ANTIBIOTCS Flashcards
Cephalosporins:
How are third and fifth gens usually given??
First generation - Cefadroxil,cefalexin and cefradine - Fad fal Fraud
Second generation- Cefuroxime,cefoxitin,cefaclor
Furry fox face
Third and fifth generation are all parenteral apart from oral cefixime
Patients with hypersensitivity to penicillin and other beta lactams should not receive this due to cross sensitivity
Chroamphemicol
- Most commonly used in eye infections
- Avoid in pregnancy - risk of neonatal grey -baby syndrome if used in third trimester
OTC guidance:
Children aged 2 years +
Clindamycin
Associated with antibiotic resistance associated colitis - can be fatal
More common in elderly patients
Discontinue and contact a doctor immediately if every,prolonged or bloody diarrhoea develops
If Clostridium difficile is suspected - DISCONTINUE
-seek specialist advice when the antibiotic cannot be stopped and the patient is experiencing crazy diarrhoea
Linezolid+ monitoring
Important safety information-
Risk of severe optic neuropathy
- Report visual impairment (blurry/altered vision)
- Monitored regularly if treatment more than 28 days
Risk of blood disorders -
Monitor full blood counts weekly
Monitored regularly if treatment more than 10-14 days
Interacts with tyramine-rich foods:
- Mature cheese
- Marmite
- Yeast extract
- Fermented soy bean extract
- Some beer and winter
Serotonin syndrome-
SSRI,Dopaminergics,5-HT1 agonist ,TCAs ,lithium, other MOAIS
ALT Cognitive = COMA
Macrolides DOSES, EXAMPLES, WHAT CAN THEY CAUSE? AND SIDE EFFECTS +. WHICH ARE SAFE IN PREGNANCY
Azithromycin (Once daily),Clarithromycin BD,erythromycin QDS
Given spread out AZITHROMYCIN - FOR COPD Prophylaxis- winter months to vulnerable patients
Cautions: Patients with myasthenias gravis
-Erythromycin preferred in pregnancy over clarithromycin
- Avoid clarithromycin in first trimester of pregnancy
Side effects:
Hepatotoxicity,ototoxicity(hearing loss in large doses),high level of gastrointestinal disturbances(nausea,vomiting,diarrhoea,can cause QT prolongation
Metronidazole:
Side effects:
- Taste disturbances - Metallic taste,furred tongue
Nausea and vomiting - take this medication with or after food
Patients must not drink alcohol whilst on this medication
- Disulfiram like side effects (nausea,vomiting,flushing)
- Avoid in alcohol during and 48 hours after treatment
Nitrofuratoin
Pregnancy - avoid at term
Take with food
Renal impairment - avoid if eGFR less than 45ml/min/1.73
May discolour urine - yellow or brown
Risk if pulmonary and hepatic events with nitrofuratoin - COUGHHHINGGGG
Penicillins- narrowwwwwwwwwwwwwwww given for what usually??? Which are beta lac sensitive?
Narrow spectrum penicillins - beta lactamase sensitive
- Penicillin G benzylpencllin- not gastric acid stable - parenteral use only
- Penicillin V :phenoxymethylpenicillin
Gastric acid - stable - suitable for oral administration
Broad spectrum penicillins - that are beta lactamase sensitive, the ones that are resistant?what is the most common with broad specs? What kind of rash?? Occur in patients with what. When shouldn’t you use broad specs
Broad spectrum penicillins - beta lactamase sensitive =
Ampicillin and amoxicillin
Amoxicillin and Clavulanic acid - co - amoxiclav - beta lactamase resistant
Diarrhoea is most common with broad spectrum penicillins which can cause antibiotic associated colitis
Maculopapular rashes commonly occur in patients with glandular fever - do not use broad spectrum penicillins blindly fro sore throat
Penicllinase-resistant penicillins (flucloxacillin)-
Penicllinase-resistant penicillins (flucloxacillin)-
Take on an empty stomach an hour before food or 2 hours after
- Cholestatic jaundice and hepatitis may occur very rarely,up to two months after treatment with flucloxacillin has been stopped
- Administration for more than 2 weeks and increasing age are risk factors
Antipseudomonal penicillins - available in combo with what?
Antipseudomonal penicillins
-piperacillin - only available in combination with beta - lactamase inhibitor Tazobactam
Tircarcillin only available in combination with beta lactamase clavulanic acid
PENICLLINS SIDE EFFECTS - CANNOOOTT GIVEEE HOWWWWWWWWWWWWWWWWWWWWWWWWWWW Also what is a true allergy you silly billy?
Side effects -
Do not give intrathecally - can cause encephalopathy which can be fatal
Penicillin allergy - rashes and anaphylaxis
True allergy- immediate rash -anaphylaxis
- May be allergic - minor rash,small,not itchy and non confluence or rash after 72 hours
Cross sensivity
Do not give cephalosporins - cross hypersensitivity
Quniolones: Ciprofloxacin,Delafloxacin,Levofloxacin,Moxifloxacin,Ofloxacin -
Drug may cause and should be used in caution in: - lowers seizure threshold - avoided in epilepsy
- Psychiatric disorders-
- Tendon disorders
- Hypersensitivity reactions
- Risk of suicidal thoughts with quinolones
Reduce sunlight and UV radiation exposure and may impair driving ability
Tetracyclines -side efffectssss binnnnnnnnnnn
Doxycycline,demeclocycline,lymecyline,minocycline,oxytetracycline,tetracycline,tigrcycline
Label - do not take milk,indigestion remedies or medicine containing iron, zinc, 2 hours before or after taking this medicine
Can have with milk: Doxycycline,lymecycline,minocycline = DLM
Side effects:
Benign intracranial hypertension- Stop and report on headache and visual disturbance
Lupus -erythematosusu-like syndrome and irreversible pigmentation - highest risk with minocycline
- Teeth discolouration and bone deposit - do not give to children under 12 or prego women
Counselling points - Hepatoxicity - avoid in liver failure
Tetracyclines can cause photosensivity - avoid exposure to sunlight or sun lamps
Tetracyclines can cause dysphasia
- Tablets should be swallowed whole with plenty of fluid - while sitting or standing
Caution in myasthenia gravis
Trimethoprim
What ones it interact with??? Long term can cause what?? Cation in who? When would it be bacteriostatic and when would it be bacterocidal?
May cause blood dyscrasias
- Long term treatment: loo out for sign of blood disorders
- Fever,sore throat,rash,mouth ulcers,bruising or bleeding development
Trimethoprim is an antifolate
- Teratogenic risk in first trimester - avoid in pregnancy
- Interaction with other antifolates - methotrexate and phenytoin
Trimethoprim can also cause hyperkalaemia
Caution in renal impairment
When used alone, trimethoprim is bacteriostatic - but bactericidal when combined with sulphonamides
