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cardiovascular system 1 > INFECTION > Flashcards

INFECTION Flashcards

1
Q

What is a super infection

A

An infection on top another infection eg cephalosporin eg fungal infections or abx associated colitis

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2
Q

Examples of broad spectrum abx

A

Aminoglycosides
Macrolides
Carbapenems
Cephalosporin
Tetracycline
Quinolones
Ampicillin
Amoxicillin
Chloramphenicol

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3
Q

Examples of narrow spectrum Abx

A

Vancomycin, Teicoplanin
Penicillin G
Clindamycin
Mnemonic
Narrow TV and PC

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4
Q

What is sepsis

A

A life threatening medical emergency, affects body reaction to severe infection, affects whole body

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5
Q

What is septicemia

A

Infection of the blood caused by bacteria, fungi or virus

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6
Q

Symptoms of sepsis in adults

A

Shivering
Extreme pain or general discomfort (worst ever)
Pale or discoloured skin
Sleepy, lethargic
I feel like I might die”
Shortness of breath

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7
Q

Mnemonic of sepsis

A

SEPSIS

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8
Q

Signs of sepsis to watch out for in children/ babies

A

Very high or low temperature ( feels hot or cold to touch)
No urine in last 12hours
Vomiting
Breathing fast ( breathlessness)
Non- blanching rash- like meningitis
Blue/ pale skin or lips
Babies ( High pitch cry and lethargic)

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9
Q

Call 999 or go to A and E if a baby or young child has any of the following symptoms

A

See photo

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10
Q

How to treat sepsis

A

Give broad spectrum antibiotics at max recommended dose ideally within 1hour to reduce risk od severe illness or death for pat at high risk

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11
Q

Give example of abx offered to pt with meningcocal sepsis in a community setting

A

Parental benzylpenicillin

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12
Q

What broad spectrum abx is offered to pt with meningococcal sepsis in hospital setting

A

IV ceftraxone

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13
Q

Parameters to monitor in high risk patients every 30 mins with sepsis

A

High resp. Rate, regularly no less than every 30mins

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14
Q

What are notifiable disease

A

Disease where there could be a public health risk
Doctors must notify the proper officer, the local authority
Eg anthrax, whooping cough, small pox, TB , typhoid

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15
Q

Which abx needs to be taken before food/empty stomach?

A

DROPFAT
Label 23 and 22
Demecyclocycline
Rifampicin
Oxytetracycline
Phenoxymethyl penicillin
Flucloxacillin
Ampicillin
Tetracycline
An hour before food or two hours after food
30-60mins before food

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16
Q

List of abx to be taken with food or just after food

A

Label 21
MPN
Metronidazole
Nitrofurantoin
Pvmecillinam

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17
Q

Which abx can be taken with milk

A

Label 6
DOX Like Milk
Doxycycline
Lymecycline
Minocycline

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18
Q

Abx you cannot take with milk

A

C.DOT
Label 7
Ciprofloxacin
Demeclocycline
Oxytetracycline
Tetracycline

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19
Q

Abx that require protection against sunlight (photosensitivity)

A

Doxycycline
Demeclocycline - most sensitive to sunlight
Tetracyclines

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20
Q

Abx to avoid in pregnancy

A

Tetracycline
Aminoglycoside
Macrolides
Co-trimaxole
Rifampicin
Metronidazole
Quinolones
Nitrofurantoin

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21
Q

Important safety information and advice for flucloxacillin

A

Cholestatic jaundice and hepatitis

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22
Q

Contraindication of co-amoxiclav

A

History of co-amoxiclav-associated jaundice or hepatic dysfunction; history of penicillin-associated jaundice or hepatic dysfunction

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23
Q

Important safety information for linezolid

A

Blood disorder and optc neuropathy

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24
Q

Safety warning for Co-trimoxazole

A

Discontinue if ( severe allergic rxn and blood disorder occur

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25
Q

Safety warning for Quinolones

A

Tendon damage, arthropathy( joint problems) in children and convulsions with NSAIDs
See Bnf

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26
Q

What abx color urine and what color?

A

Rifampicin
Nitrofurantoin
Orange/brown

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27
Q

Signs of blood disorder caused by abx

A

Sore throat
Fever
Malaise
Rash
Mouth ulcers
Bruising or bleeding

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28
Q

Which Abx cause blood disorder

A

Trimethoprim
Co-trimoxazole
Linezolid
Gentamicin
Vancomycin

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29
Q

Contraindications with penicillin

A

Penicillin allergy

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30
Q

Contraindications with tetracyclines

A

Children less than 12 and pregnant

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31
Q

Contraindications with Quinolones

A

Hx of tendon disorders related to Quinolones use

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32
Q

Contraindications with Aminoglycoside

A

Myasthenia gravis

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33
Q

First line tx c.diff

A

Vancomycin

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34
Q

Whats the second line tx for c diff

A

Fidaxomicin

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35
Q

Relapse less than 12 weeks for c diff

A

Give fidaxomicin

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36
Q

Relapse greater than 12 weeks

A

Give fidaxomicin or Vancomycin

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37
Q

If first and 2nd line not effective for c diff

A

Use IV Metronidazole initiated by Specialist

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38
Q

Tx for acute pyelonephritis in non pregnant women and men

A

Oral first line
Cefalexin or ciprofloxacin
First line IV: Amikacin , gentamicin, ceftrixone and ciprofloxacin

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39
Q

First line tx for pyelonephritis in pregnant women

A

Oral - cefalexin
IV: cefuroxime

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40
Q

What abx do you give for animal/ human bite?

A

Co-amoxiclav
Allergy- Doxycycline plus Metronidazole

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41
Q

What to give a pt with cellulitis who is allergic to penicillin( flucloxacillin)?

A

Clarithromycin, dox or erythromycin

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42
Q

Causative organism for UTI

A

E.coli

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43
Q

Causative organism for whooping cough

A

Bordetella pertusis

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44
Q

Causative organism for gonorrhea

A

Neisseria gonorrhoea

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45
Q

Causative organism for colitis

A

Clostridium difficle

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46
Q

Causative organism for TB

A

Mycobacteria tuberculosis

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47
Q

Causative organism for food poisoning

A

Salmonella, shigella, E.coli, norovirus

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48
Q

Abx to tx anaerobic infections

A

Metronidazole

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49
Q

Abx to tx streptococci infection

A

Phenoxymethypenicillin

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50
Q

Abx to tx staphylococcal infections

A

Flucloxacillin

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51
Q

Abx to tx MRSA

A

Vancomycin

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52
Q

Abx to tx pseudonyms aeruginosa

A

Gentamicin

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53
Q

Abx used to tx hospital acquired pneumonia ( Non severe signs and symptoms)

A

Oral co-amoxiclav alternatively Dox or co- trimoxazole( unlicensed)

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54
Q

Abx used to tx CAP

A

Amoxicillin alternatively dox or erythromycin or clarithromycin
High Severity- Co-amoxiclav with clarithromycin

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55
Q

What is CURB65 score?

A

It is used to assess the Severity of pneumonia
C- confusion
U- Urea
R- Respiratory rate
B- blood pressure
65 = Age greater or equal to 65

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56
Q

Contraindications of Aminoglycoside

A

Myasthenia gravis

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57
Q

Common side effects of Aminoglycoside eg Gentamicin

A

Ototoxicity
Nephrotoxicity( occurs mostly in patients with Renal impairment)
Risk in pregnancy ( auditory nerve damage in infant)

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58
Q

Signs of Ototoxicity

A

Tinnitus or ringing in the ear
Hearing loss
Dizziness
Uncoordination in movement

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59
Q

Signs of nephrotoxicity

A

Decreased urine output
SOB
Fluid retention ( swelling in legs, ankles and feet)
Fatigue

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60
Q

Dose adjustment in renal impairment in pt taken Aminoglycoside

A

If renal impairment, increase dose interval

Reduce dose in severe impairment

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61
Q

Monitoring requirements with Aminoglycoside

A

Plasma concentration
Renal function
Auditory and vestibular function

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62
Q

Side effects of Gentamicin

A

Abx associated colitis
Blood disorder
Depression
Neurotoxicity
Vestibular damage
Skin reactions
Tinnitus N and V
Neurotoxicity
Deafness
Increased infection

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63
Q

CHM/ MHRA warning for Aminoglycoside

A

Increase risk of deafness(Ototoxicity) in pts with mitochondrial mutation
Potential for histamine related adrs with some batches , caution with patients on drugs which release histamine eg opiods

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64
Q

What bacteria is Gentamicin used against

A

It is used to tx pseudomonas aeroginosa, other E.coli , klebsiella , staph aureus etc

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65
Q

What are some examples of carbapenems

A

Imipenem, meropenem, ertapenem and doripenem

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66
Q

Side effects of carbapenems

A

Diarrhoea, N and V
Headache
Allergy and cross sensitivity

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67
Q

MOA of cephalosporin

A

Attach to penicillin binding proteins to interrupt cell wall biosynthesis leading to Bacterial cell lysis or death

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68
Q

Indication of cephalosporin

A

Septicaemia, pneumonia, meningitis billary tract infections, peritonitis and urinary tract infection

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69
Q

How’s cephalosporin excreted?

A

Renally

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70
Q

Cephalosporin is structurally similar to…

A

Penicillin

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71
Q

List examples of cephalosporin suitable for infections of CNS eg meningitis

A

Cefotaxime and ceftriaxone

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72
Q

Main side effect cephalosporin

A

Allergy and anaphylaxis

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73
Q

What is the therapeutic class of vancomycin

A

Glycopeptide antibacterials

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74
Q

Drug action of Vancomycin

A

Bactericidal activity against aerobic and anaerobic Gram positive Bacteria

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75
Q

Indication of Vancomycin

A

C.difficile

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76
Q

What is the side effect of Vancomycin

A

Agranulocytosis, dizziness, drug fever hypersensitivity, neutropenia, skin rxns, RED man syndrome ( Infusion related rxn)

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77
Q

State when to withdraw Vancomycin

A

Discontinue if Tinnitus occurs

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78
Q

Monitoring with Vancomycin

A

Trough conc range 10-20mg/L
Monitor FBC , renal and hepatic function
Vestibular and auditory function

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79
Q

Drug action of Clindamycin

A

Against Gram positive bacteria

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80
Q

Indication of Clindamycin

A

Bone and joint infections eg osteomyelitis, potential bone and joint infection

Alternative to Macrolides esp in penicillin sensitive patients

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81
Q

Clindamycin is contraindicated in

A

Diarrhoea state

82
Q

Side effects of Clindamycin

A

Abx associated colitis( fatal) occurs most frequently with Clindamycin than other abx

83
Q

State when to discontinue Clindamycin

A

Discontinue if diarrhoea occur and Contact Dr.
Discontinue if c.difficile suspected or confirmed ( diarrhoea and watery stool

84
Q

Monitoring with Clindamycin

A

Liver and renal function if tx exceed 10days

85
Q

Examples of Macrolides

A

Erythromycin, clarithromycin, Azithromycin

86
Q

MOA of Macrolides

A

Bacteriostatic, they stop bacteria cell growth

87
Q

Facts about Macrolides

A

Broad spectrum abx
Similar to penicillin
Active against many penicillin resistant staphylococcus
Alternative for penicillin allergic pts

88
Q

Common indication of Macrolides

A

Respiratory/skin /soft tissue infection
Severe pneumonia
Eradication of H.pylori with PPI and amoxicillin

89
Q

Interaction of Macrolides

A

Clarithromycin and erythromycin are enzyme inhibitors
Increase plasma concentration of drugs eg warfarin and simvastatin- muscles pain

90
Q

Indication of erythromycin

A

Respiratory tract infection, legionella, skin and oral infection, campylobacter enteritis, early syphilis

91
Q

Side effects of Erythromycin

A

N,V and diarrhoea ( give lower dose to avoid in mild infection

92
Q

Cautionary labels for Erythromycin

A

Label 9
Swallow this medicine whole
Space dose evenly via out the day

93
Q

Is erythromycin safe in pregnancy and bf?

A

Use only if potential benefit outweighs risk

94
Q

Erythromycin might cause what kind of impairment

A

May cause hepatoxicity

Cerebral impairment,
AV block
can cause Ototoxicity in adults and children at high doses

95
Q

Facts about Azithromycin

A

Less active than erythromycin over Gram positive but enhanced activity over some Gram negative and H influenza

96
Q

Half life of Azithromycin

A

Long tissue half life and Once daily dosage recommended

97
Q

Pregnancy and Breastfeeding with Azithromycin

A

Use only if no other alternative

98
Q

Cautionary label for Azithromycin

A

Label 5, 9 for other medicinal forms and 23 for capsules
Label 23 -“take this medicine when your stomach is empty or 2hrs before or after food

99
Q

What is Azithromycin used to tx OTC?

A

Confirmed asymptomatic Chlamydia infection in age greater than 16 old and sexual partner ( needs a doctors prescription)

100
Q

Dose of Azithromycin used to tx Chlamydia

A

Max single dose of 1g , max daily dose 1g and a pack size of 1g

101
Q

First line tx for Chlamydia

A

Doxycycline

102
Q

Alternative treatment for uncomplicated chlamydial infection

A

Azithromycin

103
Q

Facts about Clarithromycin

A

Erythromycin derivative with slightly greater activity
Most commonly prescribed Macrolides, more stable and causes less side effect
Tissue conc higher than with Erythromycin
Given twice daily

104
Q

Indication of clarithromycin

A

See bnf

105
Q

Is clarithromycin safe in pregnancy?

A

Avoid especially in the first trimester. Only use if benefit outweigh risk

106
Q

Clarithromycin in hepatic and renal impairment

A

Avoid

107
Q

Cautionary labels for clarithromycin

A

9
Space dose evenly throughout the day

108
Q

Side effects of penicillin

A

Hypersensitivity
Diarrhoea
Encephalopathy when given intrathecal injection

109
Q

Higher risk of anaphylaxis occur in which patient group taking penicillin?

A

Asthma
Eczema
Hayfever

110
Q

Facts about benzylpenicillin

A

Pen G, inactivated by beta lactamases
Inactivated by gastric acid and absorption from GI Tract is low, therefore must be given by injection

111
Q

Indication of Benzylpenicillin

A

Throat infections, otitis media, cellulitis, pneumonia, anthrax and streptococcal infection, meningitis

112
Q

Important safety information for Pen G

A

Intrathecal injection not recommended

113
Q

Caution with Pen G

A

Accumulation of sodium from injection can occur with high doses especially in renal failure

114
Q

Side effects of PEN G

A

Fever

115
Q

Is PenG harmful in pregnancy and BF?

A

Not known to be harmful

116
Q

Benzylpenicillin and renal Impairment

A

High doses may cause neurotoxicity ( cerebral irritation, convulsion or coma

117
Q

All penicillin safe in pregnancy. True/false

A

True

118
Q

Facts about PEN V( phenoxymethypenicillin)

A

Similar activity to pen G
Gastric acid stable , so suitable for oral administration

119
Q

Indication for Pen V

A

Indicated principally for respiratory infections in children, oral infections, tonsillitis, otitis media, cellulitis, streptococcal infections and acute sinusitis

120
Q

Side effects of PenV

A

Coagulation disorder, increased risk of infection , neurotoxicity, oral disorder, paraesthesia

121
Q

Cautionary label for pen V

A

9 and 23
Take this medicine when your tummy is empty. An hour before food or two hrs after food
Space dose evenly via out the day
Drop fat

122
Q

Facts about ampicillin

A

Active against certain Gram positive and Gram negative organism
Can be given orally but less than half absorbed
Absorption further decreased by presence of food in gut( take before food)

123
Q

Main indication of Ampicillin

A

Chronic bronchitis
Middle ear infection and UTI

124
Q

Side effects of penicillin

A

Maculopapular rash( Ampicillin and amoxicillin)
Colitis haemorrhagic

125
Q

Cautionary label for Ampicillin

A

9 and 23

126
Q

Facts about amoxicillin

A

Derivative of Ampicillin with similar antibacterial spectrum
Better absorbed by mouth than Ampicillin which produces higher plasma and tissue concentration
Absorption not affected by food

127
Q

Indication of amoxicillin

A

UTI, otitis media sinusitis, uncomplicated CAP, salmonellosis, oral infections, Lyme disease anthrax, dental assessment, H.pylori

128
Q

Cautionary label for amoxicillin

A

9
Space dose evenly through out the day

129
Q

State how to differentiate between a severe and minor side effect of pen (allergy)

A

Immediate rash indicate severe
Rash after 3days, small rash non itchy- minor side effect. Continue taking penicillin

130
Q

Major Interaction of amoxicillin

A

Allopurinol- increase risk of skin rash
Methotrexate- increase risk of toxicity
Warfarin- Alters Anticoagulant effect of Warfarin
W.A.M

131
Q

Facts about Co- amoxiclav

A

Betalactamase inhibitor
Amoxicillin with clavulanic acid

132
Q

What infection is Co-amoxiclav used for?

A

Reserved for infections caused by amoxicillin resistant beta lactamase producing strain

133
Q

Is Co-amoxiclav safe in pregnancy?

A

Not known to be harmful

134
Q

Contraindication of co-amoxiclav

A

History of co-amoxiclav-associated jaundice or hepatic dysfunction; history of penicillin-associated jaundice or hepatic dysfunction

135
Q

Facts about flucloxacillin

A

Effective against infections caused by penicillin resistant staphylococcus ( impetigo, otitis external, cellulitis, pneumonia
Acid stable
Give orally or injection

136
Q

Safety info for flucloxacillin

A

Hepatic disorders such as cholestatic jaundice and hepatitis may occur rarely up to 2months after flucloxacillin had been stopped
Admin for greater 2wks and increasing age are risk factors

137
Q

Advice for flucloxacillin

A

Don’t use in pt with hx of hepatic dysfunction associated with flucloxacillin
Caution in pt with hepatic impairment
Carefu enquiry should be made about hypersensitivity reactions to beta lactam antibiotics

138
Q

Alternative for penicillin allergy

A

Macrolides/tetracycline
DEC
Doxycycline, erythromycin and clarithromycin

139
Q

Egs of Quinolones

A

Nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin

140
Q

Indication of Quinolones

A

Uncomplicated UTI
Respiratory infections
Bone and joints infections
Gonorrhoea
GI infections

Avoid in MRSA infections (not effective)

141
Q

Safety info for Quinolones

A

May induce convulsions in pts with or without hx of seizure
Taking NSAIDs at the same may induce convulsions

Tendon damage in pts within 48hrs of starting tx
Patient > 60yrs higher risk of tendon damage
Concomitant use with corticosteroid can increase the risk of tendon damage

142
Q

State when to discontinue Quinolones

A

If tendinitis occur

143
Q

Contraindications of Quinolones

A

Hx of tendon damage associated with Quinolones use

144
Q

Caution with Quinolones

A

QT prolongation
Increase risk of Arrhythmia
Pts with hx of epilepsy or seizure
Avoid exposure to excessive sunlight
Discontinue if photosensitivity occur

145
Q

Is Quinolones safe in children and growing adults?

A

Not recommended
Can cause athripathy ( joint diseases eg arthritis

146
Q

State when to discontinue Quinolones

A

If psychiatric, neurological ( hallucination) or hypersensitivity reactions occur

147
Q

Quinolones causes athropathy in pregnancy. True or false?

A

True

148
Q

Cautionary label for Quinolones

A

7, 9 and 25

149
Q

Are tetracycline broad or narrow spectrum abx?

A

Broad ( value decrease due to resistance)

150
Q

Common indication of tetracycline

A

Acne, pneumonia, Chlamydia and rickettsia
MRSA infections

151
Q

Eg of tetracycline that is different from the rest

A

MINOCYCLINE

152
Q

Facts about Minocycline

A

Broader spectrum
Greater risk if lupus- like syndrome ( photosensitive rash, swelling, unexplained fever etc)
Sometime cause irreversible pigmentation

153
Q

Caution for tetracycline

A

Can increase muscle weakness in pts with myasthenia gravis

Antacids and aluminium, Ca, Fe, Mg and Zn salts decrease absorption of Tetracycline and milk

9,7, 6,11
See bnf

154
Q

State when to discontinue tetracycline

A

If intracranial hypertension ( headache and visual disturbance occur)

155
Q

Side effects of tetracycline

A

Headache
N and V ,D
Photosensitivity rxn
Skin reactions
Discolouration of tooth enamel in children
Dysphagia and oesophageal irritation esp with DMT - advice pt to swallow whole with plenty of fluid during meals while standing or sitting upright ( label 27)

156
Q

Important interactions of tetracycline

A

Do not give within 2hrs before or after food
Photosensitivity esp dox and demeclocycline
Binds to diavalent cations preventing absorption of Cations such as , Fe , Ca and antacids

157
Q

Contraindications of tetracycline

A

Avoid in under 12’s, pregnant and Breastfeeding
Binds to growing teeth and bones
Leads to discontinuation of child’s teeth in 2nd and 3rd trimester

158
Q

When to avoid tetracycline/ caution

A

Pts with hepatic impairment

159
Q

What’s Trimethoprim indicated for?

A

UTI and respiratory tract infections( chronic bronchitis, pneumonia

160
Q

Mode of action of Trimethoprim

A

Bacteriostatic
Folate antagonist, therefore Teratogenic and can cause blood disorder( broad spectrum abx)

161
Q

Trimethoprim is contraindicated in

A

Blood disorders

162
Q

Side effects of Trimethoprim

A

Diarrhoea, electrolytes imbalance, fungal overgrowth, headache, nausea, skin reactions, vomiting and blood disorder

163
Q

When to avoid Trimethoprim in pregnancy

A

Avoid in first trimester (Teratogenic) causes fetal abnormalities

164
Q

Monitoring while on Trimethoprim

A

Full blood counts on long term therapy
Renal function
Electrolyte- due to risk of hyperkalaemia
Plasma - trimethoprim concentration

165
Q

Patient and carer’s advice

A

Long term tx patient how to recognise signs of blood disorder

166
Q

State the symptoms of blood disorder to watch out for patients on Trimethoprim

A

Fever, sore throat, rash, mouth ulcers, purpura , bruising or bleeding develops

167
Q

Cautionary label for Trimethoprim

A

Label 9

168
Q

The only abx that is a MAOI is called

A

LINEZOLID

169
Q

MHRA/CHM warning for Linezolid

A

Severe optic neuropathy particularly if used longer than 28days
Warn pt to report signs of impairment
Blood disorders
Can cause Hypertensive crisis, avoid eating tyramine rich food

170
Q

Signs of visual impairment for pt on Linezolid

A

Blurred vision, visual field defect, changes in colour and visual acuity immediately

171
Q

How often should you monitor blood count/ platelet count in patient taken Linezolid?

A

Weekly

172
Q

Facts about Linezolid used as abx

A

It’s a reversible , non selective inhibitor of MAO, however it dose used as abx does not have any antidepressant effect

173
Q

Indication of Nitrofurantoin

A

UTI

174
Q

Treatment duration of Nitrofurantoin

A

Usually 3days

175
Q

Nitrofurantoin tx duration in male and pregnant women

A

7days

176
Q

Contraindication of Nitrofurantoin

A

Acute porphyria, G6PD deficiency, infant less than 3 months

177
Q

Caution with Nitrofurantoin

A

Anaemia, diabetes, electrolytes imbalance, folate deficiency, pulmonary disease, Vit B deficiency

178
Q

Is Nitrofurantoin safe in pregnancy?

A

Avoid at term, may produce neonatal haemolysis

179
Q

Renal impairment with Nitrofurantoin

A

Avoid if EGFR is less than 45ml/mins
Use with caution if EGFR is 30-34 as a short course for 7days to tx uncomplicated UTI caused by suspected or proven multi drug resistant bacteria and if benefit outweighs risk

180
Q

Monitoring with Nitrofurantoin

A

Liver function
Pulmonary function especially in elderly
Avoid if deterioration in lung function

181
Q

Dose of Nitrofurantoin used to tx lower UTI

A

50mg QDS (IR)
100mg BD ( MR) for 3days

182
Q

Tx dose for Nitrofurantoin in male and pregnant women

A

50mg QDS [ IR]
Or
100mg BD for 7days

183
Q

Tx dose of Trimethoprim for lower UTI

A

200mg BD for 3days

184
Q

Tx dose of Trimethoprim for lower UTI in male

A

200mg BD for 7days

185
Q

How many drugs are used in the initial phase to tx TB

A

Four(4) drugs
Rifampicin, Isoniazid, Pyrazinamide, Ethambutol
(RIPE)
2months duration

186
Q

How many drugs used in the continuous phase to tx tB and duration

A

Two(2) drugs
RIISON
Rifampicin and Isoniazid
4months

187
Q

All tuberculosis drugs but one are hepatoxic . Name the one

A

Ethambutol

188
Q

Monitoring requirements with TB drugs

A

Signs of hepatoxicity
Check renal and hepatic function before tx

189
Q

What are the signs of liver toxicity to watch out for?

A

Fever, malaise, vomiting, jaundice, unexplained deterioration

190
Q

How often should you monitor pts with preexisting liver disease and alcohol dependence taking TB drugs?

A

Frequent liver check in first two months

191
Q

Facts about Rifampicin

A

It’s an enzyme inducer
Can cause discolouration of urine( orange -red)
Colour soft contact lenses

192
Q

Patient and carer advice for Rifampicin

A

Colour soft contact lenses
Discontinue medicine if signs of liver disorder occurs
Colour bodily fluid

193
Q

Which of the TB drug causes causes peripheral neuropathy?

A

Isoniazid
Give vit B6( pyridoxine hcl from start of tx to prevent neuropathy
More likely to occur if there are pre existing risk factors such as diabetes, pregnancy, HIVv CRF, etoh deficiency

194
Q

Pt and carer advice for Ethambutol

A

Causes visual side effects
Discontinue therapy immediately if any deterioration in vision, seek advice promptly

195
Q

Monitoring for ethambutol

A

Renal function should be checked before treatment
Test visual acuity using Snellen chart before tx

196
Q

Common side effects of ethambutol

A

Hyperuricaemia, nerve disorder, visual impairment

197
Q

What is Metronidazole used to tx

A

Trichomonal vaginitis
Bacterial vaginitis
Vaginosis
C.dif
Oral infections in penicillin allergy
Topical- used to reduce microbial odours and rosacea

198
Q

Route of administration of Metronidazole

A

IV, oral, rectal

199
Q

What’s the first choice of drug to tx gingivitis in penicillin allergy

A

Metronidazole ( 400mg TDS for 3days)

200
Q

Caution with Metronidazole

A

Avoid alcohol as it causes disulfiram like rxn eg vomiting, flushing, throbbing headache, general hangover like symptoms

201
Q

Side effects of Metronidazole

A

N and V
Taste disturbance - metallic
Anorexia
Dry mouth
Oral disorders

202
Q
A

cardiovascular system 1 (42 decks)

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