Antibiotic Flashcards
Monitoring for vancomycin (4)
Full blood count
Renal function
Auditory function
Urinalysis
Advice for vancomycin to patient
Immediately report hearing issues, signs of infection, rash
Therapeutic range of vancomycin
10-20mg/L trough levels
Vancomycin with loop diuretics
Increased risk of ototoxicity
Vancomycin with suxamethonium
Vancomycin enhances the effect of suxamethonium
Vancomycin with ciclosporin, aminoglycosides, polymyxin antifungals
Increased risk of nephrotoxicity and ototoxicity
Why do you look out for rash with vancomycin
Risk of red man syndrome (flushing of upper body)
Which skin disorders are signs of vancomycin toxicity
Rash, necrosis, red man syndrome
Phlebitis
Contraindication if vancomycin use
Previous hearing loss
Which is more likely to cause kidney problems- vancomycin or teicoplanin?
Vancomycin
Can you use vancomycin in pregnancy
Only if benefit outweighs risk
Ensure plasma vancomycin levels are monitored closely
When do you measure vancomycin level
Second day immediately before next dose
Earlier in renal impairment
Which patients should you be more careful with when giving quinolones (4)
Elderly
Kidney disease
Oragan transplant
Those taking corticosteroids
Advise with quinolones
Report tendinitis or tendon rupture, muscle pain or weakness, joint pain and swelling, peripheral neuropathy, CNS effects
Cardiac problems that arise from quinolone use
Small risk of heart valvue regurgitation and aortic aneurysm
Quinolones mental side effects
Memory impairment
Depression
Fatigue
Sleeping disorders
Impairs sight, hearing, taste and smell
Pain relating to quinolone usage
May cause neuropathies
May cause arthalgia
Quinolone interactions of note (5)
Macrolides
Nsaids- increased risk of convulsions
Corticosteroids-increased tendon damage
Warfarin- increases anticoagulation
Iron and calcium salts, Sucrafalate- separate by 2 hours
Gentamycin target therapeutic ranges
5-10 mg/L
3-5 mg/L in endocarditis
Less than 1 for trough
What do you monitor with gentamycin (3)
Renal function
Auditory and vestibular function
Serum concentration to determine dose
In which patients would you want to check serum gentamycin more often (4)
Elderly
Renal impairment
Obesity
Cystic fibrosis
Who when do you measure gentamycin levels
After 3 days of 4 doses, then at least every 3 days & after a dose change
More frequently in renal impairment
Which drugs increase the risk of nephrotoxicity for gentamicin
Ciclosporin tacrolimus vancomycin
Which condition should aminoglycosides be avoided in as it may exacerbate it
Myasthenia gravis
Who is more at risk of irreversible hearing loss with gentamycin
Mitochondrial mutations, those on loop diuretics and vancomycin
Important counselling for gentamicin
Ensure you are adequately hydrated
