Antibiotics and friends

Question 1

What are common indications of needing flucloxicillin?

Answer 1

staphalococcus infection - cellulitis, endocarditis, osteomyelitis, septic arthritis

Question 2

What is the mechanism of action of flucloxicillin?

Answer 2

they weaken cell walls leading to swelling and death

Question 3

What are some adverse reactions of flucloxicillin?

Answer 3

GI upset, liver toxicity

allergy - rash, anaphylaxis

Question 4

What are some warnings of flucloxicillin?

Answer 4

caution in liver or renal impairment

Caution if penicillin allergy or flucloxicillin hepatotoxicity

Question 5

What are some interactions of flucloxicillin?

Answer 5

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

Question 6

What are cephalosporins and carbapenems and give some examples?

Answer 6

broad spectrum pencillin based antibiotics

e.g. cefotaxime, meropenem

Question 7

What are indications of cephalosporins and carbapenems?

Answer 7

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

Question 8

What is mechanism of action of cephalosporins and carbapenems?

Answer 8

B lactam ring impacts cell wall = lysis, death

Question 9

What are interactions of cephalosporins and carbapenems?

Answer 9

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

Question 10

What are adverse effects of cephalosorins and carbapenems?

Answer 10

GI upset
hypersensitivity
neurotoxicity

Question 11

What are warnings of cephalosporins and carbapenems?

Answer 11

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

Question 12

What are the two broad spectrum penicillins and their uses?

Answer 12

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

co-amoxiclav - more complicated hospital acquired infections

Question 13

What is mechanism of action of broad spectrum penicillins?

Answer 13

damage cell wall = cell lysis

Question 14

What are adverse reactions of broad spectrum antibiotics?

Answer 14

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

Question 15

What are some warnings of broad spectrum penicillins?

Answer 15

history of allergy or c. diff

penicillin associated liver injury, renal injury

Question 16

What are interactions of broad spectrum penicillins?

Answer 16

increase anticoagulation of warfarin

Question 17

What are examples of quinolones and what are they?

Answer 17

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

Question 18

What are indications for using quinolones?

Answer 18

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

Question 19

What is the mechanism of action of quinolones?

Answer 19

they inhibit DNA synthesis

bacteria gain resistance to quinolones quickly

Question 20

What are some adverse reactions of quinolones?

Answer 20

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

Question 21

What are some warnings for quinolones?

Answer 21

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

Question 22

What are some interactions with quinolones?

Answer 22

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

Question 23

What are indications of metronidazole?

Answer 23

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

Question 24

What is mechanism of action of metronidazole?

Answer 24

DNA degradation and cell death

Question 25

What are adverse reactions of metronidazole?

Answer 25

``` GI upset hypersensitivity peripheral and optic neuropathy seizures encephalopathy ```

Question 26

What are warnings with metronidazole?

Answer 26

severe liver disease | alcohol

Question 27

What are interactions with metronidazole?

Answer 27

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

Question 28

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

Answer 28

gentamicin, amikacin, neomycin | act on gram negative aerobic bacteria

Question 29

What are common indications of aminoglycosides?

Answer 29

sepsis, UTI, pyelonephritis, endocarditis | skin, eye, ear infections

Question 30

What is the mechanism of action of aminoglycosides?

Answer 30

bind irreversibly to bacterial ribosomes

Question 31

What are adverse effects of aminoglycosides?

Answer 31

nephrotoxicity and ototoxicity

Question 32

What are warnings of aminoglycosides?

Answer 32

neonates, elderly renal impairment myasthenia gravis

Question 33

What are important interactions of aminoglycosides?

Answer 33

ototoxicity more likely in loop diuretics, vancomycin | nephrotoxicity more likely with ciclosporin, chemo, cephalosporins, vancomycin

Question 34

What is gentamicin dose determined by?

Answer 34

ideal body weight | if 20% heavier, use adjusted body weight

Question 35

What is important monitoring with gentamicin?

Answer 35

concentration | renal function

Question 36

How long should vancomycin be transfused over?

Answer 36

infuse over 1 hour minimum

Question 37

What are some examples of antifungals?

Answer 37

nystatin, clotrimazole, fluconazole

Question 38

What are some adverse effects of antifungals?

Answer 38

topical - skin irritation | systemic - GI upset, headache, hepatitis, QT prolongation, hypersensitivity

Question 39

What are warnings and interactions with antifungals?

Answer 39

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

Question 40

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

Answer 40

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

Question 41

What are some adverse effects of aciclovir?

Answer 41

headache, dizziness, GI disturbance, skin rash | acute renal failure

Question 42

What are some warnings and adverse reactions of aciclovir?

Answer 42

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

Question 43

What is cloramphenicol and what is it used for?

Answer 43

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

Question 44

What are some adverse reactions of chloramphenicol?

Answer 44

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

Question 45

What are some warnings or interactions with chloramphenicol?

Answer 45

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

Question 46

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

Answer 46

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

Question 47

What are some adverse effects of macrolides?

Answer 47

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

Question 48

What are warnings and important interactions of macrolides?

Answer 48

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

Question 49

What is nitrofurantoin used for?

Answer 49

treatment or prophylaxis of UTI

Question 50

What are adverse reactions of nitrofurantoin?

Answer 50

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

Question 51

What are warnings and interactions of nitrofurantoin?

Answer 51

pregnant women, babies under 3 months, renal impairment | no interactions

Question 52

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

Answer 52

hypromellose, carbomers, liquid and white soft paraffin | any dry eye conditions

Question 53

What are some SE of artificial tears?

Answer 53

stinging and blurring of vision | allergic reaction

Question 54

What are some warnings and interactions with artificial tears?

Answer 54

NONE

Question 55

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

Answer 55

benzylpenicillin, phenoxymethylpenicillin | tonsilitis, pneumonia, endocarditis, meningitis, gangrene

Question 56

What are some adverse effects of penicillins?

Answer 56

allergy, neurologiccal toxicity

Question 57

What are warnings or important interactions of penicillins?

Answer 57

renal impairment, penicillin allergy | penicillins reduce extretion of methotrexate