNs (nafcillin > piperacillin) & FQs (cipro)
- AIN

6

Hepatotoxicity (drug-induced liver injury)

1. Amox/Clav
2. TMP/SMX
3. INH > RIF = PZA

Top 10: 9 Abx and Diclofenac
Rash/fever or eosinophilia, onset 1-5 weeks

7

Chemical Phlebitis

1. Nafcillin* - burning, do NOT give peripheral IV
2. Cefepime
3. Vancomycin
4. Clindamycin

8

Disulfiram-Like Rxn

Reaction: NVD, abd cramps, flushing, tachycardia, HA

Metronidazole*, consider ETOH interaction

9

Red Man/Neck Syndrome

Vancomycin*

Rapid infusion releases histamine (rate issue)

Flushing face, neck, upper torso; wheezing, hypotension possible

Tx: slow infusion and give diphenhydramine

10

Red Lobster Syndrome

Rifampin*

Red-orange discoloration of urine, tears, sweat

Pt Ed is crucial

11

Discolored teeth

TTCs

Darkening of developing teeth

C.I. in pregnant women/kids < 8

12

Loss of red/green color perception

Ethambutol (high dose) --> optic neuritis

13

Yellow baby syndrome

Sulfonamides*

Do not use in women near term or neonates

14

K+ Dysregulation

1. Hyperkalemia
Trimethoprim
- blocks Na in distal nephron = impaired K excretion
- TMP-SMX + ACEI/ARB/spironolactone INC risk of hospital admit

2. Hypokalemia
various PCNs (esp nafcillin)

15

CDI

Highest prevalence
- PO aminopenicillins
- PO cephalosporins

Highest incidence
- clindamycin

16

EBV

Diffuse MP, nonurticarial rash

Ampicillin (Mono)

17

Pregnancy Category B

1. B-lactam
2. Macrolides (azithromycin)
3. Clindamycin
4. Fosfomycin
5. Nitrofurantoin - NOT allowed in the last month
6. Metronidazole - NOT first tri, only use short course
7. PO Vancomycin

18

Pregnancy Category C

1. FQ
2. TMP-SMX
3. IV Vancomycin

19

Pregnancy Category D

1. AG
2. TTC

20

FAST abx & pregnancy

Fluoroquinolones - arthropathy?
Aminoglycosides - possible CN8 toxicity in fetus
Sulfonamides - newborn kernicterus
Tetracyclines - tooth/bone problem for infant

21

Neurotoxicity - seizures

PCNs, CPHs, carbapenem

22

Neurotoxicity - psychosis

Clarithromycin

23

Neurotoxicity - insomnia

FQ

24

Neurotoxicity - encephalopathy

Metronidazole