Infections Q3 Flashcards
(81 cards)
1
Q
Aminoglycosides: MOA
A
- irreversibly binds to 30s ribosome
- Inhibits protein synthesis
2
Q
Aminoglycosides: SE
A
- OTO/NEPHRO
- AAC
- NV
- Electrolyte disturbance
- Peripheral neuropathy
3
Q
Aminoglycosides: CI
A
- MG
- Pregnancy
- Obese
4
Q
Aminoglycosides: Pregnancy
A
- avoid unless essential
- 2/3rd = auditory/ vestibular nerve damage
- Greater risk with strepto and less with gen and tobra
5
Q
Aminoglycosides: dose
A
- OD
- multiple daily dose - monitor
- Must not exceed 7 days
6
Q
Gentamicin: therapeutic range
A
PEAK: 5-10 (3-5)
TROUGH: < 2 (<1)
7
Q
Aminoglycosides: monitoring
A
- Renal
- Auditory/ vestibular
- Cp: renal imp, high doses, obesity, CF
8
Q
Increased risk of nephrotoxicity with aminoglycosides
A
- Ciclosporin/ tacrolimus
- Vancomycin
- NSAIDs
- ACEi
- Methotrexate/ sulfasalazine
- Trimethoprim
9
Q
Increased risk of ototoxicity with aminoglycosides
A
- Loop
- Cisplatin
- Vinca
- Vanco
- Macrolides (clarithromycin, erythromycin, azithromycin)
10
Q
GROUP 1 CEPH
A
CEFAlexin
CEFAzolin
CEFRADoxil
CEFRADine
11
Q
GROUP 2 CEPH
A
Cefuroxime
Cefoxitin
Cefaclor
12
Q
GROUP 3 CEPH
A
CefixIME
CefotaxIME
CeftazidIME
CeftriaxONE
13
Q
Cephalosporins: SE
A
- AAC
- Hypersensitivity (cross sensitivity w penicillins)
14
Q
Cephalosporins: Interactions
A
Nephrotoxic drugs
15
Q
Chloramphenicol: Interactions
A
- SU: hypo
16
Q
Chloramphenicol: Pregnancy
A
AVOID
- IV/PO = risk of grey baby syndrome in 3rd trimester
17
Q
Chloramphenicol: BF
A
AVOID
- bone marrow toxicity in infant
- Conc in milk is insufficient to cause grey baby syndrome
18
Q
Clindamycin: drug class
A
Lincosamide
19
Q
Clindamycin: MOA
A
bacteriostatic
- 50s subunit of bacterial ribosome to inhibit early stages of protein synthesis
20
Q
Clindamycin: active against
A
- Gram + aerobes
- Anaerobic
21
Q
Clindamycin: SE
A
- AAC
- GI
- Oesophageal disorders/ taste disturbance
- Jaundice
- Blood disorder
22
Q
Clindamycin: CI
A
Exhisting diarrhoea
23
Q
Clindamycin: Monitor
A
- liver
- renal
if treatment > 10 days
24
Q
Glycopeptides: examples
A
Vancomycin
Teicoplanin
25
Glycopeptides: Activity
Narrow spectrum
Bacteriocidal
Gram + (anaerobic/ aerobic)
MRSA
26
Glycopeptides: SE
- NEPHRO/OTO
- Skin disorders: SJS, red man, toxic epidermal necrosis
- Blood dyscrasias
- Thrombophlebitis
- Risk of anaphylactoid reaction at site
27
Glycopeptides: CI
- history of deafness
- Pregnancy
28
Glycopeptides: Interactions
- Oto/nephro toxic drug
- Suxamethonium- enhances effect of suxa
29
Glycopeptides: Trough levels
10-15
15-20 (endo)
30
Glycopeptides: Monitor
- K
- FBC
- Renal
- Hepatic
- Auditory function in elderly
- Urinanalysis
| Nephrotox = low urine, high serum creatinine
31
Glycopeptides: pregnancy
Avoid
Bf- low presence, and absorption insignificant
32
Linezolid: MOA
selectively inhibits bacterial protein synthesis
33
Linezolid: Activity
- GRAM +
- MRSA
- Vanco-resistant enterococci
34
Linezolid: SE
- DNV
- Headache
- Blood disorders
- Taste disturbances
- Severe optic neuropathy
35
Linezolid: MHRA
Risk of severe optic neuropathy
- Report visual impairment
- Monitor regularly if > 28 days treatment
36
Linezolid: Interactions
- SS
- tyramine rich foods
- MAOi - do not give within 2 weeks of stopping
37
Linezolid: Monitoring
FBC weekly
- severe renal
- Myelosuppression
- >10-14 days
- Drugs which affect Hb, platelet
38
Macrolides: MOA
- Binds to ribosomes of susceptible microorganisms
- Inhibits protein synthesis
- Bacteriostatic
39
Macrolides: administration - counselling
- with or after food
- Erythromycin = empty stomach
40
Macrolides: SE
- Hepato/ototoxicity
- GI SE
- QT
41
Macrolides: CI
- MG
- Pregnancy
- Hypokalaemia - QT
42
Macrolides: Interactions
- QT drugs
- Hepa/oto drugs
- CYP enzyme inhibitor = increase the levels of CYP enzyme substrates: warfarin, statins
43
Clarithromycin + solifenacin =
increased exposure of solifenacin. 5mg OD max recommended dose
44
Metronidazole: MOA
- pro drug
- Active form binds to DNA
- Disrupts helical structure
- Prevents nucleus acid synthesis = cell death
45
Metronidazole: Activity
- Anaerobic
- Protozoa - giardiasis, vaginal trichimoniasis
46
Metronidazole: SE
- GI
- Metallic taste/ furred tongue
- Oral mucositis
- Anorexia
47
Metronidazole: counselling
- WITH food
- No alcohol
48
Metronidazole: pregnancy
AVOID
49
Metronidazole: Alcohol
AVOID
DLR
48hrs
50
Nitrofurantoin: MOA
bacteriocidal activity in the urinary tract
51
Nitrofurantoin: SE
- Pulmonary reactions - long term monitor lung function
- Hypersensitivity
- N+V
- Blood disorders
- PN
52
Nitrofurantoin: Interactions
- PN = PAIM
Phenytoin
Amiodarone
Isoniazid
Metro
53
Nitrofurantoin: CI
- pregnancy at term
- <45
- Acute porphyrias
- G6PD def
- Pulmonary disease
| 37-42 weeks
54
Nitrofurantoin: Counselling
- WITH food
- Urine - brown/yellow this is harmless
55
Penicillins: MOA
- inhibit bacterial cell wall synthesis
- Inhibit peptidoglycan cross linking
56
Penicillins: SE
- HS
- Anaphylaxis
- Allergy
- Diarrhoea
- Flu: hep
57
Penicillins: narrow spectrum
PEN V/G
58
Penicillins: broad spectrum
- amoxicillin/ ampicillin
- Co-amo = beta lactamase resistant
59
Penicillins: counselling
WITHOUT food = pen v, flu, amp
Doesn’t matter = amoxicillin
60
Quinolones: MOA
Inhibits Topoisomerase - enzyme involved in DNA replication
61
Quinolones: SE
- tendinitis (48h, more common in 60+)
- GI
- QT (esp moxi)
- Psychiatric reactions
- Convulsions
- Hypersensitivity/rash
62
Quinolones: CI
- QT
- Children and adolescent - aropathy
- Pregnancy
- Epilepsy, diabetes, psychiatric disorder
63
Quinolones: Interactions
- NSAIDs = convulsions
- Theophylline + ciprofloxacin = increased risk of seizures
- QT drugs
- Alcohol
- Avoid dairy and mineral fortified drinks (reduces absorption)
64
Quinolones: Counselling
- protect from sunlight
- Impairs skilled tasks- Avoid alcohol
- Antacids 2hrs
- Avoid dairy and mineral fortified drinks
65
Quinolones: MHRA
Risk of heart valve regurgitation
- Consider other therapeutic options
- Report: SOB, peripheral oedema, heart palps
Risk of aneurysm
- FMHx
- Report: abdo, chest, back pain
66
Tetracyclines: MOA
- inhibits protein synthesis- 30s
67
Tetracyclines: SE
- DNV - AAC
- Dysphasia, oesophageal irritation
- Blood disorder
- Hypersensitivity/ photosensitivity (avoid DD)
- Teeth and bones
- LELS (mino)
- Benign intracranial hypertension
68
Tetracyclines: oesophageal irritation
- Doxy caps
- Tetra tabs
- Mino tabs/ caps = swallowed whole with plenty of fluid while standing or sitting
69
Tetracyclines: CI
- hepatic renal
- Myasthenia gravis
- Photosensitivity
- Pregnancy and breastfeeding
- Under 12
70
Tetracyclines: Renal
Avoid all
Except doxy and mino
71
Tetracyclines: Liver
Avoid or caution
72
Tetracyclines: Can have with milk
- Doxy
- Lymecycline
- Minocycline
73
Tetracyclines: cannot have with milk
DOT
- Demeoclocycline
- Oxytetracycline
- Tetracycline
Calcium, milk etc reduces absorption
74
What gap is required between doxycycline and the typhoid vaccine?
3 days
75
76
Trimethoprim: MOA
Binds irreversibly and inhibits DHFR and blocks production of THF
77
Trimethoprim: Activity
- Gram +
- Aerobic gram -
78
Trimethoprim: SE
- HyperK, HypoNa
- Allergic reaction, anaphylaxis
- Photosensitivity
- Aseptic meningitis
- GI
79
Trimethoprim: CI
- renal
- Pregnancy
80
Trimethoprim: Interactions
1. Nephrotoxic drugs: NSAIDs, tacrolimus, ciclosporin
2. HyperK
3. HypoNa
4. MOA: methotrexate - bone marrow suppression
81
Trimethoprim: Pregnancy
Avoid
Teratogenic
