Question

1. while undergoing IV aminoglycoside, patient states he has odd sounds and ringing in the ears. What does this mean?

2. allergic to sulfonamides and penicillin which orders of antibiotics should be a red flag?

3. a patient is given antibiotics prior to surgery. What type of therapy is this considered?

4. what are some side affects of penicillin drug? What to do if having difficulty breathing?

Answer 1

1.Odd sounds and ringing in the ear means tinnitus.this is the ototoxis side effect of aminoglycoside.

2.If allergic to penicillin, avoid all drugs in the immediate penicillin family (amoxicillin, ampicillin, amoxicillin-clavulanate, dicloxacillin, nafcillin, piperacillin-tazobactam and in the cephalosporin class drugs.

If allergic to  sulfonamides: antibiotic combination drugs such as trimethoprim-sulfamethoxazole (Septra, Bactrim) and erythromycin-sulfisoxazole (Eryzole, Pediazole) to be avoided.

3.Prophylactic antiobiotics to be started prior to surgery.

• intravenous 'first generation' cephalosporins - cephazolin or cephalothin
• intravenous gentamicin
• intravenous or rectal metronidazole
• oral tinidazole
• intravenous flucloxacillin
• intravenous vancomycin

4.Side effects of penicilin:

• nausea, vomiting,
• skin eruptions (maculopapular to exfoliative dermatitis),
• urticaria and other serum-sickness like reactions, laryngeal edema, and anaphylaxis.
• Diarrhea (mild)
• headache
• sore mouth or tongue
• vaginal itching and discharge
• white patches in the mouth or on the tongue
• Anaphylactic reactions cause the airways to constrict, making breathing very difficult and we have to do the following:a)Provide oxygen b)Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing.c) A beta-agonist (such as albuterol) to relieve breathing symptoms.