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  #1  
Old 02-28-2011
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Drug Which antibiotics should be avoided in high alcohol levels?

A man who has been at the local tavern, drinking alcohol heavily, is assaulted. He is transported to the hospital. Among various findings is an infection for which prompt antibiotics treatment is indicated. Given his high blood alcohol level, which of the following antibiotics should be avoided?

A. Amoxicillin
B. Cefoperazone
C. Erythromycin ethylsuccinate
D. Linezolid
E. Penicillin G
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  #2  
Old 02-28-2011
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How about:
B. Cefoperazone

I am thinking Disulfiram like action of Cephalosporins.
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Old 02-28-2011
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Arrow B is the answer!

I think B is the answer...but I am not 100% sure! I chose this because I think it will cause Disulfuram like reaction!
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Quote:
Originally Posted by Taiyakikung View Post
A man who has been at the local tavern, drinking alcohol heavily, is assaulted. He is transported to the hospital. Among various findings is an infection for which prompt antibiotics treatment is indicated. Given his high blood alcohol level, which of the following antibiotics should be avoided?

A. Amoxicillin
B. Cefoperazone
C. Erythromycin ethylsuccinate
D. Linezolid
E. Penicillin G
B. Cefoperazone is the answer due to disulfiram like reaction !
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  #5  
Old 02-28-2011
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there are five drugs which can produce DISULFIRAM like reaction when taken with Alcohol
METRONIDAZOLE
CEFOPERAZONE
CEFAMANDOLE
CEFOTETAN
CHLORPROPAMIDE

answer should be cefoperazone.
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  #6  
Old 02-28-2011
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Smile Complete list of drugs that cause disulfiram like effects

Quote:
Originally Posted by conspicous View Post
there are five drugs which can produce DISULFIRAM like reaction when taken with Alcohol
METRONIDAZOLE
CEFOPERAZONE
CEFAMANDOLE
CEFOTETAN
CHLORPROPAMIDE

answer should be cefoperazone.
I inspired me to post about this in our Bits and Pieces Forum, here's the link
Disulfiram Like Reaction (Drugs with Disulfiram like effects)
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Old 02-28-2011
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C. Erythromycin could also be the answer Since it is metabolized by cyt P450, in acute alcohol intake, this system is already involved in alcohol metabolism, so erythromycin's metabolism decreases, its blood level increases, potentially enhansing the risk for QT prolongation, ventricular arrythmias and sudden cardiac death. Erythromycin also increases gastric motility, futher increasing alcohol absorbion and its levels in blood.
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Old 02-28-2011
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Quote:
Originally Posted by seraevening View Post
C. Erythromycin could also be the answer Since it is metabolized by cyt P450, in acute alcohol intake, this system is already involved in alcohol metabolism, so erythromycin's metabolism decreases, its blood level increases, potentially enhansing the risk for QT prolongation, ventricular arrythmias and sudden cardiac death. Erythromycin also increases gastric motility, futher increasing alcohol absorbion and its levels in blood.
Although I agree with your other points (I myself was going to answer Erythro, but I guess I was wrong).

I dont know about this one:

"Erythromycin also increases gastric motility, futher increasing alcohol absorbion and its levels in blood."

Increased gastric motility will lead to increased peristalsis, and increased clearance from the stomach into small intestine. Alcohol is mainly absorbed in the stomach, so it would effectively decrease the amount that is absorbed.
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Old 02-28-2011
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It seems that most alcohol absorbtion occurs in the small intestine rather than the stomach, and its rate of absorbtion depends on gastric emptying. Erythromycin increases gastric peristalsis but decreases small intestinal transit, though increasing BAL. I know that Kaplan gives a different answer, and not sure, it seems correct in conditions of an empty stomach, and I think that is what USMLE tests.
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  #10  
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Quote:
Originally Posted by seraevening View Post
It seems that most alcohol absorbtion occurs in the small intestine rather than the stomach, and its rate of absorbtion depends on gastric emptying. Erythromycin increases gastric peristalsis but decreases small intestinal transit, though increasing BAL. I know that Kaplan gives a different answer, and not sure, it seems correct in conditions of an empty stomach, and I think that is what USMLE tests.
I guess we have to pick the best choice, that was one of the cephalosporin drugs.
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Quote:
Originally Posted by patelMD View Post
I guess we have to pick the best choice, that was one of the cephalosporin drugs.
Totally agree, I was just answering your question, or at least trying
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