Antibiotics COPY Flashcards
What antibiotics are suitable in pregnancy?
Penicillins and Cephalosporins
What are the indications for aminoglycosides?
Used for serious infections
CNS infections e.g meningitis
TB (streptomycin)
Pyelonephritis, pneumonia, endocarditis
What is the therapeutic range for gentamicin?
5-10mg/L
Which aminoglycoside is given orally? and why?
Neomycin- too toxic for IV use
What are the side effects of aminoglycosides? (3)
1) Nephrotoxicity
2) Ototoxicity
3) Peripheral neuropathy
Aminoglycosides shouldn’t be used in…? (2)
1) Myasthenia gravis (impairs neuromuscular transmission)
2) Pregnancy (ear damage)
Aminoglycosides interact with what drugs?
1) Loop diuretics and Vancomycin (ototoxicity)
2) Cisplatin, Ciclosporin and vancomycin (nephrotoxicity)
IV treatment with aminoglycosides should not exceed how many days?
7 days
Monitoring requirements for aminoglycosides? (3)
1) Plasma concentration (18-24 hours after dose)
2) Renal function (especially during periods of dehydration)
3) Auditory and vestibular function
Common bacteria in meningitis? (3)
1) Neisseria meningitidis
2) Streptococcus pneumoniae
3) Haemophilius influenza
Antibiotics used in meningitis?
Benzylpenicillin, cefotaxime, chloramphenicol
Name 8 cephalosporins?
1) Cefalexin
2) Cetrotide
3) Cefaclor
4) Cefuroxime
5) Cefixime
6) Ceftriaxone
7) Ceftaroline
8) Fosamil
Are cephalosporins broad spectrum?
Yes
Indications for cephalosporins?
2nd or 3rd line treatment for UTI and RTI
IV for severe resistant organisms
Pneumonia, meningitis, gonorrhoea
Side effects of cephalosporins? (2)
1) GI effects
2) Penicillin hypersensitivity (avoid in known allergy)
Do IV cephalosporins require approval by a microbiologist?
YES and are now mainly restricted to antibiotic associated colitis
Does warfarin interact with cephalosporins? if so, how?
YES, cephalosporins kill the gut flora responsible for synthesizing vitamin K this results in a reduction in the production of vitamin K dependent blood clotting factors-results in increased anticoagulant effect of warfarin.
What is the first line antibiotic group for MRSA?
Glycopeptides e.g vancomycin, Teicloplanin etc
What indications are glycopeptides generally used for?
MRSA
C.diff
endocarditis
surgical prophylaxis (MRSA risk)
What are the main side effects of glycopeptides? (5)
1) Nephrotoxicity
2) Blood disorders
3) Ototoxicity
4) ‘Red man syndrome’
5) Thrombophlebitis (IV)
When would you avoid using glycopeptides?
elderly, history of deafness, renal impairment, pregnancy (ear damage)
What are the monitoring requirements for glycopeptides? (5)
1) FBC
2) WCC
3) Hepatic and renal function
4) Urinalysis
5) Auditory function in elderly
What drugs do glycopeptides interact with?
Ciclosporin, cisplatin, aminoglycosides, loop diuretics
Suxamethonium- (Increases vancomycin conc)
What are the indications for clindamycin (lincosamide)? (3)
1) Staphylococcal joint and bone infections
2) Intra abdominal sepsis
3) Cellulitis and skin and soft tissue infections (effective against penicillin resistant streptococci)