Antibiotics and Side Effects

Antibiotics and Side Effects

Oral Antibiotics

• Penicillin: Ampicillin, Amoxicillin

• Cephalosporin: Cephalexin, Loracarbef, Cefixime, Cefpodoxim

Antibiotic Toxicity

• Aminoglycosides: Toxic to the kidneys, neuromuscular transmission, and hearing.

• Streptomycin: Characteristic reaction is the formation of mantol.

• Guanidine Group: Forms a-naphtol and NaBrO/OH- at red naphtoquinoimin.

• Tetracycline:

• Forms complex with Ca

• Increased sensitivity to light: Doxycyclin

• Toxic to the liver

• Digestive disorders, fungal infections

• Kidney failure due to renal acidification

• Chloramphenicol:

• Digestive disorders

• Candida superinfection

• Difficult-to-recover bone marrow suppression

• Gray baby syndrome due to a lack of a-glucuronic conjugation

• Erythromycin: Replaces benzathine benzylpenicillin in case of penicillin allergy.

• Macrolide:

• Inhibits CYP450, toxic to the liver (except Azithromycin)

• Mainly affects digestion: Vomiting, diarrhea, pseudomembranous colitis

• Quinolone:

• Musculoskeletal: Binds to articular cartilage, tendonitis, Achilles tendon rupture

• Digestive: Vomiting, diarrhea

• Increased sensitivity to light

• Nervous system: Headache, dizziness, sleep disturbances, seizures

• QT prolongation causing torsades de pointes: Moxifloxacin, Levofloxacin

• Inhibits CYP450

• Forms complex

• Sulfonamide antibacterial:

• Forms MetHb

• Urinary stones

Difficult-to-dissolve substances

• Tetracycline

• Macrolide

• Nalidixic acid

• Mefloquin.HCl

• Amphotericin

Fungal Treatment

• Systemic: Fluconazole, Itraconazole

• Topical: Terconazole, Clotrimazole

Side effects of Azole

• Sex hormone synthesis disorder: Breast enlargement

• Severe digestive disorders: Vomiting, abdominal pain, constipation, bloating, bleeding, itching, increased liver enzymes

Antituberculosis Toxicity

• Isoniazid:

• Hepatitis: Increased risk when used concurrently with rifampicin

• Peripheral neuropathy: Vitamin B6 supplementation is needed

• Rash, fever, arthritis, seizures

• Pyrazinamide:

• Toxic to the liver

• Gouty arthritis due to increased uric acid: Pain, joint swelling, hot skin in the inflamed area

Characteristic reactions

• Idoxuridin: Reacts with diphenyl amine in a water bath to give a pale blue color

• Tetracycline: Forms a complex with Zn for a yellow color

• Clotrimazole: Dissolves in H3PO4 solution for a blue ring, shakes to turn deep blue, adds water to turn pale yellow

• Nystatin: Reacts with H2SO4 turning from brown to purple

• Isoniazid: Dissolve the product in alkali then react with m-dinitrophen chloride for a reddish-brown color

• Griseofulvin: Reacts with K2Cr2O7 to form a red-wine color

• Pyrazinamide: Reacts with Fe2+ for a yellow color, add alkali to turn blue

• Rifampicin: Reacts with ammonium persulphate at pH 7.4 for a yellow-orange to reddish-violet color

• Macrolide: Characteristic reaction with xanthydrol

• Quinine, Tetracycline: Forms fluorescence

Note: This information is for reference purposes only and does not replace the advice of a physician. Always consult a doctor before using any medication.