ABx - principles of therpay Flashcards
What is a notifiable disease ?
registered medical practitioners must report notifiable disease as can present significant risk to human health as soon as possible. Urgent cases must be reported to the local health protection team by telephone within 24 hours, and all other cases reported using the online notification service within 3 days
name the 34 notifiable diseases
- Anthrax
- Botulism
- Brucellosis
- Cholera
- COVID-19
- Diarrhoea (infectious bloody)
- Diphtheria
- Encephalitis (acute)
- Food poisoning
- Haemolytic uraemic syndrome (HUS)
- Haemorrhagic fever (viral)
- Hepatitis (acute infectious)
- Legionnaires’ disease
- Leprosy
- Malaria
- Measles
- Meningitis (acute)
- Meningococcal septicaemia
- Mpox (monkeypox)
- Mumps
- Paratyphoid fever
- Plague
- Poliomyelitis (acute)
- Rabies
- Rubella
- Severe acute respiratory syndrome (SARS)
- Scarlet fever
- Smallpox
- Streptococcal disease (Group A, invasive)
- Tetanus
- Tuberculosis
- Typhoid fever
- Typhus
- Whooping cough
- Yellow fever
Children ~ abx RULES
~ Tetracyclines contraindicated <12 years
~ Quinolones cause arthropathy = avoid
Elderly ~ abx RULES
~ higher risk of C.diff (Clindamycin = highest risk)
~ Renal/Liver impairment, drug interactions
Renal Impairment ~ Abx needs
~ Nephrotoxic = aminoglycosides, glycopeptide
AVOID
~ Tetracyclines (except minocycline/doxycycline)
~ Nitrofurantoin (eGFR <45)
Hepatic impairment ~ abx RULES
hepatoxic = Rifampicin, Tetracyclines
Cholestatic jaundice =
~ Co-amoxiclav, Flucloxacillin
Pregnancy ~ abx RULES
~ Contra = tetracyclines, Trimethoprim
~ Nitrofurantoin = N, AVOID @term
AVOID
~ MCAT (metronidazole, chloramphenicol, aminoglycosides, tetracyclines
~ Quinolones
~ Sulphonamides
SAFEST = Penicillins/ Cephalosporins
GENERAL RULE OF THUMB for some ABX indications
Staphylococci ~ Flucloxacillin
MRSA ~ Vancomycin
Streptococci ~ Benzylpenillin, Pen V
Anaerobic ~ Metronidazole
Pseudomonas ~ Gentamicin
Clindamycin MOA, spec
inhibits protein synthesis
~ Narrow spec
~ Bacteriostatic
Clindamycin SE
Abx-associated colitis
Linezolid MOA, spec
inhibits protein synthesis
~ ONLY active against gram+ e.g. MRSA, anaerobes
~ Narrow spec
~ Bacteriostatic
~ alternative to vancomycin in MRSA
Linezolid SEs
Blood disorders
Optic neuropathy if >28 day use
report visual symptoms : blurry,
Linezolid interactions
Hypertensive crises
~ SSRIs, TCAs, MAOIs, sympathomimetics, dopaminergic, opioids, 5-HT agonists, Buspirone, Pethidine (raises BP)
~ avoid eating large amounts of tyramine rich food
Trimethoprim MOA, spec
inhibits DNA synthesis
~ Narrow spec
~ Bactericidal
bacteriostatic vs bactericidal
Bactericidal - kill bacteria
Bacteriostatic - suppress growth of bacteria
Trimethoprim SEs
- Anti-folate: teratogenic in 1st trimester
- Blood dyscrasias : long term use (report fever, sore throat, rash, mouth ulcers, bleeding)
- HyPER-kalaemia
Chloramphenicol MOA, spec
inhibits protein synthesis
~ broad-spec
~ bacteriostatic
Chloramphenicol use
RESERVED FOR LIFE-THREATENING INFECTIONS
Chloramphenicol SE
~ blood dyscrasias
~ grey baby syndrome : avoid in pregnant women
