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PSA questions > Antibiotics and friends > Flashcards

Antibiotics and friends Flashcards

1
Q

What are common indications of needing flucloxicillin?

A

staphalococcus infection - cellulitis, endocarditis, osteomyelitis, septic arthritis

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2
Q

What is the mechanism of action of flucloxicillin?

A

they weaken cell walls leading to swelling and death

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3
Q

What are some adverse reactions of flucloxicillin?

A

GI upset, liver toxicity

allergy - rash, anaphylaxis

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4
Q

What are some warnings of flucloxicillin?

A

caution in liver or renal impairment

Caution if penicillin allergy or flucloxicillin hepatotoxicity

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5
Q

What are some interactions of flucloxicillin?

A

increase risk of methotrexate toxicity - fluclox decreases renal excretion of methotrexate

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6
Q

What are cephalosporins and carbapenems and give some examples?

A

broad spectrum pencillin based antibiotics

e.g. cefotaxime, meropenem

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7
Q

What are indications of cephalosporins and carbapenems?

A

urinary tract or respiratory infections
very severe or complicated infections
e.g. cefotaxime and meningitis

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8
Q

What is mechanism of action of cephalosporins and carbapenems?

A

B lactam ring impacts cell wall = lysis, death

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9
Q

What are interactions of cephalosporins and carbapenems?

A

enhance anticoagulation of warfarin
increase nephrotoxicity of aminoglycosides
reduce plasma concentration of valporate

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10
Q

What are adverse effects of cephalosorins and carbapenems?

A

GI upset
hypersensitivity
neurotoxicity

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11
Q

What are warnings of cephalosporins and carbapenems?

A

more likely to have C, diff
allegy to penicillins
epilepsy
renal impairment

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12
Q

What are the two broad spectrum penicillins and their uses?

A

amoxicillin - CAP, otitis media, UTI, h. pylori GI problems

co-amoxiclav - more complicated hospital acquired infections

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13
Q

What is mechanism of action of broad spectrum penicillins?

A

damage cell wall = cell lysis

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14
Q

What are adverse reactions of broad spectrum antibiotics?

A

GI upset
allergy - skin rash, anaphylaxis
acute liver injury, jaundice

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15
Q

What are some warnings of broad spectrum penicillins?

A

history of allergy or c. diff

penicillin associated liver injury, renal injury

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16
Q

What are interactions of broad spectrum penicillins?

A

increase anticoagulation of warfarin

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17
Q

What are examples of quinolones and what are they?

A

non-penicillin broad spectrum antibiotics (esp. gram - bacteria)
ciprofloxacin, levofloxacin, moxifloxacin

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18
Q

What are indications for using quinolones?

A

used 2nd/3rd line due to c. diff risk and liklihood to gain resistance
LRTI, severe gastroenteritis, UTI

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19
Q

What is the mechanism of action of quinolones?

A

they inhibit DNA synthesis

bacteria gain resistance to quinolones quickly

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20
Q

What are some adverse reactions of quinolones?

A 
GI upset (c. diff infection)
resistance quickly 
prolong QT interval - arrthymias 
reduce seizure threshold 
tendon inflammation and rupture
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21
Q

What are some warnings for quinolones?

A

used in caution in children and where QT prolongation or lowering seizure threshold would be dangerous

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22
Q

What are some interactions with quinolones?

A

drugs containing divalent cautions - calcium, antacids
ciprofloxacin inhibits CYP enzymes
co-prescription with NSAIDs further increases risk of seizures
co-prescription with prednisilone further increases risk of tendon rupture
prescribe with caution with other drugs that prolong QT interval e.g. amiodarone, antipsychotics, SSRIs

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23
Q

What are indications of metronidazole?

A

anaerobic or protozoa infections e.g. surgical or gynae infection, C. diff, oral infections

24
Q

What is mechanism of action of metronidazole?

A

DNA degradation and cell death

25
Q

What are adverse reactions of metronidazole?

A 
GI upset 
hypersensitivity 
peripheral and optic neuropathy 
seizures 
encephalopathy
26
Q

What are warnings with metronidazole?

A

severe liver disease

alcohol

27
Q

What are interactions with metronidazole?

A

CYP inducers - reduce plasma conc.
inhibit CYP enzymes - reduce warfarin metabolism
increase risk of lithium toxicity

28
Q

What are examples of aminoglycosides and what do they act on?

A

gentamicin, amikacin, neomycin

act on gram negative aerobic bacteria

29
Q

What are common indications of aminoglycosides?

A

sepsis, UTI, pyelonephritis, endocarditis

skin, eye, ear infections

30
Q

What is the mechanism of action of aminoglycosides?

A

bind irreversibly to bacterial ribosomes

31
Q

What are adverse effects of aminoglycosides?

A

nephrotoxicity and ototoxicity

32
Q

What are warnings of aminoglycosides?

A

neonates, elderly
renal impairment
myasthenia gravis

33
Q

What are important interactions of aminoglycosides?

A

ototoxicity more likely in loop diuretics, vancomycin

nephrotoxicity more likely with ciclosporin, chemo, cephalosporins, vancomycin

34
Q

What is gentamicin dose determined by?

A

ideal body weight

if 20% heavier, use adjusted body weight

35
Q

What is important monitoring with gentamicin?

A

concentration

renal function

36
Q

How long should vancomycin be transfused over?

A

infuse over 1 hour minimum

37
Q

What are some examples of antifungals?

A

nystatin, clotrimazole, fluconazole

38
Q

What are some adverse effects of antifungals?

A

topical - skin irritation

systemic - GI upset, headache, hepatitis, QT prolongation, hypersensitivity

39
Q

What are warnings and interactions with antifungals?

A

caution with liver disease and renal impairment, don’t use in pregnancy
fluconazole inhibits CYP
don’t use with other drugs that prolong QT interval

40
Q

What is a common antiviral drug, what is it used for and how does it work?

A

aciclovir
used to treat the herpes virus
inhibits herpes-specific DNA polymerase

41
Q

What are some adverse effects of aciclovir?

A

headache, dizziness, GI disturbance, skin rash

acute renal failure

42
Q

What are some warnings and adverse reactions of aciclovir?

A

caution in pregnant women, breastfeeding and kidney problems
no important interactions

43
Q

What is cloramphenicol and what is it used for?

A

is a braod spectrum antibiotic used as eye drops (bacterial conjuncitivitis) or ear drops (otitis externa)

44
Q

What are some adverse reactions of chloramphenicol?

A

topical - stinging, itching burning
systemic (rare use) - grey baby syndrome (circulatory collapse in neonates), bone marrow suppression, aplastic anaemia, optic and peripheral neuritis

45
Q

What are some warnings or interactions with chloramphenicol?

A

hypersensitivity, bone marrow disorders
don’t give in third trimester, breastfeeding or babies <2 years
caution in hepatic impairment
no interactions topically

46
Q

What are some examples of a macrolides and what are they used for?

A

clarithromycin, erythromycin, azithromycin
used to treat respiratory, skin and soft tissue infections
also eradicate helicobacter

47
Q

What are some adverse effects of macrolides?

A

nausea, vomiting, abdo pain, diarrheoa
antibiotic-associated colitis
prolong QT interval
otoxocity

48
Q

What are warnings and important interactions of macrolides?

A

hypersensitivity
hepatic or renal impairment
inhibit CYP
don’t prescribe with other drugs that prolong QT

49
Q

What is nitrofurantoin used for?

A

treatment or prophylaxis of UTI

50
Q

What are adverse reactions of nitrofurantoin?

A

GI upset, hypersensitivity, urine yellow or brown, chronic pulmonary disease, heptatits, perihperal neuropathy

51
Q

What are warnings and interactions of nitrofurantoin?

A

pregnant women, babies under 3 months, renal impairment

no interactions

52
Q

What are some names of artifical tears and what are they used for?

A

hypromellose, carbomers, liquid and white soft paraffin

any dry eye conditions

53
Q

What are some SE of artificial tears?

A

stinging and blurring of vision

allergic reaction

54
Q

What are some warnings and interactions with artificial tears?

A

NONE

55
Q

What are the names of some penicillins and what are they used for?

A

benzylpenicillin, phenoxymethylpenicillin

tonsilitis, pneumonia, endocarditis, meningitis, gangrene

56
Q

What are some adverse effects of penicillins?

A

allergy, neurologiccal toxicity

57
Q

What are warnings or important interactions of penicillins?

A

renal impairment, penicillin allergy

penicillins reduce extretion of methotrexate

PSA questions (14 decks)

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