Infection Flashcards
(268 cards)
1
Q
Preventing streptococcal
A
Phenoxymethylpenicillin, (erythromycin, azithromycin)
2
Q
Meningococcal prevention
A
Ciprofloxacin or rifampicin or ceftriaxone
3
Q
Influenza prevention
A
Rifampicin if not then ceftriaxone for all household contacts if there is a vulnerable individual
4
Q
Diphtheria prevention
A
Erythromycin
5
Q
Pertussis prevention (whoopig cough)
A
Clarithromycin (or azi/ery)
6
Q
Pneumococcal infection treatment
A
Phenoxymethylpenicillin, (if pen allergic) erythromycin
7
Q
Animal/human bites treatment
A
Co-amoxiclav (doxycycline+metronidazole if pen allergy)
8
Q
Stomach/oesophagus operation antibiotics
A
Gentamicin, cefuroxime, co-amoxiclav (teicoplanin/vancomycin added if high MRSA risk, metronidazole added if biliary surgery)
9
Q
Orthopaedic surgery antibiotics
A
Cefuroxime, flucloxacillin, gent, co-amox, metronidazole (if pen allergy or mrsa risk = teicoplanin/vancomycin)
10
Q
Urological surgery antibiotics
A
Ciprofloxacin, metro, gent, cefuroxime
11
Q
Cardio procedure prophylaxis
A
Cefuroxime or flucloxacillin+gentamicin or teic/vanc+gent
12
Q
Enchinocandin drugs
A
Anidulafungin, caspofungin, micafungin
13
Q
What are echnicondin used for
A
Only aspergilus (only caspo) and candida
14
Q
Nystatin indications
A
Oral, oropharyngeal, perioral and candida albicans infection of skin
15
Q
Polyene antifungals
A
Amphotericin, nystatin
16
Q
Miconazole use
A
Oral infections, intestinal infections,
17
Q
Imidazole antifungals
A
Clotrimazole, econazole, ketoconazole, tioconazole
18
Q
When is voriconazole used
A
Broad spectrum used for life threatening infections
19
Q
Itraconazole cautions
A
Liver damage
20
Q
How to treat fungal meningitis and why
A
Fluconazole as it has good penetration into CSF
21
Q
Triazole antifungals
A
Voriconazole, posaconazole, itraconazole. Fluconazole
22
Q
Treating pityriasis
A
Itaconzaole or Fluconazole
23
Q
Treating CNS candidiasis
A
Amphotericin
24
Q
Vaginal candidiasis treatment
A
Locally (clotrimazole) or fluconazole if not then itraconazole
25
Oropharyngeal candidiasis treatment
fluconazole if not then itraconazole
26
Aspergillosis treatment
Voriconazole if not then amphotericin (itraconzole or caspofungin if refractory/intolerant to voriconazole) (fluconazole not effective)
27
What treats p aeruginosa
Aminoglycosides (tobramycin ideally), carbapenem
28
What treats pseudomonas
Ciprofloxacin
29
Treating MSRA
Vancomycin, Teicoplanin
30
Treating Staph
Flucloxacillin
31
Treating respiratory infections
Amox – clarithromycin/erythro
32
Treating skin infections
Flucloxacillin, co-amoxiclav if serious
33
Treating anaerobic infections
Metronidazole
34
treatment of acute uncomplicated falciparum malaria
Artemether with lumefantrine , Atovaquone with proguanil
35
prophylaxis acute uncomplicated falciparum malaria
Atovaquone with proguanil
36
When is doxycycline used in malaria
When travelling to areas of chloroquine resistance
37
When is primaquine used
To eliminate the liver stages of P. vivax or P. ovale following chloroquine treatment
38
When can you use quinine
if the infective species is not known
39
Non-pharmacological malaria prophylaxis
Net with permethrin, insect repellants DEET,
40
How long before travel should you take chloroquine+proguanil
1 week
41
How long before travel should you take mefloquine
2-3 weeks
42
How long before travel should you take atovaquone + proguanil/ doxycycline
1-2 days
43
How long should prophylaxis be taken after leaving the area for most antimalarials
4 weeks
44
What antimalarial has a short period of time that the drug should be taken after leaving the area and how long
Atovaquone with proguanil 1 week
45
Antimalarial drugs used in pregnancy
Chloroquine and proguanil give folic acid,quinine, mefloquine - weigh up benefits and negatives of all regimens
46
What antimalarial to use if a patient has epilepsy
Atovaquone with proquanil
47
Atovaquone with proquanil brand name
Malarone
48
Mefloquine brand name
Lariam
49
What to use if malaria infection is not known/mixed
Atovaquone with proquanil or Quinine
50
How to treat malaria if patient is pregnant
Quinine then use clindamycin
51
Treating falciparum malaria
Chloroquine, atovaquone with proguanil, primaquine
52
Treating Trichomonacides
Metronidazole
53
Trichomoniasis symptoms
Abnormal vaginal discharge ( yellow-green, fishy smell), soreness, swelling, itching, discomfort in sex or when urinating
men: pain when urinatic/ejaculating, frequent urinating, white discharge, swelling/soreness around head of penis
54
Treating septicaemia
Broad spectrum antipseudomonal penicillin or cephalosporin e.g pip taz, ticarcillin with clavulanic acid, cefuroxime
55
What to add to community septicaemia if MRSA suspected
Vancomycin/Teicoplanin
56
What to add to community septicaemia treatment if anaerobic
Metronidazole
57
What to use in community septicaemia treatment if resistant
Meropenem (broad spectrum beta lactam)
58
What sort of drug is need to treat hospital acquired septicaemia
Broad spectrum antipseudomonal beta lactam e.g. Pip taz, ceftazadime, meropenem
59
Treating septicaemia related to vascular catheter
Vancomycin/teic
60
Treating meningococcal septicaemia
Benzylpenicillin or cefotaxime or chloramphenicol
61
Covid-19 transmission
Respiratory droplets generated
62
Common COVID symptoms
Fever, cough, sob, delirium loss of smell, headache
63
Who is at risk developing severe pneumonia
Impaired immunity or reduced ability to cough/clear secretions
64
Characteristics of carbapenem
Broad-spectrum activity
65
Carbapenems gram characteristics
positive and negative
66
What carbapenems are active against p aeruginosa
Imipenem and meropenem
67
Common uses of carbapenem
Hospital acquired septicaemia and pneumonia, intra abdominal infections, skin and soft tissue ifections and complicated UTIs
68
Why is imipenem given with cilastatic
It is partially inactivated in the kidney by enzymatic activity
69
Examples of cabapenems
Meropenem, ertapenem, imipenem
70
What is ertapenem used for?
CAP, gynae and abdominal infections
71
Initial blind endocarditis treatment
Amoxicilin/ampicillin could add low dose gentamicin (Vancomycin if pen allergic)
72
Endocarditis staphylococci treatment
Flucloxacillin (vancomycin+rifampicin for pen allergy) 4 weeks
73
Endocarditis prosthetic valve staphylococci
Flucloxacillin (vancomycin if pen)+rifampicin+low dose gent - 6 weeks then review (review gent at 2 weeks)
74
Endocarditis caused by streptococci
Benzypenicillin (if less sensitive low dose gent added), vancomycin if pen allergy
75
When to stop gentamicin
Stop gentamicin at 2 weeks if micro-organisms moderately sensitive to penicillin
76
Endocarditis caused by HACEK treatment
Amoxicillin/ceftriaxone + low dose gent
77
Endocarditis caused by Enterococci treatment
Amoxicillin (vanc if pen)+ low dose gent (Benzypenicillin may also be added)
78
Mild diabetic foot infection treatment
Flucloxacillin first line.
| If penicillin allergy/ C/I = clarithromycin, doxycycline, erythromycin (pregnancy)
79
Moderate diabetic foot infection treatment
Flucloxacillin+ gentamicin +/or metronidazole if not then amoxicillin + gentamicin or ceftriaxone+metronidazole (pen allergy = co-trimoxazole +gentamicin +metronidazole)
80
When to treat campylobacter enteritis and how
Immunocompromised/severe.
Clarithromycin (macrolide) or ciprofloxacin
81
First line diverticulitis
Co-amoxiclav(pen allergy , cefalexin+metronidazole, trimethoprim, metrondazole, or cipro+metronidazole)
82
Treating typhoid
Cipro or azithromycin
83
Treating salmonella
Cipro or cefotaxime
84
Treating c diff
Metronidazole then vancomycin, then fidaxomicin
85
Peritonitis treatment
Cephalosporin+ metronidazole or gent+metro
86
Otitis externa cause
P aeruginosa, staph a
87
Treating otitis externa
Flucloxacillin or clarithromycin/macrolide (if pen allergy)
88
Treating pseudomonas otitis externa
Ciprofloxacillin or aminoglycoside
89
Otitis media is
Infection in middle ear
90
Treating ear infection
Amoxicillin then co-amoxiclav. (if pen allergy = clarithromycin /erythromycin if pregnant)
91
Blepharitis cause
Staphylococci
92
Conjunctivitis cause
Streptococcus pneumoniae, Staphylococcus aureus, or Haemophilus influenzae
93
Blepharitis treatmebt
Chloramphenicol ointment, oral tetracyclines if >12yo
94
General HIV treatment strategy
2 NRTI+ Integrase inhibitor/NNRTI/Protease inhibitor
95
HIV backbone treatment
Emtricitabine+tenofovir or abacavir+iamivudine
96
HIV prep treatment
Emtricitabine with tenofovir or just tenofovir
97
Integrase inhibitors
bictegravir (BIC), dolutegravir (DTG), elvitegravir (EVG), and raltegravir (RAL).
98
nucleoside reverse transcriptase inhibitors (NRTI)
abacavir (ABC); emtricitabine (FTC), lamivudine (3TC); stavudine (d4T), tenofovir alafenamide fumarate (TAF), tenofovir disoproxil fumarate (TDF), and zidovudine (AZT).
99
CCR5 antagonist
Maraviroc
100
Protease inibitors
atazanavir (ATZ), darunavir (DRV), fosamprenavir (FOS-APV), lopinavir (LPV), ritonavir (RTV), saquinavir (SQV), and tipranavir (TPV).
101
Why do threadworms cause itching
Lay eggs on perianal skin
102
Treating threadworms
Mebendazole, single dose or another after 2 weeks
103
Treating Hep C
Interferon alfa, Ribavirin (not alone)
104
Treating chronic hepatitis b
Peginterferon alfa or interferon alfa(stop after 4 months) entecavir (if unresponsive after 6-9 months), tenofovir (if unresponsibe after 6-9 months)
105
Herpes labialis is
Cold sores
106
When is aciclovir used
Against all herpesviruses
107
Treating cytomegalovirus
Ganciclovir , valganciciclovir
108
Bacterial vaginosis treatment
Metronidazole
109
Syphyllis treatment
Benzathine benzylpenicillin
110
Pelvic inflammatory disease trearment
Doxycycline+metronidazole or ceftriaxone/ofloxacin+metronidazole
111
Gonorrhea treatment
Ceftriaxone if unknown, ciprofloxacin if known or azithromycin
112
Chlamydia treatment
Azithromycin or doxycycline
113
Bacterial vaginosis symptoms
Thin, gray, white or green vaginal discharge.
Foul-smelling "fishy" vaginal odor.
Vaginal itching.
Burning during urination.
114
Chlamydia symptoms
pain when peeing
unusual discharge from the vagina, penis or bottom
in women, pain in the tummy, bleeding after sex and bleeding between periods
in men, pain and swelling in the testicles
not always symptomatic
115
Gonorrhea symptoms
unusual discharge from your vagina or penis and pain when peeing.
116
Influenza treatment
Oseltamivir and zanamivir, licensed within 48 hours
117
What is post exposure prophylaxis
Giving dose post exposure
118
When oseltamivir be used post exposure
Within 48 hours
119
Leprosy treatment
Dapsone, rifampicin, clofazimine
120
Drugs used to treat lyme disease
Doxycycline in most instances and amoxicillin as alternative and azithromycin if not suitable. Ceftriaxone used if CNS involvement
121
Macrolide indications
Campylobacter enteritis, respiratory infections (pneumonia, whooping cough, legionella) chlamydia, skin infections (impetigo, cellulitis)
122
Erythromycin indications
Syphilis, chlamydia
123
Azithromycin indications
Chlamydia , gonorrhoea, typhoid, lyme disease
124
Treating MRSA skin infections
Rifampicin+fusidic acid+ tetracycline/ tetracycline/ clindamycin alone/ glycopeptide
125
Treating MRSA Pneumonia
Gentamicin
126
MRSA bronchiectasis treatment
Tetracycline/ clindamycin
127
MRSA UTI treatment
Tetracycline or trimethooprim/nitrofurantoin/glycopeptide
128
MRSA septicaemia treatment
Glycopeptide
129
MRSA Surgery prophylaxis
Vancomycin/teicoplanin
130
Osteomyelitis treatment
Flucloxacillin(clinda if pen, vanc/teic if mrsa) +(fusidic acid+ rifampicin)
131
Sinusitis treatment if needed
Phenoxymethylpenicillin, second line = co-amoxiclav. If penicillin allergy doxycycline/clari/erythromycin if pregnant
132
Treating severe bacterial oral infections
Penicillin and metronidazole
( Typically metronidazole, amoxicillin, phenoxy, macrolides if pen allergy)
https://bnf.nice.org.uk/treatment-summary/oral-bacterial-infections.html
133
Sore throat with complications like tonsilitis treatment
Phenoxymethylpenicillin 5-10 days (clarithromycin/ erythromycin if pen allergy 5 days)
https://bnf.nice.org.uk/treatment-summary/oropharyngeal-infections-antibacterial-therapy.html
134
Treating oropharyngeal viral infections
Benzydamine, chlorhexidine
https://bnf.nice.org.uk/treatment-summary/oropharyngeal-viral-infections.html
135
Oral thrush treatment
Nystatin, miconazole , fluconazole if topical innappropriate (itraconazole if resistant), refer if not workig 1-2 weeks treatment
https://bnf.nice.org.uk/treatment-summary/oropharyngeal-fungal-infections.html
136
Angular cheilitis treatment
Miconazole and fusidic acid or hydrocortisone with miconazole
https://bnf.nice.org.uk/treatment-summary/oropharyngeal-fungal-infections.html
137
Treating tetanus
Metronidazole
138
What is pen V used for
RTI in children, streptococcal tonsilitis
139
Ampicillin main use
Chronic bonchitis and middle ear infections largely due to streptococcus pneumoniae and h. Influenzae
140
Amoxicillin and ampicillin side effect
Maculopapular rashes
141
Clavulanic acid purpose
Inactivates beta lactamases
142
Antipseudomonal penicillins
Piperacillin and ticarcillin (with clavulanic acid)/ Pip Tazobactam
143
Pneumocystis pneumonia treatment - moderate
Co-trimoxazole if not then atovaquone, clindamycin and primaquine combination can also be used or dapsone with trimethoprim
144
Pcp severe treatment
High dose co-trimoxazole then pentamidine
145
Co-trimoxazole components
Sulfamethoxazole and trimethoprim are used in combination (as co-trimoxazole)
146
Preventing PCP
Co-trimoxazole , inhaled pentamidine, dapsone, atovaquone
147
Ciprofloxacin is active against
Gram Negative = salmonella, Shigella, Campylobacter, Neisseria, and Pseudomonas. moderate activity against Gram-positive = Streptococcus pneumoniae and Enterococcus faecalis. Chlamydia , RTI, GI, bone, joint, gonorrhoea, septicaemia
148
Treating Epiglottitis (Haemophilus influenzae)
Cefotaxime/ceftriaxone (chloramphenicol if allergy)
149
Acute bronchiectasis exacerbation
Amoxcillin/clari/doxy, (co-amox/piptaz/levoflox if severe IV)
150
COPD exacerbation treatment first line
Amoxcillin/clari/doxy if unsuccessful use levoflox (co-amox/piptaz/co-trimox if severe iv unable to take oral)
151
First line serious cough treatment
Doxycycline, amox/clari/erythromycin
152
Low severity CAP (community acquired pneumonia) treatment
Amoxicillin/clari/doxy/ery in pregnancy
153
Moderate severity CAP treatment
Amoxicillin, if atypical pathogens suggested , amoxicillin with clari/erythro
/clari/doxy/ery in pregnancy if pen allergy
154
High severity CAP treatment
Co-amoxiclav with clari/erythromycin - levofloxacin used in pen allergy
155
Non severe Hospital Acquired Pneumonia (HAP) tretment
Co-amoxiclav, if pen allergy - doxy,cefalexin, co-trimoxazole, levoflox
156
Severe HAP treatment
Pip/taz, ceftazidime, ceftriaxone, cefuroxime, levofloxacin, meropenem
157
Severe HAP with MRSA additional treatment
Vanc, teic or linezolid
158
Fusidic acid use
Staphylococcal, impetigo
159
Metronidazole skin treatment indications
Rosacea, reduce odour from anaerobic infections
160
Scalp fungal infection name
Tinea capitis
161
Body fungal infection name
Tinea corporis
162
Groin fungal infection name
Tinea cruris
163
Hand fungal infection name
Tinea manuum
164
Foot fungal infection name
Tinea pedis, athletes foot
165
Nail fungal infection name
Tinea unguium
166
Scalp fungal treatment
Systemic , topical in early stages
167
Ringworm treatment
Imidazoles
168
Treating onychomycosis/unguium / nail infection
Amorolfine or tioconazole
169
Pityriasis tinea versicolor treatment
Ketoconazole or selenium shampoo, leave on affected area for 10 minutes then rinse, od 7 days, imidazoles can be used topically but a lot needed, if fails triazole can be used systemically
170
Herpes labialis treatment
Aciclovir
171
Scabies treatment
Permethrin, malathion
172
Head lice treatment
Dimeticone cant use permethriin, shampoo dilutes too much - wet combing
173
Impetigo looks like
Dry crusting yellow, contagious
174
If firstline impetigo treatment fails
Treat with topical antibacterial if local or oral if widespread if fails then micro
175
Impetigo firstline treatment if topical if hydrogen peroxide fails
Fusidic acid or mupirocin
176
Impetigo oral drugs
Fluclox or clar/ery if pen allergy
177
Cellulitis first line
Fluclox or clar/ery if pen allergy
178
Cellulitis if near eyes/nose
Co-amoxiclav - metro/clarithromycin if pen allergy
179
Cellulitis severe treatment
Co-amoxiclav, clindamycin, intravenous cefuroxime, or intravenous ceftriaxone (ambulatory care only
180
Treating leg ulcer non-severe
Fluclox - doxy, clari, erythromycin then stepped by giving co-amoxiclav (co trimox if pen)
181
Treating leg ulcer severe first line
IV fluclox with/without gent and/or metro. Or co-amoxi with/without gent (pen allergy = co-trimox with/without gent and/or metro)
182
Treating leg ulcer severe firstline
IV fluclox with/witout gent and/or metro. Or co-amoxi with/without gent (pen allergy = co-trimox with/without gent and/or metro)
183
Treating leg ulcer severe second line
Pip/taz or IV ceftriaxone with/without metro
184
What is CURB-65
30‑day mortality risk in adults with pneumonia.
185
CURB Points/used for
Confusion, urea>7, resp rate>30,
| low systolic<90/diastolic<60, age>65
186
What point to consider referring to hospital CURB 65
2
187
When to urgently refer to hospital for admission CURB65
3
188
CRB65 risk
0: low risk (less than 1% mortality risk) 1 or
2: intermediate risk (1% to 10% mortality risk) 3 or
4: high risk (more than 10% mortality risk).
189
UTI common cause
E coli
190
Lower UTI symptoms
dysuria, increased urinary frequency, urgency, smelly urine, cloudy urine, blood in urine, Lower abdominal persistant pain
191
Upper UTI symptoms
Loin pain, fever
192
When are UTIs recurrent
2 episodes in 6 months or 3/4 in 12 months
193
Prostatitis symptoms
fever, acute urinary retention or irritative voiding symptoms
194
Non drug UTI treatment
Drink plenty of fluids to avoid dehydration, wiping from front to back after defaecation, not delaying urination, and not wearing occlusive underwear. D-mannose, cranberry or urine alkalinising products may be used as self-care treatment strategies,
195
Lower UTI first line
Nitrofurantoin or trimethoprim
196
Lower UTI second line
No improvement after 48 hours into (if not used first line), fosfomycin, pivmecillinam
197
Pregnant women lower UTI 1st line
Nitro
198
Pregnant women lower UTI 2nd line
Amoxicillin if culture susceptible or cefalexin, consult local micro if not possible
199
Prostatitis first line
Ciprofloxacin, ofloxacin or trimethoprim (if not then use fluoroquinolones)
200
Prostatitis second line
Levofloxacin or co-trimoxazole
201
Prostatitis treatment if sepsis concern
Amikacin, ceftriaxone, cefuroxime, ciprofloxacin, gentamicin, or levofloxacin.
202
Pyelonephritis pregnant treatment
Cefalexin (cefuroxime iv)
203
Pyelonephritis non-pregnant women and men treatment
Cefalexin or cipro (if sensitivity known trimeth/co-amox ( if sepsis concern: Amikacin, ceftriaxone, cefuroxime, ciprofloxacin, gentamicin, or levofloxacin. Possibly co-amox)
204
Pyelonephritis pregnant treatment
Cefalexin (cefuroxime iv)
205
When to refer UTIs
refer or seek specialist advice for men, pregnant women, patients with suspected cancer, those presenting with recurrent upper UTI, and those with recurrent lower UTI with an unknown cause.
206
What to use in prophylactic/ reccurent UTI
First line = trimethoprim/nitro, second line= amoxicillin/ cefalexin
207
Tetracycline uses
Chlamydia, ricketssia, brucella, acne, resp and genital mycoplasma infections , chronic bronchitis exacerbation
208
Initial phase TB drugs
rifampicin, ethambutol hydrochloride, pyrazinamide and isoniazid (with pyridoxine hydrochloride) for 2 months
209
Continuation phase TB drugs
Rifampicin and isoniazid for 4 months (10 months in active TB in CNS)
210
Flucloxacillin main side effect
Hepatotoxicity
211
How should flucloxacillin, amipicillin and phenoxymethylpenicillin be taken
Empty stomach (1 hour before food or 2 hours after food)
212
What antibiotics need to be taken ater food
Nitrofurantoin , metronidazole
213
What are cephalosporins used for
UTI, Pneumonia, meningitis
214
What tetracyclines can’t be taken with milk
DOT, demcycline, oxytetracycline, tetracycline
215
What tetracyclines can be taken with milk
Doxycycline, lymecycline, minocylcline - DLM (does like milk)
216
Key tetracycline side effect/counselling point
Protect skin from sunlight
217
SJS symptoms
Hives, facial swelling, tongue swelling, shading of skin, purple/red rash
218
Sulfonamide side effects
SJS, blood disorders
219
Vancomycin side effects
Ototoxicity and nephrotoxicity
Red man syndrome -
Hypotenstion/anaphylaxis
220
What age can mebendazole be used
Over 2
221
What is used to prevent non-falciparum if no resistance
Chloroquine
222
What is used to prevent non-falciparum
mefloquine/doxycycline
223
Shingles symptoms
Sharp stabbing in one side
224
Measles symptoms
Koplik spots
225
one-hour (‘peak’) serum concentration of gentamicin and trough
5–10 mg/litre; pre-dose (‘trough’) concentration should be less than 2 mg/litre.
226
multiple daily dose regimen in endocarditis, one-hour (‘peak’) and trough of gent
3–5 mg/litre; pre-dose (‘trough’) concentration should be less than 1 mg/litre
227
When to measure gent
measured after 3 or 4 doses, then at least every 3 days and after a dose change (more frequently in renal impairment).
228
Treating meningitis
Benzylpenicillin ASAP then Ceftriazone
229
How long can doxycycline be used as malaria prophylaxis
2 years
230
Most effecting barrier against insects when combating malaria
Mosquito nets impregnated with permethrin
231
How to apply DEET and sunscreen
DEET should be applied after the sunscreen
232
DEET effect on sunscreen
reduces the SPF of sunscreen, so a sunscreen of SPF 30–50 should be applied
233
Whose skin can't DEET be applied to?
Under 2s, can be used on anyone else including breastfeeding (wash hands before handling infants)
234
What class of antibiotics decreases the concentration of valproate
Carbapenems
235
What antibiotics increase statins effects
Erythromycin
236
What antibiotics result in QT prolongation
Macrolides
237
Linezolid contraindications
tyramine-rich foods
238
Vancomycin typical dose
125 QD 10 days for C diff, 15-20mg/kg
239
Vancomycin indications
c diff, skin, joint, bone, pneumonia, endocarditis, meningitis, peritonitis
240
Vancomycin side effects
Ototoxicity, nephrotoxicity, red man, SJS, hypotension, phlebitis
241
Vancomycin dosing strategy
Initial doses should be based on body-weight; subsequent dose adjustments should be based on serum-vancomycin concentrations to achieve targeted therapeutic concentrations
242
What vancomycin concentration is monitored and what is the therapeutic range
Pre-dose (‘trough’) concentration should normally be 10–20 mg/litre depending on the site of infection and the susceptibility of the pathogen; trough concentration of 15–20 mg/litre is usually recommended to cover susceptible pathogens with MIC greater than or equal to 1 mg/litre
243
Tazocin (Piperacillin with tazobactam) indication
HAP, sepsis, complicated UTI/soft tissue/skin infections, Acute exacerbation of COPD, acute exacerbation of bronchiectasis, diabetic foot, leg ulcer infections in neutropenic patients
244
Tazocin(pip/taz) dose
4.5g TDS/QD
245
Unlicensed uses of pip taz
Acute exacerbation of COPD and acute exacerbation of bronchiectasis
246
Tazobactam role
Beta-lactamase inhibitor
247
Piperacillin role
Penicillin
248
Pip/taz side effects
Diarrhoea; hypersensitivity; nausea; skin reactions; thrombocytopenia; vomiting
249
Rifampicin indication
Brucellosis, legionnaires, staph, endocarditis, TB, meningitis, Haemophilus influenzae prevention, meningococcal meningitis prevention
250
Monitoring checks before starting rifampicin
Renal and Liver
251
Rifampicin indications
Brucellosis, legionnaires, staph, endocarditis, TB, meningitis, Haemophilus influenzae prevention, meningococcal meningitis prevention, leucopenia
252
Rifampicin side effects
Nausea, vomiting, thrombocytopenia, GI, bone pain, flu like symptoms, psychosis
253
Rifampicin counselling points/considerations
Hormonal contraceptive effectiveness reduced, discolours (soft) contact lenses, should be told how to recognise liver disorder and seek attention if it occurs, older patients excrete it slower, LFTshould be tested, renal tested, CYP 3A4 inducer, interacts with many drugs
254
Rifampicin contraindications
Acute porphyrias ; jaundice
255
Amphotericin side effects
hypokalaemia, headache, hyponatraemia, hypocalcaemia, hypomagnesaemia, tachycardia, hypotension, dyspnoea, renal impairment , hepatic impairment , skin reactions, vomiting
256
Amphotericin monitoring
Hepatic and renal function tests, blood counts, and plasma electrolyte (including plasma-potassium and magnesium concentration) monitoring required.
257
Amphotericin indication
systemic fungal infections, Visceral leishmaniasis, Aspergillosis, Severe invasive candidiasis
258
Flucytosine indication
Systemic yeast and fungal infections, Cryptococcal meningitis (adjunct to amphotericin B)
259
Flucytosine MHRA announcement
DPD can determine efficacy
260
Flucytosine side effects
Agranulocytosis; aplastic anaemia; blood disorder; cardiotoxicity; confusion; diarrhoea; hallucination; headache; hepatic disorders; leucopenia; nausea; rash; sedation; seizure; thrombocytopenia; toxic epidermal necrolysis; ventricular dysfunction; vertigo; vomiting
261
Fluconazole indication
Candidiasis ,tiniea pedis/cruris/corporis, Invasive candidal infections, pityriasis versicolor, Dermal candidiasis, Vaginal candidiasis, Candidal balanitis, prevention in immunocompromised patients
262
Amphotericin caution
Rapid infusion
263
Fluconazole caution
Susceptibility to QT interval prolongation
264
Fluconazole unlicensed use
Not licensed for tinea infections in children, or for vaginal candidiasis in girls under 16 years, or for prevention of relapse of cryptococcal meningitis after completion of primary therapy in children with AIDS.
265
Fluconazole side effects
Diarrhoea; gastrointestinal discomfort; headache; nausea; skin reactions; vomiting
266
Fluconazole and renal impairment
Usual initial dose then halve subsequent doses if eGFR less than 50 mL/minute/1.73 m2.
267
Caspofungin indication
Invasive aspergillosis, candidiasis, fungal
268
Caspofungin side effects
Arthralgia; diarrhoea; dyspnoea; electrolyte imbalance; fever; headache; hyperhidrosis; nausea; skin reactions; vomiting
