antibiotics

Question 1

What is benzylpenecillin used for

Answer 1

Throat infections, 
Otitis media, 
Cellulitis, 
Pneumonia +/- macrolide
meningococcal infection

Question 2

what should benzypenecillin be used with caution in?

Answer 2

renal impairment

contraindicated if previous allergic reaction

Question 3

What is phenoxymethylpenecillin known as?

Answer 3

Pen V

Question 4

can benpen be given PO?

Answer 4

No, IV/ IM only

Question 5

if a patient has a sore caused by an unknown organism which antibiotic should be avoided?

Answer 5

amoxicillin- might be caused by EBV which will cause a rash if treated with amoxicillin

Question 6

what is tazocin?

Answer 6

piperacillin + tazobactam

Question 7

when is tazocin used?

Answer 7

sever infection where resistance likely (hospital acquired) or a broad spectrum of potential pathogens
or in immunocompromised
LRTI/ UTI/ skin/ intra-abdo sepsis

Question 8

which infection does tazocin increase your risk of?

Answer 8

C diff

Question 9

can tazocin be given orally?

Answer 9

no, IV no oral switch

Question 10

which penicillins are broad spectrum?

Answer 10

amoxicillin

co-amoxiclav

Question 11

what are indications for co-amox/ amoxicillin?

Answer 11

pneumonia where cause could be gram +ve (strep pneumoniae) or gram -ve (HiB)
UTI (trimethoprim/ nitro 1st line)
hospital acquired infection/ intra-abdo sepsis
H. pylori

Question 12

what infection does co-amox increase your risk of?

Answer 12

C diff

Question 13

what are indications for flucloxacillin?

Answer 13

skin infections (+benpen)
osteomyelitis/ Septic arthritis
endocarditis

Question 14

what are indications for cephalosporins?

Answer 14

2nd line for UTI
gonorrhoea
surgical prophylaxis

Question 15

name some cephalosporins

Answer 15

cefalexim

cefotaxime

Question 16

name a carbopenem?

Answer 16

meropenem

Question 17

what are carbopenems used for?

Answer 17

severe or complicated infections

Question 18

what should carbopenems be used cautiously in?

Answer 18

epilepsy, renal impairment

increase risk of C diff

Question 19

what are the indications for trimethoprim?

Answer 19

UTI

co-trimazole (+sulfamethazole) used for pneumocystis pneumonia (in HIV)

Question 20

which antibiotics are contraindicated in pregnancy

Answer 20

trimethoprim (1st semester)

nitrofurantoin (towards term)

Question 21

Which drugs interact with trimethoprim?

Answer 21

other potassium raising drugs; ACEIs ARB, aldosterone agonists
warfarin- increases anticoagulant effect
methotrexate/ phenytoin as increases folate metabolism therefore haematological effects

Question 22

what side effect is it important to warn patients on nitrofurantoin of?

Answer 22

turns urine dark yellow/ brown

rarely can cause pneumonitis/ peripheral neuropathy especially if long term

Question 23

name some macrolides

Answer 23

Clarithromycin, erythromycin, azithromycin

Question 24

indications for macrolides?

Answer 24

respiratory/ skin infections in penecillin allergy
severe pneumonia added to a penecillin- eg legionella/ mycoplasma
eradication of H pylori + amoxicillin and PPI

Question 25

What are adverse effects of macrolides?

Answer 25

cholestatic jaundice
pronlongation of QT
Ototoxicity at high doses

Question 26

which antibiotic is hepatically excreted?

Answer 26

macrolides

Question 27

which drugs interact with macrolides?

Answer 27

macrolides are p450 inhibitors so statins/ warfarin etc

other QT prolonging drugs (antipsychotics, quinine, SSRI)