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chapter 5 - infection > bacterial infection > Flashcards

bacterial infection Flashcards

1
Q

If patient is allergic to penicillins, which other classes of abx should they avoid?

A

cephalosporins and carbapenems (as they are also b lactams) esp if pt has immediate hypersensitivity

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2
Q

trimethoprim = which electrolyte disturbances?

A

hyperkalaemia

hyponatraemia

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3
Q

gentamicin peak and trough levels for norm and for endocarditis:

A

norm: peak 5-10mg/L trough <2
endocarditis: 3-5mg/L trough <1

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4
Q

electrolyte disturbances with aminoglycosides?

A

hypomagnesaemia

hypokalaemia

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5
Q

which classes of abx are nephrotoxic?

A

aminoglycosides

glycopeptides

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6
Q

examples of each gen of cephalosporins:

A

1st: cefalexin
2nd: cefuroxime
3rd: ceftriaxone

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7
Q

which abx classes can cause ototoxicity?

A

aminoglycosides
glyopeptides
macrolides

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8
Q

glycopeptide trough level pre dose? norm and for endocarditis

A

norm: 10-15mg/L
endocarditis: 15-20mg/L

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9
Q

if you adminster vancomycin IV too rapidly, what can happen?

A

thrombophlebitis presented as red man syndrome (flushing)

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10
Q

macrolides are enzyme inhibitors therefore avoid use of? (give examples)

A

inducers e.g. carbamazepine, theophylline, warfarin, statins

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11
Q

macrolides and pregnancy?

A

CCP, EE! (clarithromycin contraindicated pregnancy, erythromycin embroyos! (so is ok))

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12
Q

metronidazole (for anaerobic targets) side effects?

A 
GI (take with/after food)
taste disturbance
furry tongue
sore mouth
- avoid alcohol
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13
Q

administration difference between benzylpen and phenoxymethylpen

A

benzylpen IV or IM only (not PO)

phenoxymethylpen can be given orally

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14
Q

broad vs narrow spec penicillin examples?

A

broad: amoxicillin, tazocin
narrow: benzylpen, phenoxymethylpen

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15
Q

quinolone interactions?

A

theophylline/NSAIDs are CI as reduces seizure threshold

caution with warfarin as increases INR

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16
Q

3 main points for quinolones?

A
  • report muscle pain (tendonitis MHRA alert)
  • reduces seizure threshold so CI in epileptics
  • causes QT prolongation
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17
Q

which abx class is only suitable for those above 12 years?

A

tetracyclines

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18
Q

which tetracyclines do you need to avoid milk with and which can you take milk with?

A

milk allowed? Does Like Milk (doxy, lyme, minocycline)
milk not allowed? DOT (demeclocycline, oxytetracycline, tetracyline)

  • ALL tetracyclines though, you need to avoid indigestion remedies 2hrs before or after
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19
Q

tetracycline interactions?

A

isotretinoin, lithium, warfarin and statins

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20
Q

which class of abx can cause intracranial hypertension?

A

tetracyclines

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21
Q

what class of abx is co-trimoxazole in?

A

sulphonamides (the only one)

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22
Q

interaction with Na valproate and which abx?

A

meropenum

23
Q

SE of co-trimox?

A

SJS/skin rashes

24
Q

rifampicin 2 key points?

A
  • enzyme inducer. CI contraceptives, use IUD

- hepatotoxic so patient to report signs

25
Q

which abx should you avoid tyramine foods with?

A

linezolid and isoniazid

26
Q

patient to report what when on linezolid?

A

visual symptoms as can cause optic neuropathy

27
Q

patient to report what when on trimethoprim?

A

fever/sore throat/rash as blood dyscrasias is a side effect

28
Q

which abx colours urine yellow/brown?

A

nitrofurantoin

29
Q

best abx for pregnancy?

A

penicllins, cephalosporins, clindamycin, meropenum

30
Q

trimeth and nitro when to avoid in pregnancy?

A

trimeth avoid in 1st trimester

nitro avoid at term

31
Q

most likely abx to cause c.diff?

A

Clindamycin, Cephalosporins, Broad spec pens, Fluoroquinolones, PPIs (crazy chimps buy fluorescent poo)

32
Q

c.diff tx?

A

1st ep: PO metronidazole 10-14 days

subsequent: vanc or last line fidoxamicin

33
Q

endocarditis tx?

A

amoxicillin +/- low dose gent

34
Q

UTI tx?

A

nitro 100mg BD MR
or
trimeth 200mg BD
- 3 days for women, 7 days for everyone else inc pregnant women

35
Q

CAP tx:

A

mild: amox
mod: amox + clarith OR doxy alone
severe: benzylpen + clarith/doxy

36
Q

HAP tx:

A

early onset? co-amox

late onset? BS ceph

37
Q

meningitis tx:

A

benzylpen or cefotaxime if pen allergy (chloramphenicol is immediate pen allergy)

38
Q

osteomyelitis tx:

A

flucloxacillin long term usually

39
Q

imetigo tx?

A

local? fusidic acid 7 days

spread? flucloxacillin 7 days

40
Q

cellulitis tx:

A

fluclox

41
Q

animal/human bites tx:

A

co-amox OR doxy + met

42
Q

MRSA tx?

A

tetracycline or if severe, vanc

43
Q

oral/dental infection tx:

A

metronidazole 200mg TDS for 3/7

OR amox/doxy

44
Q

sore throat tx (caused by strep):

A

phenoxymethylpen or benzylpen if severe, remember benzylpen only IV or IM

45
Q

sinusitis tx?

A

amox/clarith/doxy

46
Q

otitis externa tx:

A

flucloxacillin

47
Q

otitis media tx:

A

amoxicillin

48
Q

TB tx:

A
  1. RIPE (rifampicin, isonazid, pyrazinamide, ethambutol) for 2 months
    - isonazid causes peripheral neuroathy so always given with pyroxidine
    - ethambutol; patient to report visual changes
  2. then continue rifampicin and isonazid for 4 further months
49
Q

which abx causes urine/tears/contacts red/orange/yellow?

A

rifampicin

50
Q

h.pylori tx:

A

triple therapy for 7 days:

  1. PPI
  2. amoxicillin
  3. clarithromycin or metro (both used if pen allergy so cant use amox)
51
Q

abx with food?

A 
metro
pivemecillinam
itraconazole
nitrofurnatoin
cefuroxime
52
Q

abx on empty stomach?

A 
azithromycin
phenoxymethylpen
fluclox
oxytetracycline
rifampicin
53
Q

abx with full glass of water?

A

clindamycin
doxycycline
metronidazole

chapter 5 - infection (3 decks)

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