dose and ADR

Question 1

Clindamycin PO (SSTI)

Answer 1

300mg QDS

Question 2

Clindamycin IV (SSTI)

Answer 2

600mg Q8h

Question 3

Penicillin G (IV) SSTI

Answer 3

2-4 million units Q4-6h*

Question 4

Penicillin VK PO (SSTI)

Answer 4

250-500mg QDS

Question 5

Cloxacillin PO (SSTI)

Answer 5

250-500mg QDS

Question 6

Cloxacillin IV (SSTI)

Answer 6

1-2g Q4-6h

Question 7

Amoxicillin/Clavulanate PO (SSTI)

Answer 7

625mg BD/TDS*

Question 8

Amoxicillin/Clavulanate IV (SSTI)

Answer 8

1.2g Q8h*

Question 9

Piperacillin/Tazobactam IV (SSTI)

Answer 9

4.5g Q6-8h*

Question 10

Cephalexin PO (SSTI)

Answer 10

250-500mg QDS*

Question 11

Cefazolin IV (SSTI)

Answer 11

1-2g Q8h*

Question 12

Cefepime IV (SSTI)

Answer 12

2g Q8h *

Question 13

Metronidazole PO (SSTI)

Answer 13

500mg TDS

Question 14

Metronidazole IV (SSTI)

Answer 14

500mg TDS

Question 15

Cotrimoxazole (Sulfamethoxazole/trimethoprim) PO (SSTI)

Answer 15

960 (800/160) mg BD

Question 16

Vancomycin PO (SSTI)

Answer 16

15mg/kg Q8-12h*

Question 17

drugs that need renal dosing (SSTI)

Answer 17

1. cotrimoxazole
2. penicillin g
3. cephalexin
4. cefazolin
5. cefepime
6. amoxi/clav
7. pipe/tazo
8. vanco

Question 18

Carbapenems in nosocomial pyelonephritis

Answer 18

IV Imipenem 500mg Q6h

IV meropenem 1g Q8h

Question 19

Fluoroquinolones in community pyelonephritis

Answer 19

ciprofloxacin PO 500mg BD x 7d

levofloxacin PO 750mg x5d

Question 20

Fluoroquinolones in nosocomial pyelonephritis

Answer 20

ciprofloxacin PO 500mg BD x 7-14d

levofloxacin PO 750mg x 7-14d

Question 21

Fluoroquinolones in cystitis

Answer 21

ciprofloxacin PO 250mg BD x3d

levofloxacin PO 250mg x3d

Question 22

Cotrimoxazole for cystitis

Answer 22

PO 960mg BD x3d

Question 23

Nitrofurantoin for cystitis

Answer 23

PO 50mg QDS x5d

Question 24

Fosfomycin for cystitis

Answer 24

PO 3g x 1 dose

Question 25

Fosfomycin for complicated cystitis

Answer 25

PO 3g x 3 dose EOD

Question 26

Beta-lactam for cystitis

Answer 26

Amoxicillin/Clavulanate 625mg BD x3-7d Cephalexin 500 mg BD x 3-7d Cefuroxime 250mg BD x 3-7d

Question 27

Beta-lactam for community pyelonephritis

Answer 27

Amoxicillin/Clavulanate 625mg TDS x10-14d | cephalexin 500 BD x10-14d

Question 28

take note of cotrimoxazole

Answer 28

Avoid in sulpha allergy, G6PD def, 1st & 3rd | trimester pregnancy, CrCl < 15ml/min.

Question 29

take note of cephalexin

Answer 29

<10% cross-sensitivity for penicillin allergy (avoid | if anaphylaxis).

Question 30

Cephalexin ADR and counsel tips

Answer 30

Generally safe in pregnancy ADR: GI Tips: Take without regards to food, if GI discomfort, take with food.

Question 31

Cotrimoxazole ADR and counsel tips

Answer 31

``` ADR: nausea, vomiting, myelosuppression, SJS, hyperkalemia, hepatotoxicity, photosensitivity Tips: N/V (take after food), photosensitivity, adequate hydration to prevent crystalluria, Discontinue at first sign of rash. ```

Question 32

take note of cipro/levo

Answer 32

1. Avoid in pregnancy, children, patient with altered cardiac conduction 2. Caution in pt at risk of seizures

Question 33

Cipro/Levo ADR and counsel tips

Answer 33

ADR: tendon inflammation, hypo/hyperglycemia, photosensitivity, QTc prolongation Tips: GI upset (take w food). Administration apart from Ca, Fe. CNS (headache, dizziness), photosensitivity. Tendon inflammation (discontinue at first sign of pain, esp in elderly).

Question 34

Nitrofurantoin ADR and counselling tips

Answer 34

ADR: GI, Pulmonary fibrosis (unexplained malaise, cough, SOB). Tingling extremities (neuropathy) with dose-accumulation. Tips: Take with food (incr absorption, reduce GI upset). Nausea, headache, dark-coloured urine.

Question 35

things to note of nitrofurantoin

Answer 35

Not for pyelonephritis. Avoid in renal impaired Crcl < 30ml/min, pregnancy at term (38-42 weeks), G6PD def

Question 36

Amoxicillin/Clavulanate ADR and tips

Answer 36

ADR: cholestatic jaundice, GI esp diarrhea, vaginal mycosis Tip: take w/ or w/o food. N&V, diarrhoea

Question 37

things to note of Amoxicillin/Clavulanate

Answer 37

Avoid in penicillin allergy, history of hepatic impairment with Augmentin/penicillin. Generally safe in pregnancy

Question 38

things to note for Fosfomycin

Answer 38

Not for pyelonephritis; not for CrCl<30ml/min

Question 39

Fosfomycin ADR and tips

Answer 39

ADR: headache, diarrhoea, vaginitis Tips: Take with/ without food, HA, diarrhoea