CBM - Prescribing Antibiotics for self limiting RTIs Flashcards Preview

Community Based Medicine > CBM - Prescribing Antibiotics for self limiting RTIs > Flashcards

Flashcards in CBM - Prescribing Antibiotics for self limiting RTIs Deck (6)
Loading flashcards...
1
Q

Px Antibiotics for

Self Limiting URTIs

PENNICLIN β-lactams Benzylpennicilin (penicillin G) phenoxymethylpennicilin (penicillin V)

Indications?

A
  • acute pharyngitis,
  • tonsillitis,
  • sore throat,
  • otitis media,
  • oral infection,
  • cellulitis,
  • streptococcal (including pneumococcal ),
  • erysipelas,
  • clostridail infection,
  • meningococcal,
  • gonococcal,
  • lyme disease,
  • gangrene
2
Q

Px Antibiotics for

Self Limiting URTIs

PENNICLIN β-lactams Benzylpennicilin (penicillin G) phenoxymethylpennicilin (penicillin V)

Dose/Side Fx/Warnings/Interaction

A

DOSE

  • Benzylpenicillin (penicillin G) IV OR IM 1.2g every 4-6hrly
  • Phenoxymethylpenicillin (penicillin V) orally .Adult 500mg 6hrly increase dose if necessary​

SIDE EFFECT

  • Allergy and cross-sensitivity
  • CNS toxicity
  • Patient with hx of hypersensitivity with penicillin

WARNING

  • Dose reduction for pt with renal impairment
  • Hx of allergy
  • Accumulation of Na from injection Benzylpennicilin (penicillin G) can occur renal failure
  • High dose may cause neurotoxicity

INTERACTION

  • Penicillin reduce renal excretion of methotrexate increasing risk toxicity
3
Q

Px Antibiotics for

Self Limiting URTIs

PENNICILIN (BROAD-SPECTRUM) AMOXICILIN, CO-AMOXICLAV

​INDICATION

A
  • sinusitis,
  • otitis media,
  • oral infection,
  • respiratory track,
  • acute bronchitis,
  • UTI,
  • CAP,
  • salmonellosis,
  • cellulitis,
  • genito-urinary
  • abdominal infection,sepsis
4
Q

Px Antibiotics for

Self Limiting URTIs

PENNICILIN (BROAD-SPECTRUM) AMOXICILIN, CO-AMOXICLAV

Contr-indications/Side Fx/Interactions/Dose

A

CONTRA-INDICATION-

  • hx of CO-AMOXICLAV associate hepatic jaundice or hepatic dysfunction

SIDE EFFECTS

  • GI upset-diarrhoea, nausea
  • Abx associated colitis
  • Penicillin allergy
  • Cholestatic jaundice -rare

WARNING

  • Reduce dose in pt with renal impairment risk of crystalluria
  • Hx of penicillin allergy
  • Monitor liver function in pt with liver impairment

INTERACTION

  • Reduce renal excretion of methotrexate, increase toxicity
  • Can enhance anticoagulant effect of warfarin

DOSE

  • AMOXICILLIN orally –adult 500mg 8hrly
  • CO-AMOCILAV-250/125 mg 8hrly, increase dose 500/125mg in severe infection
5
Q

Px Antibiotics for

Self Limiting URTIs

MACROLIDES-Erythromycin, azithromycin, clarithromycin (alternative to penicillin)​

Indications

​​

A
  • respiratory tract infection (mycoplasma pneumonia)
  • skin,
  • soft tissue and oral infection,
  • otitis media,
  • Legionella infection,
  • campylobacter enteritis,
  • chlamydia)
6
Q

Px Antibiotics for

Self Limiting URTIs

MACROLIDES-Erythromycin, azithromycin, clarithromycin (alternative to penicillin)​

MOA/Dose/Side Fx/Warnings/Interactions

A

Mechanism of action:

  • inhibits bacterial protein synthesis (BATERIOSTATIC ACTIVITY)

DOSE:

  • Clarithromycin mostly prescribed in the UK 250mg-500mg 2xdaily 7-14day
  • Erythromycin 250-500mg 4x daily or 500-100mg for 5day

SIDE EFFECT:

  • QT prolongation
  • Irritant- abdominal pain, nausea and vomiting, diarrhoea
  • Ototoxicity at high dose
  • Allergic antibiotic associated colitis

WARNING:

  • Metabolized by the liver, small amount in the kidney
  • Avoid in severe hepatic /renal impairment
  • Avoid in pregnancy/ breastfeeding except if benefit outweigh risk
  • caution in drugs that prolong OT interval eg amiodarone, antipsychotic drugs and SSRI, quinine

INTERACTION:

  • warfarin risk of bleeding. Statin- risk of myopathy
  • Also interact with digoxin, theophylline, carbamazepine