General antibiotic quiz Flashcards by Leafy Charlton

Counselling for doxycycline

Don’t take indigestion remedies or medicines containing iron or zinc for 2 hours before/after
Protect skin from sunlight and don’t use sunbeds
Take with a full glass of water

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Why don’t we give doxyxyline to children

deposition of tetracyclines in bones and teeth of under 12

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Antibiotics that interact with statins & action to take

Clarithromycin & erythromycin - increase Increased risk of mypoathy - simv should be withheld during treament

Daptomycin, fusidic acid and telithromycin
Avoid all statins and for 7 days after fusidic acid dose

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What diuretics interact with aminogylcosides and vanc?

Loop - increase risk of ototoxicity

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Diuretic interaction with trimethoprim?

Increased risk of hyperglycemia with spironolactone - increase monitoring

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2 CSM warnings for quinolones

and one other drug that increases the likelihood of this occuring

Convulsions - even in pt with no history. Increase likelihood with NSAIDs

Tendon damage

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Who is more prone to tendon damage as a result of taking a particular class of antibiotcs

Quinolones:

over 60
history of tendon disorders
corticosteroids

If suspected stop quinolone immediately

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Anti-infectives that can prolong the QT interval (5)

Erythromycin
Clarithromycin

Moxifloxacin

Fluconazole
Ketoconazole

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Other medicines that can prolong the QT interval (5)

Some:
Antiarrhymics (amiodarone)
Antipsychotics
Antidepressants
Antiemetics (domepridone/ondansetron)
Methadone

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Does ciprofloxacin interact with much? (2)

Yes - it’s a CYP inhibitor (e.g. theophylline)

Also NSAIDs with cipro increases risk of convulstions

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Interactions with co-amoxiclav

Nothing significant

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Caution with co-amoxiclav

limits treatment course to ……. days

14 days
Cholestatic jaundice - liver tox risk 6x greater than with just amox. Greater risk in over 65. Can occur shortly after use.

Usually self limiting.

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Rare but serious potential side-effect of penicillins

CNS toxicity (high doses and renal failure increase risk)

Therefore penicillin should not be given intrathcally

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Patients with history of …… more at risk of penicillin anyphalaxis

atopic allergy - asthma, eczema, hayfever

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Compare a rash likely to be penicillin allergy and one that isn’t

anaphylaxis, urticaria or rash immediately after administration = likely

Minor rash (non-confluent, non-pruritic, small) occuring 72 hours after admin = less likely

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What classes of antibiotic should penicillin allergic patients not recieve

cephlasporins or beta-lactams

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Interaction of methotrexate and an antibiotic

Trimethoprim - bone marrow suppression and other blood things

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Restrictions in the use of co-trimoxazole

Should only be used for exacerbations of bronchitis/UTI/otitis media when there is evidence of sensitivity and good reason to prefer this to single antibacterial

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Rare serous side-effect of co-trimoxazole

blood disorders or rash (e.g. steven-johnsons syndrome) - discontinue immediately

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Effect of tetracyclines on warfarin

increase anticoagulant effect

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Rare serious side effect of tetracyclines and a class of drugs that increases the risk

Benign intracranial hypertension - report headache and visual disturbance.
Increased with retinoids

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Antibiotic colitis and diarrhoea is more common with broad or narrow spec

broad

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Cholestatic jaundice is particular risk with which penicillin and what are the risk factors…? (3)

Fluclox
Over 2 weeks
Increasing age
Hepatic dusfunction

Can occur up to two months after treatment

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effect of metronidazole on warfarin

increased anticoag effect

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Long term s/e of nitrofuranitoin (2)

liver issues and pulmonary fibrosis (monitor)

Who should be notified about notifiable disease

Proper officer of the local authority

``` What are these examples of? Acute encephalitis Acute infectious hepatitis Acute meningitis Acute poliomyelitis Anthrax Botulism Brucellosis Cholera Diphtheria Enteric fever (typhoid or paratyphoid fever) Food poisoning Haemolytic uraemic syndrome (HUS) Infectious bloody diarrhoea Invasive group A streptococcal disease Legionnaires’ disease Leprosy Malaria Measles Meningococcal septicaemia Mumps Plague Rabies Rubella Severe Acute Respiratory Syndrome (SARS) Scarlet fever Smallpox Tetanus Tuberculosis Typhus Viral haemorrhagic fever (VHF) Whooping cough Yellow fever ```

Notifiable diseases

Empirical treatment for meningitis

Benzylpenicillin OR cefotaximine or chloramphenicol in allergy Dexamethasone as adjuvant

Preventative therapy for meningitis

Ciprofloxacin, Rifampicin or ceftriaxone Healthcare workers don't require unless direct exposure to mouth and nose droplets of patient treated for less than 24hours

Antibacterial therapy for otitis externa

Flucloxacillin or clarithromycin in allergy

Antibacterial therapy for otitis media

Usually viral - only start antibacterial soap after 72 hours (amoxicillin or clarithromycin)

Antibacterial therapy for c diff

Oral metronidazole Then Oral vancomycin

Are penicillins or cephalosporins preferred for dental infections

Penicillins - cephalosporin are less effective against anaerobes

Are organisms causing dental infections likely aerobic or anaerobic ?

Anaerobic

First line for dental infections

Phenoxymethyl penicillin or metronidazole

CAP treatment low,med and high severity | And treatment duration

Low severity pneumococci - amoxicillin (7 days) Med severity - amoxicillin + clarithromycin or doxy (7-10days) High severity - benpen or co-amoxicillin + clarithromycin or doxy (7-10 days)

What would make you treat someone with cap automatically with high severity treatment

Nursing home | Comorbidities

Cap treatment if staph suspected

For all With staphylococci add flucloxacillin - total 14-21 days

Treatment for pneumonia caused by atypical pathogens

Clarithromycin

What makes HAP early onset

Less than five days after admission to hospital

Treatment for early and late onset hap

Early - coamox | Late - tazocin

What to add to HAP if MRSA suspected

Vancomycin

What to add to hap in pseudomonas aeruginosa suspected

Aminoglycaside

Treatment for exacerbation of COPD and duration

Amox or tetracycline for five days

When do you treat and exacerbation of COPD?

Increased sputum purilence | Accompanied by increased sputum volume or sob

Treatment for cellulitis

Flucloxacillin

2 drugs that should not be used alone for MRSA s resistance rapidly develops

Rifampicin | Fusidic acid

Is MRSA gram positive or negative ?

Positive

First line for MRSA ... And what to treat with if severe?

A Tetracycline +/- Rifampicin & Fusidic acid If severe use glycopeptide (e.g vancomycin )

Why do we not normally use Linezolid for mixed gram infections

Not active against gram negative

Duration and number of drugs used in the phases of TB

Initial - Four drugs for two months | Continuation - 2 drugs for four months

Drugs for the initial phase of TB

Iaoniazid Rifampicin Pyrazinamide Ethambutol

Continuation phase of TB components

Isoniazid and Rifampicin

Colour that Rifampicin chafed urine?

Red orange

Difficult with treating tab in children?

Ethambutol can effect eyesight but it's difficult to test in children and hard to get the, to report visual symptoms

Two most common organisms causing UTI

Ecoli | Then staphylococcus saprophyticus in young sexually active women

Treatment duration for UTI

7 days or 3 days if uncomplicated in women

First line for Utis

Trimethoprim or nitro | Alternatively Amox, ampicillin or oral cephalosporin

First line for upper UTI

Cephalosporin (cefuroxamine)

Duration of treatment for an upper UTI

10-14 days

UTI in pregnancy treatment (3)

Penicillins or cephalosporins | Nitrofurantoin but avoid this at term

Can nitrofurantoin be used in renal impairment

Should be avoided

Treatments for UTI in children

From 3 months - trimethoprim, cephalosporins or nitrofurantoin

Who does pneumocystis pneumonia occur in ?

Immunocompromised patients

What is first line for pneumocystis pneumonia ?

Co-trimoxazole (also used prophylactically until immune recovery daily or on alternate days) May also give corticosteroids as a adjuvant in HIV

General antibiotic quiz Flashcards

(65 cards)