Pharmacy Phriday #7: Bactrim Adverse Events

Pharmacy Phriday #7: Bactrim Adverse Events

Contributor: Cheyenne Bean, PharmD

Educational Pearls:

  • Bactrim (TMP-SMX) is a sulfa antibiotic used for a number of infections but can have untoward effects.
  • Hypoglycemia can be induced by the sulfa component of Bactrim, which binds receptors in the pancreas causing insulin to be secreted, dropping blood sugar levels.
    • Oral diabetic medications, specifically sulfonylureas, when taken with Bactrim most often lead to these hypoglycemic episodes.
  • Hyperkalemia can be induced by Trimethoprim by blocking potassium excretion in the kidney, so Bactrim in combination with ACE inhibitors/ARBs/spironolactone can induce high potassium.
  • When prescribing Bactrim, remember to check home medications and if a patient is taking an above medication, check a baseline BGL and potassium.

References

1) Khorvash F, Moeinzadeh F, Saffaei A, Hakamifard A. Trimethoprim-sulfamethoxazole Induced Hyponatremia and Hyperkalemia, The Necessity of Electrolyte Follow-up in Every Patient. Iran J Kidney Dis. 2019 Jul;13(4):277-280. PMID: 31422395.

2) Kennedy KE, Teng C, Patek TM, Frei CR. Hypoglycemia Associated with Antibiotics Alone and in Combination with Sulfonylureas and Meglitinides: An Epidemiologic Surveillance Study of the FDA Adverse Event Reporting System (FAERS). Drug Saf. 2020 Apr;43(4):363-369. doi: 10.1007/s40264-019-00901-7. PMID: 31863282; PMCID: PMC7117991.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

Episoder(1147)

Podcast #320: PE in Pregnancy

Podcast #320: PE in Pregnancy

Author: Don Stader, M.D. Educational Pearls: Pulmonary embolism is one of the leading causes of maternal mortality. There is disagreement among different medical societies about the value of D-di...

23 Apr 20184min

Podcast #319: Cardiac Arrest Survival Factors

Podcast #319: Cardiac Arrest Survival Factors

Author: Aaron Lessen, MD Educational Pearls: Shockable rhythms like V-fib or V-tach have a better prognosis than patients with PEA or asystole. Recent study has shown an initial electrical freque...

20 Apr 20182min

Podcast #318: Nystagmus

Podcast #318: Nystagmus

Author: Erik Verzemnieks, M.D. Educational Pearls: ● Common causes of nystagmus: Congenital disorders, CNS diseases (MS, CVA), Intoxication ● Drugs associated (ETOH, Ketamine, PCP, SSRI, MDMA, Lit...

13 Apr 20181min

Podcast #317: Elbow Dislocation

Podcast #317: Elbow Dislocation

Author: John Winkler, M.D. Educational Pearls: ● Lower mechanisms of injury have a lower chance of an associated fracture or major ligament injury ● One major concern is having a fracture fragment i...

11 Apr 20182min

Podcast #316: Abnormalities in Alcohol Intoxication

Podcast #316: Abnormalities in Alcohol Intoxication

Author: Michael Hunt, M.D. Educational Pearls: 1% of patients presenting to ED with alcohol intoxication end up going to the ICU Most common critical illnesses were acute hypoxic respiratory fail...

9 Apr 20183min

Podcast #315: Retropharyngeal Infections in Pediatrics

Podcast #315: Retropharyngeal Infections in Pediatrics

Author: Dr. Karen Woolf, MD Educational Pearls: Anatomy : base of skull to posterior mediastinum, anteriorly bounded by middle layer of deep cervical fascia and posteriorly by the deep layer, communi...

6 Apr 20186min

Podcast #314: Psychogenic nonepileptic seizures (PNES)

Podcast #314: Psychogenic nonepileptic seizures (PNES)

Author: Gretchen Hinson, M.D. Educational Pearls: PNES vs. epilepsy: postictal state is diagnostic of an epileptic seizure (sonorous respirations and/or confusion, lasting typically 20-30 minutes);...

4 Apr 20185min

Podcast #313: Flu Screening

Podcast #313: Flu Screening

Author: Dr. Peter Bakes Educational Pearls: High risk patients: underlying lung disease, immunocompromised, extremes of age (65), underlying cardiac/renal/neurologic disease, and pregnant women Testi...

2 Apr 20187min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
liberal-halvtime
rss-rekommandert
rss-paradigmepodden
villmarksliv
sinnsyn
forskningno
pod-britannia
dekodet-2
fjellsportpodden
rss-overskuddsliv
tidlose-historier
rss-lundqvist-podden
hva-er-greia-med
rss-nysgjerrige-norge
tomprat-med-gunnar-tjomlid
noen-har-snakket-sammen