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Infections Flashcards

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1
Q

What age are tetracyclines CI under ?

A

12 years

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2
Q

In renal impairment what antibiotics should be avoided?

A
  • Aminoglycosides and Glycopeptides - they are nephrotoxic
  • Avoid tetracyclines except minocycline and doxycycline
  • Avoid nitrofurantoin if eGFR is less than 45
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3
Q

In Hepatic impairment what antibiotics should be avoided?

A
  • Rifampicin and tetracyclines
  • Reduce metronidazole dose if severely impaired
  • Cholestatic jaundice avoid caused by co-amoxi and flucloxacillin
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4
Q

Which antibiotics are not recommended during pregnancy?

A
  • Nitrofurantoin during term i.e. 37 weeks to 42 weeks
  • Diaminopyrimidines i.e. antimalarial drugs and quinolones i.e. “floxacin drugs” should be avoided during pregnancy
  • Trimethoprim should be avoided in the first trimester as its an antifolate
  • AVOID MCAT- metronidazole, Chloramphenicol, Aminoglycosides, Tetracyclines
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5
Q

Community acquired pneumonia which has staphylococci or skin infection or impetigo what is it usually treated with?

A

Flucloxacillin

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6
Q

What is MRSA usually treated with?

A

1st line Vancomycin

2nd line Linezolid

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7
Q

What is Streptococci usually treated with?

A

Benzylpenicillin or Pen V i.e. Phenoxymethylpenicillin

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8
Q

What are anaerobic bacteria usually treated with?

A

Metronidazole

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9
Q

What are pseudomonas aeruginosa usually treated with?

A

Gentamicin

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10
Q

What is caused if chloramphenicol is taken during pregnancy and BF?

A

Grey baby syndrome

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11
Q

Daptomycin is given for gram + bacteria and should be given with other gram - antibiotics if cause is unknown
True or false

A

True

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12
Q

What is fosfomycin used for?

A

Use for persistent uncomplicated lower UTI- 3g one dose

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13
Q

What is fusidic acid mainly used for ?

A
  • Staphylococcal skin infection

- Non-bullous impetigo

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14
Q

What are the warning signs with linezolid?

A
  • Visual impairment usually if treatment is longer than 28 days
  • Blood disorders if treatment longer than 10-14 days
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15
Q

What conditions should be a caution if linezolid is prescribed?

A
  • Bipolar depression
  • Elderly
  • History of seizures
  • Schizophrenia
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16
Q

What is linezolid drug class and what interactions will that have?

A

Reversible monoamine oxidase inhibitor - avoid consuming large amounts of tyramine-rich food —> hypertensive crises

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17
Q

What is trimethoprim commonly used for and what is the dosage?

A

Respiratory tract infection
Prophylaxis of recurrent UTI
Treatment of UTI- 200mg BD

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18
Q

What does co-trimoxazole consist of?

A

Trimethoprim and sulfamethoxazole

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19
Q

What are some trimethoprim SE?

A

Anti-folate i.e. its teratogenic in the first trimester
Blood dyscrasias i.e. fever, sore throat, rash, mouth ulcers, bruising, bleeding
Hyperkalaemia

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20
Q

What class is metronidazole? and what is it used for

A

its a nitroimidazole
Bacterial vaginosis
alternative to penicillin in dental infections
H. pylori eradication

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21
Q

What some side effects of metronidazole?

A 
Furry tongue 
Dry mouth
Nausea
Metallic taste
Vomiting 
GI disturbance
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22
Q

What is the advice given with metronidazole?

A

AVOID alcohol as it causes disulfiram like reaction

Take with or just after food

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23
Q

Which antibiotic commonly used to treat urinary infections should be avoided in the first trimester if the patient suffers from morning sickness ?

A

Nitrofurantoin

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24
Q

What colour does nitrofurantoin change the urine?

A

dark yellow or brown

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25
what action is taken if the peak concentration of a drug is high?
The dose must be decreased
26
When is a peak dose measured?
An hour after the drug has been administered through IV/IM
27
What action if taken if the trough concentration of a drug is high?
The dose intervals should be increased
28
When is a trough dose measured?
Right before the next dose
29
What is gentamicin target concentrations for a single dose treatment?
``` Peak= 5 to 10mg/L Trough= <2mg/L ```
30
What is gentamicin target concentrations for a multiple dose treatment?
``` Peak= 3 to 5mg/L Trough= <2mg/L ```
31
What are the warning signs of gentamicin?
``` Irreversible ototoxicity Nephrotoxicity Nausea and vomiting Antibiotics associated colitis Peripheral neuropathy ```
32
What are gentamicin interactions and what does it result in?
- Nephrotoxicity with ciclosporin, tacrolimus, and vancomycin - Ototoxicity with loop diuretics and vancomycin
33
What are the cautions / warning signs of vancomycin?
``` Thrombophlebitis Red man syndrome Ototoxicity Nephrotoxicity Blood and skin disorders ```
34
What is vancomycin target concentrations?
Trough concentration is 10 to 15mg/L | 15 to 20mg/l for more serious infections
35
What are vancomycin interactions ?
- Nephrotoxicity with ciclosporin, tacrolimus, and gentamicin - Ototoxicity with loop diuretics and gentamicin
36
Why are tetracyclines avoided in under 12, pregnancy and BF?
- Affects skeletal development in first trimester - Discolouration of child teeth in second and third trimester - Maternal hepatoxicity with parenteral administration
37
Which tetracyclines should avoid exposure to sunlight/sunlamps?
DD Demeclocycline Doxycycline
38
Which tetracyclines should avoid antacids as it decreases their absorption?
DOT Demeclocycline Oxytetracycline Tetracycline Take antacids / Milk 2 hrs before or after
39
Which tetracyclines cause oesophageal irritation?
DMT Doxycycline Minocycline Tetracycline Swallow whole with plenty of fluids and stay sat up right for 30 minutes
40
Which antibiotics should be avoided if the patient has a history of seizures?
Quinolones
41
What taken with quinolones can trigger a seizure in patient with history of seizures?
NSAIDs | Theophylline
42
What antibiotics can result in tendon damage?
Quinolones Can cause tendon damage within 48hrs The risk is increased with concurrent use of corticosteroids
43
What are the cautions with quinolones?
- Seizures - Tendon damage - Diabetes - Prolong QT intervals - G6PD deficiency - Psychiatric disorders - DISCONTINUE
44
Else than tetracyclines what other antibiotics should be taken 2hrs before or after zinc based antacids?
Quinolones
45
What class of antibiotics is clindamycin?
Lincosamides
46
What is clindamycin highly associated with?
C. Diff
47
What are some SE of clindamycin?
``` GI disturbances Oesophageal disturbance Jaundice Blood disorders Rash SJS C. DIff ```
48
Which antibiotic if patient presents with diarrhoea you stop immediately?
Clindamycin because its a sign of C. Diff
49
What are the cautions associated with co-trimoxazole?
- asthma - avoid in blood disorders - avoid in infants under 6 weeks risk of kernicterus (brain damage) - in elderly increased risk of serious side effects - G6PD deficiency - good adequate fluid intake - Its teratogenic
50
Which penicillin should be taken with food?
PENICLLIN WITH FOOD | Pivmecillinam
51
Which penicillin should be taken on an empty stomach?
PENICLLIN AFTER FOOD Phenoxymethylpenicillin Ampicillin Flucloxacillin
52
Which penicillin cause cholestatic jaundice?
Flucloxacillin | Co-Amoxiclav
53
What are first generation cephalosproins?
"Look out for cefa" Cefadroxil Cefalexin Cefazolin Cefradine
54
What are second generation cephalsoprins?
"Fox Fur for tanning" Cefoxitin Cefuroxime Cefaclor Cefotetan
55
What are third generation cephalosporins?
"Its a Fix T" Cefixime Cefotazime Ceftazidime Ceftriaxone
56
What are fourth generation cephalosporins?
"Quinoa pie" - Cefquinome - Cefepime - Cefpirome
57
What are the fifth generation cephalosporins?
"look out for ceft + ol" - Ceftobiprole - Ceftaroline used in CAP and complicated skin and soft tissue infections - Ceftolozane
58
What does trimethoprim interact with ?
Methotrexate
59
What does macrolides interact with ?
Statins
60
What does Quinolones interact with ?
Theophylline- increased risk of seizure
61
What does rifampicin interact with ?
combined hormonal contraceptive
62
What is endocarditis usually treated with if its not staphylococci involved?
Amoxicillin + gentamicin for 4 to 6 weeks | Gentamicin is stopped after 2 weeks
63
What is endocarditis usually treated with if its not staphylococci involved? and if the patient is penicillin allergic?
Vancomycin + Gentamicin
64
What is endocarditis usually treated with if its staphylococci involved?
Flucloxacillin + gentamicin + Rifampicin
65
What is acute diverticulitis usually treated with?
Co-amoxiclav + cephalosporin if its complicated
66
C. Diff treatment ?
mild, moderate or severe 1st line- vancomycin 2nd- Fidaxomicin 3rd line - Vancomycin +metronidazole
67
What is sinusitis treated with?
Amoxicillin OR Clarithromycin OR Doxycycline
68
Otitis media treatment?
Only treat if symptoms persist longer than 72 hrs 1st line: Amoxicillin 2nd line: Co-amoxiclav CI: Clarithromycin/ Erythromycin
69
Otitis externa treatment?
1st line: flucloxacillin | CI: one of the Macrolides
70
Treatment for localised non-bullous impetigo?
1st line: hydrogen peroxide 1% cream 2nd line: Fusidic acid 2% cream 3rd line: Mupirocin 2% cream
71
Treatment for widespread non-bullous impetigo?
oral or topical flucloxacillin or macrolide if CI
72
Treatment for bullous impetigo?
Oral flucloxacillin
73
Treatment for cellulitis not involving the eyes?
Oral/ IV flucloxacillin
74
Treatment for cellulitis involving the eyes?
Oral/Iv co-amoxiclav
75
Treatment of animal/ human bites?
1st line: Co-amoxiclav | Penicillin allergy: Doxycycline + metronidazole
76
Which anti TB meds are taken for 2 month and then 4 months?
RIPE for 2 months Rifampicin, Isoniazid, Pyrazinamide, ethambutol RI for 4 months Rifampicin, Isoniazid
77
Why is pyridoxine i.e. vitamin b6 given with isoniazid?
to prevent peripheral neuropathy
78
Which antimalarial should be avoided if a patient has history of psychiatric disorders?
Mefloquine
79
Which antimalarial should be avoided if a patient has renal impairment?
Proguanil, malarone (combo of atovaquone and proguanil hydrochloride) and chloroquine
80
Which antimalarial should be avoided if a patient is pregnant?
Doxycycline, mefloquine, malarone (combo of atovaquone and proguanil hydrochloride )

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