Antibiotics

Question 1

statin interaction

Answer 1

clarithromycin

rhabdomyolysis

Question 2

methotrexate interaction

Answer 2

trimethoprim

BM suppression

Question 3

warfarin interaction

Answer 3

clarithromycin
(raises INR)
(increases EFFECT of warfarin)

erythromycin
(enzyme inhibitor)
(↑ INR)
(↑ warfarin effect)

Question 4

steroids interaction

Answer 4

fluroquinolone

achilles tendon rupture

Question 5

metronidazole interaction

Answer 5

alcohol

V & flushing

Question 6

COCP interaction

Answer 6

TB drugs - rifampicin, isoniazid

pregnancy risk

Question 7

what to prescribe for UTI?

Answer 7

nitrofurantoin (avoid in renal dysfunction)

trimethoprim (teratogenic in 1st trimester)

Question 8

what to try and do when prescribing Abx?

Answer 8

write the indication
write a stop/review days
(generally 3 days for IV)

Question 9

Abx for meningitis?

Answer 9

cefotaxime (TAX the meningitis)

Question 10

Abx for neutropenic sepsis (neutrophils <1)?

Answer 10

IV tazocin

Question 11

Tx bacterial meningitis?

Answer 11

ABC, O2
IV fluids, blood cultures
IV 2g cefotaxime (pre-LP if delayed > 1hr)
LP when stable (+/- CT head)
IV dexamethasone (if stiff neck, suspected ↑ICP)
+/- ITU

Question 12

Abx used to treat bone infection with S/E of abx colitis?

Answer 12

clindamycin

Question 13

S/E co-amoxiclav?

Answer 13

cholestatic jaundice can commonly, or very commonly occur, either during or shortly after treatment with co-amoxiclav

risk of acute liver toxicity was about 6 times greater with co-amoxiclav than with amoxicillin

Question 14

Tx of scarlet fever (macular red rash, strawberry tongue, red throat, fever >38.3°C)?
(“secondary case of invasive group A streptococcal infection”)

Answer 14

• phenoxymethylpenicillin 125 mg PO 6-hrly for 10 days
• if has tolerated oral fluid, oral antibiotics
• 10 day course

Question 15

when is gentamicin contraindicated?

Answer 15

Myasthenia gravis (aminoglycosides may impair neuromuscular transmission)