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afsha - infections > abx info + random > Flashcards

abx info + random Flashcards

1
Q

Which abx need to be taken with food

A

metro
nitro
clarith MR
pivmecillinam (+full glass water)

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2
Q

which abx need to be taken empty stomach

A

pen V (phenoxy)
fluclox
azith CAPSULES
D (caps) OT

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3
Q

TB abx - specific dosage instructions for isoniazid, rifampicin

A

rifampicin empty stomach (1h before or 2h after food)

isoniazid: 30-60mins before food

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4
Q

pt been prescribed ofloxacin eye drops to treat an eye infection after having a corneal surgery. Which of the following side-effects can occur with these eye drops?
corneal perforation
longer lashes
disclouration around eyes
rhinitis
reduce visual field

A

Ocular administration of ofloxacin can cause corneal perforation, and should be used in caution in people with corneal damage.

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5
Q

A patient has been prescribed a vancomycin infusion to treat a severe hospital acquired pneumonia episode. They will need to be on this infusion for a while and the nurse would like some guidance on how to administer this infusion. Which of the following points would be the least appropriate to advise the nurse?

  • quick infusion can lead to cardiogenic shock
  • quick infusion can lead to histamine reaction known as red man syndrome
  • IV infusion can lead to pain and thrombophlebitis
  • risk of infusion related reactions increases with anaesthetics
  • avoid rotating infusion sites to reduce number of extravasation injuries
A

answer: Changing the sites of infusion regularly can minimise the frequency and severity of thrombophlebitis. Quick infusion can lead to cardiogenic shock (hypotension) and red man’s syndrome. Infusions can also cause pain and thrombophlebitis, where any infusion related event can be exacerbated if given with anaesthetics.

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6
Q

why shouldnt penicillin be given intrathecally

A

Penicillin must not be given intrathecally as this can cause encephalopathy which may be fatal.

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7
Q

1st line for trichomoniasis (symptoms abnormal green discharge, and an unpleasant fishy smell)

A

metronidazole

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8
Q

dental absess treatment
1st line and alt/allergy

A

Dental abscesses are treated with amoxicillin or phenoxymethylpenicillin. If they have a penicillin allergy, metronidazole or a macrolide can be used instead.

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9
Q

the following can exacerbate myasthenia gravis

A

AGs (CI - may impair NM transmissioin)
quinolones
macrolides
tetracyclines

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10
Q

which ones are hepatotoxic

A

macrolides
fluclox
co-amox
tetracyclines
chloramphenicol
nitro
RIP

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11
Q

which ones are nephrotoxic

A

nitro
AGs
glycopeptides
cephalosporins
tetracyclines
trimethoprim

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12
Q

Which 5 are narrow spectrum

A

PGTLC
penicillins: Pen V and pen G
glycopeptides
trimethoprim
linezolid
clindamycin

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13
Q

Which 8 are broad spectrum

A

CAPTN MCQ
chloramphenicol
AGs
penicillins - ampicillin, amox
tetracyclines
nitro
macrolide
cephalosporins
quinolones

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14
Q

83-year-old patient, has been staying in hospital for the last week after a COPD exacerbation and has been diagnosed with a mild pneumonia. Given that the first line treatment is not suitable for this patient, which of the following medications would not be a suitable alternative?

  • clarithromycin
  • cefalexin
  • co trimoxazole
  • doxycyline
  • levofloxacin
A

answer = clarithromycin

rationale:
- the pt has HAP
- 1st line: co amox
- 2nd line options: co trimox, levoflox, cefalexin, doxycyline

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15
Q

State treatment in severe osteomyelitis in patients with penicillin allergy

A

co trimox +/- getamicin and/or metro

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16
Q

Patient needs an abx for otitis externa.
What would you give if it was caused by
a) P. aureginosa
b) Staph aureus

A

A) AG or ciprofloxacin
B) flucloxacillin, penicillin: macrolide

17
Q

An 11-year-old boy has come into the pharmacy with their mother and has been complaining of an earache, fever and restlessness. They have also come in with a prescription from the GP are the doctor has diagnosed the patient to have otitis media. Which of the following medications is most likely to have been prescribed for the 11-year-old boy?

  • doxy
  • clarith
  • amox
  • eryth
  • fluclox
A

Answer = Amoxicillin

– The first line treatment for otitis media in children is amoxicillin. Clarithromycin or erythromycin would be most appropriate in penicillin allergy.

18
Q

A 42-year-old female has been admitted to hospital after experiencing severe diarrhoea which has led them to have extreme dehydration. The patient had a stool sample sent to the labs for testing and results showed that they had a clostridium difficile infection as a result of using antibiotics. Which of the following antibiotics would least likely be associated with antibiotic associated colitis?

  • clindamycin
  • linezolid
  • cefradine
  • ciprofloxacin
  • amoxicillin
A

Answer = linezolid

Antibiotic colitis less commonly seen in narrow spectrum antibiotics, such as linezolid, and more commonly seen with broad spectrum antibiotics. Antibiotics frequently associated with C. difficile infection (CDI) include clindamycin, cephalosporins (especially third and fourth-generation), fluoroquinolones, and broad-spectrum penicillins.

19
Q

A patient has come into the pharmacy with fluid-filled pustules around their mouth spreading down to their chins. The doctor has diagnosed this as impetigo and has prescribed something to help with the blisters. Which of the following is most likely to have been prescribed?
- hydrogen peroxide 1% cream
- fusidic acid
- mupirocin cream
- fluclox
- clarith

A

Fluclox

As this impetigo has presented as fluid-filled pustules and blisters, this would be bullous impetigo. The first line treatment for bullous impetigo is oral antibiotics, with first line being flucloxacillin.

20
Q

A patient has been admitted to hospital with non-alcoholic fatty liver disease after developing jaundice. The pharmacist would like to make a list of medications that they could take in case of an infection as some antibiotics could damage the patient’s liver even further. Which of the following antibiotics is most appropriate to be given to a patient with liver damage?
- fluclox
- clarith
- trimethoprim
- rifampicin
- coamox

A

Answer - trimethoprim

Antibiotics with high risk of hepatotoxicity includes macrolides, flucloxacillin, co-amoxiclav, rifampicin, isoniazid, and pyrazinamide. Chloramphenicol, nitrofurantoin and tetracyclines also should be used in caution in patients with hepatotoxicity.

21
Q

Miss Penny Cillin has been initiated on clarithromycin for a chest infection after having an allergic reaction to amoxicillin. They would like to know which side-effects could be expected with this new medication. Which of the following is least likely to be a side-effect of clarithromycin?
- ototoxicity
- renal toxicity
- hepatotoxicity
- diarrhoea
- vomiting

A

Answer - renal toxicity

As well as causing high levels of gastrointestinal disturbances such as nausea, vomiting and diarrhoea, macrolides cause hepatotoxicity, ototoxicity, and QT interval prolongation.

22
Q

The pharmacist has started their new rotation on the renal ward and wants to make some notes on which medications they should pay close attention to when giving it to patients with reduced renal function. Which of the following antibiotics would be the least cause for concern in patients with renal failure?
- nitro
- metro
- vancomycin
- tobramycin
- trimeth

A

answer = metronidazole

Nitrofurantoin, trimethoprim, aminoglycosides and glycopeptides should be used in caution in patients with renal impairment. Metronidazole has no warnings.

23
Q

A patient has been admitted to hospital with a high fever and malaise. On lab results, the tests showed that the patient’s sputum produced a positive culture for bacterial beta-lactamases and would need to be treated with a penicillin which is resistant to beta-lactamases. Which of the following medications would be most appropriate to prescribe in this situation?
- amox
- ampicillin
- benzylpenicillin
- coamox
- phenoxy

A

Out of the list above, only co-amoxiclav has beta-lactamase resistance meaning that it cannot be broken down by bacterial beta-lactamase. The rest would be broken down.

24
Q

A patient with tuberculosis has been initiated on their treatment of antibiotics, one of which medications is isoniazid. The isoniazid can cause peripheral neuropathy and should be co-administered with a vitamin. Which of the following vitamins should be administered to reduce the risk of peripheral neuropathy?
B1
B2
B6
B9
B12

A

B6 also known as pyridoxine can reduce the risk of peripheral neuropathy in patients taking isoniazid.

25
Q

Mr Hitch Hee has come into the pharmacy with a skin rash which is more present between the webbing of his fingers. The pharmacist has identified this to be scabies and has supplied them with permethrin cream. Which of the following counselling points would be inappropriate to give to the patient?
- avoid sex and close physical contact until treatment course finsihed
- do not send children >5 to school until a week after first dose of treatment
- put all clothing that cant be washed in a sealed bag for 3 days
- wash all bedding and clothes at 60 degrees or higher
- do not share bedding, towels, clothing

A

answer: do not send children >5 to school until a week after first dose of treatment

Adults and children aged 5 years or over can go back to work or school as soon as they have started treatment. It’s important to avoid close contact with other people for the first 24 hours.

26
Q

Mrs Al Prazolam has been initiated on ciprofloxacin for the treatment of chronic suppurative otitis media and would like some extra counselling on the medication. Which of the following counselling points would be most appropriate to give regarding ciprofloxacin?

  • avoid sun and UV
  • driving may be impaired due to build up of microdeposits on cornea
  • continue breast feeding
  • take with food
  • take with iron to increase absorption
A

answer: avoid sun and UV

Ciprofloxacin may cause photosensitivity reactions meaning sunlight and UV radiation should be avoided. Driving can be impaired, but this would be due to neurological affects, and not corneal microdeposits. The patient should not carry on breast-feeding, and iron and food will decrease the rate of absorption.

27
Q

Mrs Sue Cloxacillin has been prescribed clarithromycin for a skin infection as she has a penicillin allergy. The pharmacist refused the supply due to their current medication. Which of the following medications is the only medication which would not interact with clarithromycin?
- atorv
- lithium
- metformin
- salbutamol
- warfarin

A

answer = metformin

Clarithromycin would increase the levels of atorvastatin and warfarin as it is a CYP450 enzyme inhibitor. It may also increase the risk of QT interval prolongation with lithium, and increase the risk of hypokalaemia with salbutamol. No interaction with metformin.

28
Q

three 1st gen and 2nd gen cephalosporins

A

Cefradine, as well as cefadroxil and cefalexin are considered first generation cephalosporins

where cefuroxime, cefoxitin and cefaclor are second generation.

29
Q

true or false - you can never use nitro if egfr less than 45

A

Though nitrofurantoin should be avoided in anyone with an eGFR lower than 45 ml/min/1.73m2, it can be used in caution in patients with an eGFR between 30-44 ml/min/1.73m2.

30
Q

which bacteria most common cause meningitis

A

Streptococcus pneumoniae is the most common causative agent of meningitis.

31
Q

which bacteria most common cause CAP

A

Streptococcus pneumoniae the most common causative agent in community acquired pneumonia.

32
Q

metallic taste common se of

A

metro

33
Q

Pt has been admitted to hospital with suspected bacterial meningitis. What is most appropriate treatment in hospital?

IV benzylpenicillin
IV cefotaxime
oral clarith
IV coamox
IV vancomycin

A

answer is IV cefotaxime

RATIONALE
- benzylpenicillin is only 1st line before transfer to hospital
- once the patient is admitted to hospital, if aetiology is unknown, give cefotaxime (or ceftriaxone)

afsha - infections (57 decks)

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