bacterial conjunctivitis

Question 1

name aminoglycosides

Answer 1

gentamicin, amikacin, neomycin

Question 2

aminoglycoside indications

Answer 2

• severe infection esp gram -ve aerobes
• severe sepsis
• pyelonephritis and complicated UTI
• Biliary and other intrabdo sepsis
• endocarditis

topical e.g. neomycin
- bacterial skin, eye or external ear infections

Question 3

spectrum of activity

Answer 3

gram -vve aerobes
- some work for staph and mycobacteria

inactive for strepp and anerobes

Question 4

MOA aminoglycosides

Answer 4

• bind irreverisbly to 30s ribosome - inhbiit protein synthesis
• bactericidal. enter cells by oxygen dependant transport system = resistant in anerobes

Question 5

SE aminoglycosides

Answer 5

• nephrotoxic

- ototoxic - tinnituss, hearing loss etc

Question 6

relative CI aminoglycosides

Answer 6

• neonates
• elderly
• renal impairment
• Myasthenia gravis - impair neuromuscular transmission

Question 7

when are aminoglycosides more liekly to be ototoxic

Answer 7

when prescribed with loops or vanc

Question 8

when are aminoglycosides mroe likely to be nephrotoxic

Answer 8

• if co prescribed with ciclosporin, platinum chemo, cephalospsorins, vancomycin

Question 9

route of transmission of aminoglycosides

Answer 9

• iv; always diulyed e.g. 50ml nacl

- topical

Question 10

how to monitor aminoglycosides

Answer 10

• plasma drug conc 18-24hrs post 1st dose = trough level. only give next if safe levels

Question 11

how to dose aminoglycosides in obese

Answer 11

• • the drug distributes through body water not fat, which obese people have more of. so dose based on adjusted body weight; (ideal body weight) + 0.4 x (actual bw) - (ideal bw)

Question 12

chloramphenicol indications

Answer 12

• bacterial conjunctivitis
• otitis externa
  only as drops as toxic otherwise

Question 13

spectrum of activity chloramphenicol

Answer 13

• broad -ve and +ve, aerobes and anaerobes

Question 14

MOA chloramphenicol

Answer 14

• binds to bacterial ribsolones - bacteriostatic. high conc = bactericidal.
• resistance via accetyltransferase enzymes tha tinactivate drug.

Question 15

SE chloramphenicol

Answer 15

• topical; stinging, bruning, itching
• systemic; rare use; BM toxicity. dose related BM supression with high dose or hepatic impairment . reversed after withdrawal
• aplastic anaemia; idiosyncratic

grey baby syndrome in neonates

optic and peripheral neuritis = prolonged systemic admin

Question 16

CI chloramphenicol

Answer 16

• hypersensitivity
• Bm disorder

Systemic CI

• 3rd trim pregnancy
• BF
• KIDS <2 , avoid topical too

relative in hepatic impairment