Antibiotics administration/counselling/ side effects Flashcards by Temi Ogunseye

What are the s/e associated with Clindamycin

Antibiotic-associated colitis
Most frequently with clindamycin – can be fatal
Most common in middle-aged, elderly women, especially after operations.

How well did you know this?

Not at all

Perfectly

What is one of the counselling points for Clindamycin

If pt experiences diarrhoea it must be stopped immediately and they should see a GP. Could be a sign of Pseudomembranous colitis which refers to swelling or inflammation of the large intestine (colon) due to an overgrowth of (C difficile) bacteria

How well did you know this?

Not at all

Perfectly

What are the pt counselling points associated with Linezolid

report visual symptoms: blurred vision, visual field defects and changes in visual acuity and colour vision.
Report any signs of bruising or bleeding

How well did you know this?

Not at all

Perfectly

what are the s/e associated with Linezolid

Blood disorders: leukopenia and thrombocytopenia

Optic neuropathy if >28 days use

How well did you know this?

Not at all

Perfectly

What are the contra-indications and interactions associated with Linezolid

It is a maoi so pt can go into a hypertensive crisis if they consume Tyramine rich foods such as cheese, soya beans or given at the same time as other drugs that increase blood pressure e.g SSRI, Other MAOI (wait two weeks before giving another), sympathomimetics, TCA, Opioids, dopaminergic drugs, 5HT1 agonists, buspirone and pethidine.

How well did you know this?

Not at all

Perfectly

When should Linezolid be stopped

If bone suppression occurs

How well did you know this?

Not at all

Perfectly

How are aminoglycosides administered and why

parenteral injection because it is not absorbed by the gut

How well did you know this?

Not at all

Perfectly

what is the typical dose for trimethoprim

200mg BD

How well did you know this?

Not at all

Perfectly

S/e for trimethoprim

anti-folate: teratogenic in 1st trimester
blood dyscrasias
hyperkalaemia

How well did you know this?

Not at all

Perfectly

does trimethoprim cause hyper or hypokaleamia

hyperkalaemia

How well did you know this?

Not at all

Perfectly

counselling points for trimethoprim

report fever, sore throat, rash, mouth ulcers, purpura, bruising and bleeding

How well did you know this?

Not at all

Perfectly

why should chloramphenicol be avoided in pregnancy

grey baby syndrome if used in the third trimester

How well did you know this?

Not at all

Perfectly

Why is chloramphenicol reserved for life-threatening infections when given systemically

causes blood dyscrasias- a lot of haematological s/e

How well did you know this?

Not at all

Perfectly

common s/e associated with metronidazole

GI, disturbances, taste disturbances, oral mucositis, furred tongue

How well did you know this?

Not at all

Perfectly

pt counselling associated with metronidazole

take with or after food
avoid alcohol due to to disulfiram like reactions: flushing of face, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulties and anxiety
avoid for 48 hours
Darkens urine

How well did you know this?

Not at all

Perfectly

what the side effects associated with nitrofurantoin

nausea, risk of peripheral neuropathy in renal impairment

How well did you know this?

Not at all

Perfectly

pt counselling assocaited with nitrofurantoin

take with or after food

colours urine yellow or brown

How well did you know this?

Not at all

Perfectly

what age is nitrofurantoin contra-indicated in

3 months and under

How well did you know this?

Not at all

Perfectly

At which point in pregnancy should nitrofurantoin be avoided and why

term due to it causing neonatal haemolysis

How well did you know this?

Not at all

Perfectly

should vancomycin be used in preganancy

avoid unless essential

must monitor serum conc

How well did you know this?

Not at all

Perfectly

what are the plasma monitoring requirements for vancomycin

pre- dose trough level = 10-15mg/ml. 15-20 for endocarditis, less sensitive strains of MRSA or a complicated S. aureus infection
monitor after 3-4 doses and after a dose change
renal impairment more regular monitoring

How well did you know this?

Not at all

Perfectly

patient counselling for ethambutol

visual changes- report immediately

How well did you know this?

Not at all

Perfectly

pt counselling for Isoniazid

report signs of hepatoxicity: n&v, rash, jaundice, loss of appetite, fever

How well did you know this?

Not at all

Perfectly

what are the pt counselling points for pyrazinamide

Look out for signs of hepatoxicity: n&v, rash, jaundice, loss of appetite, fever

How well did you know this?

Not at all

Perfectly

Is Isoniazid an enzyme inhibitor or inducer

inhibitor

How is peripheral neuropathy when using Isoniazid over come

concomitant pyridoxine

what are the patient counselling points for using rifampicin

report signs of hepatotoxicity: n&v, rash, jaundice, loss of appetite, fever colours soft contact lenses and urine red/orange

Mrs T is looking for a suitable contraceptive. She also currently taking medications for her Tuberculosis. Which contraception should she go for and why

She is receiving treatment for her TB which includes rifampicin. Rifampicin is an enzyme inducer meaning it cant be use d with oral contraceptives. The best option is the IUD

What are the side effects associated with Itraconazole

Heart failure and hepatoxicity

which OTC medication is Contra-indicated in Itraconazole and why

Antacids because it needs an acidic environment for absorption

what is the MHRA alert associated with ketoconazole

risk of fatal hepatoxicity is greater than benefit of suing for fungal infections This does not apply to using it for Cushings syndrome of topical infections

what is the max dose of cobicistat that can be used concomitantly with ketoconazole

200mg

what are the s/e associated with voriconazole

phototoxicity and hepatoxicity

what are the s/e associated with voriconazole

phototoxicity and hepatoxicity

pt counselling for Voriconazole

Causes pre-malignant lesions or skin cancer- avoid direct sunlight or sunlamps. Use high factor SPF and carry alert card

what are the s/e associated with Amphoteracin B

Nephrotoxicity Anaphylaxis with IV preps so do a test dose and monitor for 30 minutes specific brand and not interchangeable

what are the s/e associated with doxycyline

photosensitivity and oesophageal irritation

what are the contra-indications for doxycyline

pregnancy, breastfeeding and under 12 year olds

in what condition are Mefloquine, Chloroquine and Chloroquine with Proguanil contraindicated in

epilepsy

what are the s/e associated with Mefloquine (Lariam)

Neuro-psychiatric reactions

Which anti-malarial tablets are contra-indicated in renal impairment

Malarone Proguanil Chloroquine Chloroquine with Proguanil

when should a once daily regimen of gentamicin be avoided

renal impairement <20ml/min HACEK or gram +ve endocarditis burns cob=ver >20% of body

what is the MHRA alert associated with using aminoglycosides e.g gentamicin, neomycin, tobracycin, amikacin

increased risk of deafness (ototoxicity) in patients with mitochondrial mutations-particularly the m.1555A>G mutation- risk and benefit should be weighed up. Genetic testing considered in those that need long term treatment. monitor auditory and hepatic markers

what is the max length of treatment aminoglycosides should be given for

7 days

for multiple daily dosing in endocarditis what is the plasma monitoring required

3-5mg/L for the peak level taken 1 hr in 1mg/L for the pre dose trough level Plasma conc should be taken after every 3-4 doses then every 3 days

what are the two major interactions associated with macrolides erythromycin and clarithromycin as enzyme inhibitors

warfarin= increased risk of bleeding | statins: increased risk of myopathy

should azithromycin be taken before or after food | And what is is the dosing

before food OD

With which antibiotics should a 2 hur gap be left for indigestion remedies

erythromycin | azithromycin

which macrolide can cause taste disturbance and is given twice a day

clarithromycin

what is the toxic effect spiramycin has

toxoplamosis

which macrolide causes visual disturbances, hepatoxicity and transient loss of consciousness

telithromycin

which macrolide causes visual disturbances, hepatoxicity and transient loss of consciousness

telithromycin

What are the patient counselling points for quinolones

can impair performance of skilled tasks: it's effects is enhanced by alcohol antacid and zinc/iron: leave 2 hours before or after taking a quinolone avoid milk with ciprofloxacin and norfloxacin With oral ciprofloxacin avoid concurrent consumption of dairy and mineral fortified drinks due to reduced exposure With Ofloxacin protect from sunlight and avoid sunbeds

which drug class has an increased risk of tendon damage when used with steroids in over 60 year olds

quinolones

what is the age range that fluconazole is indicated in

16-60 years

List the interactions associated with quinolones

increased risk of QT Prolongation (avoid when taking SSRI, Quinine, amiodarone, macrolide and antipsychotics), ventricular arrhythmias and heart regurgitation increased risk of seizures : ciprofloxacin and theophylline- cipro is an enzyme inhibitor so causes theophylline toxicity and a side effect of theophylline is convulsions NSAIDS can also increase the risk of convulsions arthopathy: avoid in pregnancy, children and adolescent

What are the CI for using moxifloxacin

QT prolongation: electrolyte disturbances, heart failure with reduced LVEF, bradycardia, congenital QT syndrome, other QT prolonging drugs

when should quinolones be discontinued

psychiatric, neurological and hypersensitivity reactions occur

which of the tetracycline antibiotics should you avoid milk | DOT

demeclocycline Oxytetracycline Tetracycline

Which of the tetracycline should you avoid using sunlight's/ lamps DD

demeclocycline | doxycycline

Which tetracyclines is there decreased absorption when taking antacids, iron or zinc salts 2 hrs before or after taking

all tetracyclines

which tetracyclines are associated with oesophageal irritation DMT

Doxycycline Minocycline Tetracycline

What eGFR is CI in nitrofurantoin

45 and under

Which tetracyclines can be used in renal impairement

doxycycline and minocycline

Are tetracycline hepatoxic

yes- avoid and or use with caution especially in those already using hepatoxic drugs

What are the s/e associated with tetracyclines

benign intracranial hypertension minocycline cn cause vertigo, dizziness, irreversible pigmentation, lups-erythrateaosus syndrome deposit in growing bone and teeth and causes teeth discolouration and dental (enamel) hypoplasia

pt counselling associated with tetracyclines

stop if headache and visual disturbances

When tetracyclines are contra-indicated

children under 12 pregnancy and breast feeding- deposit in growing bone and teeth and causes teeth discolouration and dental (enamel) hypoplasia

what are the plasma monitoring requirements for gentamicin in adults (not endocarditis)

for multiple daily dosing regimens peak serum conc should be taken an hour in and should be 5-10mg/L trough (pre-dose) should be less than 2mg/L monitor trough after 3-4 doses and a dose change at least every 3 days more frequently and earlier in renal impairment

What affect does amoxicillin have on methotrexate

Increases the clearance of methotrexate