Antibiotics Flashcards
Gram -ve, +ve Broad spectrum Narrow spectrum
Broad spectrum
Ampicillin Amoxicillin and Co-amoxiclav Chloramphenicol Clindamycin Aminoglycosides Quinolone Tetracyclines Cephalosporins Carbapenems
Narrow spectrum
Vancomycin Teicoplanin Penicillin G (Benzylpenicillin) Metronidazole Penicillin V (Phenoxymethylpenicillin) Macrolides: Erythromycin Azithromycin Clarithromycin
Vancomycin Therapeutic Drug Monitoring
Therapeutic trough (minimum) levels: 10-20mg/L Measure serum concentration just before 2nd dose
Vancomycin shall only be administered as slow intravenous infusion of at least 1 HOUR duration or at a MAXIMUM RATE of 10 mg/min (whichever is longer) which is sufficiently diluted.
Label 23- Take on empty stomach
DROPFAT Rifampicin (label 22: take 30-60mins before food) Oxytetracycline Penicillin V (phenoxymethylpenicillin) Flucloxacillin Ampicillin Tetracycline
Label 21- Take with or just after food
Metronidazole
Nitrofurantoin
Label 6- can take with milk
Do Love Milk
Doxycycline
Lymecycline
Minocycline
Label 7- cannot take with milk
No milk OTC
Oxytetracycline
Tetracycline
Ciprofloxacin
Flucloxacillin CSM warnings & advice
Cholestatic jaundice and hepatitis.
Administration for more than 2 weeks and increasing age are risk factors. Healthcare professionals are reminded that:
- should not be used in patients with a history of hepatic dysfunction associated with flucloxacillin
- use with caution in patients with hepatic impairment
- careful enquiry should be made about hypersensitivity reactions to beta-lactam antibacterials
Co-amoxiclav caution
Cholestatic (obstructed bile flow in the liver) jaundice. Acute liver toxicity - risk 6 times greater with co-amoxiclav than with amoxicillin.
Jaundice is usually self-limiting.
More common in over 65yo males
Linezolid CSM warning & advice
Optic neuropathy & blood disorder
Severe optic neuropathy may occur rarely, particularly if linezolid is used for longer than 28 days. The CHM recommends that:
patients should be warned to report symptoms of visual impairment (including blurred vision, visual field defect, changes in visual acuity and colour vision) immediately;
patients experiencing new visual symptoms (regardless of treatment duration) should be evaluated promptly, and referred to an ophthalmologist if necessary;
visual function should be monitored regularly if treatment is required for longer than 28 days.
Haematopoietic disorders (including thrombocytopenia, anaemia, leucopenia, and pancytopenia) have been reported in patients receiving linezolid. It is recommended that full blood counts are monitored weekly. Close monitoring is recommended in patients who:
-receive treatment for more than 10–14 days;
have pre-existing myelosuppression;
-are receiving drugs that may have adverse effects on haemoglobin, blood counts, or platelet function;
have severe renal impairment.
If significant myelosuppression occurs, treatment should be stopped unless it is considered essential, in which case intensive monitoring of blood counts and appropriate management should be implemented.
Co-trimoxazole CSM warnings & advice
blood dyscrasias & stevens Johnson syndrome
DISCONTINUE immediately if blood disorders (including leucopenia, thrombocytopenia, megaloblastic anaemia, eosinophilia) or rash (including Stevens-Johnson syndrome or toxic epidermal necrolysis) develop.
Quinolones CSM warnings & advice
Arthropathy in children
Tendonitis- co-prescription with prednisolone increases the risk
Increased risk of convulsions when used with NSAIDs
Amphotericin B CSM warnings & advice
Anaphylaxis with IV
Itraconazole CSM warnings & advice
risk of Heart Failure
Following reports of heart failure, caution is advised when prescribing itraconazole to patients at high risk of heart failure. Those at risk include:
patients receiving high doses and longer treatment courses;
older adults and those with cardiac disease;
patients with chronic lung disease (including chronic obstructive pulmonary disease) associated with pulmonary hypertension;
patients receiving treatment with negative inotropic drugs, e.g. calcium channel blockers.
Itraconazole should be avoided in patients with ventricular dysfunction or a history of heart failure unless the infection is serious.
Ketoconazole CSM warnings & advice
Fatal hepatoxicity
