Other ABs

Question 1

Cefalexin class?

Answer 1

Cephalosporins

Question 2

Indication for cefalexin?

Answer 2

Staph or strep infections where the pt has a mild penicillin allergy
UTI Tx or prophylaxis

Question 3

Cefalexin dose

Answer 3

250mg every 6 hours (up to 4g daily)
- higher doses can be used IV
- 250mg at night for UTI prophylaxis

Question 4

Cefalexin MOA?

Answer 4

Same as penicillins

Question 5

Dose reduction for cefalexin?

Answer 5

If CrCl is below 10

Question 6

Precaution with administering cefalexin IV?

Answer 6

Slow infusion to avoid neurotoxicity - could cause confusion, seizures, etc

Question 7

Name a macrolide

Answer 7

Clarithromycin

Question 8

Clarithromycin indications?

Answer 8

Helicobacter pylori eradication, LRTIs, used in penicillin / cephalosporin allergies

Question 9

Clarithromycin dose?

Answer 9

250-500mg bd, up to 1g bd

Question 10

Clarithromycin is effective against haemophilus influenziae and which other organisms?

Answer 10

Staph, strep, mycoplasma pneumoniae

Question 11

ADRs of clarithromycin

Answer 11

Taste disturbances, nausea, diarrhoea, abdominal pain, Prolonged QT interval

Question 12

Dose reduction in clarithromycin?

Answer 12

If CrCl is below 30

Question 13

Counselling point for clarithromycin?

Answer 13

Interactions are common. Advice HPs that you are taking it before taking anything new

Question 14

Metronidazole dose?

Answer 14

200 - 400mg every 8-12 hours.
Max = 4g daily

Question 15

Metronidazole spectrum?

Answer 15

Anaerobic bacteria

Question 16

Metronidazole ADRs?

Answer 16

N/V/D, metallic taste, CNS effects (dizziness, headache)

Question 17

Reduce dose of metronidazole when?

Answer 17

Hepatic impairment

Question 18

Ciprofloxacin class?

Answer 18

Quinolone

Question 19

Ciprofloxacin indications?

Answer 19

Complicated UTIs, typhoid fever, prophylaxis for travellers

Question 20

Is pseudomonas aeruginosa sensitive to ciprofloxacin?

Answer 20

Yes

Question 21

Ciprofloxacin dose?

Answer 21

250-500mg bd. Max = 1.5g daily

Question 22

ADRs associated with ciprofloxacin?

Answer 22

Itchy skin, pain at injection site, N/V/D, headache, tingling

Question 23

Ciprofloxacin needs its dosed reduced in hepatic impairment. True or false?

Answer 23

False. In renal impairment.

Moa of drug= topoisomerase inhibitor

Question 24

Doxycycline dose?

Answer 24

100mg once or twice daily

Question 25

Indications for doxycycline?

Answer 25

Acne, CAP, malaria prophylaxis

Question 26

ADRs of doxycycline aside from nausea, vomiting and diarrhoea?

Answer 26

Tooth discolouration and photosensitivity

Question 27

Counselling points for doxycycline?

Answer 27

Take in the morning with food, avoid antacids and metal supplements within 2 hours

Question 28

Which ribosomal subunit does doxycycline bind to?

Answer 28

30S

Question 29

Name an infection that pseudomonas aeruginosa could cause?

Answer 29

Hospital acquired pneumonia, CF exacerbations

Question 30

Clarithromycin spectrum?

Answer 30

Broad - covers a range of G positive and negative Step, staph, haemophillus influenzas (-) + mycoplasma pneumoniae

Question 31

Example of anaerobic bacteria?

Answer 31

Clostridium difficle

Question 32

Ciprofloxacin spectrum?

Answer 32

G positive (few), negative (most), and mycoplasma bacteria

Question 33

First line for s. Aureus?

Answer 33

Flucloxacillin if mild, vancomycin if severe or if MRSA

Question 34

Alternative for c. Diff if metronidazole is not effective

Answer 34

Vancomycin oral

Question 35

First line Tx for mild / moderate clostridium difficile infection?

Answer 35

Metronidazole (IV or oral) If severe, oral vancomycin is used (IV is not effective)

Question 36

First line Tx for chlamydia?

Answer 36

Doxycycline 100mg bd for 7 days

Question 37

First line Tx for bacterial vaginosis and trichomonas vaginalis?

Answer 37

Metronidazole (400mg for 7 days) Or 2g stat dose (less effective but better compliance) Trichomonas vaginalis is protozoal STI

Question 38

Empirical Tx of uncomplicated UTIs?

Answer 38

Trimethoprim 300mg for 3 days (7 days if male) Other option = nitrofurantoin 100mg q6h for 5 days

Question 39

Dose for first line uncomplicated UTI tx?

Answer 39

Women= 300mg Nocte for 3 days Men = 300mg nocte for 7 days

Question 40

UTI prophylaxis dose?

Answer 40

150mg nocte

Question 41

Trimethoprim spectrum?

Answer 41

Narrow. Gram negative - e.g. escherichia coli

Question 42

ADRs unique to trimethoprim? Aside from nausea and vomiting

Answer 42

Hyperkalaemia, anaemia, thrombocytopenia

Question 43

Dose reduction in trimethoprim?

Answer 43

If CrCl is below 30. Avoid if below 10. Also avoid in pregnancy (especially the first trimester)

Question 44

Dose of trimethoprim - sulfamethoxazole?

Answer 44

1:5 ratio Mild = 80 / 400 Severe = 160 / 800 (resprim forte)

Question 45

Monitoring required while on trimethoprim?

Answer 45

If on prolonged or high dose Tx, monitor folate synthesis and blood count If more than 3 days, monitor potassium