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Oncology > Anti Bacterial Practice Points 🦠 > Flashcards

Anti Bacterial Practice Points 🦠 Flashcards

1
Q

Class of b-lactams

A

Penicillins
Cephalicosporins
Carbapenems

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2
Q

Natural penicillins

  1. Are active against?

And

  1. Indicated for what condition?
A
  1. Against STREPTOCOCCUS
  2. Indicated for: strep throat: pharyngitis, tonsillitis
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3
Q

Natural penicillins

Medication name

A

Phenoxymethylpenicillin

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4
Q

Penicillinase- resistant penicillins:

1
Active against?

  1. Indicated for?
A
  1. Streptococcus and staphylococcus
  2. Cellulitis
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5
Q

Penicillinase resistant penicillins

Name medication

A

Flucloxacillin / dixloxacillin

*Oral or iv

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6
Q

Aminopenicillins:

Active against?

Indicated for?

A
  1. Strep
  2. Few G-ve rods
    (Influenza)

*broken down by B-lactamases

Indicated for = pneumonia

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7
Q

Aminopenicillins

Medication name

A

Amoxicilkin

Ampicillin = iv

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8
Q

Name

B-lactamase Inhibitors

A

Clavulanic acid
Tazobactam

Suicide Inhibitors
+
Increase gram -ve activity

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9
Q

Penicillins and b-lacatamase Inhibitors:

A

Oral/iv amoxicillin + clauvanic acid = doesn’t cover pseudomonas

Iv Ticarcillin + clauvanic acid
Iv Piperacillin + tazobactam
= covers pseudomonas

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10
Q

Cephalosporins:

1st generation
Name?
Coverage?

A

Cefalexin (oral)

Gram +ve (strep and straph) and some Gram -ve (e coli)

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11
Q

Cephalosporins

2nd generation
Names

A

Cefaclor/cefuroxime (oral)

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12
Q

Cephalorsporins

3rd generation

Names
Coverage?

A

Ceftriaxone / cefotaxime (iv)

Covers Gram +ve and Gram -ve

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13
Q

Cephalosporins

4th generation
Name

A

Cefepime

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14
Q

Which part of the B-lactam structure causes ALLERGIES?

A

Due to R1 ring

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15
Q

If allergic to AMOXICILLIN,
what else should be avoided?

A

Avoid

Cefalexin or cefaclor

(1st and 2nd gen cephalosporin)

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16
Q

What can ESBL inactivate?

A

All penicillins and cephalosporins

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17
Q

Name Carbapenems 3

A

Imipenem
Meropenem
Ertapenem

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18
Q

What does Carbapenems cover?

A

Gram +ve, Gram -v and anaerobes

Except MRSA

REVESERVED for bacteria with ESBL

Can use if allergic to penicillins + blactamase inhibitor combo

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19
Q

MRSA is resistant to what?

A

Resistant to all B lactams

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20
Q

MOA of Glycopeptides

A

Inhibit transpeptidase to crosslink peptidoglycan

21
Q

Glycopeptides

Name 2

Coverage

A

Vancomycin (iv, oral)

Tecioplanin (iv)

Covers = G +ve Including MRSA

22
Q

Glycopeptides

ADVERSE EFFECTS

A

-nephrotoxicity
-ototoxicity
-rash with eosinophilia
-Thrombocytopenia, neutropenia

23
Q

What is the Redman syndrome?

A

When infusing VANCOMYCIN too quickly, not an allergic reaction

24
Q

Vancomycin monitoring:

If on for more than 48 hours:

AUC/MIC ratio predicts?

A

Vancomycin efficacy

25
Q

Quinolones

Name 3

A

Norfloxacin
Ciprofloxacin
Moxifloxacin

26
Q

Quinolones

What does
Ciprofloxacin/ norfloxacin cover?

A

Gram -ve + pseudomonas

27
Q

Quinolones

What is norfloxacin ALONE INDICATED FOR

A

Norfloxacin has low serum levels

Used for UTI

28
Q

Quinolones

What does MOXIFLOXACIN cover

A

Gram +ve, Gram -ve, anaerobes, atypicals

Less pseudomonas activity

29
Q

Quinolones

ADVERSE EFFECTS

A

-peripheral neuropathy: tingling, pins and needles

-tendon damage

30
Q

Aminoglycosides

Name 3

A

Amikacin
Gentamicin
Tobramycin (inj)

31
Q

Aminoglycosides

Cover

A

Gram -ve rods

Severe kidney infections

32
Q

Aminoglycosides

adverse reactions

A

Nephrotoxicity = reversible
Ototoxicty

33
Q

Anti folates

Name 2

A

Sulfamethoxazole
Trimethoprim

34
Q

Anti folates

Active against

Indicated for

A

Gram -ve bacteria

Used for UTIs
Concentrates in urine,prostate, vaginal fluid

35
Q

For anaerobic bacteria,

  1. Nitroimidazoles

Name 2

A

Metronidazole
Tinidazole

36
Q

For anaerobic bacteria,

  1. Nitroimidazoles

Are first line for which condition?

A

Necrotising gingivitis

Can add other antimicrobials to get anaerobic cover => for aspiration pneumonia

37
Q

For anaerobic bacteria,

  1. Nitroimidazoles

Important practice point?

A

Avoid alcohol during and 24 hrs after finishing course

38
Q

For anaerobic bacteria,

  1. Lincosamides

Coverage?

A

Gram +v3 (some MRSA) + anaerobes (except c.difficile)

39
Q

Why are LINCOSAMIDES great for allergies?

A

Can give if have
Immediate hypersensitivity reactions to penicillins (superficial cellulitis)

40
Q

Lincosamides

Adverse reaction?

A

C.difficile associated disease!!!

= Causes most severe antibiotics related Dirrhoea! = fatal (spores survive months)

41
Q

What is Clostridium Difficile?

How to treat?

A

Gram +ve anaerobe

Treat = first line:
Metronidazole

If resistant to metronidazole, use Vancomycin orally

42
Q

Macrolides (mycins)

Name 4

A

Azithromycin
Clarithromycin
Erythromycin
Roxithromycin

43
Q

Macrolides

Coverage

A

G +ve and G -ve
Mainly aerobic g +ve

And atypical bacteria (chlamydia)

*can be used in penicillin/,cephlasporin allergies

44
Q

Macrolides

Interactions?

A

Clarithromycin, erythromycin = inhibit CYP3A4

Clarithromycin, erythromycin, azithromycin = inhibit p,gp

Clarithromycin = inhibits OATP 1B1

ALL INCREASE QT INTERVAL.

45
Q

What other effects do MACROLIDES have? Other than antibacterial

A

Immunomodulatory
Anti inflammatory

Used for Diffuse panbronchiolitis and cystic fibrosis

46
Q

Tetracyclines

Name 3

A

Tetracycline
Minocycline
Doxycycline

47
Q

Tetracyclines

Covers

A

Gram +ve and gram -ve
Also atypical bacteria (chlamydia)

48
Q

Tetracyclines

Used to treat ?

A

Pneumonia,

If atypical is suspected

49
Q

Tetracyclines

Councilling points

A
  1. Do not take antacids, Fe, Ca, Zn within 2 hours

= Decreases absorption = Binds to calcium deposits

  1. Take with food
  2. Remain upright after dose 30 mins
    = prevents gastric burns
  3. Best taken in the morning
  4. May increase sensitivity to light
    Use protective clothing and sunscreen

Oncology (15 decks)

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