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5 Infection > General antibiotic quiz > Flashcards

General antibiotic quiz Flashcards

1
Q

Counselling for doxycycline

A

Don’t take indigestion remedies or medicines containing iron or zinc for 2 hours before/after
Protect skin from sunlight and don’t use sunbeds
Take with a full glass of water

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2
Q

Why don’t we give doxyxyline to children

A

deposition of tetracyclines in bones and teeth of under 12

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3
Q

Antibiotics that interact with statins & action to take

A

Clarithromycin & erythromycin - increase Increased risk of mypoathy - simv should be withheld during treament

Daptomycin, fusidic acid and telithromycin
Avoid all statins and for 7 days after fusidic acid dose

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4
Q

What diuretics interact with aminogylcosides and vanc?

A

Loop - increase risk of ototoxicity

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5
Q

Diuretic interaction with trimethoprim?

A

Increased risk of hyperglycemia with spironolactone - increase monitoring

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6
Q

2 CSM warnings for quinolones

and one other drug that increases the likelihood of this occuring

A

Convulsions - even in pt with no history. Increase likelihood with NSAIDs

Tendon damage

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7
Q

Who is more prone to tendon damage as a result of taking a particular class of antibiotcs

A

Quinolones:

  • over 60
  • history of tendon disorders
  • corticosteroids

If suspected stop quinolone immediately

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8
Q

Anti-infectives that can prolong the QT interval (5)

A

Erythromycin
Clarithromycin

Moxifloxacin

Fluconazole
Ketoconazole

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9
Q

Other medicines that can prolong the QT interval (5)

A 
Some:
Antiarrhymics (amiodarone)
Antipsychotics
Antidepressants
Antiemetics (domepridone/ondansetron)
Methadone
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10
Q

Does ciprofloxacin interact with much? (2)

A

Yes - it’s a CYP inhibitor (e.g. theophylline)

Also NSAIDs with cipro increases risk of convulstions

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11
Q

Interactions with co-amoxiclav

A

Nothing significant

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12
Q

Caution with co-amoxiclav

limits treatment course to ……. days

A

14 days
Cholestatic jaundice - liver tox risk 6x greater than with just amox. Greater risk in over 65. Can occur shortly after use.

Usually self limiting.

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13
Q

Rare but serious potential side-effect of penicillins

A

CNS toxicity (high doses and renal failure increase risk)

Therefore penicillin should not be given intrathcally

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14
Q

Patients with history of …… more at risk of penicillin anyphalaxis

A

atopic allergy - asthma, eczema, hayfever

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15
Q

Compare a rash likely to be penicillin allergy and one that isn’t

A

anaphylaxis, urticaria or rash immediately after administration = likely

Minor rash (non-confluent, non-pruritic, small) occuring 72 hours after admin = less likely

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16
Q

What classes of antibiotic should penicillin allergic patients not recieve

A

cephlasporins or beta-lactams

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17
Q

Interaction of methotrexate and an antibiotic

A

Trimethoprim - bone marrow suppression and other blood things

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18
Q

Restrictions in the use of co-trimoxazole

A

Should only be used for exacerbations of bronchitis/UTI/otitis media when there is evidence of sensitivity and good reason to prefer this to single antibacterial

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19
Q

Rare serous side-effect of co-trimoxazole

A

blood disorders or rash (e.g. steven-johnsons syndrome) - discontinue immediately

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20
Q

Effect of tetracyclines on warfarin

A

increase anticoagulant effect

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21
Q

Rare serious side effect of tetracyclines and a class of drugs that increases the risk

A

Benign intracranial hypertension - report headache and visual disturbance.
Increased with retinoids

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22
Q

Antibiotic colitis and diarrhoea is more common with broad or narrow spec

A

broad

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23
Q

Cholestatic jaundice is particular risk with which penicillin and what are the risk factors…? (3)

A

Fluclox
Over 2 weeks
Increasing age
Hepatic dusfunction

Can occur up to two months after treatment

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24
Q

effect of metronidazole on warfarin

A

increased anticoag effect

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25
Q

Long term s/e of nitrofuranitoin (2)

A

liver issues and pulmonary fibrosis (monitor)

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26
Q

Who should be notified about notifiable disease

A

Proper officer of the local authority

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27
Q 
What are these examples of?
Acute encephalitis
Acute infectious hepatitis
Acute meningitis
Acute poliomyelitis
Anthrax
Botulism
Brucellosis
Cholera
Diphtheria
Enteric fever (typhoid or paratyphoid fever)
Food poisoning
Haemolytic uraemic syndrome (HUS)
Infectious bloody diarrhoea
Invasive group A streptococcal disease
Legionnaires’ disease
Leprosy
Malaria
Measles
Meningococcal septicaemia
Mumps
Plague
Rabies
Rubella
Severe Acute Respiratory Syndrome (SARS)
Scarlet fever
Smallpox
Tetanus
Tuberculosis
Typhus
Viral haemorrhagic fever (VHF)
Whooping cough
Yellow fever
A

Notifiable diseases

28
Q

Empirical treatment for meningitis

A

Benzylpenicillin
OR cefotaximine or chloramphenicol in allergy

Dexamethasone as adjuvant

29
Q

Preventative therapy for meningitis

A

Ciprofloxacin, Rifampicin or ceftriaxone
Healthcare workers don’t require unless direct exposure to mouth and nose droplets of patient treated for less than 24hours

30
Q

Antibacterial therapy for otitis externa

A

Flucloxacillin or clarithromycin in allergy

31
Q

Antibacterial therapy for otitis media

A

Usually viral - only start antibacterial soap after 72 hours (amoxicillin or clarithromycin)

32
Q

Antibacterial therapy for c diff

A

Oral metronidazole
Then
Oral vancomycin

33
Q

Are penicillins or cephalosporins preferred for dental infections

A

Penicillins - cephalosporin are less effective against anaerobes

34
Q

Are organisms causing dental infections likely aerobic or anaerobic ?

A

Anaerobic

35
Q

First line for dental infections

A

Phenoxymethyl penicillin or metronidazole

36
Q

CAP treatment low,med and high severity

And treatment duration

A

Low severity pneumococci - amoxicillin (7 days)

Med severity - amoxicillin + clarithromycin or doxy (7-10days)

High severity - benpen or co-amoxicillin + clarithromycin or doxy (7-10 days)

37
Q

What would make you treat someone with cap automatically with high severity treatment

A

Nursing home

Comorbidities

38
Q

Cap treatment if staph suspected

A

For all With staphylococci add flucloxacillin - total 14-21 days

39
Q

Treatment for pneumonia caused by atypical pathogens

A

Clarithromycin

40
Q

What makes HAP early onset

A

Less than five days after admission to hospital

41
Q

Treatment for early and late onset hap

A

Early - coamox

Late - tazocin

42
Q

What to add to HAP if MRSA suspected

A

Vancomycin

43
Q

What to add to hap in pseudomonas aeruginosa suspected

A

Aminoglycaside

44
Q

Treatment for exacerbation of COPD and duration

A

Amox or tetracycline for five days

45
Q

When do you treat and exacerbation of COPD?

A

Increased sputum purilence

Accompanied by increased sputum volume or sob

46
Q

Treatment for cellulitis

A

Flucloxacillin

47
Q

2 drugs that should not be used alone for MRSA s resistance rapidly develops

A

Rifampicin

Fusidic acid

48
Q

Is MRSA gram positive or negative ?

A

Positive

49
Q

First line for MRSA

… And what to treat with if severe?

A

A Tetracycline +/- Rifampicin & Fusidic acid

If severe use glycopeptide (e.g vancomycin )

50
Q

Why do we not normally use Linezolid for mixed gram infections

A

Not active against gram negative

51
Q

Duration and number of drugs used in the phases of TB

A

Initial - Four drugs for two months

Continuation - 2 drugs for four months

52
Q

Drugs for the initial phase of TB

A

Iaoniazid
Rifampicin
Pyrazinamide
Ethambutol

53
Q

Continuation phase of TB components

A

Isoniazid and Rifampicin

54
Q

Colour that Rifampicin chafed urine?

A

Red orange

55
Q

Difficult with treating tab in children?

A

Ethambutol can effect eyesight but it’s difficult to test in children and hard to get the, to report visual symptoms

56
Q

Two most common organisms causing UTI

A

Ecoli

Then staphylococcus saprophyticus in young sexually active women

57
Q

Treatment duration for UTI

A

7 days or 3 days if uncomplicated in women

58
Q

First line for Utis

A

Trimethoprim or nitro

Alternatively Amox, ampicillin or oral cephalosporin

59
Q

First line for upper UTI

A

Cephalosporin (cefuroxamine)

60
Q

Duration of treatment for an upper UTI

A

10-14 days

61
Q

UTI in pregnancy treatment (3)

A

Penicillins or cephalosporins

Nitrofurantoin but avoid this at term

62
Q

Can nitrofurantoin be used in renal impairment

A

Should be avoided

63
Q

Treatments for UTI in children

A

From 3 months - trimethoprim, cephalosporins or nitrofurantoin

64
Q

Who does pneumocystis pneumonia occur in ?

A

Immunocompromised patients

65
Q

What is first line for pneumocystis pneumonia ?

A

Co-trimoxazole (also used prophylactically until immune recovery daily or on alternate days)

May also give corticosteroids as a adjuvant in HIV

5 Infection (9 decks)

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