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OD2 (S1&2) > AED - Anti-bacterial Agents II - Week 6 > Flashcards

AED - Anti-bacterial Agents II - Week 6 Flashcards

1
Q

What 8 factors are taken into account when prescribing an antibiotic?

A

Age
Weight
General health status
Mental status
Allergy history
Liver and kidney function
Present medications
Pregnancy status

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2
Q

List the 5 classes of commonly used antibiotics.

A

Penicillins
Cephalosporins
Macrolides
Fluoroquinolones
Tetracyclines

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3
Q

Are penicillins commonly used in eyecare?

A

No, rarely used

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4
Q

Are penicillins bacteriostatic or bactericidal?

A

Bactericidal

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5
Q

Which bacterial species produce penicillinase?

A

Most staphylococcal species

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6
Q

Can penicillins be penicillinase resistant?

A

Yes

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7
Q

What is the dosage for dicloxacillin and why? Must it be taken with meals?

A

It has a short half life, so therefore 250mg q.i.d
Can be taken without regard to meals

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8
Q

What is a classic synthetic penecillin? Give its alternate name as well and describe why it is named so (name the component as well).

A

Amoxycillin
It is combined with a beta lactam inhibitor, potassium clavulanate
This increases its spectrum
It is also known as augmentin

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9
Q

What is the dosage of amoxycillin based on? Give the dosage (4).

A

Based on severity of the condition
Mild - 500mg
Most - 750mg
Severe - 1000mg
Taken b.i.d for 1 week

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10
Q

What are most penicillin side effects limited to?

A

Skin rashes

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11
Q

Up to what percentage are penicillin hypersensitivity reactions reported?

A

20%

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12
Q

Is severe anaphylaxis common with penicillins?

A

Uncommon

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13
Q

Does penicillin alter the normal flora of t respiratory tract?

A

Yes

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14
Q

What are three options if the patient is allergic to penicillins?

A

Cephalosporins
Macrolides
Fluoroquinolones

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15
Q

What is the first choice ophthalmic antibiotic?

A

Cephalosporins

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16
Q

How are cephalosporins related to penicillins?

A

Has a beta lactam ring, but with different amino acids

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17
Q

Give an example of a cephalosporin and the usual dose.

A

Cephalexin
500mg q.i.d for 1 week

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18
Q

What is a consequence of taking cephalosporins and in patients with which disease is it contraindicated?

A

It can kill intestinal bacteria necessary for synthesising vitamin K, which can impair clotting
Contraindicated in haemophiliacs

19
Q

What is the primary adverse reaction to cephalosporins?

A

Hypersensitivity

20
Q

What percentage of individuals allergic to penicillin are also allergic to cephalosporins, if any?

A

5-10%

21
Q

If there is a minor adverse reaction to penicillin, is selection of cephalosporins still common? What about if there is a history of anaphylaxis to penicillins (2)?

A

Minor - selection is common
If there is a history of anaphylaxis, then consider a macrolide or a fluoroquinolone

22
Q

Is fluoroquinolone narrow or broad spectrum?

A

Broad spectrum

23
Q

What is fluoroquinolone reserved for?

A

When there is penicillin allergy

24
Q

Give an example of a fluoroquinolone and the dosage.

A

Ciprofloxacin
500mg q.i.d for a week

25
Q

Are macrolides typically a first-line antibiotic?

A

No

26
Q

List two cases where macrolides are generally used.

A

Chlamydial infections
Pregnancy

27
Q

How do macrolides work? Are they bacteriostatic or bactericidal?

A

Inhibit protein synthesis
Mainly bacteriostatic but can be bactericidal in higher concentrations

28
Q

What properties do macrolides have at low doses?

A

Anti-inflammatory

29
Q

What is the alternative when tetracyclines are contraindicated?

A

Macrolides

30
Q

What antibiotic (name specifically) is commonly used as a second choice and in what population is it a common choice in?

A

Erythromycin
Common choice in pregnancy

31
Q

What is azithromycin good against?

A

Chlamydial infections

32
Q

What is the dose for azithromycin for chlamyia? What about erythromycin and doxycycline?

A

Azthromycin - 1gm p.o single dose
Erythromycin - 500mg q.i.d for a week
Doxycycline - 1000mg b.i.d for 1 to 3 weeks

33
Q

Are the use of tetracyclines common or limited? Explain why.

A

Limited due to resistance

34
Q

What tetracycline is the most effective in ocular disease? Explain why.

A

Doxycycline, it has the fewest potential side effects

35
Q

What does doxycycline decrease the bioactivity of?

A

Major inflammatory cytokines

36
Q

How does doxycycline affect lipid metabolism?

A

Modifies and enhances it

37
Q

How does doxycycline affect the eyelid glands (2)?

A

Alters gland and tear film function

38
Q

How does doxycycline treat surface ocular disease (2)?

A

Inhibits the formation of cytokines
Damages the enzyme MMP

39
Q

What is MMP implicated in?

A

Corneal damage (such as recurrent erosion)

40
Q

In what 4 cases are tetracyclines prescribed?

A

When topical medication is ineffective
Needs repeat topical anti-inflammatory treatment
Severe inflammation of the ocular surface
Significant lid disease

41
Q

List 3 potential side effects of doxycycline. What is it minimised by?

A

GI disturbance (drink with water)
Yeast infections
Photosensitivity
Minimised by a low dose

42
Q

Doxycycline is ineffective when taken by what two other products? Explain why and how long one should wait between taking the two.

A

Ineffective when taken with dairy products or antacids
Calcium chelates the medication
Wait 2 hours between the two

43
Q

In what four cases is doxycycline contraindicated?

A

Children <8 years
Osteoporosis
Pregnant or nursing women
Poor renal function

44
Q

What may doxycycline do to bone and teeth?

A

May discolour teeth and hinder bone development

OD2 (S1&2) (174 decks)

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