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antibiotics Flashcards

1
Q

what is the interaction between trimethoprim + methotrexate

A

increased risk of nephrotoxicity and methotrexates side effects

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2
Q

which antibiotic has high activity against anaerobic bacteria

A

metronidazole

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3
Q

what is the interaction between ciprofloxacin + theophylline

A

Ciprofloxacin interacts with theophylline- increases exposure by altering the rate of metabolism of theophylline.

Moderate interaction -manufacture advises monitor + adjust dose

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4
Q

should phenoxymethylpenicillin be taken with food or without

A

Phenoxymethylpenicillin- take on an empty stomach

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5
Q

what should be avoided 2 hours before/after taking doxycycline

A

indigestion remedies/iron/zinc 2 hours before or after

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6
Q

what are the counselling points for doxycycline

A
  • full glass of water
  • protect skin from sunlight
  • no indigestion remedies/iron/zinc 2 hours before or after
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7
Q

should flucloxacillin be taken with food or without food

A

Flucloxacillin should be taken on an empty stomach

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8
Q

which antibiotic should not be routinely used in children under 12 due to deposition in growing bones + teeth

A

doxycycline

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9
Q

which antibiotic may impair the performance of skilled tasks e.g driving

A

ciprofloxacin

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10
Q

which antibiotic is used for antibiotic-associated colitis (pseudomembranous colitis)

A

vancomycin

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11
Q

which antibiotic class is associated with tendon rupture

A

quinolones e.g ciprofloxacin, ofloxacin, levofloxacin

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12
Q

why should you avoid using Gentamicin in patients with renal impairment

A

because gentamicin is excreted by the kidneys. Renal impairment can cause accumulation- increased risk of nephrotoxicity + ototoxicity

note: if you must use it, reduce or increase the dose according to impairment

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13
Q

what colour can rifamipicin change your urine to

A

urine colour can be change anywhere from:

yellow - reddish/orange - reddish/brown

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14
Q

what colour can nitrofurantoin change your urine to

A

dark yellow to brownish

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15
Q

what symptoms should patients taking Trimethoprim recognise + report

A

seek immediate medical attention if symptoms such as fever, sore throat, rash, mouth ulcers, purpura, bruising or bleeding develop

note: these are signs of blood disorders

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16
Q

which medication interact with quinolones + increase the risk of seizures

quinolones e.g ciprofloxacin, ofloxacin, levofloxacin

A
  • ibuprofen
  • naproxen
  • indometacin
  • theophylline
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17
Q

which antibiotics are most likely to cause a c.difficile infection

A
  • Clindamycin
  • cephalosporins (cefalexin, cefradine, cefadroxil, cefaclor)
  • fluoroquinolones (Ciprofloxacin, Moxifloxacin, Levofloxacin, Ofloxacin)
  • broad-spectrum penicillins
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18
Q

what is the first line treatment for c.difficle

A

first line: vancomycin

second line: Fidaxomicin

19
Q

which antibiotic class is not suitable to children and why

A

tetrayclines: e.g doxycycline, tetracyline, Tigecycline

it causes deposits in growing bone and teeth, by binding to calcium, causes staining and occasionally dental hypoplasia

20
Q

which antibiotic is contraindicated in patients with jaundice or hepatic dysfunction

A

co-amoxiclav

co-amoxiclav can cause jaundice + reduce hepatic function

21
Q

describe the monitoring around vancomycin

A
  • All patients require serum-vancomycin measurement (on the second day of treatment, immediately before the next dose if renal function normal, earlier if renal impairment—consult product literature)
  • The next vancomycin dose should not be withheld whilst awaiting results unless toxicity is suspected
  • Administration rate should not exceed 10mg/min to reduce the risk of red-man’s syndrome.
22
Q

what is the interaction between amoxicillin + methotrexate

A

Amoxicillin is predicted to increase the risk of toxicity when given with methotrexate. Manufacturer advises
monitor.

23
Q

what is the first line treatment for community acquired pneumonia

A

first line= amoxicillin

alternative if penicillin allergic: clarithromycin, doxycycline, or erythromycin (in pregnancy)

note: this is for both low + moderate severity

24
Q

which antibiotic is commonly used as an alternative for penicillin allergy in pregnant/breastfeeding women

A

erythromycin

25
Q

what is the antibiotic regimen for a h-pylori infection

A 
Oral first line for 7 days:
- A proton pump inhibitor (twice daily)
- amoxicillin (1 g twice daily)
and either 
- clarithromycin (500 mg twice daily) or
-  metronidazole (400 mg twice daily)

note: if penicillin allergy: just give PPI + Clarithromycin + Metronidazole

26
Q

what is the interaction between clarithromycin + atorvastatin

A

Clarithromycin increases the exposure to Atorvastatin - severe

27
Q

what is the interaction between clarithromycin + amlodipine

A

Clarithromycin increases the exposure to Amlodipine

28
Q

which food should not be taken with ciprofloxacin

A

avoid dairy products and mineral-fortified drinks with oral ciprofloxacin- reduces exposure of ciprofloxacin

29
Q

which antibiotic is used to treat meningitis

A

Benzylpenicillin

30
Q

what is the treatment for acute sinusitis

A

first line: phenoxymethylpenicillin, if severe or high risk co-amoxiclav

  • if penicillin allergy: doxycycline or clarithromycin (erythromycin in pregnancy)
  • note: acute sinusitis is usually viral + self limiting. antibiotics only used if the patient has had no improvement in symptoms after trying nasal corticosteroids*
31
Q

which antibiotic do you give to a pregnant woman if she has a UTI but is it at term in her pregnancy

A

cefalexin

note: nitrofurantoin is given if pregnant but not at term. nitrofurantoin should avoid at term (36-42 week)—may produce neonatal haemolysis. once the pregnant woman is at term, can only give cefalexin

32
Q

when should you avoid giving nitrofurantoin in pregnant women

A

can give nitrofurantoin in pregnancy but at term (36-42 weeks in pregnancy)

33
Q

which antibiotic is contraindicated in patients with G6PD deficiency

A

nitrofurantoin

note: G6PD is an enzyme that supports the functioning of red blood cells. Individuals with this deficiency are susceptible to haemolytic anaemia

34
Q

which class of antibiotics are potent enzyme inhibitors

A

Macrolides e.g Clarithromycin, erythromycin, azithromycin

35
Q

which antibiotic is used to treat meningitis if the person is allergic to penicillin

A

cefotaxime

note: first line is normally benzylpenicllin

36
Q

can chloramphenicol eye drops containing borax or boric acid buffers be used in children younger than 2 years

A

yes- it is safe to use them

37
Q

which antibiotic can cause ‘neonatal grey-baby syndrome’

A

chloramphenicol

38
Q

why should pregnant women avoid chloramphenicol in the 3rd trimester

A

because it can cause ‘neonatal grey-baby syndrome’

note: this is chloramphenicol drops/ iv + oral use

39
Q

what is the treatment for otitis externa

A

first line: Flucloxacillin

  • penicillin allergy: Clarithromycin (or azithromycin or erythromycin).

If pseudomonas suspected: Ciprofloxacin

40
Q

what is the treatment for otitis media

A

first line: amoxicillin. if worsening: co-amoxiclav

penicillin allergy: clarithromycin or erythromycin

note otitis media can be viral, bacterial or both

41
Q

which antibiotics are used in the “initial blind therapy” of endocarditis

A
  • amoxicillin/ ampicillin + low dose gentamicin

penicillin allergy/sepsis: vancomycin + dose dose gentamicin

note: in endocarditis, gentamicin (‘peak’) serum concentration should be 3–5 mg/litre; pre-dose (‘trough’) concentration should be less than 1 mg/litre

42
Q

which antibiotics should be used for Patients with a human or an animal bite

A

first line: co-amoxiclav

penicillin allergy: doxycycline + metronidazole

43
Q

which tablets, when taken with quinolones, further increase the risk of tendon damage

A
  • the risk of tendon damage is increased by the concomitant use of corticosteroids

quionolones e.g ciprofloxacin, Ofloxacin, Levofloxacin, Moxifloxacin

learning from past papers (21 decks)

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