Pharmacology Teaching

Question 1

Can Bendroflumethiazide contribute to Gout?

Answer 1

Yes - it reduces urate excretion

Question 2

What drugs are: a) antibacterials b) antifungals c) antivirals

• Pivmecillinam
• Ribavarin
• Amphoteracin
• Rifampicin
• Nitrofurantoin
• Itraconazole
• Amoxicillin
• Fluconazole
• Aciclovir

Answer 2

A) Antibacterials:

• Pivmecillinam
• Rifampicin
• Nitrofurantoin
• Amoxicillin

B) Antifungals

• Amphoteracin
• Itraconaole
• FLuconazole

C) Anti-virals

• Ribavarin
• Aciclovir

Question 3

Is it better to give clarithromycin orally or IV?

Answer 3

Oral - as clarithromycin has same bioavailability whether given IV or by mouth

*oral is cheaper, pt does not need to have cannula inserted, hospital stay etc.

Question 4

Antibiotics that have similar bioavailability both IV and by mouth

Answer 4

• Clarithromycin
• Levofloxacin 99-100%
• Metronidazole 99-100%
• Ciprofloxacin 70-80%
• Linezolid 99-100%
• Rifampicin 99-100%
• Co-trimoxazole 99-100%

Question 5

What’s Linezolid?

• class
• use
• mode of action

Answer 5

Linezolid

It is synthetic antibiotic

Class: Oxazolidinone

Use: treatment of MRSA infections

MoA: inhibition of the initiation of bacterial protein synthesis

Question 6

Start SMART then focus principles

Answer 6

Question 7

What are patient-specific factors to consider while prescribing the antibiotics? (11)

Answer 7

• Weight
• Age
• Renal/hepatic function
• Administration Route and bioavailability
• Contra-indications and cautions
• Pregnancy/breastfeeding
• Interactions
• Side-effects
• Previous antimicrobial use
• Previous microbiology results
• Severity of infection
• Immune system

Question 8

How acute pyelonephritis is treated initially?

How long should the course of antibiotics be?

Answer 8

Intial Rx by broad spectrum Abx -> Injection of either:

• cephalosporin -> e.g. cefuroxime
• quinolone -> if pt is severly ill
• gentamycin

Duration: 10-14 days (longer if complications)

Question 9

Prostatitis

• medications used
• how long is the treatment used for?

Answer 9

Prostatitis - usually difficult to treat

Antibiotics that may be used - the ones that can penetrate prostatic tissue:

• some of the quinolones (ciprofloxacin, ofloxacin)
• trimethoprim

Duration of treatment: 28 days

Question 10

What medication to stop in AKI? (7)

Answer 10

• Angiotensin-converting enzyme inhibitors and angiotensin-II receptor blockers
• Non-steroidal anti-inflammatory drugs
• Cyclo-oxygenase-2 inhibitors
• Metformin
• Contrast media
• Some analgesics (eg, renally cleared opioids)
• Disease-modifying antirheumatic drugs (eg, methotrexate)

Question 11

Medications that require close monitoring, dose adjustment or to temporarily stopped in AKI (7)

Answer 11

• Aminoglycosides
• Anticoagulants
• Anticonvulsants (eg, phenytoin, gabapentin)
• Antivirals (eg, aciclovir, ganciclovir)
• Digoxin
• Immunosuppressants (eg, ciclosporin)
• Hypoglycaemic medicines

Question 12

What type of medication requires dosing by an ideal body weight?

Give an example

Answer 12

Dosing by ideal body weight -> hydrophilic medication

e.g. Gentamicin

*most medication require dosing via actual body weight mg/kg

Question 13

Examples of common medication with narrow therapeutic index (7)

Answer 13

*narrow therapeutic index = toxicity can build up quickly

• Warfarin
• Theophylline
• Phenytoin
• Carbamazepine
• Digoxin
• Lithium
• Clozapine