Adverse Drug Reactions Quiz

General Adverse Effects

• GI effects: nausea, vomiting, diarrhea, and abdominal pain are common side effects, indicating gut disturbance.
• Bone marrow suppression: leads to anemia (low red blood cells), thrombocytopenia (low platelet counts), and leukopenia (low white blood cells), increasing infection risk.
• Grey baby syndrome: observed in newborns, characterized by vomiting, abdominal distension, and a grayish-blue skin color.
• Neurological effects: includes headache, confusion, and seizures, highlighting potential brain impacts.
• Visual disturbances: symptoms like blurred vision and double vision can occur, indicating possible ocular side effects.
• Hypersensitivity reactions: may present as fever, rash, and joint pain, indicating immune response to the drug.

Chloramphenicol

• Mechanism of action: inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit and preventing peptide bond formation.
• Resistance mechanisms: bacteria may develop resistance through:
  • Enzymatic inactivation of the drug.
  • Alterations in ribosome binding sites, preventing effective binding.
  • Reduced uptake by cell membranes.
• Therapeutic uses:
  • Effective against typhoid fever, bacterial meningitis, conjunctivitis, and various enteric infections.
  • Particularly useful for G+ bacteria and some cases of bacterial conjunctivitis.

Oxazolidinones

• Common drugs include linezolid and tedizolid, effective against multi-drug resistant pathogens.
• Mechanism of action: target the 50S ribosomal subunit, inhibiting protein synthesis and acting on the initiation complex.
• Resistance mechanisms:
  • Mutations in the 23S rRNA binding site on the ribosome, which is the most common resistance mechanism encountered.
  • Production of alternate ribosomal proteins that avoid antibiotic effects and maintain protein synthesis.
  • Efflux pumps expelling the drug to lower effective concentrations.
  • Enzymatic modification of the antibiotic structure, rendering it inactive.

Side Effects and Considerations

• Adverse effects of oxazolidinones include headache, dizziness, insomnia, and rash.
• Serious risks: myelosuppression (suppressing bone marrow function), optic neuropathy, and hematopoietic disorders, especially with linezolid.
• Continuous monitoring of blood cell counts is recommended due to potential risks of cytopenias (lowered blood components).### Streptogramins
• Antimicrobial agents primarily used for treating:
  • Cellulitis
  • Cancer-associated pain
  • Bone and joint infections
  • Bloodstream infections (sepsis)
  • Tuberculosis in combination with other drugs

Adverse Effects

• Common gastrointestinal effects include:
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain

Additional Uses

• Effective against:
  • Skin and soft tissue infections
  • Respiratory tract infections
  • Intra-abdominal infections