Ai Generated Flashcards
What are the main uses of macrolides like Erythromycin?
Respiratory, skin and soft tissue infections; severe pneumonia; eradication of H.pylori
Macrolides serve as alternatives to penicillins.
Which macrolides are CYP inhibitors?
Erythromycin and Clarithromycin
These can affect the metabolism of other drugs.
What is the mechanism of action of macrolides?
Inhibit bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome
This action blocks translocation required for elongation of the polypeptide chain.
What are the common side effects of macrolides?
Nausea, vomiting, abdominal pain, diarrhea, thrombophlebitis, allergy, cholestatic jaundice, QT interval prolongation
High doses can also lead to ototoxicity.
What should be monitored when prescribing macrolides?
Resolution of infection, C-reactive protein, white cell count
These markers help assess the effectiveness of treatment.
What are the main uses of penicillins like Benzylpenicillin?
Streptococcal infections, clostridial infections, meningococcal infections
Also used for skin and soft tissue infections.
What is the mechanism of action of penicillins?
Inhibit PBP responsible for cross-linking peptidoglycans in bacterial cell walls
This weakens the cell wall leading to bacterial lysis and death.
What are the side effects associated with penicillins?
Diarrhea, fever, thrush, skin rash, anaphylaxis, central nervous system toxicity
Anaphylaxis is a life-threatening reaction.
Which penicillin is resistant to penicillinase?
Flucloxacillin
Effective against penicillin-resistant Staphylococcal infections except MRSA.
What is the recommended way to take Amoxicillin?
Can be taken before or after food
It is important to complete the full course of antibiotics.
What are the main uses of cephalosporins?
2nd and 3rd line treatment for urinary and respiratory tract infections
IV cephalosporins are used for severe or complicated infections.
What is the mechanism of action of cephalosporins?
Inhibit PBP responsible for cross-linking peptidoglycans in bacterial cell walls
They have a broad spectrum of action and are more resistant to beta-lactamases.
What are common side effects of cephalosporins?
GI upset, antibiotic-associated colitis, hypersensitivity reactions, CNS toxicity
More common in 2nd and 3rd generation cephalosporins.
What are aminoglycosides primarily used for?
Severe infections caused by gram-negative aerobes, including pseudomonas aeruginosa
They are typically given via parenteral injection.
Which aminoglycoside is often used for cystic fibrosis?
Tobramycin
Administered via inhaler for pseudomonal infection.
What should be avoided in patients with a history of penicillin allergy?
Cephalosporins, especially if there was anaphylaxis
Cross-reactivity can occur between beta-lactam antibiotics.
What is a true penicillin allergy characterized by?
Immediate rash, anaphylaxis, hives
This requires avoidance of all beta-lactam antibiotics.
Fill in the blank: Erythromycin is primarily used for _______.
respiratory, skin, and soft tissue infections
True or False: Macrolides are bactericidal.
False
Macrolides are bacteriostatic, assisting the immune system.
Which drug class is used to treat severe sepsis?
Aminoglycosides
They are effective against gram-negative bacteria.
What is the side effect of cholestatic jaundice associated with?
Amoxicillin, Flucloxacillin
Risk increases with duration of treatment.
What is the primary use of GENTAMICIN?
Active against pseudomonas aeruginosa
Gentamicin is commonly used for infections caused by Pseudomonas aeruginosa.
What is the mechanism of action of aminoglycosides?
Bind irreversibly to bacterial ribosomes 30S subunit and inhibit protein synthesis. They are bactericidal.
What is a key side effect of aminoglycosides?
Nephrotoxicity and ototoxicity
Nephrotoxicity can be reversible, while ototoxicity may lead to irreversible hearing loss.
What is the role of TOBRAMYCIN in cystic fibrosis?
Administered via inhaler for pseudomonal infection.
Which aminoglycoside is reserved for treating tuberculosis?
STREPTOMYCIN.
Fill in the blank: NEOMYCIN is _______.
parenterally toxic; used in bowel sterilization.
What is the significance of monitoring serum aminoglycoside concentrations?
To avoid excessive dosage and prevent toxicity.
True or False: Aminoglycosides are effective against anaerobes.
False.
What are the contraindications for aminoglycosides?
Myasthenia gravis, severe renal impairment, and pregnancy unless necessary.
What should be monitored before starting treatment with aminoglycosides?
Renal function.
What is the main use of METRONIDAZOLE?
Treatment of anaerobic bacteria.
What mechanism does METRONIDAZOLE use to kill bacteria?
Generates a nitroso free radical that binds to DNA, causing degradation and cell death.
List common side effects of METRONIDAZOLE.
- GI upset: nausea, vomiting
- Neurological adverse effects: peripheral neuropathy, seizures
- Taste disturbances.
What is a key drug interaction to be aware of with METRONIDAZOLE?
Alcohol can cause a disulfiram-like reaction.
What is TRIMETHOPRIM primarily used for?
1st choice for uncomplicated urinary tract infections.
What is the mechanism of action of TRIMETHOPRIM?
Inhibits bacterial folate synthesis, making it bacteriostatic.
What are potential side effects of TRIMETHOPRIM?
- GI upset
- Skin rash
- Hyperkalaemia.
What should be monitored during long-term use of TRIMETHOPRIM?
Blood counts.
What is the main use of CHLORAMPHENICOL?
Treatment of superficial eye infections.
What mechanism does CHLORAMPHENICOL use to inhibit bacterial growth?
Binds to the 50S ribosomal subunit and blocks peptidyl transferase activity.
Fill in the blank: RIFAMPICIN is commonly used for _______.
treatment and prevention of tuberculosis.
What side effect is associated with RIFAMPICIN?
Orange-red discoloration of tears and urine.
What should be monitored in patients taking RIFAMPICIN?
Liver function tests and blood counts.
What are common symptoms associated with infections like fever?
Fever, chills, bone pain
These symptoms may indicate various infections that require further investigation.
How does rifampicin affect hormonal contraception?
Effectiveness of hormonal contraception is reduced
Alternative family planning advice should be offered, such as using condoms.
What teratogenic risks are associated with high doses of rifampicin during pregnancy?
Very high doses are teratogenic in the first trimester and risk of neonatal bleeding may be increased in the third trimester.
What is the recommended daily limit of rifampicin for patients with hepatic impairment?
Avoid or do not exceed 8 mg/kg daily.
What precautions should be taken for patients with renal impairment when using rifampicin?
Use with caution if the dose is above 600mg daily.
What drug interactions are known with rifampicin?
Accelerated metabolism reduces concentration of:
* Aminophylline
* Theophylline
* Benzodiazepines
* Bisoprolol
* Chloramphenicol
* Ciclosporin
* Tacrolimus
* Cimetidine
* Clozapine
* Codeine
* Diclofenac
* Diltiazem, verapamil, nifedipine
* Digoxin
* Eplerenone
* Fentanyl, morphine
* Fluconazole
* Haloperidol
* Itraconazole
* Ketoconazole
* Simvastatin
* Terbinafine
* Trimethoprim
* Corticosteroids
* Coumarins
* Oestrogens, progestogens.
What is the primary mechanism of action of vancomycin?
Inhibits growth and cross-linking of peptidoglycan chains inhibiting synthesis of the cell wall of gram-positive bacteria.
What are the side effects of vancomycin?
Side effects include:
* Pain and inflammation of the vein
* Red man syndrome
* Nephrotoxicity
* Ototoxicity
* Blood disorders.
What is a significant caution for using vancomycin in elderly patients?
Dose reduction is necessary due to increased risk of hearing impairment.
What are the main uses of clindamycin?
Most frequently associated with antibiotic-associated colitis, especially in middle-aged, elderly women.
What should patients do if they develop diarrhea while taking clindamycin?
STOP! and see GP.
What is the mechanism of action of antifungals like nystatin?
Bind to ergosterol in fungal cell membranes creating a polar pore which allows intracellular ions to leak out.
What are common side effects of fluconazole?
GI upset, headache, hepatitis, skin rash, life-threatening reactions.
What is an important caution when prescribing fluconazole?
Caution in liver disease due to risk of hepatotoxicity.
What is the primary use of terbinafine?
Treatment of tinea pedis (athlete’s foot), corporis (ringworm), cruris (jock itch).
What is the mechanism of action of terbinafine?
Inhibits the enzyme squalene epoxidase, which inhibits the biosynthesis of ergosterol.
What are the side effects of mebendazole?
Abdominal pain, diarrhea, flatulence, dizziness, rash, hepatitis.
What precautions should be taken when using mebendazole?
Avoid in pregnancy and not suitable for children under 2 years.
What is a critical counseling point for patients taking antifungals like clotrimazole?
If symptoms do not improve within seven days, speak with your doctor.
Fill in the blank: Rifampicin may discolour soft contact lenses, urine and other bodily fluids – don’t _______.
worry
True or False: Ketoconazole should be prescribed orally due to its effectiveness.
False
Ketoconazole shouldn’t be prescribed orally as it can cause severe hepatotoxicity.
What should be monitored in patients receiving high doses of medication?
Blood counts
What is the maximum single dose of Mebendazole for treating enterobiasis in adults and children over 2 years?
100 mg
What is the maximum amount of Mebendazole that can be supplied in a package?
800 mg
What hygiene practice is crucial to prevent re-infection of enterobiasis?
Wash hands and scrub nails after visiting the toilet and before eating
True or False: Mebendazole kills the eggs of the parasite.
False
What is the primary use of Aciclovir?
Herpes simplex infection
For how many days is Aciclovir usually used for Herpes simplex infections?
5 days
What is the mechanism of action of Aciclovir?
Inactivates DNA polymerase and causes chain termination in viral DNA synthesis
What are common side effects of systemic use of Aciclovir?
- Abdominal pain
- Diarrhoea
- Fatigue
- Headache
- Nausea
- Photosensitivity
- Pruritus, rash
In which condition should the frequency and dose of Aciclovir be reduced?
Renal impairment
What should be monitored while using Aciclovir?
Renal function
What are the main uses of Proguanil?
Prophylaxis of malaria
What is the recommended dosage of Proguanil for malaria prophylaxis?
200 mg OD
What is the mechanism of action of Proguanil?
Inhibits dihydrofolate reductase, interfering with folic acid synthesis and DNA replication
What are common side effects of Proguanil?
- Constipation
- Diarrhoea
- Mild gastric intolerance
- Cholestasis
- Hair loss
- Skin reactions
- Mouth ulcers, stomatitis
What should be ensured for pregnant women taking Proguanil?
Adequate folate supplements
What should be monitored when taking Proguanil?
- Renal function
- Symptoms of malaria up to one year after returning
Fill in the blank: Proguanil should be started _______ before entering a malaria endemic area.
one week
What measures should be taken to avoid mosquito bites during malaria prophylaxis?
- Wear long loose fitting clothing
- Use permethrin or DEET insecticide sprays
- Avoid traveling outdoors after sunset
- Use a mosquito net when sleeping outdoors
What should be done if a person falls ill within a year after returning from a malaria endemic area?
Immediately visit the doctor
