Abx Facts To Know Flashcards
Aminoglycoside - Gentamicin monitoring measurement??
Measure Serum Gentamicin conc
After 3 or 4 Doses
Measure 1hr (Peak) after dose and just before next dose (Trough)
Gentamicin multiple dose regimen
Peak serum conc?
5-10mg/L
However Endocarditis
3-5mg/l
Lower because coprescribed with other abx
Gentamicin multiple dose regimen
Trough serum conc?
<2mg/L
However
Endocarditis: <1mg/L
Lower because coprescribed with other abx
If trough Is too high in gentamicin?
Increase dose interval
If peak level is too high in gentamicin?
Increase dose
Gentamicin - Renal impairment
Increase dose interval
Gentamicin - Severe Renal impairment
Reduce dose as well
What is common MHRA warning with aminoglycosides?
OTOTOXICITY
What causes renal impairment which may as a result interact?
METFORMIN
ACE
ARBS
NSAIDS
MAAN Remember
Aminoglycoside contraindications
Myasthenia gravis
Aminoglycoside Pregnancy Avoid why?
Risk of AUDITORY or Vestibular NERVE DAMAGE
What are the 1st gen cephalosporins?
FAD, FAL, FRAD 3 brothers
Cefadroxil, Cefalexin, Cefradine
What are the 2nd gen cephalosporins?
FURRY FOX FACE ( Remember)
Cefuroxime, Cefoxitin, Cefaclor
What are 3rd and 5th gen cephalosporins?
Cefixime- parental
If pt is hypersensitive to penicillin or other beta lactams should they take cephalosporin?
NO
CROSS SENSITIVE
Chloramphenicol pregnancy?
AVOID
In 3rd trimester
RISK OF GREY BABY SYNDROME
risk of neonatal
Clindamycin interactions
And associated Colitis - infected diarrhoea
MORE COMMON IN ELDERLY
Vancomycin how should it be given?
Parenteral
Due to reduced absorption orally
Vancomycin pregnancy?
AVOID unless benefits overweigh risks
Vancomycin trough conc?
15-20mg/litre
Measure hour before
Vancomycin initial dose based on?
Body weight
Glycopeptides Interactions IMPORTANT
OTOTOXICITY
Nephrotoxicity
Glycopeptides side effect?
Cardiogenic shock
Anaphylactic reaction
Red man syndrome
Blood Dyscrasia
Steven Johnson syndrome
CARBS
Why should you not rapid infusion Glycopeptides?
Too quick causes cardiogenic shock
Also can lead to anaphylactoid shock
(Rotate sites)
Linzeloid RISKS
Optic Neuropathy
Monitor regularly over 28days
Blood Disorders
Monitor regularly over 10-14days
Linezolid interactions
Tyramine Rich foods
(Anything fermented)
Similar to MAOI
Can Linezolid lead to any other complications?
Serotonin syndrome
Too much serotonin
Macrolides usual dose
Clarithromycin BD
Erythromycin QDS
Azithromycin OD (tds in copd winter prophylactic)
THINK PACK SIZES
Macrolide cautions
MYASTHENIA GRAVIS
When to avoid clarithromycin
First trimester of pregnancy