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Infections November 23 > Infections part 4 Q 150-200 > Flashcards

Infections part 4 Q 150-200 Flashcards

(52 cards)

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1
Q

Q150: Which tetracyclines require sun protection?

A
  • Doxycycline
  • Demeclocycline (label 11)
  • DD(acronym)
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2
Q

Q151: Which tetracyclines can and can’t be taken with milk?

A
  • **With milk: **
  • Doxycycline,
  • Lymcycline,
  • Minocycline
  • ** Without milk:**
  • Demeclocycline, tetracycline, oxytetracycline, etc.
  • ** - Memory trick: remember Dox Likes Milk for tetracyclines that can be taken with milk.**
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3
Q

Q152: What are the main cautions with tetracyclines?

A

Increase muscle weakness in pts with myasthenia gravis

Antacids & Al, Ca, Fe, Mg, and Zn salts decrease absorption of tetracyclines

Milk can reduce absorption of some tetracyclines (DOT)

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4
Q

Q153: What are the main drug interactions with tetracyclines?

A

**- Hepatotoxicity with anything that damages the liver **

Label 7: Do not take milk, indigestion remedies, or medicines containing iron or zinc, 2 hours before or after taking this medicine

Binds to divalent cations: Fe2+, Ca2+, and antacids, preventing absorption of tetracycline

Label 11: Protect your skin from sunlight—even on a bright but cloudy day.
Do not use sunbeds

Especially Demeclocycline and Doxy

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5
Q

Q154: What are the main contraindications for tetracyclines?

A
  • **Pregnancy + breastfeeding
  • Children < 12 years of age (permanently stains teeth)
  • Hepatic impairment**
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6
Q

Q155: What is trimethoprim used for?

A

UTI
Respiratory tract infections

(e.g., chronic bronchitis, pneumonia)

Acute pyelonephritis

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7
Q

Q156: How does trimethoprim work?

A
  • DHFR inhibitor
  • Prevents bacterial replication by inhibiting DNA synthesis
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8
Q

Q157: What are the main contraindications for trimethoprim?

A

-** Blood disorders **
- Avoid in pregnancy (folate antagonist)

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9
Q

Q158: What are the main side effects of trimethoprim?

A

- Diarrhea
- Electrolyte imbalance (HYPERKALEMIA)
- Fungal overgrowth
- Headache
- Nausea
- Skin reactions
- Vomiting
- Blood disorders

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10
Q

Q159: What are the monitoring requirements for trimethoprim, and what advice would you give to patients on long-term therapy?

A

- Monitor FBC on long-term therapy Patient & carer advice:
Recognize signs of blood disorders,
fever,
sore throat
rash,
mouth ulcers,
purpura, bruising, or bleeding.

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11
Q

Q160: What’s the main MHRA/CMH warning regarding linezolid?

A

**- Severe optic neuropathy risk,

  • especially if used for longer than 28 days.
  • Report signs of visual problems immediately to ophthalmology.
  • Blood disorders such as myelosuppression have been reported.**
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12
Q

Q161: What’s the main use of nitrofurantoin?

A

- UTIs (both treatment and prevention)
Genitourinary surgical prophylaxis

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13
Q

Q162: What are the main contraindications for nitrofurantoin?

A

- Acute porphyria
- - G6PD deficiency
- - Infants less than 3 months

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14
Q

Q163: What’s the advice regarding renal function with nitrofurantoin?

A

- Risk of peripheral neuropathy
- AVOID if eGFR < 45 mL/minute/1.73 m2; CAUTION if eGFR 30–44 mL/minute/1.73
- m2 - as a short-course only (3 to 7 days),
- to treat uncomplicated lower UTI caused by suspected
- or proven multidrug-resistant bacteria if benefit > risk.

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15
Q

Q164: What are the monitoring requirements for nitrofurantoin?

A

- On long-term therapy:
-Liver function
Lung function for pulmonary symptoms
(especially in the elderly; discontinue if deterioration)

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16
Q

Q165: What are the time frames for treating UTIs for each patient group of nitrofurantoin and trimethoprim?

A
  • ADD ANSWER (information not provided)
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17
Q

Q166: Which drugs are used for TB and how long are they used for?

A

- Initial phase lasts 2 months
- with RIPE
- (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol)
-
- Continuous phase lasts 4 months with RIISON (Rifampicin and Isoniazid)

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18
Q

Q167: What are the main monitoring requirements for TB drugs?

A
  • **- Renal and hepatic function before treatment
  • All TB drugs except ethambutol are hepatotoxic, so monitor signs of hepatotoxicity
  • Frequent liver checks for patients with pre-existing liver disease + alcohol dependence, especially in the first 2 months
    **
  • Rifampicin can discolor urine and color soft contact lenses red**
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19
Q

Q168: What are the main side effects of ethambutol, and what is done when this happens?

A
  • Ocular toxicity (visual impairment)
  • Early discontinuation of the drug almost always results in recovery of eyesight
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20
Q

Q169: What are the main side effects of isoniazid, and what is given to treat this side effect?

A

**- Liver toxicity: stop if this happens **

-  Gout due to raised uric acid levels: colchicine or high-    dose NSAIDs 
-  Peripheral neuropathy: 
-  oral B6/pyridoxine to prevent, 
- especially in diabetics, alcoholics, 
-  chronic renal failure, 
-  pregnancy, 
-  HIV, 
-  malnourished `individuals`
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21
Q

Q170: What are the main side effects of rifampicin, and when should it be stopped?

Study These Flashcards
A
  • Color urine red, normal with contact lenses **
  • Discontinue if signs of liver toxicity develop
  • Influenza-like symptoms
  • (chills, fever, dizziness, bone pain)
  • Shortness of breath
  • Acute renal failure
  • Discontinue if serious side effects develop**
22
Q

Q171: What are the main side effects of pyrazinamide, and what should be done in this case?

Study These Flashcards
A
  • Main side effects:
  • Gout and hepatotoxicity (raises uric acid levels)
  • Stop pyrazinamide
  • Give acute gout meds such as colchicine or a high dose NSAID
  • Refer to specialist to give alternative antibiotics
23
Q

Q172: What are the main uses of metronidazole?

Study These Flashcards
A

- Trichomonal vaginitis
- Bacterial vaginitis and vaginosis
- C. difficile infections
- Topical metronidazole used to reduce microbial odors in rosacea
- Oral infections (e.g., gingivitis)

24
Q

Q173: What are the main side effects of metronidazole?

Study These Flashcards
A

- Nausea and vomiting
- Taste disturbance
- Anorexia (decreased appetite)

25
Q174: What is the main warning label when dispensing metronidazole?
**- Label 4: Do not drink alcohol, and for as long as possible after the course. - - Label 9: Space doses evenly throughout the day, finish the course. - - Label 21: Take with or just after food. - Label 25: Swallow medicine whole. - Label 27: Take with a full glass of water.**
26
Q175: What are the different classes of antifungals?
**- Triazole - Imidazole - Polyene - Echinocandin - Memory trick: "TIPE"**
27
Q176: Give examples of triazole and imidazole antifungals?
- Memory trick: both classes end in "conazole" - Examples: - Triazoles: Fluconazole, Itraconazole, Voriconazole - Imidazoles: Ketoconazole, Miconazole
28
Q177: What’s the main MHRA advice around amphotericin B?
Liposomal and lipid-complex formulations: Name change to reduce medication errors - Formulations are NOT interchangeable due to different bioavailability
29
Q178: What are the main cautions with amphotericin B?
**- Avoid rapid infusion (risk of arrhythmias) - Close supervision necessary for parenteral use - Anaphylaxis with IV use - Use a test dose before the first infusion in a new course, followed by careful observation. - Infusion-related reactions, prophylactic antipyretics or hydrocortisone can be used for patients who have previously experienced infusion-related reactions**
30
Q179: What are the monitoring requirements with amphotericin B?
- Liver function - Renal function - Blood counts - Plasma electrolytes (potassium and magnesium)
31
Q180: What is special about fluconazole in terms of drug interactions?
**It is an inhibitor Liver toxicity: interacts with anything else that damages the liver, like statins, paracetamol, alcohol, etc. QT prolongation when given together with drugs that prolong QT, e.g., Lithium, macrolides**
32
Q181: What are the main side effects of fluconazole, and when should it be discontinued?
**Main Side effects:** Liver toxicity, diarrhea, nausea, vomiting `Safety Information: `can cause heart failure, so use cautiously in patients with heart conditions `Stop immediately` if any signs of liver toxicity such as abdominal pain, dark urine, jaundice, and itching all over
33
Q182: What age can fluconazole be given OTC, and what’s the max dose?
Sold for vaginal candidiasis + candida balanitis ` Age 16-60 years` Pack size not >150mg → max dose 150mg
34
Q183: What’s the important safety information regarding Itraconazole?
`Reports of heart failure associated with itraconazole` At-risk patients include PT receiving higher daily doses and longer courses, patients with cardiac disease, chronic lung disease, & receiving treatment with calcium channel blockers Avoid in patients with `ventricular dysfunction,` i.e., a history of congestive heart failure
35
Q184: What's the CPMH warning regarding oral ketoconazole?
`Not to be used to treat fungal infections ` Too much liver toxicity compared to other antifungals Patients taking it to treat fungal infections need to be taken back to their GP’s `However, it can be taken orally for Cushing syndrome`
36
Q185: What non-infectious disease can ketoconazole be used for? (Gloria)
Cushing syndrome
37
Q186: What are the 2 main side effects of voriconazole that patients are advised about?
``` - Hepatotoxicity - Phototoxicity ``` Memory trick: all “azole” antifungals are toxic to the liver. V for UV, which means light
38
Q187: What parts of the body do dermatophyte infections affect?
Skin Hair Nail
39
Q188: What are the most common dermatophyte infections seen in practice?
**Tinea pedis (foot) Tinea corporis (body) Tinea capitis (head) Tinea unguium (toes) Tinea cruris (moist areas of the body)**
40
Q189: What are the main features seen in fungal infections?
Clear boundary between healthy skin and the infected part Raised skin Red rash
41
Q190: What is tinea pedis, and what’s used to treat it?
Fungal foot infection Clotrimazole 1% (Canesten) Ketoconazole 2% (Daktarin) Terbinafine 1% (Lamisil) Miconazole 2% (C/I warfarin) Also powder but not as effective as cream
42
Q191: What is tinea corporis, and what’s used to treat it?
Fungal infection, also known as ringworm Main symptoms: ring-like red rash, scaly edges, itching Main treatments: ketoconazole, itraconazole, Terbinafine Memory trick: Ringworm KIT
43
Q192: What is tinea capitis, and what’s used to treat it?
Fungal infection of the scalp Miconazole, clotrimazole, terbinafine
44
Q193: What is tinea unguium, and what’s used to treat it?
Fungal nail infection Systemic treatment more effective than topical Refer to GP if more than 2 nails are infected
45
Q194: What are the main risk factors for getting fungal infections?
Diabetes Immunocompromised (e.g., HIV) Poor circulation (peripheral arterial disease)
46
Q195: What are the main symptoms of measles, and what's used to treat it?
**`Urgent appointment with GP, notifiable disease `** Symptoms: high temperature, runny or blocked nose, sneezing, coughing, red sore watery eyes, **` small white spots in the mouth**` (Koplick spots) Treatments: Paracetamol, Ibuprofen, `avoid` aspirin in children under 16 years
47
Q196: What’s contact dermatitis, and what’s used to treat it?
Eczema/dermatitis after CONTACT with something Treatment: avoid the trigger, emollient creams, steroid creams such as hydrocortisone `**(10 and above) **` or clobetasone (12 and above)
48
Q197: What is oral thrush, and what’s used to treat it?
A white coating on the tongue like cottage cheese, Can’t be rubbed off easily `**Nystatin**`, `**miconazole**`
49
Q198: What’s molluscum contagiosum, and what’s used to treat it?
Viral infection that affects the skin Small, firm, raised papules (spots) with a characteristic small dimple in the middle. Not painful but can be itchy Treatment usually recommended for adults and older children with unsightly spots affecting their quality of life `Potassium hydroxide, ` `podophyllotoxin, ` `imiquimod, ` `benzoyl peroxide, ` `tretinoin`
50
Q199: When do you give topical antifungals vs. oral antifungals?
Topical for mainly skin infections, mild or localized cases + internal infections are wide-spread or topical treatment fails Oral for systemic infections and when topical treatment is contraindicated
51
Q200: What is used to treat threadworms, and what’s the patient advice?
Treatment: Mebendazole Treat all family members regardless of symptoms Repeat treatment if symptoms persist after 2 weeks
52

Infections November 23 (5 decks)

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