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Flashcards in Antibiotics Deck (60):
1

Examples of penicillins

amoxicillin, flucloxacillin, ampicillin

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Class of penicillins

B-lactam antibiotics

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how do penicillins work?

cell wall synthesis inhibitors. bacteriacidal. prevents cross linking between peptidoglycan chains

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What are penicillins used for?

broad spectrum. UTI, otitis media, sinusitis, bronchitis. Gram negative bacteria (strep/staph). Gram negative bacteria (H.influenza). H.pylori

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Contra-indications for penicillin

hypersensitivity (also sensitive to cephalosporins and other B-lactams)

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Penicillin side effects

GI effects. Rash/anaphylaxis. Oral candidosis. Mac-pap rashes = ampicillin/amoxicillin

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penicillin interactions

methotrexate (increases toxicity). warfarin (increase blood thinning). allopurinol (increases chance if rash)

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Cephalosporin examples

cephradine, cephalexin, cefazolin

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cephalosporins drug class

B lactam antibiotics

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How do cephalosporins work?

disrupts synthesis of peptidoglycan layer so less susceptible to B-lactamases

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indications: cephalosporins

very broad - septicaemia, pneumonia, meningitis, peritonitis, surgical prophylaxis

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Contra-indications: cephalosporins

history of hypersenstivity to penicillin/carbapenams

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side effects: cephalosporins

diarrhoea, vomiting, hypersensitivity

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Interactions: cephalosporins

aminoglycosides (nephrotoxicity)

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Trimethoprim drug class

antifolate

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Trimethoprim - how does it work?

inhibit folate synthesis - folate essential for DNA synthesis.

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indications: trimethoprim

UTI. Uncomplicated pyelonephritis and mild acute prostatitis

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Contra-indications: trimethoprim

pregnancy, renal impairment, blood disorders

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Side effects: trimethoprim

nausea, rash, GI effects, thrombocytopenia, toxic epidermal necrolysis

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Interactions: trimethoprim

Ace inhibitors (hyperkalaemia), cyclosporins

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Nitrofurantoin - how does it work?

damages bacterial DNA. Attacks ribosomes, DNA, respiration

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Nitrofurantoin - indications

UTI 1st line

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Contra-indications: nitrofurantoin

decreased renal function. Young babies/elderly. Late pregnancy.

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Side effects: nitrofurantoin

nausea, headaches

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Interactions: nitrofurantoin

Amiodarone (peripheral neuropathy). phenytoin. Metronidazole.

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Examples: aminoglycosides

gentamicin

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How does it work? Aminoglycosides

Bacteriacidal. Protein synthesis inhibitors

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Indications: aminoglycosides

serious gram negative infection. septicaemia, neonatal sepsis, CNS infections, acute pyelonephritis, prostatitis,

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Contra-indications: aminoglycosides

myasthenia gravis, mitochondrial disease, pregnancy

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Side effects: aminoglycosides

hearing loss, vestibular damage, vision problems, kidney problems

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interactions: aminoglycosides

vancomycin (nephrotoxicity/ototoxicity), loop diuretics (nephrotoxicity), cephalosporins (nephrotoxicity), bisphosphonates

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Examples: tetracyclines

doxycycline, lymecycline

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Tetracyclines - how does it work?

inhibits protein synthesis. Prevents new amino acids binding to peptide chain

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Indications: tetracyclines

Lyme disease, chlamydia, acne, cholera, malaria, syphilis. Exacerbations of chronic bronchitis

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Contra-indications: tetracyclines

children. Acute porphyria, breastfeeding (caution), myasthenia gravis, renal failure

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Side effects: tetracyclines

GI effects, rash, loss of appetite

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Interactions: tetracyclines

alcohol (hepatotoxicity), atorvastatin (hepatotoxicity), carbamazepine (hepatotoxicity), warfarin (increases risk of bleeding)

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Examples: macrolide

erythromycin, clarithromycin, azithromycin

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Macrolides - how do they work?

bacteriostatic activity or inhibits growth of bacteria

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Indications: macrolides

skin infection. Upper respiratory tract infection. Alternative to penicillin. Chlamydia. mycoplasm pneumoniae.

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Contra-indications: macrolides

liver disease, heart rhythm disorder, myasthenia gravis

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side effects: macrolides

GI disturbances. prolonged QT interval, reversible deafness, psychotic reactions, nightmares, night sweats

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Interactions: macrolides

antihistamines, amiodarone (QT interval), carbamazepine, cyclosporin, digoxin, theophylline, warfarin

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Examples: quinolones

ciprofloxacin, levofloxacin

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Quinolones - how do they work?

bacteriacidal. prevent bacterial DNA from unwinding and duplicating

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Indications: quinolones

HAP, pyelonephritis, 2nd line for CAP

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contra-indications: quinolones

epilepsy, QT prolongation, CNS lesions, UTIs, GI infection, bone/joint infection, gonorrhoea, septicaemia

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Side effects: quinolones

risk of tendonitis and tendon rupture, insomnia, restlessness, GI effects

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Interactions: quinolones

theophylline, warfarin cyclosporin, ibuprofen (seizures)

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examples: anaerobic antimicrobials

metronidazole

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Metronidazole- how does it work?

bacteriacidal. inhibits nuclei acid by disrupting function and synthesis of microbial cells

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Indications - metronidazole

anaerobic protozoal infections, H.pyrlori eradication, rosacea, dental infections, bacterial infections of vagina/stomach

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Contra-indications: metronidazole

liver disease, kidney disease, Crohn's, anaemia, pregnancy, breastfeeding, hepatic impairment, low white blood cell count

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Side effects: metronidazole

GI effects, rash/itching, mouth sores, swollen tongue

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Interactions: metronidazole

alcohol, phenytoin, warfarin

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Examples: glycopeptides

Vancomycin

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Vancomycin - how does it work?

inhibits cell wall synthesis by inhibiting peptidoglycan synthesis

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Indications: vancomycin

MRSA. C.diff. Allergy to B.lactam. Enterococcal infections. Complicated skin infections. Bloodstream infections. Endocarditis

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Contra-indications: vancomycin

decreased neutrophils, hypersenstivity, kidney disease, systemic mastocytosis

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Side effects: vancomycin

allergic reaction. hypotension. bone marrow suppression. thrombophlebitis. kidney/renal toxicity. "red man syndrome"