Abx counselling

Question 1

tetracyclines: DOT, do not take milk within 2 hours of taking these abx, also take these on empty stomach

Answer 1

• demeclocycline
• oxytetracycline
• oxytetracycline

Question 2

tetracyclines: DML do like milk

Answer 2

you can take the following with milk
- doxycycline
- minocycline
- lymecycline

Question 3

phenoxymethylpenicillin - with or without food?

Answer 3

empty stomach (1hr before or 2hr after food)

Question 4

flucloxacillin - with or without food?

Answer 4

empty stomach (1hr before or 2hr after food)

Question 5

pivmecillinam - with or without food?

Answer 5

full glass of water & take with or after food

Question 6

which tetracyclines need to be taken on empty stomach

Answer 6

DOT: demeclocycline, oxytetracycline, tetracycline

Question 7

which tetracyclines cannot be taken with milk 2 hours before of after

Answer 7

DOT - demeclocycline, oxytetracycline, tetracycline

Question 8

which tetracyclines require labelling warnings to ensure skin is protected

Answer 8

Double Ds: DD
- demeoclocycline
- doxycycline

Question 9

what is the labelling requirement for demeclocycline and doxycycline

Answer 9

Protect your skin from sunlight - even on a bright but cloudy
day. Do not use sunbeds

Question 10

Labelling requirement for all tetracyclines

(plus milk)

Answer 10

Do not take indigestion remedies or medicines containing iron or zinc, 2 hours before or after you take this medicine

(also add no milk for DLM, doxy, lyme, mino)

Question 11

what age are tetracyclines contraindicated in and why?

Answer 11

<12
Deposit in growing bone and teeth, by binding to calcium, causes staining and occasionally dental hypoplasia

Question 12

which two conditions should all tetracyclines be used with caution in and why?

Answer 12

• myasthenia gravis: can exacerbate muscle weakness
• SLE: may be exacerbated, common SE of tetracyclines

Question 13

can tetracyclines be used in pregnancy and why

Answer 13

No
- risk of effects on skeletal development in 1st trimester
- may cause discoloration of the child’s teeth 2nd or 3rd trimester
- maternal hepatotoxicity has been reported with large parenteral doses

Question 14

which tetracycline may be used in pregnancy

Answer 14

• when travel to malarious areas is unavoidable and other regimens are unsuitable, doxycycline can be used for malaria prophylaxis
• the entire course must be completed before 15 weeks’ gestation.

Question 15

can tetracyclines be used in BF

Answer 15

avoid although absorption and therefore discoloration of teeth in the infant is probably usually prevented by chelation with calcium in milk

Question 16

3 situations to use macolides with caution in

Answer 16

• electrolyte disturbances (predisposition to QT interval prolongation)
• may aggravate myasthenia gravis
• predisposition for QT interval prolongation

Question 17

azithromycin tablets - labelling requirements

Answer 17

Do not take indigestion remedies 2 hours before or after you take this medicine

Question 18

azithromycin capsules - 2x labelling requirements

Answer 18

• Do not take indigestion remedies 2 hours before or after you take this medicine
• Take this medicine when your stomach is empty. This means an hour before food or 2 hours after food

Question 19

erythromycin GR tabs labelling requirements

Answer 19

• Do not take indigestion remedies 2 hours before or after you take this medicine
• Swallow whole, do not crush or chew

Question 20

do erythromycin normal tabs have any labelling requirements?

Answer 20

no

Question 21

does clarithromycin have any labelling requirements

Answer 21

only for MR tabs:
- Take with or just after food, or a meal.
- Swallow this medicine whole. Do not chew or crush

Question 22

macrolides & statins

Answer 22

• statins: increases exposure = increased risk of myopathy
• stop statin while taking macrolide

Question 23

Main interactions of macrocodes are due to… (3)

Answer 23

• drugs that cause hypokalaemia - increases risk torsade de pointes
• drugs that increase risk QT interval prolongation
• increases anticoagulant effect e.g. warfarin

Question 24

clindamycin patient counselling

Answer 24

• Patients and their carers should be advised to discontinue and contact a doctor immediately if severe, prolonged or bloody diarrhoea develops.
• Take caps with full glass water

Question 25

clindamycin is contraindicated in

Answer 25

diarrhoeal states