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PRP2 > Abx Facts To Know > Flashcards

Abx Facts To Know Flashcards

1
Q

Aminoglycoside - Gentamicin monitoring measurement??

A

Measure Serum Gentamicin conc

After 3 or 4 Doses

Measure 1hr (Peak) after dose and just before next dose (Trough)

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2
Q

Gentamicin multiple dose regimen
Peak serum conc?

A

5-10mg/L

However Endocarditis
3-5mg/l

Lower because coprescribed with other abx

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3
Q

Gentamicin multiple dose regimen
Trough serum conc?

A

<2mg/L

However
Endocarditis: <1mg/L

Lower because coprescribed with other abx

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4
Q

If trough Is too high in gentamicin?

A

Increase dose interval

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5
Q

If peak level is too high in gentamicin?

A

Increase dose

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6
Q

Gentamicin - Renal impairment

A

Increase dose interval

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7
Q

Gentamicin - Severe Renal impairment

A

Reduce dose as well

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8
Q

What is common MHRA warning with aminoglycosides?

A

OTOTOXICITY

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9
Q

What causes renal impairment which may as a result interact?

A

METFORMIN
ACE
ARBS
NSAIDS

MAAN Remember

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10
Q

Aminoglycoside contraindications

A

Myasthenia gravis

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11
Q

Aminoglycoside Pregnancy Avoid why?

A

Risk of AUDITORY or Vestibular NERVE DAMAGE

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12
Q

What are the 1st gen cephalosporins?

A

FAD, FAL, FRAD 3 brothers

Cefadroxil, Cefalexin, Cefradine

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13
Q

What are the 2nd gen cephalosporins?

A

FURRY FOX FACE ( Remember)

Cefuroxime, Cefoxitin, Cefaclor

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14
Q

What are 3rd and 5th gen cephalosporins?

A

Cefixime- parental

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15
Q

If pt is hypersensitive to penicillin or other beta lactams should they take cephalosporin?

A

NO

CROSS SENSITIVE

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16
Q

Chloramphenicol pregnancy?

A

AVOID

In 3rd trimester
RISK OF GREY BABY SYNDROME
risk of neonatal

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17
Q

Clindamycin interactions

A

And associated Colitis - infected diarrhoea

MORE COMMON IN ELDERLY

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18
Q

Vancomycin how should it be given?

A

Parenteral

Due to reduced absorption orally

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19
Q

Vancomycin pregnancy?

A

AVOID unless benefits overweigh risks

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20
Q

Vancomycin trough conc?

A

15-20mg/litre

Measure hour before

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21
Q

Vancomycin initial dose based on?

A

Body weight

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22
Q

Glycopeptides Interactions IMPORTANT

A

OTOTOXICITY
Nephrotoxicity

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23
Q

Glycopeptides side effect?

A

Cardiogenic shock

Anaphylactic reaction

Red man syndrome

Blood Dyscrasia

Steven Johnson syndrome

CARBS

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24
Q

Why should you not rapid infusion Glycopeptides?

A

Too quick causes cardiogenic shock

Also can lead to anaphylactoid shock
(Rotate sites)

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25
Q

Linzeloid RISKS

A

Optic Neuropathy
Monitor regularly over 28days

Blood Disorders
Monitor regularly over 10-14days

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26
Q

Linezolid interactions

A

Tyramine Rich foods

(Anything fermented)

Similar to MAOI

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27
Q

Can Linezolid lead to any other complications?

A

Serotonin syndrome

Too much serotonin

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28
Q

Macrolides usual dose

A

Clarithromycin BD

Erythromycin QDS

Azithromycin OD (tds in copd winter prophylactic)

THINK PACK SIZES

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29
Q

Macrolide cautions

A

MYASTHENIA GRAVIS

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30
Q

When to avoid clarithromycin

A

First trimester of pregnancy

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31
Q

Macrolide side effects

A

Hepatotoxicity
Ototoxicity (large dose hearing loss)
GI disturbances
QT Prolongation

HOGQ remember

32
Q

Macrolide interactions with which meds

A

CYP INHIBITORS THEREFORE

  • Statins - increased myopathy risk
  • Warfarin - increased bleeding risk
33
Q

Macrolides cause what electrolyte imbalance?

A

Hypokalaemia

Therefore
Avoid loop/thiazide diuretic, steroids, salbutamol, theophylline

34
Q

Macrolides can cause what other interaction?

A

QT PROLONGATION

Avoid
Amiodarone, Domperidone, fluconazole
Lithium, methadone, ondansetron
Quinine, quinolones
Sotalol, SSRIs

35
Q

Metronidazole Side effects

A

Alcohol - during & 48hrs after
Nausea and vomiting
Taste disturbance

ANT Remember

36
Q

Nitrofurantoin when to avoid

A

AVOID IN PREGNANCY AT TERM

AVOID if egfr less than 45ml/min/1.73

37
Q

Nitrofurantoin other side effects

A

DISCOLOUR URINE YELLOW/brown

38
Q

Nitrofurantoin important MHRA

A

Risk of Pulmonary and hepatic events

39
Q

What are narrow spectrum penicillins?

A

Phenoxymethylpenicillin ( Pen V)

Or Benzylpenicillin (Pen G)
Parenteral only due to unstable gastric acid

40
Q

What are broad spectrum penicillins?

A

Ampicillin
Amoxicillin

Co-Amoxiclav

41
Q

Common issue with broad spectrum penicillins?

A

Diarrhoea - antibiotic associated colitis

42
Q

Why not use broad spectrums for sore throats all the time?

A

Glandular fever pt can have maculopapular rashes appear

43
Q

Fluclox label requirement?

A

Empty stomach or 2 hours after

___Adherence issue

44
Q

Fluclox rare but possible side effects

A

Chloestatic jaundice

Hepatitis

Can occur up to 2 months after stopping treatment

Risk factors of this: increased age or use for more than 2wks

45
Q

What are some antipseduomonal penicillins

A

Piperacillin - combo with Tazobectam

Ticarcillin - combo with clavulanic acid

SERIOUS HOSPITAL PENICILLINS

46
Q

Penicillin can I give intrathecally?

A

NO DO NOT GIVE INTRATHECALLY

can cause encephalopathy

47
Q

What is defined as true allergy to penicillin?

A

Immediate rash

48
Q

Quinolones - Ciprofloxacin, levofloxacin, Moxifloxacin, ofloxacin

They may cause what?

A

Psychiatric Disorders

Lowers seizure threshold

Tendon disorders

Hypersensitivity reaction

PLT-H Remember

49
Q

Quinolones what to counsel?

A

Reduce sunlight and UV RADIATION

MAY IMPAIR DRIVING ABILITY

50
Q

Tendinitis in quinolones?

A

Common over 60yrs

Stop and seek medical attention

51
Q

Qujnlones with abdominal chest back pain

A

Seek medical attention

52
Q

Quinolones shortness of breath, palpitations, oedema

A

Seek medical attention

53
Q

MHRA WARNING W/ Quinolones

A

Suicidal thoughts and behaviour

54
Q

Quinlones cautions

A

QT prolongations

Myasthenia Gravis

Arthropathy in children/youth

Perforated tympanic membrane

Q-MAP Remember

55
Q

Quinolones interactions

A

AVOID DAIRY and mineral fortified drink

QT prolongation drugs

Seizure threshold reduction

56
Q

Tetracycline label

A

No milk, indigestion remedies or zinc/iron meds 2 hours before or after taking this med

57
Q

Which tetracyclines can I take with milk?

A

Doxycycline
Lymecycline
Minocycline

DOES LIKE MILK

58
Q

Which tetracyclines can I take with milk?

A

Doxycycline
Lymecycline
Minocycline

DOES LIKE MILK

59
Q

Tetracycline side effects

A

Benign intercrannial hypertension

Lupus erythematosus (minocycline highest risk)

Teeth discolour and bone deposit
(Avoid children under 12/ pregnant)

BLT Remember

60
Q

Tetracycline counselling points?

A

Dysphagia

Hepatotoxic - Avoid Liver failure

Photosensitivity

Myasthenia Gravis

D-HMP Remember

61
Q

Trimethoprim can cause?

A

Blood Dyscrasia - bruising, bleeding , sore throat, fever, rash

Teratogenic in 1st trimester

Interacts with other antifolates:
Methotrexate and phenytoin

62
Q

What electrolyte imbalance can trimethoprim cause?

A

Hyperkalaemia

63
Q

Trimethoprim caution in?

A

Renal impairment

Pregnancy - 1st trimester

64
Q

Which drugs to avoid with Trimethoprim?

A

Methotrexate

Or

Phenytoin

65
Q

When trimerhoprim used alone?

A

Bacteriostatic

66
Q

When trimethoprim combined with Sulfonamides?

A

Bactericidal

67
Q

Narrow spectrum abx list?

A

Glycopeptides
Penicillin G and V

Trimethoprim
Linezolid
Clindamycin

GP TLC Remember

68
Q

Broad spectrum abx list?

A

Chloramphenicol
Aminoglycoside
Penicillin (amox & amp)
Tetracycline
Nitrofurantoin
Macrolides
Cephalosporins
Quinolones

CAPTN MCQ Remember

69
Q

Which are bacteriostatic abx? (Prevents bacterial growth)

A

Chloramphenicol
Macrolides

Tetracycline
Linezolid
Clindamycin

CM TLC Remember

70
Q

Which are bactericidal abx? (Kills bacteria)

A

Everything else other than CM TLC

71
Q

Empty stomach abx

A

Phenoxymethylpenicillin
Flucloxacillin
Azithromycin
Tetracycline

PFAT Remember

72
Q

With or after food abx

A

Pivmecillinam
Clarithromycin mr
Nitrofurantoin
Metronidazole

PCN - M Remember

73
Q

Hepatotoxic Abx

A

Co-amoxiclav
Macrolides

Flucloxacillin
Rifampacin
Isoniazid
Pyrazinamide

CM FRIP Remember

NOT IFAMBUTOL TB 4th med

74
Q

Nephrotoxic Antibiotic

A

Nitrofurantoin
Aminoglycoside
Glycopeptides

NAG Remember

75
Q

Myasthenia Gravis Abx

A

Quinolones
Macrolides
Aminoglycoside
Tetracycline

Q-MAT Remember

76
Q

4 antibiotics that cause C Difficile?

A

4 C’s!!!!

Clindamycin
Cephalosporins
Co-amoxiclav
Ciprofloxacin

PRP2 (74 decks)

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