5 Anti-infectives

Question 1

Antibiotic reacting with alcohol?

For how long after treatment?

Answer 1

Metronidazole - 48 hours
disulfaram-like reaction: flushing, a racing heartbeat, dizziness, throbbing headache, shortness of breath, palpitations, nausea and vomiting.

Question 2

What organism usually causes oral fungal infections?

Answer 2

Candida

Thrush = pseudomembrenous candidiasis

Question 3

Pt taking ………………..(3)……… likely to get thrush

Answer 3

Cytotoxics
ICS
Broad spec antibacterials

Question 4

Pt with ……………(3)………… comorbidities likely to get thrush

Answer 4

Reduced immunity (leukemia)
Other malignancies
HIV

Question 5

Avoiding thrush with ICS?

Answer 5

After use:
Rinse out mouth
Brush teath

Question 6

Treatment for ICS thrush

Answer 6

1st: Nystatin
also
Miconazole
Fluconazole

Question 7

When might fluconazole be more suitable than miconazole for oral thrush

Answer 7

Unresponsive
or 
Pt can't use topical due to dry mouth
or
Compromised pt where topical is not enough

Question 8

Treatment dose of nystatin

Answer 8

100 000 units QDS for 7 days (and continuing until 48 hours after lesions have resolved)
after food & hold in mouth for a few mins

Question 9

Why is fluconazole generally preferred to intraconazole

Answer 9

hepatotoxicity

risk of heart failure (MHRA)