Drugs

Question 1

Aciclovir

Answer 1

Class: antiviral
Indications: cold sores, shingles, chicken pox
Dose/timing: 400mg up to 5 times a day, apply cream 5 times a day for 5-7 days
Counselling: start as soon as possible withing 72h of rash onset, ensure that drinking plenty of fluids (1.5-2L), may make you feel dizzy or confused. Don’t drive or operate machinery if affected
Was hands after use, very contagious do not kiss or share towels.
Monitoring: renal function, HYDRATION, blood dyscrasias

Question 2

Famciclovir

Answer 2

Class: antiviral
Indications: cold sores, shingles, chicken/p
Dose/timing: 250mg-500mg bd or tds or 1500mg stat
Counselling: start as soon as possible within 72h of rash/blister onset, ensure drinking plenty of fluids (1.5-2L), may make you feel dizzy or confused. Don’t drive or operate machinery if affected
Monitoring: renal function, HYDRATION, blood dyscrasias

Question 3

Valaciclovir

Answer 3

Class: antiviral
Indications: cold sores, shingles, CMV in transplants
Dose/timing: 400mg up to 5 times a day
Counselling: start as soon as possible within 72h of rash onset, ensure that drinking plenty of fluids (1.5-2L), may make you feel dizzy or confused. Don’t drive or operate machinery if affected
Monitoring: renal function, HYDRATION, blood dyscrasias

Question 4

Amikacin

Answer 4

Class: aminoglycoside
Indications: resistant infections
Dose: 15mg/kg daily
Counselling: injection, may affect your kidneys but once drug is stopped they should improve, sometimes hearing and balance is affected and may be some hearing loss, tell doctor straight away
Monitoring: ototoxicity, nephrotoxicity, CrCl, TDM for Tx>48h,

Question 5

Gentamicin

Answer 5

Class: aminoglycoside
Indications: empiric for gram - infections
Dose: 5-7mg/kg daily based on CrCl
Counselling: injection, may affect your kidneys but once drug is stopped they should improve, sometimes hearing and balance is affected and may be some hearing loss, tell doctor straight away
Monitoring: ototoxicity, nephrotoxicity, CrCl, TDM for Tx>48h,

Question 6

Tobramycin

Answer 6

Class: aminoglycoside
Indications: empiric for gram- infections 48h,
Dose: based on weight
Counselling: injection, may affect your kidneys but once drug is stopped they should improve, sometimes hearing and balance is affected and may be some hearing loss, tell doctor straight away
Monitoring: ototoxicity, nephrotoxicity, CrCl, TDM for Tx>48h,

Question 7

Meropenem
Ertapenem
Imipenem

Answer 7

Class: Carbapenem
Indication: empiric treatment, broad spec g-and+ infections, meningitis, CF,
Dose: 0.5-1g q8h max 2g q8h based on CrCl
Counselling: if you develop diarrhoea let doctors no immediately
Monitoring: signs of neurotoxicity, c-diff, renal, hepatic, blood count

Question 8

Cephalexin

Answer 8

Class: cephalosporin
Indication: 2nd line allergy to penicillins, prophylaxis after surgery, UTI
Dose: 250-500mg bd for 5-10days
Counselling: until all taken
Monitoring: c-diff, renal function (dose reduction), allergy,

Question 9

Cefaclor

Answer 9

Class: cephalosporin
Indication: 2nd line allergy to penicillins, prophylaxis after surgery, acute sinusitis
Dose:250-500mg tds or 375-750mg bd CR, max 4g for 5 days
Counselling: swallow whole, take with food until all taken
Monitoring: c-diff, renal function (dose reduction), allergy,

Question 10

Cefuroxime

Answer 10

Class: cephalosporin
Indication: 2nd line allergy to penicillins, prophylaxis after surgery, acute sinusitis
Dose:250-500mg bd for 7 days
Counselling: Swallow whole, take with food until all taken
Monitoring: c-diff, renal function (dose reduction), allergy,

Question 11

Vancomycin

Answer 11

Class: glycopeptide
Indication: MRSA, c-diff, surgical prophylaxis
Dose: load 25-30mg/kg then 15-20mg/kg bd or d
Counselling: needs to be run slowly to prevent red man syndrome, 10mg/min. Let doctors know if u develop a rash or fever or if u get dizzy and ringing in ears
Monitoring: ototoxicity, nephrotoxicity, renal function, TDM trough levels 15-20mg/L, red man syndrome,

Question 12

Clindamycin

Answer 12

Class: lyncosamide
Indications: allergy to pen+ceph, bacterial vaginosis
Dose: 150-450mg q6-8h for 3-4 days
Counselling: take with a full glass of water. Stop taking and tell dr immediately if u develop diarrhoea, take until all finished
Monitoring: renal,function, infection, hydration

Question 13

Azithromycin

Answer 13

Class: macrolide
Indication: chlamydia, CAP, 
Dose: 1g as a single dose or 500mg d 
Counselling: take until all finished 
Monitor: hepatic function (dose reduce)

Question 14

Clarithromycin

Answer 14

Class: macrolide
Indication: h.pylori, LRTI,
Dose: 500mg bd for 7 days
Counselling: take until all finished, tell dr or pharmacist that you are taking this medication as it interacts with many drugs.
Monitoring: QT interval, renal function (decrease dose if

Question 15

Erythromycin

Answer 15

Class: macrolide
Indication: resp infections, acne
Dose: 1-2g d in 2-4 doses max 4g, liquid form
Counselling: best absorbed on an empty stomach, take at least 30mins before food, however if it upsets your stomach take with food. Tell dr or pharmacist that you are taking this medication as it interacts with many drugs. Avoid eating or drinking grapefruit
Monitoring: QT interval, renal and hepatic function. Use with caution in neonates- infantile hypertrophic pyloric stenosis

Question 16

Metronidazole

Tinidazole

Answer 16

Class: nitromidazole
Indication: gut infections, aspiration pneumonia
Dose: 200-400mg bd or tds max 4g
Counselling: take with food to reduce stomach upset, avoid alcohol during treatment and 24hours after finishing course to prevent nausea. This medication may make you feel dizzy or confused avoid driving if affected. Stop taking and see dr immediately if you get any numbness, tingling, pain in your hands or feet.
Monitoring: renal & hepatic (risk of accumulation). Long term use: peripheral neuropathy, CNS toxicity, leukopenia

Question 17

Amoxicillin

Answer 17

Class: penicillin
Indication: surgical prophylaxis, sinusitis
Dose: 250-500mg tds, or 1g bd. max12g
Counselling: take with or without food, until all taken
Monitoring: allergy, rash, renal, electrolyte disturbance, neurotoxicity, neutropenia, c-diff

Question 18

Dicloxacillin

Answer 18

Class: penicillin
Indication: staph skin infections
Dose:250-500mg qid. Max4g
Counselling: absorbed best on an empty stomach at least 30mins before food or 2h after food. until all taken
Monitoring: allergy, rash, renal, electrolyte disturbance, neurotoxicity, neutropenia, c-diff, HEPATC FUNCTION if >2weeks

Question 19

Phenoxymethylpenicillin

Answer 19

Class: penicillin
Indication: strep throat or skin infection, scarlet fever
Dose: 250-500mg qid or 500mg bd for 10 days
Counselling: with or without food, until all taken
Monitoring: allergy, rash, renal, electrolyte disturbance, neurotoxicity, neutropenia, c-diff

Question 20

Flucloxacillin

Answer 20

Class: penicillin
Indication: staph skin infections
Dose:250-500mg qid. Max4g
Counselling: absorbed best on an empty stomach at least 30mins before food or 2h after food. until all taken
Monitoring: allergy, rash, renal (reduce dose), electrolyte disturbance, neurotoxicity, neutropenia, c-diff, liver enzymes, HEPATC FUNCTION if >2weeks CHOLESTATIC HEPATITIS

Question 21

Amoxicillin + clavulanic acid

Answer 21

Class: penicillin
Indication: beta-lactamase producing organisms
Dose:500/125 or 875/125 bd for 5-10days
Counselling: absorbed best if taken with food, until all taken
Monitoring: allergy, rash, renal, electrolyte disturbance, neurotoxicity, neutropenia, c-diff HEPATC function>14 days, CHOLESTATIC HEPITITS

Question 22

Ciprofloxacin
Moxifloxacin
Norfloxacin

Answer 22

Class: quinolones
Indications: last line- due to resistance, complicated UTIs, bone and joint infections
Dose: Cipro- 250,500,750 bd 7days. Moxi- 400mg d. Norflox- 400mg bd
Counselling: Take 1h before or 2h after food, drink plenty of fluids while taking. Dairy products, antacids, iron, zinc or calcium supplements may reduce absorption; do not take within 2h of dose. May cause dizziness, alcohol may worsen the effect.
Monitoring: renal (dose reduction), urine output (crystallisation), tendon soreness (stop taking immediately)

Question 23

Rifabutin
Rifampicin
Rifaximin

Answer 23

Class: rifamycins
Indication: mycobacterium infections, TB. Rifaximin- hepatic encephalopathy
Dose:
Counselling: your urine, faeces, sweat and tears may become orange/red and soft contact lenses permanently stained. Tell dr if you have any loss of appetite, nausea, vomiting, unusual tiredness, jaundice, dark or pale stools. This medicine interacts with many drugs tell dr and pharmacist. Rifampicin, rifabutin can make the pill less effective - use barrier methods during and 7 days after stoping medication.
Monitoring: liver function test, serum creatinine, complete blood count

Question 24

Doxycycline

Answer 24

Class: tetracycline
Indication: acne, CAP, malaria prophylaxis
Dose: 200mg on day 1 then 100mg d or 100mg d
Counselling: take with food or milk, Take with a large glass of water in the morning and do not lie down for 1hr after dose, this is to prevent the tablet from sticking to your oesophagus and causing painful damage. Do not take antacids,zinc, iron, calcium supplements within 2h or dose as can interfere with absorption. Can cause your skin to be more sensitive to sunlight, cover up and use sunscreen.
Monitoring: renal and hepatic function (not recommended in impairment)

Question 25

Minocycline

Answer 25

Class: tetracycline Indication: acne Dose: 200mg on day 1 then 100mg bd Counselling: take with food or milk, Take with a large glass of water in the morning and do not lie down for 1hr after dose, this is to prevent the tablet fro sticking to you ur oesophagus and causing painful damage. Do not take antacids,zinc, iron, calcium supplements within 2h or dose as can interfere with absorption. Can cause your skin to be more sensitive to sunlight, cover up and use sunscreen. This medication may make you dizzy and be careful driving until u no how u r effected. It may cause changes in the colour of your skin tell dr if this happens. Monitoring: renal and hepatic function (not recommended in impairment)

Question 26

Tetracycline

Answer 26

Class: tetracycline Indication: H.pylori Dose: 500mg qid for 7-14 days Counselling: best absorbed on an empty stomach 1h before or 2h after food, Take with a large glass of water in the morning and do not lie down for 1hr after dose, this is to prevent the tablet fro sticking to you ur oesophagus and causing painful damage. Do not take antacids,zinc, iron, calcium supplements within 2h or dose as can interfere with absorption. Can cause your skin to be more sensitive to sunlight, cover up and use sunscreen. Monitoring: renal and hepatic function (not recommended in impairment)

Question 27

Nitrofurintoin

Answer 27

Class: antibacterial Indication: prophylaxis for UTI, acute UTI Dose: 50-100mg qid for 5-7 days or 50-100mg at bed time (prophylaxis) Counselling: Take with food or milk to reduce nausea and improve absorption. This medication may cause drowsiness do not drive if effected. Tell dr immediately if you develop difficulty breathing or cough. May make urine a brownish colour Monitoring: renal function, hepatotoxicity, pulmonary toxicity, peripheral neuropathy. Long term treatment: pulmonary function, liver function, renal function

Question 28

Trimethoprim

Answer 28

Class: antibacterial Indication: UTI Dose: 300mg nocte for 3 days in women and 7 days for men Counselling: take a night to maximise urinary concentration Monitoring: monitor complete blood count and FOLATE status, serum POTASSIUM (hyperkalaemia). Renal function

Question 29

Trimethoprim + sulfamethoxazole

Answer 29

Class: antibacterial Indication: UTI Dose: 300mg nocte for 3 days in women and 7 days for men Counselling: take a night to maximise urinary concentration may cause stomach upset take with food to reduce risk. Drink a lot of fluid during long term high dose treatment. Can cause skin to be more sensitive to sunlight, cover up. Tell doctor if you develop; sore throat,fever,rash, cough, difficulty breathing, joint pain, dark urine, pale stools. Monitoring: monitor complete blood count and FOLATE status, serum POTASSIUM (hyperkalaemia). Renal function

Question 30

Fluconazole

Answer 30

Class: azole anti fungal Indication: candida infection Dose: 150mg stat can be used for prophylaxis 150mg every 3 days for 3 doses then 150mg once a week for 6 months. Can use up to 400mg daily to prevent serious fungal infections in BMT patients. Use topical anti fungal first then oral form. Counselling: generally well tolerated especially just the one dose. Tell dr if fatigued nauseous or are not eating. Monitor: liver function, serum potassium at baseline and at regular intervals depending on dose and duration

Question 31

Gabapentin

Answer 31

Mood changes, label 1 Partial seizures Neuropathic pain Increases effects of alcohol do not drive Renal Fatigue, rash, vision changes, strange movements

Question 32

Nitrofurantoin

Answer 32

Class: other antibacterials Indication: UTI

Question 33

Ketoconazole

Answer 33

Class: azole anti fungal Indication: dandruff Dose: 1-2% shampoo twice a week for 2-4weeks Counselling: wash hair thoroughly, leaving the shampoo on for 3-5minutes before rinsing off. This should be done twice a week for 2-4weeks. It may cause irritation to the scalp if painful or bleeding go see doctor. Occasionally it may cause hair discolouration. Monitoring: improvement of symptoms, irritation

Question 34

Miconazole

Answer 34

Class: azole anti fungal (daktarin) Indication: oral thrush, fungal skin infections, thrush Dose: >2years old - half a spoonful qid. Birth-2years- quarter of a spoonful qid for 7-14days Counselling: it is best to use the gel after a meal or drink and keep it in your mouth for as long as possible before swallowing. Apply gel directly to the area with a clean finger. For children apply with clean finger to the front of the mouth in small amounts to prevent choking. For young babies you can smear the gel onto the affected areas. Mioconazole can occasionally cause nausea and vomiting but this is rare. Treatment should be continued for up to seven days after symptoms have cleared to prevent relapse. Monitoring: infection duration >3weeks, patients with diabetes (refer)

Question 35

Roxithromycin

Answer 35

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