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Infection > Anti-Microbials > Flashcards

Anti-Microbials Flashcards

1
Q

Penicillin Ax

A

Benzypen / Pen V
Amoxicillin
Flucloxacillin

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2
Q

What are broader spectrum

A

C-amoxiclav

Piperacillin / tazobactam

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3
Q

How are penicillin excreted so caution

A

Renal

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4
Q

What is BenPen used for

A

Gram +ve streptococci / enterococcus
BenPen = IV only
PenV = oral

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5
Q

What is Amoxicillin used for

A

Gram +Ve streptococci
Slightly broader spec
Covers some coliform and gram -ve resp
Rash if used to treat EPV

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6
Q

What is Flucloxacillin used for

A

Staphlycocci
1st line in SSTI
Risk of cholestasis after a few weeks

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7
Q

What is co-amoxiclav used for

A 
Broad spectrum as B-lactamase inhibitor 
Severe respiratory
Severe soft tissue
Surgical wounds
Contaminated wound
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8
Q

What can it cause

A

C.diff

Cholestasis

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9
Q

What else causes C.diff

A

Clindamycin
Cephalosporins
Ciprofloxacin (Quinolone)

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10
Q

What are Piperacillin / tazobactam used for

A 
Very broad
IV 
Covers pseudomonas 
No cover against MRSA / atyipcal / ESBL 
NEUTROPENIC SEPSSI ONLY
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11
Q

Examples of carbapenem

A

Ertapenem

Meropenem

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12
Q

What do they cover

A

All organisms except atypical / MRSA

Used as last resort in infections

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13
Q

Examples of Cephalopsorin

A

Ceftriaxone
Cefataxime
Come in 5 generations

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14
Q

What do they cover

A

Good action against gram -ve coliforms / resp
Resistance arising
Also covers staph / strep

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15
Q

What are they 1st line in

A

Meningitis

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16
Q

What else

A

Hospital infections e.g. HAP / abdominal sepsis / bacteraemia

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17
Q

What are they a RF for

A

C.diff

MRSA

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18
Q

What does 5th generation cover

A

MRSA but no reason to use

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19
Q

Example of tetracycline

A

Doxycycline

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20
Q

What are SE

A 
Photosensitivity 
Discolouration teeth
Black hairy tongue
Angioedema 
Liver impairment 
CI in children and pregnancy
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21
Q

What is it use for / 1st line

A 
Acute chest and skin infection 
Atypical cover
- Chlamydia = 1st line
- Mycoplasma
- Lyme's
- Q-fever
- Brucellosis
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22
Q

What are anti-folate

A

Trimethoprim

Co-trimoxazole

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23
Q

What should you be careful

A

DO NOT combine with other anti-folate drugs as will cause bone marrow suppression

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24
Q

What is trimethoprim used for

A

Coliforms (E.coli) in UTI

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25
Q

What can it cause

A 
Temporary rise in creatinine
Rash
Photosensitiity 
Pruritus 
Suppression haematopoesis
B12 deficiency
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26
Q

What is co-trimoxazole used for

A

PJP

Toxoplasmosis

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27
Q

What can it cause

A 
SJS / TENS
Bone marrow suppression 
Sulphonamides = aplastic anaemia 
Hyperkalaemia
Headache
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28
Q

What are macrocodes

A

Erythromycin
Clarithromycin
Azithromycin

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29
Q

What are SE of macrolides

A 
Prolong QT
p450 inhibitor so interact with warfarin 
Nausea esp erythromycin 
RENAL
CI with statin use
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30
Q

What are Macrolides useful for

A

Used if gram +ve but patient penicillin allergic

Atypical cover

  • Mycoplasma
  • Pseudomona
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31
Q

Azathromycin

A

Paeds

One daily or stat for chlamydia

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32
Q

What is clindamycin used for

A

Bone

SSTI / gangrene

33
Q

What does it cover

A

Staph
Strep
Anerobes

34
Q

What antibiotics are for gram +Ve cover only (inc MRSA)

A

Glycopeptides

  • Vancomycin
  • Teicoplanin

Linezolid
Daptomycin
Dalbavancin

Sodium fusidate

35
Q

When is Vancomyxin useful

A

MRSA
Mostly IV
But can give oral for C.diff

36
Q

Resistance

A

Virtually unknown

37
Q

What are SE

A

Ototoxcitiy
Nephrotoxicity
Thrombophlebitis
Red man rash

38
Q

Teicoplanin

A

More expensive

Less toxic

39
Q

What is required

A

Regular drug monitoring due to nephrototxicit

40
Q

What has similar spectrum of cover

A

Linezolid
Daptomycin
Dalbavancin - expensive but once weekly

41
Q

What are they used for

A

2nd line for MSSA / MRSA / VRE

42
Q

AE Linezolid

A

Serotonin syndrome if MAOI
Blood neuropathy
Optic neuropathy

43
Q

AE Daptomycin

A

IV only
Interferes with surfactant production so not if chest infection
Used for SSTI

44
Q

`What is sodium fusidate used for

A

Impetigo
Minor SSTI
Can be used topical

45
Q

What can it cause

A

Muscle damage with a statin

46
Q

Gram -ve cover

A

Aminoglycosides

Quinolones

47
Q

Examples of aminoglycoside

A

Gentamicin
Tobramycin
Amikacin

48
Q

What does it cover

A

Gram -ve
MRSA / staph
No atypical

49
Q

When is it used

A

Serious gram -ve
Neutropenic sepsis
Urospesis

50
Q

AE and CI

A

Ototoxicty (balance worse than hearing)
Nephrotoxicity due to ATN
Needs regular monitoring as narrow therapeutic index
- Peak (1 hour after) and trough (before next dose)
CI in myasthenia gravis

51
Q

Tobramycin

A

Used in CF

52
Q

Examples of Quinolones

A

Ciprofloxacin

Levofloxacin - known as respiratory quinolone

53
Q

When is Cipro used

A

Pneumonia if no alternative
Complicated HAP
Complicated UTI

54
Q

What does it cover

A

All Gram -ve inc pseudomona + atypical

Some Staph / strep

55
Q

When is Levofloxacin used

A

Chest infection

UTI

56
Q

What does it cover

A

All Gram -ve + pseudomona + atypical

Better staph / strep cover

57
Q

Why should you avoid quinolone

A 
Due to SE
Prolonged QT
P450 interaction 
Decreased Seizure
Increased tendinopathy
Confusion
Weakness
Depression
CI in G6PD / pregnancy
58
Q

What are Miscellaneous Ax

A

Metronidaole
Nitrofurantoin
Rifampicin
Chloramphenicol

59
Q

What is metronidazole 1st line in

A

Anorobic cover

Often abdominal sepsis

60
Q

What must you avoid

A

Alcohol

Can cause optic neuritis

61
Q

What is nitrofurantoin used for

A

UTI ONLY

62
Q

AE

A

Lung fibrosis
Haemolytic anaemia
Do not use 3rd trimester pregnancy

63
Q

What is Rifampicin used for

A

TB
Staph SSTI with prosthesis
Any metal work

64
Q

AE

A

Hepatic enzyme inducer

Orange tears

65
Q

What is chloramphenicol used for

A

Eye drops

Meningitis if B-lactam allergic (cephalosporin)

66
Q

AE

A

Aplastic anaemia so unlikely to use

67
Q

What can occur with after Rx with benpen

A

Jarisch-Herxiemer reaction

  • Fever, rash + tachy after 1st dose
  • No wheeze or hypo
  • Due to release of bacterial toxins
  • Resolves
68
Q

What Ax react with alcohol

A

Metronidazole

  • Flushing
  • Headache
  • Vomiting
  • Palpitations
69
Q

Common drug reactions with Ax

A 
Anaphylaxis 
Delayed allergic - rash / fever
GI
Candida
Liver impairment
Renal impairment
Neurological
Haematological
70
Q

What rash

A

Erythema nodosum

SJS

71
Q

Common Ax

A

Penicillin
Cephalosporin
Co-trimox

72
Q

What GI

A

N+V+D

C.diff

73
Q

Common thrush

A

Penicillin

Cephalosporin

74
Q

What liver

A

Most drugs
Tetracycline
Rifampicin

75
Q

Renal

A

Gentamicin

Vancomycin

76
Q

Ototoxicity

A

Gentamicin

Vancomycin

77
Q

Peripheral neuropathy

A

Isonzaid

Metronidazole

78
Q

Haematological

A 
Marrow toxicity (anti-folate) 
Aplastic anaemia (chloramphenicol / sulphonamide) 
Penicillin - haemolytic anaemia

Infection (14 decks)

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