side effects and toxicity n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
SIDE EFFECTS AND TOXICITY PowerPoint Presentation
Download Presentation
SIDE EFFECTS AND TOXICITY

Loading in 2 Seconds...

play fullscreen
1 / 88

SIDE EFFECTS AND TOXICITY - PowerPoint PPT Presentation


  • 116 Views
  • Uploaded on

SIDE EFFECTS AND TOXICITY. GI EFFECTS. Almost all antibiotics are irritating to the GI tract. Diarrhea is very common. Nausea, vomiting. TETRACYCLINES-GI EFFECTS. Common upon oral administration. Epigastric burning and distress, abdominal discomfort, nausea and vomiting and diarrhea.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

SIDE EFFECTS AND TOXICITY


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
    Presentation Transcript
    1. SIDE EFFECTS AND TOXICITY

    2. GI EFFECTS • Almost all antibiotics are irritating to the GI tract. • Diarrhea is very common. • Nausea, vomiting.

    3. TETRACYCLINES-GI EFFECTS • Common upon oral administration. • Epigastric burning and distress, abdominal discomfort, nausea and vomiting and diarrhea.

    4. ADVERSE EFFECTS • Nausea and vomiting usually subside as medication continues. • If troublesome GI irritation can be controlled with food. • Important to distinguish irritative diarrhea from superinfection.

    5. CLINDAMYCIN • Diarrhea fairly common

    6. HYPERSENSITIVITY REACTIONS • Most antibiotics produce hypersensitivity reactions. • β-lactams. • Sulfonamides and its combinations.

    7. PENICILLINS • Cross allergenicity among all the penicillins (and other beta lactams). • Results from a previous treatment.

    8. HYPERSENSITIVITY REACTIONS • Occurs with almost any dosage form of penicillin. Oral penicillins have a lower risk than parenterals. • Usually clear with elimination of the penicillin.

    9. HYPERSENSITIVITY REACTIONS • Skin rashes. • Fever. • Bronchospasm. • Vasculitis, serum sickness, exfoliative dermatitis, contact sensitivity, local swelling and redness,oral lesions, eosinophilia. • ANGIOEDEMA AND ANAPHYLAXIS.

    10. ANAPHYLAXIS • Most important immediate danger. • Incidence is low (0.04 -0.2%). • Sudden, severe hypotension and rapid death.

    11. ANAPHYLAXIS • Careful observation of the patient is important.

    12. ANAPHYLAXIS-TREATMENT • Epinephrine (IV or IM) • IV steroids • Supportive measures

    13. MGMT. OF THE PATIENT POTENTIALLY ALLERGIC • Evaluation and history.

    14. www.bris.ac.uk/ Depts/ ENT

    15. DESENSITIZATION.

    16. CEPHALOSPORINS • Rashes occur frequently. • Cross-sensitivity to penicillins.

    17. HYPERSENSITIVITY REACTIONS • Patients with a history of a mild or temporally distant reactionto penicillin appear to be at low risk.

    18. Sulfonamides • Skin rashes are common.

    19. STEVENS JOHNSON SYNDROME • Uncommon but most likely to occur following sulfonamide therapy

    20. PHOTOSENSITIVITY • Sulfonamides • Tetracyclines • Fluoroquinolones

    21. HEMATOLOGICAL TOXICITY • Sulfonamides (with trimethoprim) • Chloramphenicol • Ticarcillin and Piperacillin • Linezolid

    22. Trimethoprim-Sulfamethoxazole

    23. TRIMETHOPRIM DNA FOLINICACID DIHYDROPTEROIC ACID Dihydropteroate Synthetase DHF Dihydrofolate Reductase THF

    24. CHLORAMPHENICOL • HEMATOLOGICAL TOXICITY-2 TYPES

    25. IDIOSYNCRATIC APLASTIC ANEMIA • Leukopenia, thrombocytopenia, and aplasia of the marrow. • Not dose-related. • Can be fatal.

    26. DOSE-DEPENDENT ANEMIA • Reversible dose-related suppression of bone marrow. • Usually presents as anemia, reticulocytopenia and increased serum iron. • Associated with high doses and/or prolonged treatment. • Results from inhibition of mitochondrial protein synthesis.

    27. TICARCILLIN AND PIPERACILLIN • Prolong bleeding time (by altering platelet function).

    28. LINEZOLID` • Myelosuppression (anemia, thrombocytopenia, leukopenia)

    29. HEPATOTOXICITY • Erythromycin estolate (cholestatic hepatitis) • Tetracyclines

    30. CHOLESTATIC HEPATITIS • It is caused primarily by the estolate. • Not dose-related. • It is probably a hypersensitivity reaction (to estolate ester).

    31. TETRACYCLINES • Dose-related hepatotoxicity (pregnancy).

    32. NEUROLOGICAL EFFECTS • Imipenem (seizures) • Aminoglycosides • Fluoroquinolones • Metronidazole

    33. AMINOGLYCOSIDES

    34. NEUROMUSCULAR BLOCKADE • Rare but potentially serious. • Occurs at high concentrations of aminoglycosides or in patients with an underlying risk factor. • Acute neuromuscular blockade, respiratory paralysis and death can occur.

    35. Amino Glycosides

    36. FLUOROQUINOLONES • CNS effects such as headache, restlessness, and dizziness. High doses may produce convulsions.

    37. METRONIDAZOLE • Headache, dizziness, peripheral neuropathy.

    38. CARDIOVASCULAR EFFECTS • Fluoroquinolones • Erythromycin • Chloramphenicol

    39. FLUOROQUINOLONES • Some 3rd and 4th generation FQ’s can prolong the QT interval.