Penicillins

Question 1

Common SEs of Amoxicillin

Answer 1

Hypersensitivity- causes rashes, normally 7-10 days after starting treatment

Diarrhoea

Nausea

Vomiting

Question 2

Rare SE associated with amoxicillin

Answer 2

black hairy tongue

Question 3

Interaction with Warfarin

Answer 3

Increases anticoagulation effect- kills gut flora that produce vitamin K

Question 4

Clavulanic acid role

Answer 4

Inactivates beta-lactamases so then active against bacteria resistant to Amoxicillin

Question 5

SEs of Co-amoxiclav

Answer 5

Same as Amoxicillin but can cause acute liver injury but self-limiting

Question 6

Amoxicillin cover

Answer 6

Gram Positive

Question 7

Co-amoxiclav cover

Answer 7

Gram Negative, positive, and anaerobic

Question 8

What condition is flucloxacillin cautioned in?

Answer 8

Liver impairment

Question 9

SEs of flucloxacillin

Answer 9

Same as Co-amoxiclav + hypokalaemia in high doses

Question 10

MHRA warning associated with Flucloxacillin

Answer 10

Risk of cholestatic jaundice- can occur up to 2 months after treatment has stopped

Question 11

Which penicillin is inactivated by gastric acid and must be given IV?

Answer 11

Benzylpenicillin

Question 12

Role of tazobactam in Pip/Taz

Answer 12

Beta-lactamase inhibitor

Question 13

Cover of Piperacillin/Tazobactam

Answer 13

Active against gram positive, negative, and anaerobes

Question 14

What is given alongside pip/taz in Pseudomonas infections to provide a synergistic effect?

Answer 14

Gentamicin

Question 15

Which penicillin can be used in penicillin-resistant staphylococci and why?

Answer 15

Flucloxacillin- as not inactivated by penicillinases produced by the bacterium

Question 16

Flucloxacillin cover

Answer 16

Gram positive

Question 17

Pivmecillinam cover

Answer 17

Gram negative

Question 18

Blood dyscrasia associated with penicillins?

Answer 18

Thrombocytopaenia