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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
Linzeloid RISKS
Optic Neuropathy Monitor regularly over 28days Blood Disorders Monitor regularly over 10-14days
26
Linezolid interactions
Tyramine Rich foods (Anything fermented) Similar to MAOI
27
Can Linezolid lead to any other complications?
Serotonin syndrome Too much serotonin
28
Macrolides usual dose
Clarithromycin BD Erythromycin QDS Azithromycin OD (tds in copd winter prophylactic) THINK PACK SIZES
29
Macrolide cautions
MYASTHENIA GRAVIS
30
When to avoid clarithromycin
First trimester of pregnancy
31
Macrolide side effects
Hepatotoxicity Ototoxicity (large dose hearing loss) GI disturbances QT Prolongation ***HOGQ*** remember
32
Macrolide interactions with which meds
CYP INHIBITORS THEREFORE - Statins - increased myopathy risk - Warfarin - increased bleeding risk
33
Macrolides cause what electrolyte imbalance?
Hypokalaemia Therefore Avoid loop/thiazide diuretic, steroids, salbutamol, theophylline
34
Macrolides can cause what other interaction?
QT PROLONGATION Avoid Amiodarone, Domperidone, fluconazole Lithium, methadone, ondansetron Quinine, quinolones Sotalol, SSRIs
35
Metronidazole Side effects
Alcohol - during & 48hrs after Nausea and vomiting Taste disturbance ***ANT*** Remember
36
Nitrofurantoin when to avoid
AVOID IN PREGNANCY AT TERM AVOID if egfr less than 45ml/min/1.73
37
Nitrofurantoin other side effects
DISCOLOUR URINE YELLOW/brown
38
Nitrofurantoin important MHRA
Risk of Pulmonary and hepatic events
39
What are narrow spectrum penicillins?
Phenoxymethylpenicillin ( Pen V) Or Benzylpenicillin (Pen G) **Parenteral only due to unstable gastric acid**
40
What are broad spectrum penicillins?
Ampicillin Amoxicillin Co-Amoxiclav
41
Common issue with broad spectrum penicillins?
Diarrhoea - antibiotic associated colitis
42
Why not use broad spectrums for sore throats all the time?
Glandular fever pt can have maculopapular rashes appear
43
Fluclox label requirement?
Empty stomach or 2 hours after ___Adherence issue
44
Fluclox rare but possible side effects
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
What are some antipseduomonal penicillins
Piperacillin - combo with Tazobectam Ticarcillin - combo with clavulanic acid ***SERIOUS HOSPITAL PENICILLINS***
46
Penicillin can I give intrathecally?
NO DO NOT GIVE INTRATHECALLY can cause encephalopathy
47
What is defined as true allergy to penicillin?
Immediate rash
48
Quinolones - Ciprofloxacin, levofloxacin, Moxifloxacin, ofloxacin They may cause what?
Psychiatric Disorders Lowers seizure threshold Tendon disorders Hypersensitivity reaction ***PLT-H*** Remember
49
Quinolones what to counsel?
Reduce sunlight and UV RADIATION MAY IMPAIR DRIVING ABILITY
50
Tendinitis in quinolones?
Common over 60yrs Stop and seek medical attention
51
Qujnlones with abdominal chest back pain
Seek medical attention
52
Quinolones shortness of breath, palpitations, oedema
Seek medical attention
53
MHRA WARNING W/ Quinolones
Suicidal thoughts and behaviour
54
Quinlones cautions
QT prolongations Myasthenia Gravis Arthropathy in children/youth Perforated tympanic membrane ***Q-MAP*** Remember
55
Quinolones interactions
AVOID DAIRY and mineral fortified drink QT prolongation drugs Seizure threshold reduction
56
Tetracycline label
No milk, indigestion remedies or zinc/iron meds 2 hours before or after taking this med
57
Which tetracyclines can I take with milk?
Doxycycline Lymecycline Minocycline ***DOES LIKE MILK***
58
Which tetracyclines can I take with milk?
Doxycycline Lymecycline Minocycline ***DOES LIKE MILK***
59
Tetracycline side effects
Benign intercrannial hypertension Lupus erythematosus (minocycline highest risk) Teeth discolour and bone deposit (Avoid children under 12/ pregnant) ***BLT*** Remember
60
Tetracycline counselling points?
Dysphagia Hepatotoxic - Avoid Liver failure Photosensitivity Myasthenia Gravis ***D-HMP*** Remember
61
Trimethoprim can cause?
Blood Dyscrasia - bruising, bleeding , sore throat, fever, rash Teratogenic in 1st trimester Interacts with other antifolates: Methotrexate and phenytoin
62
What electrolyte imbalance can trimethoprim cause?
Hyperkalaemia
63
Trimethoprim caution in?
Renal impairment Pregnancy - 1st trimester
64
Which drugs to avoid with Trimethoprim?
Methotrexate Or Phenytoin
65
When trimerhoprim used alone?
Bacteriostatic
66
When trimethoprim combined with Sulfonamides?
Bactericidal
67
Narrow spectrum abx list?
Glycopeptides Penicillin G and V Trimethoprim Linezolid Clindamycin ***GP TLC*** Remember
68
Broad spectrum abx list?
Chloramphenicol Aminoglycoside Penicillin (amox & amp) Tetracycline Nitrofurantoin Macrolides Cephalosporins Quinolones ***CAPTN MCQ*** Remember
69
Which are bacteriostatic abx? (Prevents bacterial growth)
Chloramphenicol Macrolides Tetracycline Linezolid Clindamycin ***CM TLC*** Remember
70
Which are bactericidal abx? (Kills bacteria)
Everything else other than CM TLC
71
Empty stomach abx
Phenoxymethylpenicillin Flucloxacillin Azithromycin Tetracycline ***PFAT*** Remember
72
With or after food abx
Pivmecillinam Clarithromycin mr Nitrofurantoin Metronidazole ***PCN - M*** Remember
73
Hepatotoxic Abx
Co-amoxiclav Macrolides Flucloxacillin Rifampacin Isoniazid Pyrazinamide ***CM FRIP*** Remember NOT IFAMBUTOL TB 4th med
74
Nephrotoxic Antibiotic
Nitrofurantoin Aminoglycoside Glycopeptides ***NAG*** Remember
75
Myasthenia Gravis Abx
Quinolones Macrolides Aminoglycoside Tetracycline ***Q-MAT*** Remember
76
4 antibiotics that cause C Difficile?
4 C’s!!!! Clindamycin Cephalosporins Co-amoxiclav Ciprofloxacin

PRP2 (74 decks)

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