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Pre reg pharmacy > Antimicrobials > Flashcards

Antimicrobials Flashcards

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1
Q

Human and animal bite antibiotics

A

First line - co-amoxiclav
Second line -doxycycline and metronidazole
3 days prophylaxis/ 5 days treatment

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2
Q

Lymes disease antibiotics

A

First line - doxycycline
Second line - amoxicillin
Treat for 21 days

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3
Q

Mild diabetic foot antibiotics

A

First line - flucloxacillin
Second line - clarithromycin/ erythromycin/ doxycycline

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4
Q

Moderate to severe diabetic foot antibiotics

A

First line - flucloxacillin/ co-amoxiclav +/ gentamicin
Second line - co-trimoxzole +/ gentamicin

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5
Q

Cellulitis antibiotics

A

First line - flucloxacillin
Second line - clarithromycin/ erythromycin/ doxycycline

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6
Q

Cellulitis near nose/mouth antibiotic

A

First line - co-amoxiclav
Second line - clarithromycin and metronidazole

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7
Q

Treatment of low severity community acquired pneumonia

A

First line - amoxicillin
Second line - doxycycline / clarithromycin/ erythromycin

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8
Q

Treatment of moderate severity community acquired pneumonia

A

First line - amoxicillin and clarithromycin (erythromycin in pregnancy)
Second line - doxycycline/ clarithromycin

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9
Q

Treatment of high severity community aqired pneumonia

A

First line - co-amoxiclav and clarithromycin (erythromycin in pregnancy)
Second line - levofloxacin

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10
Q

Antibiotic treatment of C.diff

A

First line - Vaancomycin
Second line - Findamoxacin
Life threatening - vancomycin and IV metronidazole

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11
Q

Treatment of travellers diarrhoea

A

Standby - azithromycin
Prophylaxis/treatment - bismuth subsalicylate

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12
Q

Treatment of otitis media

A

First line - amoxicillin
Second line (worsen in 2-3 days despite treatment) - co-amoxiclav
Alternative in penicillin allergy - clarithromycin / erythromycin

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13
Q

Treatment of otitis externa

A

First line - acetic acid 2%
Second line - neomycin sulphate with corticosteroid
Systemic treatment - flucloxacillin

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14
Q

Treatment of H.pylori

A

Triple therapy - PPI + 2x antibiotics
Amoxicillin/metronidazole/ clarithromycin
Include amoxicillin unless penicillin allergy

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15
Q

Diagnosis of H.pylori

A

Urea 13c breath test

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16
Q

Urea breath test period between PPI and Abx

A

2 weeks after PPI
4 weeks after Abx

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17
Q

Treatment of non-severe hospital acquired pneumonia

A

First line - co-amoxiclav
Second line - Doxycycline / cefalexin/ co-trimoxazole/ levofoxacin
Second line in children - clarithromycin

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18
Q

Treatment of localised non-bollous impetigo

A

First line - hydrogen peroxide 1%
Second line - fucidic acid (mupirocin 2% if FA resistance suspected)

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19
Q

Treatment of wide spread non-bollous impetigo

A

Fucidic acid (mupirocin 2% if FA resistance suspected)

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20
Q

Treatment of bollouse/systematic unwell impetigo

A

First line - flucloxacillin
Second line. - clarithromycin / erythromycin

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21
Q

Treatment of UTI in men

A

Nitrofurantoin/ trimethoprim
7 DAYS TREATMENT

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22
Q

Treatment of UTI in non-pregnant women

A

First line - nitrofurantoin/ trimethoprim
Second line - pivmecillin/ fosfomycin
3 DAYS UNCOMPLICATED/ 7 DAYS COMPLICATED

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23
Q

Treatment of UTI in pregnant women

A

First line - nitrofurantoin only if eGFR >45ml/min
Second line - cefalexin/fosfomycin
7 DAYS TREATMENT

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24
Q

Treatment of Strep infection (strep throat/ scarlet fever)

A

First line - phenoxymethylpenicillin
Second line - clarithromycin / erythromycin

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25
Symptoms of scarlet fever
Flu symptoms - high temp, swollen glands Rash - red, small raised pimples, sandpaper White coating on tongue
26
Treatment of acne vulgaris
Adapalene/ clarithromycin/ benzoyl peroxide/ lymecycline
27
Treatment of BV and Trichomoniasis
Metronidazole
28
Treatment of chlamydia
Doxycycline
29
Treatment of conjunctivitis / blepharitis
Chloramphenicol
30
Treatment of dental abscess
Amoxicillin/ metronidazole
31
Treatment of gonorrhoea
Ceftriaxone/ ciprofloxacin
32
Treatment of meningitis
Benzylpenicillin
33
Treatment of scabies
Permethrin
34
Treatment of sinusitis
Phenoxymethylpenicillin / doxycycline
35
Treatment of threadworm
Mebendazole
36
When to measure serum - conc of gentamicin
After 3/4 doses, then every 3 days and after dose changes Measure 1 hour AFTER dose and just before next dose
37
Co prescribed gentamicin serum concentration levels
Peak 5-10mg/L (3-5mg/L in endocarditis) Trough <2mg/L (<1mg/L in endocarditis)
38
Dose Adjustments for gentamicin (trough / peak high and impairments)
Trough to high - increase dose interval Peak to high - decrease dose Renal impairment - increase dose interval Severe renal impairment - increase dose interval and decrease dose
39
Aminoglyciosides MHRA warning
Ototoxicity
40
Interactions that increase ototoxicity
Ciplatin, loop diuretics, vancomycin, vinca alkaloids
41
Aminoglycoside contraindications
Myasthenia gravies
42
Aminoglycosides in pregnancy
Avoid - risk to auditory/vestibular nerve damage Monitor serum conc
43
Aminoglycosides in obesity
Use IBW to calculate parenteral dose
44
FIRST GEN cephlosporins (FAD/FAL/FRAD)
Cefadroxil, Cefalexin , Cefradine
45
SECOND GEN cephalosporins (FURRY FOX FACE)
Cefurozime, Cefoxitin, cefaclor
46
THIRD AND FIFTH GEN cephalosporins
All parenteral except Cefixime
47
Drug class with penicillin cross sensitivity
Cephalosporins
48
Chloramphenicol in preganancy
Avoid - grey baby syndrome if used in third trimester
49
Antibiotic associated with colitis + c.diff
Clindamycin - discontinue is suspected / seek specialist advice
50
5 Aminoglycosides
Amikacin, gentamicin, neomycin, streptomycin, tobramycin
51
4 glycopeptides
Dalbavancin, Teicoplanin, Telavancin, vancomycin
52
Vancomycin route of administration
Parenteral - reduced absorption with oral
53
Vancomycin serum concentration trough level
15-20mg/L
54
Vancomycin side effects
Red man syndrome Severe cutaneous ADR - Steven Johnson syndrome Blood dyscrasia Cardiogenic shock on rapid Iv Risk of anaphylactoid
55
Linezolid risks
Severe optic neuropathy - report visual impairment, monitor regularly if treatment > 28 days Risk of blood disorders - monitor FBC weekly, regularly if treatment > 10-14 days
56
Linezolid interactions
Tyramine rich foods Serotonin syndrome
57
3 Macrolides
Azithromycin, clarithromycin, erythromycin
58
Cautions with macrolide use
Patients with myasthenia gravis AVOID clarithromycin in first trimester of pregnancy
59
Macrolide side effects
Hepatotoxicity Ototoxicity - hearing loss in larger doses High level GI disturbance QT prolongation
60
Macrolide interactions
Macrolides are CYP enzyme inhibitors Statins - increased risk of myopathy Warfarin - increased risk of bleeding Hypokalaemia - loop/thiazide diuretics, steroids, salbutamol, theophylline Increase risk of QT prolongation - Amidodarone, domperidone, fluconazole, lithium, methadone, ondansetron
61
Metronidazole side effects
Taste disturbance - metalic, furred tongue Nausea and vomiting - take WITH/AFTER food
62
Metronidazole interactions
Alcohol - disulfiram like side effects (nausea , vomiting, flushing) AVOID TILL 2 DAYS AFTER
63
Nitrofurantoin side effects
Yellow/brown wee
64
Nitrofurantoin Administration
With/After food
65
When to avoid nitrofurantoin
EGFR <45ml/min Pregnancy at term
66
2 narrow spec penicillins
Benzylpenicillin Phenoxymethylpenicillin
67
3 Broad spec penicillins
Ampicillin, amoxicillin, co-amoxiclav
68
Penicillinase resistant antibiotic
Flucloxacillin
69
Broad and narrow spec penicillin side effects
Diarrhoea - most common in broad spec Maculopapular rash - common in glandular fever
70
Flucloxacillin administrations
Take on an empty stomach - 1hr before or 2hrs after food
71
Flucloxacillin side effects
Cholestatic jaundice and hepatitis - up to 2 months after treatment
72
5 quinolones
Ciprofloxacin, delafloxacin, levofloxacin, maxifloxacin, oflofloxacin
73
Quinolone cautions
Lower seizure threshold - avoid in epilepsy Psychiatric disorders Tendon disorders
74
Quinolone counselling
Reduce sunlight / uv May impair driving
75
3 quinolone safety points
Tendinitis - more common in over 60s - stop and seek medical attention if suspected Aortic aneurysm and dissection - report severe abdominal/back pain Heart valve regurgitation - specialist attention if short breath, heart palpitations
76
Quinolone interactions
Dairy and mineral fortified foods Drugs that cause QT prolongation Drugs that reduce seizure threshold
77
Tetracycline administration
No milk, indigestion remedies, med containing zinc/iron 2hrs before/after meds
78
3 tetracyclines can have milk
Doxycycline, lymecycline, minocyclinr
79
Tetracycline side effects
Benign intracranial hypertension - stop and report headache, visual disturbance Lupus-erythematosus like syndrome and irreversible pigmentation - higher risk in minocycline Teeth discolour/bone deposits - avoid <12wks pregnancy
80
Trimethoprim side effects
Blood dyscrasia
81
Symptoms of blood dyscrasia
Fever, sore throat, rash, mouth ulcer, bruising, bleeding
82
Trimethoprim in pregnancy
Teratogenic in first trimester - avoid in pregnancy
83
Trimethoprim interactions
Methotrexate Phenytoin
84
Which antibiotic is an anti folate
Trimethoprim
85
Narrow spec antibiotic 5 pg tlc
Penicillins, gycopeptides, trimethoprim, Linezolid, clindamycin
86
Broad spec antibiotics CAPTN MCQ
Chloramphenicol, Aminoglycosides, penicillins, tetracyclines, nitrofurantoin, macrolides,cephalosporins , quinolones
87
Anaerobic antibiotics
Metronidazole
88
Antibiotics to be taken with or after food 4
Metronidazole Nitrofurantoin Clarithromycin mr Pivmecillin
89
Antibiotic to be take 1hr before/ 2hrs after food 4
Flucloxacillin Phenoxymethylpenicillin Azithromycin (NOT tab/liq) Tetracycline/oxytetracycline
90
Antibiotics to be used in caution in myasthenia gravis 4
Quinolones Aminoglycosides Macrolides Tetracyclines
91
Antibiotics that are hepatotoxic 7
Macrolides Flucloxacillin Co-amoxiclav Chloramphenicol Nitrofurantoin Tetracyclines Rifampicin, isoniazid, pyrazinamide
92
Treatment of initial phase tuberculosis RIPE
2 months - ripe RIFAMPACIN ISONIAZID PYRAZINIMIDE ETHAMBUTOL
93
Treatment of continuous phase tuberculosis 4 months
Rifampicin Isoniazid
94
Treatment of latent tuberculosis
3 months Rifampicin and isoniazid 6 months isoniazid only
95
Rifampicin side effects
Discolour soft contact lenses and bodily fluids - orangey red
96
RIFAMPACIN interaction
Cyp450 interactions
97
Isoniazid side effects
Peripheral neuropathy
98
Prophylaxis treatment for peripheral neuropathy
Pyridoxine (vit b6)
99
Isoniazid interactions (enzyme inhibitor)
Cyp450 enzyme interactions
100
2 types of malaria bite protection
Impregnate nets with permethrin DEET
101
DEET counselling points 5
1. 2 years + 2. Avoid ingestion (wash hands before eating ) 3. 50% gives longer protection 4. Suitable for pregnant and breast feed - wash breast before feeding 5. Apply AFTER sun cream - reduces SPF - use higher SPF
102
Which 2 antimalarials are weekly dose
Chloroquine Mefloquine
103
Which 3 antimalarials are daily dose
Malarone, proguanil, doxycycline
104
Which 2 antimalarials are started 1-2 days before travel
Malarone Doxycycline
105
Which 2 antimalarials are started 1 week before travel
Chloroquine Proguanil
106
Which antimalarials should be started 2-3 weeks before travel
Mefloquine
107
Which antimalarial is taken till 1 week after travel
Malarone
108
which 2 antimalarials can be taken long term
Chloroquine Proquinil
109
How long after travel is antimalarials taken except Malarone
4 weeks
110
Illnes within 1 yr of return esp 3 months - which antimalarial might still cause malaria
Malarone
111
Which antimalarials suitable in pregnancy
Chloroquine Proguanil
112
Antimalarials to be avoided in epilepsy
Chloroquine Mefloquine
113
Requirements for antimalarial given with warfarin
Treatment 2-3 wks before departure Inr should be stable before travel - measure before antimalarial, 7 days after taking and after completing course Prolonged stays - check inr regularly
114
When should standby antimalarial be given
If remote location and likely >24hrs away from medical care Self treat if care not availability within 24hrs of fever
115
Antifungal treatment for aspergillosis
Voriconazole
116
Antifungal treatment for cryptococcosis
Amphotericin B
117
Treatment for vaginal thrush
Clotrimiazole Flucnoazole
118
Treatment for oral thrush
Nysatin Miconazole Fluconazole
119
Treatment of oral / vaginal resistant thrush
Itraconazole
120
Antifungal treatment for skin and nails
First line - topical Second line - systemic itraconazole/ terbinafine
121
Ring worm treatment
First line - Antifungal cream/ terbinafine
122
Who to refer in fungal nail infection
<18yrs >2 nails affected Diabetic Pregnant/breastfeeding
123
Fungal nail treatment
Terbinafine/Amorolfine Once weekly up to 1 year
124
Azole side effects
Qt prolongation Hepatotoxicity
125
Azole that can cause life threatening Hepatotoxicity
Ketoconazole
126
Which Azole bioavailability improved with carbonated drink
Itraconazole
127
Which azole is associated with photo toxicity
Voriconazole
128
Risk in terbinafine
Hepatotoxicity
129
Treatment for varicella zoster, chicken pox, herpes zoster, shingles
Aciclovir Valaciclovir
130
When to treat chicken pox
14 yrs plus present within 24 hours of onset

Pre reg pharmacy (4 decks)

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