Conditions Flashcards by Sonia chandarana

What do you use to treat MRSA?

Vancomycin

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What is used in phase 1 of treating TB and how long for?

RIPE

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

2 months

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What is used in phase 2 of treating TB and how long for ?

Rifampicin
Isoniazid

4 months

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TB - What are key warning signs for rifmapicin?

enzyme inducer
report hepatotoxicity
colours soft contact lenses and urine red/orange

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TB - what are key things about isoniazid?

peripheral neuropathy - give pyridoxine

- enzyme inhibitor

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TB - What should be immediately reported with ethambutol?

visual changes

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What is used to treat fungal infections?

Azoles - e.g. itraconazole, ketoconazole.

- Amp B - for serious infs

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What is a key interaction with itraconazole?

antacids - needs acidic pH for absorption

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What does MHRA say about oral ketoconazole?

risk of heptaotoxicity is greater than benefit of treating fungal infections

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What are ADRs of voriconazole?

phototoxicity

- hepatotoxicity

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What needs to be taken into consideration when giving Amphotericin B?

specify brand

- anaphylaxis with IV preps - do test dose and monitor for 30 mins

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What is used to treat oral candidiasis? (oral thrush)

Nystatin or miconazole

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What is used to treat vaginal thrush?

oral fluconazole or clotrimazole

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What is used for tinea? e.g. ringworm, athletes foot etc

miconazole/clotrimazole/terbinafine

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What is the treatment for Community acquired pneumonia?

7 day treatment
14-21 days if staph

Mild - amoxicillin. alternative = clarithromycine or doxycycline

Moderate - amoxicillin + clarithromycin OR just doxycycline

Severe - Pen G + clarithromycin/doxycycline

Add fluclox if staph
Add vancomycin if MRSA

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What is the treatment for Hospital acquired pneumonia?

7 day treatment

Early onset < 5 days = co-amox or cefurozime

Severe or > 5 days = antipseudomonal penicillin or broad spec cephalosporin or quinolone

Add vancomycin if MRSA
Add aminoglycoside for pseudomonas aeruginosa

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Helminth infections - what do you give for threadworm?

mebendazole

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Helminth infections - what do you give for tapeworm?

praziquantel

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Helminth infections - what do you give for hookworm?

mebendazole

Helminth infections - what do you give for scabies?

ivermectin

What is the most effective at preventing insect bites in order to prevent malaria transmission?

nets lined with permethrin

What spray is used for mosquito bites?

DEET

safe in people over the age of 2 months
can reduce spf

When should you take doxycycline for malaria prevention?

Take 1-2 days before entering area and continued for 4 weeks after leaving

What are rules when taking doxycycline?

avoid sunlight - photosensitivity
do not take indigestion remedies, iron or zinc 2 hours before or after taking (reduces abs)
swallow capsules whole while standing or sitting - oesophageal irritation

Who should mefloquine be avoided in?

- people with psychiatric orders or convulsions

Why should you be cautious when driving after having mefloquine?

- long half life | - can cause dizziness/disturbed sense of balance

What is the length of prophylaxis of antimalarials before travel?

1 week exceptions: - mefloquine - 2 to 3 weeks before - malarone and doxy - 1 to 2 days before

What is the length of prophylaxis after travel?

4 weeks after exception: - malarone - 1 week after

Which anti-malarials should be avoided in those with epilepsy?

- chloroquine or mefloquine

Which anti-malarials should be avoided in those with renal imp?

- proguanil, malarone and chloroquine choose doxy or meflo

Which anti-malarials are chosen in pregnancy?

- chloroquine and proguanil (give 5mg folic acid) - doxycycline CI due to dental problems - malarone can be given in 2nd or 3rd trimester only if really ecessary

When should INR be monitored in pts who require antimalarials?

- before - 7 days after starting - after completing course

What is the standby TREATMENT of malaria?

- quinine | - only take if you can't access medical care in 24 hours of fever onset

What is used for viral infections such as HSV?

aciclovir

What is olseltamivir used in?

- prophylaxis of influenza - for at risk groups - 65+, DM, immunocompromised - start within 48 hours of symptoms

How do you treat endocarditis?

- Amoxicillin and/or low dose gentamicin - Vancomycin: in MRSA/penicillin allergy - Flucloxacillin: in staph - PenG: in strep

How do you treat osteomyelitis (bone inf)?

- fluclox | - if allergic - clindamycin

How do you treat impetigo?

- Fusidic acid for 7 days if small areas infected | - Flucloxacillin for 7 days if widespread

How do you treat cellulitis?

fluclox

How do you treat animal and human bites?

co-amox OR doxycycline + metronidazole

How do you treat MRSA skin and soft tissue inf?

tetracycline OR sodium fusidate + rifampicin OR clindamysin

How do you treat oral gingivitis?

metronidazole 400mg TDS for 3 days OR amox

How do you treat a sore throat caused by streptococci?

Pen V

How do you treat sinusitis?

amox or clarithro or doxy

How do you treat otitis externa (staph aureus )?

fluclox

How do you treat otitis media ?

amox or clarithro