CH5: INFECTIONS Flashcards
(43 cards)
Antibiotics that are contraindications to children?
Tetracycline CI < 12 years and breastfeeding
- Bind to teeth and bones
- Hepatotoxicity
Quinolones contraindicated = Risk of joint pain
antibiotics that are contraindications for pregnant women?
- Tetracycline = Hepatotoxic
- Aminoglycosides (1st/ 2nd T)
- Metronidazole (high dose)
- Clarithromycin
- Chloramphenicol = Grey baby syndrome at 3rd T
- Trimethoprim
- Nitrofurantoin at term (28-40 w)
- Quinolones
- Sulphonamides
- Glycopeptides: unless benefit > risks
name the antibiotics that are safe to use in pregnancy
- penicillin’s
- cephalosporins
state the antibiotics that have increased risk of C.diff
- Clindamycin
- Cephalosporins
- Ciprofloxacin
- Co-amoxiclav
state the antibiotics that can cause renal impairment
NAG TT
- Aminoglycoside/ glycopeptides = risk of nephrotoxicity/ ototoxicity
- Nitrofurantoin avoided at eGFR <45ml/min
- Tetracyclines (except doxycycline and minocycline)
- Trimethoprim
state the antibiotics that can cause liver impairment
- Rifampicin
- Tetracyclines
- Metronidazole = dose reduction needed in severe hepatic impairment by 1/3rd of the normal dose.
Name the 1st generation drugs of cephalosporin and what it is used to treat.
PO
‘Fa’ e.g. cefalexin, cefadroxil
Used to Tx: UTI, Sinusitis and otitis media
Cefalexin + Warfarin = increases the risk of bleeding
- mainly gram-positive
Name the 2nd generation drugs of cephalosporin and what it is used to treat.
PO
e.g. cefoxitin, cefuroxime
Used to Tx: UTI, Sinusitis and otitis media
- mainly gram-positive
Name the 3rd generation drugs of cephalosporin and what it is used to treat.
IV
‘one, ime’
Ceftriaxone= meningitis/ gonorrhoea
Ceftazidime = pseudonomas aug. infections
- mainly gram negative
Name the 5th generation drugs of cephalosporin and what it is used to treat.
- Ceftaroline = used in CAP and complicated soft tissue infection
- mainly gram negative
side effects of cephalosporins
- 2nd/ 3rd generations of cephalosporins = can lead to abx associated colitis
- C.diff infection
- Avoid in patients with hypersensitivity to penicillin and other beta-lactams due to cross sensitivity
what type of spectrum is chloramphenicol?
broad spectrum
indication and age used for chloramphenicol?
- Tx: Eye infections such as conjunctivitis
- OTC= 2years +
when to AVOID the use of chloramphenicol?
- pregnancy in 3rd Trimester (28-40 weeks)
- risk of grey baby syndrome
what type of spectrum is clindamycin?
narrow spectrum, gram-positive and anaerobes
indication of clindamycin
- mainly used for skin and soft tissue infections
- LRTIs
- Osteomyelities
- Acne vulgaris
cautions for use of clindamycin
- Can cause abx-associated colitis
- stop in severe/prolonged/bloody diarrhoea
- more common in elderly
- Greater risk of C.diff
- seek specialist advice if can’t be stopped
- Can cause metallic taste if taken orally
contraindications of clindamycin
- Acute porphyria’s: intermittent attacks of abdominal pain and neurological symptoms
- GI disease e.g., colitis
what are the indications of clindamycin
- erythromycin
- CYP enzyme inhibitors - SICKFACES.COM GAVID
what are the indications of clindamycin?
- erythromycin
- CYP enzyme inhibitors - SICKFACES.COM GAVID
what type of spectrum is linezolid?
narrow spectrum, gram positive
safety information of linezolid & monitoring advice
- Risk of severe optic neuropathy
- report a visual disturbance
- monitored regularly if treatment is more than 28 days
- Risk of blood disorders
- Monitor full blood counts weekly
- Monitor regularly if treatment is more than 10-14 days
drug interactions of linezolid
linezolid- is a reversible MAOI inhibitor (avoid antidepressants).
- Tyramine-rich foods: mature cheese, yeast extra, and marmite = can cause hypertensive crisis
- SSRIs, 5-HT1 agonist (triptans), TCAs, Lithium, MAOIs = can cause serotonin syndrome
state the doses differences of macrolides
Clarithromycin (BD)
Azithromycin (OD)
Erythromycin (QDS)
