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BNF GPhC > INFECTION > Flashcards

INFECTION Flashcards

1
Q

Methotrexate, clari+ery?

A

Safe

BUT AMOXI L!

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2
Q

nitrofurantoin risk?

A

pulmonary fibrosis

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3
Q

METHOTREXATE+AMOXICILLIN?

A

TOXICITY!!!!

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4
Q

RECURRENT VAGINAL THRUSH DOSE?

A

moetronidazole

150MG every third day for 3 doses+150mg ONCE weekly for 6 months

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5
Q

DISULFIRAM, DRINK ALCOHOL?>

A

FULL BODY RASH!

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6
Q

SET INTERACTION?

A

SILDENAFIL
ERYTHROMYCIN
TADALAFIL

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7
Q

isotretinoin+vitamin A, cod liver?

A

avoid in pregnant!

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8
Q

septicaemia?

A

tazobacta+piperacillin

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9
Q

osteomyelitis treatment?

A

fluclo (6 weeks)
w/
fusidic acid/rifampicin (2 weeks)

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10
Q

TRI UTI DOSE?

A

Adult

200 mg twice daily for 3 days (7 days in males).

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11
Q

UPPER UTI?

A

Oral first line (upper UTI symptoms):

Cefalexin, ciprofloxacin, co-amoxiclav (if culture susceptible), or trimethoprim (if

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12
Q

CURB65 SCORE?

A

CONFUSIONt
UREA NITROGEN>7mmol/L
RAISED RESP. RATE>/= 30breaths/min
low bp systolic <90, dyastolic /=65 years

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13
Q

CURB65 SCORE?

A

CONFUSIONt
UREA NITROGEN>7mmol/L
RAISED RESP. RATE>/= 30breaths/min
low bp systolic <90, dyastolic /=65 years

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14
Q

CRB SCORES?

A 
• low severity - CRB65 score 0 or
CURB65 score 0 or 1
• moderate severity - CRB65 score 1
or 2 or CURB65 score 2
• high severity - CRB65 score 3 or 4 or
CURB65 score 3 to 5
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15
Q

ABX WITHOUT FOOD?

A 
FAT PA- 
flucloxacillin,
ampicillin,
tetracycline/oxytetracycline,
phenoxy,
azithromycin capsules - 1 hour before food or two hours after food
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16
Q

ABX WITHOUT FOOD?

A

FAT PA?

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17
Q

d

A
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18
Q

NITROFURANTOIN

Egfr less than?

A

45, don’t use

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19
Q
  1. A 29-year old patient prescribed isoniazid as part of a tuberculosis treatment regimen
A

LIVER TOXICITY!

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20
Q
  1. A 42-year old woman who has been prescribed Yasmin® who smokes two packets of cigarettes a day
A

thrombosis

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21
Q
  1. A 51-year-old patient who has bone metastases and has been prescribed 4 mg zoledronic acid as treatment.
A

HYPOCALCAEMIA, electrolyte disturbacen

but treats
tumour induced hypercalcaemia

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22
Q
  1. A 67-year-old patient who has recently upped her lansoprazole to 30 mg twice daily.
A

hyponatraemia

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23
Q
  1. A 82 year old man who presents to hospital with jaundice. His liver function tests show raised bilirubin and alkaline phosphatase.
A

CO-AMOX, HEPATIC IMPAIRMENT

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24
Q
  1. A 68 year old woman with newly diagnosed pulmonary fibrosis
A

G ( Nitrofurantoin, SPC: Chronic pulmonary reactions (including pulmonary fibrosis and diffuse interstitial pneumonitis) can develop insidiously, and may occur commonly in elderly patients. Close monitoring of the pulmonary conditions of patients receiving long-term therapy is warranted (especially in the elderly).

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25
Q
A
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26
Q

ABX WITHOUT FOOD? EMPTY STOMACH?

A

AMPICILLIN
CO-FLUAMPICIL
FLUCLOXACILLIN
PHENOXYMETHYLPENICILLIN

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27
Q

ABX WITH FOOD?

A

PIVMECILLINAM

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28
Q

ALWAYS SENSE CHECK ANSWERS, DOES IT MAKE SENSE? RATIONALISE AND ELIMINATE EACH OPTION, READ THE Q AGAIN

A
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29
Q

TIP:

IF A QUESTION HAS AN ANTI-EPILEPTIC, IDENTIFY THE INTERACTION- MACROLIDES/QUINOLONES,NSAIDs, etc

A
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30
Q
A
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31
Q

SEVERE CELLULITIS?

A

CO-AMOXICLAV
CLINDAMYCIN
IV CEFUROXIME
IV CEFTRIAXONE

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32
Q

CELLULITIS MANAGEMENT?

penicillin allergy?

near eyes or nose?
alternative?

A

FLUCLOXACILLIN

penicillin allergy? DOXYCYLINE/CLARITHROMYCIN/ERYTHROMYCIN

near eyes or nose? CO-AMOXICLAV
alternative? CLARITHROMYCIN W/ METRONIDAZOLE

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33
Q
A
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34
Q

Hydrocortisone+quinolones?

A

Higher risk of tendonitis, okay

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35
Q

WHAT TB MEDICATION CAUSES POOR EYE VISION?

A

ETHAMBUTOL, not isoniazid

ISONIAZID is peripheral neropathy- body nerves are damaged

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36
Q

MALOFF- ATOVAQUONE w/ PROGUANIL?

A

Max 12 weeks P med

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37
Q
A
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38
Q

SIDE-EFFECTS OF INSULIN?

A

WEIGHT GAIN
OEDEMA
LIPODYSTROPHY- body storing fat,
SKIN REACTIONS

NOT WEIGHT LOSS

(hypertrophy- lump of fat tissue under skin, repeated injection)

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39
Q

Cellulitis?

A

Flucloxacillin
Doxy/Clari/Ery
Co-amoxiclav (children, not pen allergy)

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40
Q

HUMAN/ANIMAL BITES- TREATMENT

1st LINE?

2nd LINE?

PROPHYLAXIS/TREATMENT?

A

1st LINE? CO-AMOXICLAV

2nd LINE? DOXYCYCLINE AND METRONIDAZOLE

PROPHYLAXIS/TREATMENT DAYS? 3/5 DAYS

Treatment when there’s presenting symptoms*

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41
Q

CELLULITIS- TREATMENT

INFECTION NEAR EYES/NOSE

1st LINE?

PENICILLIN ALLERGY?

A

1st LINE? Co-amoxiclav

PENICILLIN ALLERGY? Clarithromycin & Metronidazole

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42
Q

AMINOGLYCOSIDES DO NOT CAUSE C DIFF

A
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43
Q

SORE THROAT TREATMENT

1st line?

2nd line?

A

SORE THROAT TREATMENT

1st line? Phenoxymethylpenicillin

2nd line? Clarithromycin or Erythromycin (in pregnancy)

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44
Q 
A Cefalexin
B Ciprofloxacin
C Clarithromycin
D Co-amoxiclav
E Vancomycin
A

normal
flucloxacillin
doxycycline/clarithromycin/erythromycin

severe
co-amoxiclav/clindamycin | iv cefuroxime/ceftriaxone

MRSA- add iv vancomycin/teicoplanin/linezolid

SO ANSWER CEFTRIAXONE?

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45
Q

TRIMETHOPRIM CAN ALSO CAUSE…?

A

BLOOD DYSCRASIA, HEAD TOP!

not hepatoxic silly

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46
Q

FLUCLOXACILLIN IS CAUTIONED IN..?

A

HEPATIC IMPAIRMENT!

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47
Q

DOXYCYCLINCE CAN BE?

A

HEPATOTOXIC, don’t forget that

can get DYSPHASIA AS WELL

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48
Q

WHAT DO WE NOT GIVE IN OTITIS MEDIA?

A

DOXYCYCLINE, don’t be fooled

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49
Q

Trimethoprim in pregnancy? Teratogenic, avoid completely!

A
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50
Q

meningitis order?

A

benzylpenicillin

cefotaxime/ceftriaxone (penicillin allergy)

chloramphenicol (immediate penicillin allergy)

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51
Q

NEPHROTOXIC DRUGS? DAMN-LAG

A 
DIURETICS
ACE
ARB
METFORMIN
NSAIDS
LITHIUM
AMINOGLYCOSIDES
GENTAMICIN
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52
Q

Clotrimazole spray?

A

Large hairy area

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53
Q

CANESTEN IN PREGNANCY?

A

With topical use:
Minimal absorption from skin; not known to be harmful.

With vaginal use:
Pregnant women need a longer duration of treatment, usually about 7 days, to clear the infection. Oral antifungal treatment should be avoided during pregnancy.

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54
Q

HYOSCINE BUTYLBROMIDE?

A

GASTRO, SICKNESS, BUSCOPAN

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55
Q

QT PROLONGATION DRUGS?

A

THE AMAZING SPIDERMAN Q

TCA amiodarone SSRIS anti antipsychotics malaria quinine/quinolone

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56
Q

INFECTIVE COPD?

A

For adults aged 18 years and over, the first-choice antibiotic for the management of an
infective exacerbation of COPD are amoxicillin, doxycycline or clarithromycin.
Doxycycline is prescribed at a dose of 200 mg on first day, then 100 mg once a day for
5‑day course in total.

OR
CO-AMOXICLAV
LEVOFLOXACIN
CO-TRIMOXAZOLE

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57
Q

MENINGITIS?

A

BENZYL
CEFOTAXIME (calm with minor penicillin alllergy)
CHLORAMPHENICOL

Signs of meningitis. 1st line is benzylpenicillin but unsuitable due to penicillin allergy.
Cefotaxime can be used as no history of immediate anaphylactic reaction to penicillins.

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58
Q

SESPSIS?

A 
B - bloods cultures
U - urinary output 
F - IV fluids adm
A - antibiotics broad spec IV
L - lactate levels 
O - O2 if hypoxia
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59
Q

YELLOW-GREEN DISHARGE?

A

TRICHO

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60
Q

VAGINAL DISCHARGE GUIDE

A
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61
Q

One week after his hospital admission, the patient develops diarrhoea. A stool sample confirms
the presence of Clostridium difficile infection. Doctors decide to stop the lansoprazole and review
the antibiotic for his infection.
Which ONE of this patient͛s medications listed below is MOST likely to require temporary
discontinuation in view of his Clostridium difficile infection?

A

IBUPROFEN NSAID, he’s sick!!

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62
Q

CLARI, ATYPICAL PATHOGENS!

A
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63
Q

Penicillin V PHENOXYMETHYLPENICLLIN?

A

empty stomach

space doses evenly

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64
Q

A 4–year-old girl, presents with sore throat, low-grade fever and tender lesions in the mouth and papulovesicular lesions of the distal limbs

A

HAND
FOOT
MOUTH DISEASE

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65
Q

WAT THIS?

A

hives

batches of red/skin-coloured welts? itching, painful swelling?

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66
Q

A 73-year-old man with a history of allergy to penicillin (anaphylaxis) and
azithromycin (anaphylaxis), who is feeling unwell. His respiratory rate is 19
breaths/minute and his blood pressure is 121/82. He has a history of cough for
1 week.. Single choice.

A

DOXYCYCLINE

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67
Q

daktarin sugar free minimum age?

A

4 months+

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68
Q

A 26-year-old woman has contact dermatitis on her wrist. The maximum
number of times per day that hydrocortisone cream should be used is

A

twice

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69
Q

antibiotic-associated colitis

A

loperamide capsules

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70
Q

DD

cutanoues

lipohyper…

A
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71
Q

Clindamycin also used in cellulitis btw, but severe? Hm

A
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72
Q

WARFARIN-RIVAROXABAN, when INR?

A

<1.5, no need monitoring, safe

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73
Q

DOXYCYCLINE

HEADACHE VISUAL BENIGN REPORT

A
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74
Q

H PYLORI

A
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75
Q

MALARIA PROPHYLAXIS

A
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76
Q

vegan deficiency,?

A

b12?

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77
Q

METRO+OMEP H PYLORI?

A

USE 400MG TDS, OTHERWISE 400MG BD

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78
Q

AMOX+OMEP H PYLORI?

A

USE 500MG BD, otherwise 1000MG BD AS PER

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79
Q

IMPORTANCE OF STEWARDSHIP?

A

Prevents antibiotic resistance
Less unnecessary treatment, more caution
Higher risk of resistance w/ broad-spectrum antibiotics

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80
Q

ANTIMICROBIAL- NICE GUIDANCE

DO NOT START WITHOUT CLINICAL EVIDENCE

OBTAIN CULTURES-:
NARROWING OF BROAD SPECTRUM
CHANGE THERAPY TO EFFECTIVELY TREAT RESISTANT PATHOGENS
STOP ABs when CULTURES SUGGEST INFECTION IS UNLIKELY

AVOID BROAD-SPECTRUM ANTIBIOTICS, e.g. (risk
co-amoxiclav
quinolones (cipro, levo)
cephalosporins (cefaclor, ceftriaxone)

AVOID WIDESPREAD USE OF TOPICAL ANTIBIOTICS (e.g. fusidic acid is systemic, use that!)

A
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81
Q

HUMAN/ANIMAL BITES- TREATMENT

1st LINE?

2nd LINE?

PROPHYLAXIS/TREATMENT?

A

1st LINE? CO-AMOXICLAV

2nd LINE? DOXYCYCLINE AND METRONIDAZOLE

PROPHYLAXIS/TREATMENT DAYS? 3/5 DAYS

Treatment when there’s presenting symptoms*

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82
Q

TICK BITES (LYME DISEASE)- TREATMENT

1st LINE?

2nd LINE?

No. of days?

A

1st LINE? Doxycycline 100mg BD

2nd LINE? Amoxicillin 1000mg TDS

No. of days? 21 days

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83
Q

DIABETIC FOOT INFECTION- TREATMENT

MILD (<2cm)

1st LINE?

If penicillin allergy..?

A

1st LINE? Flucloxacillin

If penicillin allergy..? Clarithromycin/Erythromycin/Doxycycline

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84
Q

DIABETIC FOOT INFECTION- TREATMENT

MODERATE/SEVERE (abscess, osteomyelitis)

1st LINE?

2nd LINE?

A

1st LINE? FLUCLOXACILLIN or CO-AMOXICLAV with/without GENTAMICIN

2nd LINE? (Penicillin allergy) CO-TRIMOXAZOLE with/without GENTAMICIN

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85
Q

CELLULITIS- TREATMENT

FIRST LINE?

PENICILLIN ALLERGY?

A

FIRST LINE? Flucloxacillin

PENICILLIN ALLERGY?
Clarithromycin OR
Erythromycin (in pregnancy)
Doxycycline

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86
Q

CELLULITIS- TREATMENT

INFECTION NEAR EYES/NOSE

1st LINE?

PENICILLIN ALLERGY?

A

1st LINE? Co-amoxiclav

PENICILLIN ALLERGY? Clarithromycin & Metronidazole

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87
Q

COMMUNITY ACQUIRED PNEUMONIA-

THREE TYPES?

A

LOW SEVERITY
MODERATE SEVERITY
HIGH SEVERITY

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88
Q

COMMUNITY ACQUIRED PNEUMONIA

LOW SEVERITY TREATMENT

1st LINE?

2nd LINE?

A

1st LINE? Amoxicillin

2nd LINE? Doxycycline OR Clarithromycin OR Erythromycin (in pregnancy)

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89
Q

COMMUNITY ACQUIRED PNEUMONIA

MODERATE SEVERITY TREATMENT

1st LINE?

2nd LINE?

A

1st LINE? Amoxicillin w/ Clarithromycin OR Erythromycin in pregnancy

2nd LINE? Doxycycline OR Clarithromycin

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90
Q

COMMUNITY ACQUIRED PNEUMONIA

HIGH SEVERITY TREATMENT

1st LINE?

2nd LINE?

A

1st LINE? Co-amoxiclav w/ Clarithromycin (OR Erythromycin in pregnancy)

2nd LINE? Levofloxacin

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91
Q

DIARRHOEA TREATMENT

CLOSTRIDIUM DIFFICILE

1st LINE?

2nd LINE?

LIFE-THREATENING?

No. of days?

A

1st LINE? ORAL! Vancomycin

2nd LINE? Fidaxomicin

LIFE-THREATENING? Oral Vancomycin+IV metronidazole

No. of days? 10 days

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92
Q

DIARRHOEA

TRAVELLER’S DIARRHOEA

STANDBY?

PROPHYLAXIS/TREATMENT?

A

STANDBY? Azithromycin

PROPHYLAXIS/TREATMENT? Bismuth Subsalicylate

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93
Q

EAR INFECTIONS

OTITIS MEDIA (inner, need systemic)

1st LINE?

2nd LINE? (worsened symptoms after 2-3 days treatment)

Penicillin allergy?

A

Can resolve itself if it’s not bad!
so standard paracetamol, ibu, first initially, 3days-1week

1st LINE? Amoxicillin

2nd LINE? Co-amoxiclav

Penicillin allergy? Clarithromycin (Erythromycin in pregnancy)

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94
Q

EAR INFECTIONS

OTITIS EXTERNA

1st LINE?

2nd LINE?

SYSTEMIC TREATMENT NEEDED?

Pseudomonas?

A

1st LINE? Topical Acetic Acid 2%

2nd LINE? Topical Neomycin Sulphate w/ Corticosteroid

SYSTEMIC TREATMENT NEEDED? Flucloxacillin (clari/azy/ery back up)

Pseudomonas? Cipro/aminogly

Note: prolonged use of topical, can affect flora in canal, risk of fungal infection

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95
Q

HELICOBACTER PYLORI

TRIPLE THERAPY?
PPI?
+
2 of the following..?

A 
PPI? Omeprazole, Lansoprazole, etc (30mg BD)
\+
2 of the following..?
Amoxicillin 1000mg BD
OR
Metronidazole 400mg BD
OR
Clarithromycin 500mg BD

tetracycline also used, blah blah, 7 days

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96
Q

HOSPITAL ACQUIRED PNEUMONIA
Non-severe

1st LINE?

2nd LINE? (adults) DC^2L

2nd LINE? (children)

A

1st LINE? Co-amoxiclav

2nd LINE? (adults)
Doxycycline
OR
Cefalexin
OR
Co-trimoxazole
OR 
Levofloxacin

2nd LINE? (children)
Clarithromycin

97
Q

Why do we avoid doxycycline in children<12?

A

Deposition in growing bone & teeth
Binding to calcium
Causes staining
Dental hypoplasia

98
Q

IMPETIGO TREATMENT

LOCALISED NON-BULLOUS
1st LINE?
2nd LINE?

A

1st LINE? Hydrogen Peroxide 1%

2nd LINE? Fusidic Acid (Mupirocin 2% if fusidic acid resistance suspected)

99
Q

IMPETIGO TREATMENT

WIDESPREAD NON-BULLOUS
1st LINE?

A

1st LINE? Fusidic Acid (Mupirocin 2% if fusidic acid resistance suspected)

100
Q

IMPETIGO TREATMENT

BULLOUS/SYSTEMICALLY UNWELL
1st LINE?
2nd LINE?

A

1st LINE? Flucloxacillin

2nd LINE? Clarithromycin (OR Erythromycin in pregnancy)

101
Q

LOWER UTI TREATMENT

MEN
1st LINE?

A

Nitrofurantoin (eGFR>45) OR Trimethoprim

102
Q

LOWER UTI TREATMENT

NON-PREGNANT WOMEN
1st LINE?
2nd LINE?

A

1st LINE? Nitrofurantoin OR
Trimethoprim (low risk of resistance)

2nd LINE? Pivmecillinam OR Fosfomycin

103
Q

LOWER UTI TREATMENT

PREGNANT WOMEN
1st LINE?
2nd LINE?

A

1st LINE? Nitrofurantoin (avoid at term)

2nd LINE? Cefalexin OR Amoxicillin

104
Q

Nitrofurantoin should only be used if eGFR is…?

A

> /= 45mL/min

105
Q

LOWER UTI TREATMENT- No. of days

MEN?
PREGNANCY?
UNCOMPLICATED?
CATHETER-ASSOCIATED?

A

MEN? 7 days treatment
PREGNANCY? 7 days treatment
UNCOMPLICATED? 3 days treatment
CATHETER-ASSOCIATED? 7 days treatment

106
Q

STREP THROAT/SCARLETT FEVER

BACTERIA?

A

Streptococcus

107
Q

STREP THROAT/SCARLETT FEVER

1st LINE?

2nd LINE?

A

1st LINE? Phenoxymethylpenicillin

2nd LINE? Clarithromycin OR Erythromycin (in pregnancy)

108
Q

SCARLETT FEVER

1st LINE?
2nd LINE?

A

1st LINE? Phenoxymethylpenicillin–> Amoxicillin

2nd LINE? Azithromycin–> true penicillin allergy

109
Q

SYMPTOMS OF SCARLETT FEVER?

A

Flu-like- high temp, swollen neck glands
Red rash w/ small, raised bumps, rough feeling like sandpaper
White coating on tongue- strawberry like

110
Q

TREATMENT

ACNE VULGARIS?

A

ADAPALENE/CLINDAMYCIN/BENZOYL PEROXIDE/LYMECYCLINE

111
Q

TREATMENT

BACTERIAL VAGINOSIS/TRICHOMONIASIS? (anaerobic)

A

METRONIDAZOLE

112
Q

TREATMENT

CHLAMYDIA?

A

1g STAT azithromycin- uncomplicated chlamydia

DOXYCLCINE

113
Q

TREATMENT

CONJUNCTIVITIS/BLEPHARITIS?

A

CHLORAMPHENICOL

114
Q

Chloramphenicol OTC sale?

A

0.5% eye drops (10mL) OR
1% eye ointment (4g)
2 years+
Max. treatment 5 days

115
Q

TREATMENT

DENTAL ABSCESS?

A

AMOXICILLIN
OR
METRONIDAZOLE

116
Q

TREATMENT

GONORRHOEA

A

CEFTRIAXONE/CIPROFLOXACIN

IM gent+azi if allergy

117
Q

TREATMENT

MENINGITIS?

A

BENZYLPENICILLIN

118
Q

TREATMENT

SCABIES?

A

PREMETHRIN-

apply over whole body including face, neck, scalp & ears

119
Q

TREATMENT

SINUSITIS?

A

PHENOXYMETHYLPENICILLIN
Very unwell? Co-amoxiclav
(pen allergy? Doxycycline/Clarithromycin/Ery in pregnancy

120
Q

TREATMENT

THREADWORM?

OTC sale?

A

MEBENDAZOLE

2 YEARS+
MAX. SINGLE DOSE 100mg
MAX. PACK SIZE 800mg

121
Q

PATHOGENS

CAP/MENINGITIS?

UTI?

THRUSH?

CELLULITIS?

A

CAP/MENINGITIS? Streptococcus Pneumoniae

UTI? Eschericia Coli

THRUSH? Candida Albicans

CELLULITIS? Staphylococcus Aureus

122
Q

ANTIBIOTICS

AMINOGLYOSIDES- EXAMPLES?

A 
Amikacin
Gentamicin
Neomycin
Streptomycin
Tobramycin
123
Q

AMINLOGLCYCOSIDES

Concs measured in all patients receiving parenteral aminoglycosides.

Must be determined in…?

A

Obesity
High doses
Cystic fibrosis
Elderly

124
Q

AMINOGLYCOSIDES

When do you measure serum-gent conc?

A

After 3/4 doses
Every 3 days
After a dose change (common in renally impaired)

125
Q

Aminoglycosides

Peak?
Trough?

A

Peak? 1hr after dose

Trough? Just before next dose

126
Q

AMINOGLYCOSIDES- MULTIPLE DAILY DOSE REGIMEN TARGETS

PEAK?
ENDOCARDITIS?

TROUGH

A

MULTIPLE DAILY DOSE REGIMEN
PEAK? 5-10mg/L
ENDOCARDITIS? 3-5mg/L (co-prescribed w/ other ABxs)

TROUGH
<2
<1 endo

127
Q

AMINOGLYCOSIDES- DOSE ADJUSTMENTS

TROUGH TOO HIGH?

PEAK TOO HIGH?

A

TROUGH TOO HIGH? Increase dose interval

PEAK TOO HIGH? Decrease dose

128
Q

AMINOGLYCOSIDES- DOSE ADJUSTMENT

RENAL IMPAIRMENT?

SEVERE RENAL IMPAIRMENT?

A

RENAL IMPAIRMENT? Increase dose interval

SEVERE RENAL IMPAIRMENT? Reduce dose

129
Q

Aminoglycosides, avoid concomitant use of…?

A

Nephrotoxic drugs

130
Q

AMINOGLYCOSIDES- MHRA WARNING

Drugs that cause ototoxicity? CLVV

A 
Interactions w/ Ototoxicity?
Cisplatin
Loop Diuretics
Vancomycin
Vinca Alkaloids (vinblastine, vincristine, vindesine, vinflunine)
131
Q

AMINOGLYCOSIDES- MHRWA WARNING

Drugs that cause renal impairment?

NEPHROTOXIC RISK?

A

NSAIDs
ACEi
ARBs
Metformin

NEPHROTOXIC RISK? Loop/NSAIDs/

132
Q

AMINOGLYCOSIDES

CONTRAINDICATED IN..?

PREGNANCY?

OBESITY?

A

CONTRAINDICATED IN..? Myasthenia Gravis (chronic, autoimmune disease of muscles)

PREGNANCY? AVOID: risk of auditory/vestibular nerve damage (Vertigo)
Have to use? Just monitor

OBESITY? Use IBW to calculate dose

133
Q

CEPHALOSPORINS

1ST GENERATION? Fad, Fal, Frad

A

CeFadroxil
CeFalexin
CeFradine

134
Q

CEPHALOSPORINS

2ND GENERATION? Furry Fox Face

A

CeFuroxime
CeFoxitin
CeFaclor

135
Q

CEPHALOSPORINS

3rd & 5th GENERATION?

A

All parenteral except from oral Cefixime (3rd)

136
Q

Patients with hypersensitivity to penicillin should not receive a cephlaosporin due to…?

A

Cross-sensitivity

137
Q

CHLORAMPHENICOL

USE?

AVOID IN?

OTC AGE?

A

USE? Eye infections

AVOID IN? Pregnancy- grey-baby syndrome, if used in third trimester

OTC AGE? 2years+

138
Q

CLINDAMYCIN

Associated with…?

A

Antibiotic-associated colitis (inflammation of lining of colon- FATAL?
Common in elderly
Discontinue+contact a doctor ASAP if severe/prolonged/bloody diarrhoea develops

139
Q

CLINDAMYCIN

Clostridium difficile suspected?

A

STOP!

Can’t stop ABx/severe diarrhoea? Seek specialist advice

140
Q

GLYCOPEPTIDES- EXAMPLES? VDT^2

A

VANCOMYCIN
DALBAVANCIN
TEICOPLANIN (can be used in COMMUNITY ACQUIRED PNEUMONIA!
TELAVANCIN

141
Q

GLYCOPEPTIDES

WHICH DRUG MUST BE GIVEN PARENTERALLY FOR SYSTEMIC INFECTIONS DUE TO REDUCED ABSORPTION W/ ORAL INTAKE..?

AVOID IN..?

TROUGH CONC.?

A

WHICH DRUG MUST BE GIVEN PARENTERALLY FOR SYSTEMIC INFECTIONS DUE TO REDUCED ABSORPTION W/ ORAL INTAKE..? Vancomycin

AVOID IN..? Pregnancy

TROUGH CONC.? 15-20mg/L (for endo/worse?) 10-20 usually?

142
Q

GLYCOPEPTIDES

Vancomycin oral, monitor?

A

Conc. in inflammatory intestinal disorders

143
Q

GLYCOPEPTIDES- SIDE-EFFECTS?

NO CRABS

A

NEPHROTOXICITY
OTOTOXICITY

CARDIOGENIC SHOCK ON RAPID IV
RED MAN SYNDROME
ANAPHYLACTOID REACTIONS- avoid rapid infusion+rotate site
BLOOD DYSCRASIAS: agranulocytosis/eosinophilia/neutropenia
SEVERE CUTANEOUS ADVERSE REACTIONS- SJS syndrome?

144
Q

LINEZOLID- SAFETY INFORMATION

RISK OF SEVERE OPTIC NEUROPATHY?

A

Report visual impairment (blurry/altered vision)

Monitor regularly if treatment >28 days

145
Q

LINEZOLID- SAFETY INFORMATION

RISK OF BLOOD DISORDERS?

A

Monitor full blood counts weekly
Close monitoring if treatment>10-14 days/renal impairment

A REVERSIBLE MAOI BTW, FUN FACT!

146
Q

LINEZOLID- INTERACTIONS

TYRAMINE-RICH FOODS?

SEROTONIN SYNDROME?

A 
TYRAMINE-RICH FOODS?
mature cheese
marmite
salami
yeast extract
fermented soya bean extract
some beers/wines
SEROTONIN SYNDROME? (altered cognitive state)
SSRIs
Dopaminergics
5-HT1 agonists
TCAs
Lithium
Other MAOIs
147
Q

MACROLIDES- EXAMPLES?

A
C
E

A

AZITHROMYCIN (OD)

CLARITHROMYCIN (BD)

ERYTHROMYCIN (QDS)

148
Q

MACROLIDES

AZITHROMYCIN TDS 1/52 for..?

A

Prophylaxis in COPD patients

149
Q

MACROLIDES

CAUTIONED IN..?

A

Patients w/ myasthenia gravis
Pregnancy? Erythromycin>Clarithromycin
Avoid Clarithromycin in 1st trimester of pregnancy (teratogenicity)

150
Q

MACROLIDES- SIDE-EFFECTS?

HOG-QT

A

HEPATOXICITY
OTOTOXICITY
GI DISTURBANCES
QT PROLONGATION

151
Q

MACROLIDES- INTERACTIONS

Macrolides are CYB ENZYME INHIBITORS (so will increase levels of CYP enzyme substrates)
STATINS?
WARFARINS?

A

Macrolides are CYB ENZYME INHIBITORS (so will increase levels of CYP enzyme substrates)

STATINS? Increased risk of myopathy

WARFARINS? Increased risk of bleeding

152
Q

MACROLIDES- INTERACTIONS

HYPOKALAEMIA?

A

LOOP/THIAZIDE DIURETICS
STEROIDS
SALBUTAMOL
THEOPHYLLINE

abcde i

153
Q

MACROLIDES- INTERACTIONS

QT PROLONGATION?

A 
AMIODARONE
DOMPERIDONE
FLUCONAZOLE
LITHIUM
METHADONE
ONDANSETRON
QUININE
QUINOLONES
SOTALOL
SSRIs
154
Q

METRONIDZOLE- SIDE-EFFECTS

TNVDA

A

TASTE DISTURBANCE- metallic taste, furred tongue
N&V- take w/ OR after food
MUST NOT DRINK ALCOHOL- disulfiram like side-effect (N&V, flushing)
-AVOID ALCOHOL during & >/=48hrs after treatment

155
Q

NITROFURANTOIN

PREGNANCY?

RENAL IMPAIRMENT?

URINE DISCOLOURED?

TAKE?

A

PREGNANCY? avoid at term?

RENAL IMPAIRMENT? Avoid if eGFR<45mL/min/1.73m^2

URINE DISCOLOURED? Yellow/Brown

TAKE? W/ OR after food

156
Q

PENICILLINS

NARROW-SPECTRUM (beta-lactamase sensitive, broken down by beta-lactamases, useless in these infections causing):

PENICILLIN G? Benzylpenicillin
Gastric acid stable?

PENICILLIN V? Phenoxymethylpenicillin
Gastric acid stable?

A

PENICILLIN G? Benzylpenicillin
Gastric acid stable? Parenteral use only

PENICILLIN V? Phenoxymethylpenicillin
Gastric acid stable? Suitable for oral administration

157
Q

PENICILLINS- BROAD-SPECTRUM (beta-lactamase sensitive):

EXAMPLES?

A

Ampicillin

Amoxicillin

158
Q

PENICILLINS- BROAD-SPECTRUM

Beta-lactamase resistant combo?

A

Amoxicillin+Clavulanic Acid (Co-amoxiclav)

159
Q

BROAD-SPECTRUM PENICILLINS

SIDE-EFFECTS?

A

DIARRHOEA- antibiotic-associated colitis
MACULOPAPULAR rash- most common in patients w/ glandular fever; DO NOT USE BROAD-SPEC BLINDLY FOR ‘SORE THROAT’

Do you DD

160
Q

PENICILLINASE-RESISTANT PENICILLIN

EXAMPLE?

A

Flucloxacillin

161
Q

PENICILLINASE-RESISTANT PENICILLIN

FLUCLOXACILLIN

Take on empty stomach..?

Safety information?

Cautioned in?

A

Take on empty stomach..? 1hr before food/2hrs after

Safety information? Cholestatic jaundice+hepatitis can occur, up to 2 months after treatment has ben stopped. Risk factors: >2 weeks use+elderly

Cautioned in? Hepatic impairment

162
Q

ANTIPSEUDOMONAL PENICILLINS?

A

Piperacillin- only available in combo w/ beta-lactamase inhibitor Tazobactam

Ticarcillin- only available in combo w/ beta-lactamase Clavulanic Acid

163
Q

PENICILLINS- SIDE-EFFECTS

INTRAHETCAL?
CROSS-SENSITIVITY?
PENICILLIN ALLERGY?

A

INTRAHETCAL?
Do not give INTRATHECALLY- can cause encephalopathy (same with Vincristine sulfate/vinca alkaloids!)

VINCRISTINES- NEUROTOXICITY!

CROSS-SENSITIVITY?
Cross-sensitivity: DO NOT GIVE CEPHALOSPORINS in history of immediate penicillin hypersensitivity

PENICILLIN ALLERGY?
True allergy-> immediate rash, anaphylaxis
Maybe not? minor rash, small, not itchy/confluent >72hrs after

164
Q

QUINOLONES- EXAMPLES?

A 
CIPROFLOXACIN
DELAFLOXACIN
LEVOFLOXACIN
MOXIFLOXACIN
OFLOXACIN
165
Q

QUINOLONES- SIDE-EFFECTS

MAY CAUSE?

Advice?

A

MAY CAUSE?
LOWERS SEIZURE THRESHOLD- avoid in epilepsy (+tramadol, sertraline, ibuprofen)

PSYCHIATRIC DISORDERS

TENDON DISORDERS

PHOTOSENSITIVITY

HYPERSENSITIVITY DISORDERS

Advice? Reduce sunlight+UV radiation exposure+can impair driving ability

166
Q

QUINOLONES- IMPORTANT SAFETY INFORMATION?

A

TENDINITIS- common in >60years, STOP!

AORTIC ANEURYSM+DISSECTION- seek help asap if sudden-onset severe abdominal/chest/back pain

HEART VALVE REGURGITATION- seek help asap if SOB/peripheral neuropathy/new heart palpitations

FLUOROQUINOLONES ARE VERY VERY BAD

167
Q

QUINOLONES- CAUTIONS?

MAP-QT

A

MYASTHENIA GRAVIS

ARTROPATHY (arthritis joint disease, yutes/adults)

PERFORATED TYMPANIC MEMBRANCE (when used by ear)

QT INTERVAL PROLONGATION

168
Q

QUINOLONES- INTERACTIONS

FOOD & DRINKS?

DRUGS THAT CAUSE..?

A

FOOD & DRINKS? AVOID dairy/mineral-foritifed drinks- reduces absorption

DRUGS THAT CAUSE..?
QT prolongation (amiodarone, SSRIs, haloperidol, chlorpromazine)
Reduce seizure threshold (quinolones+NSAIDs)

169
Q

TETRACYCLINES- EXAMPLES?

A

DOXYCYCLINE
TETRACYCLINE
MINOCYCLINE

170
Q

TETRACYCLINES

LABEL?

LABEL exception? DLM

A

LABEL? Do not take w/ milk, indigestion remedies, or medicines containing iron/zinc, 2hrs before/after you take this medicine

LABEL exception? DLM- DOES LIKE MILK
Doxycycline
Lymecycline
Minocycline

171
Q

TETRACYCLINES- SIDE-EFFECTS?

A

TEETH DISCOLOURATION/BONE DEPOSIT- avoid in >12 years/pregnant women

BENIGN INTRACRANIAL HYPERTENSION- stop & report headache/visual disturbances

LUPUS-ERYTHMEATOSUS-LIKE SYNDROM+IRREVERISBLE PIGMENTATION- highest risk w/ minocycline

172
Q

TETRACYCLINES- COUNSELLING POINTS

A

HEPATOXIC- avoid in liver failure

PHOTOSENSITIVITY- avoid exposure to sunlight/lamps

DYSPHAGIA- swallow whole with plenty of fluid, sitting/standing

CAUTION IN MYASTHENIA GRAVIS

173
Q

TRIMETHOPRIM- SIDE-EFFECTS?

A

BLOOD DYSCRASIA- long-term; look out for signs of blood disorders
fever, sore throat, rash, mouth ulcers, bruising or bleeding

ANTIFOLATE- teratogenic risk in first trimester, avoid
interactions w/ other antifolates:: methotrexate/phenytoin

HYPERKALAEMIA- ACEi, ARB, digoxin, K+ sparing/aldosterone

CAUTION IN RENAL IMPAIRMENT!

174
Q

ANTIBIOTICS- NARROW vs BROAD SPECTRUM

NARROW? PvPGG TLC

A 
PG TLC
PENICILLIN (Pen V+Pen G)
GLYCOPEPTIDES
TRIMETHOPRIM
LINEZOLID
CLINDAMYCIN

Anaerobic- METRONIDAZOLE

175
Q

ANTIBIOTICS- NARROW vs BROAD SPECTRUM

BROAD? CAPTN MCQ

A 
CAPTN MCQ
CHLORAMPHENICOL
AMINOGLYCOSIDES
PENICILLINS (amoxicillin+ampicillin)
TETRACYCLINES
NITROFURANTOIN
MACORLIDES
CEPHALOSPORINS
QUINOLONES
176
Q

ANTIBIOTICS- BACTERIOSTATIC vs BACTERICIDAL

BACTERIOSTATIC (prevents growth)? CLTMC

A 
CHLORAMPHENICOL
LINEZOLID
TETRACYCLINE
MACROLIDES
CLINDAMYCIN
177
Q

ANTIBIOTICS- BACTERIOSTATIC vs BACTERICIDAL

BACTERICIDAL (kills)?

A 
CEPHALOSPORIN
AMINOGLYCOSIDES
NITROFURANTOIN
TRIMETHOPRIM
QUINOLONES
METRONIDAZOLE
GLYCOPEPTIDES
PENICILLINS
178
Q

ANTIBIOTIC DIRECTIONS

WITH/AFTER FOOD? MNCP

A 
WITH/AFTER FOOD?
Metronidazole
Nitrofurantoin
Clarithromycin MR
Pivmecillinam
179
Q

ANTIBIOTIC DIRECTIONS

TAKE ON EMPTY STOMACH? (30-60mins before meal/snack OR at least 2hours after)

A

FLUCLOXACILLIN
PHENOXYMETHYLPENICILLIN
AZITHROMYCIN CAPS (not tabs/liquid)
TETRACYCLINE/OXYTETRACYCLINE

180
Q

ANTIBIOTICS

CAUTION IN MYASTHENIA GRAVIS?

A

QUINOLONES- Ciprofloxacin

AMINOGLYCOSIDES- Gentamicin, Metronidazole…

MACROLIDES- Clarithromycin…

TETRACYCLINES- Doxycycline…

181
Q

ANTIBIOTICS

NEPHROTOXIC/CAUTIONIN KIDNEY FAILURE?

A

(BIG 3)
NITROFURANTOIN

AMINOGLYCOSIDES

GLYCOPEPTIDES- vancomycin, teicoplanin…

tetracyclines

trimethoprim

182
Q

ANTIBIOTICS

HEPATOXIC/CAUTION IN LIVER FAILURE?

A 
MACROLIDES
FLUCLOXACILLIN
CO-AMOXICLAV
chloramphenicol
nitrofurantoin
tetracyclines

3/4 TB meds- rifampicin, isoniazid & pryazinamide (RIPE)

What’s the 4th? ethambutol

183
Q

TUBERCULOSIS TREATMENT

INITIAL PHASE? MONTHS? RIPE

A 
RIPE- 2 MONTHS
RIFAMPICIN
ISONIAZID
PYRAZINAMIDE
EHTAMBUTOL
184
Q

TUBERCULOSIS TREATMENT

CONTINUATION PHASE? MONTHS? RI.

A

RI- 4 MONTHS

RIFAMPICIN ISONIAZID

185
Q

TUBERCULOSIS TREATMENT

Isoniazid sometimes with..?

A

Pyridoxine (vitamin b6)

186
Q

TUBERCULOSIS TREATMENT

LATENT TUBERCULOSIS?

A

3 MONTHS OF RIFAMIPICIN+ISONIAZID
OR
6 MONTHS OF ISONIAZID

187
Q

TUBERCULOSIS MEDICATIONS

Patients w/ latent TB 35-65 years should be cleared of…?

A

Hepatooxicity

188
Q

TUBERCULOSIS MEDICATIONS

RIFAMPICIN?

A

Discolours contact lenses
Orangey-red body fluids
Enzyme inducer- CYP450 interactions

189
Q

TUBERCULOSIS MEDICATIONS

ISONIAZID?

A

PERIPHERAL NUEROPATHY- give prophylactic pyridoxine (vitamin b6) pain/numbness/tingling/weakness in hands/feet
Enzyme inhibitor- CYP450 interaction

190
Q

TUBERCULOSIS MEDICATIONS

PYRAZNIAMIDE?

A

HEPATOTOXIC

191
Q

TUBERCULOSIS MEDICATIONS

ETHAMBUTOL?

A

VISUAL IMPAIRMENT

OCULAR TOXICITY

192
Q

FUNGAL INFECTIONS- TREATMENT

ASPERGILLOSIS?

A

VORICONAZOLE

193
Q

FUNGAL INFECTIONS- TREATMENT

CRYPTOCOCCOSIS?

A

AMPHOTERICIN B

194
Q

FUNGAL INFECTIONS- TREATMENT

VAGINAL THRUSH?

A

CLOTRIMAZOLE/FLUCONAZOLE. RESISTANT? ITRACONAZOLE

195
Q

FUNGAL INFECTIONS- TREATMENT

ORAL THRUSH?

A

NYSTATIN/MICONAZOLE/FLUCONAZOLE. RESISTANT? ITRACONAZOLE

196
Q

FUNGAL INFECTIONS- TREATMENT

SKIN/NAIL INFECTIONS?

A

TOPICAL->SYSTEMIC THERAPY

TERBINAFINE/ITRACONAZOLE

197
Q

FUNGAL INFECTIONS- TREATMENT

TERBINAFINE KEY POINTS?

A

Apply thinly
Report liver dysfunction- dark urine/ stools, jaundice, N&V, abdominal pain
Continue use-> monitor liver function

198
Q

TERBINAFINE OTC

Age?

TREATMENT PACK SIZE

Tinea pedis OR Tinea pedis+cruris?

Tinea pedis+cruris+corporis?

A

Age? 16+

TREATMENT PACK SIZE

Tinea pedis OR Tinea pedis+cruris? 15g

Tinea pedis+cruris+corporis? 30mL spray/30g gel

199
Q

FUNGAL INFECTIONS

TINEA (ringworm)

Capitis?
Corporis?
Cruris?
Pedis?
Unguim/Oncyhomycosis?
A 
Capitis? Head
Corporis? Body
Cruris? Groin
Pedis? Feet
Unguim/Oncyhomycosis? Nails
200
Q

FUNGAL INFECTIONS

TINEA TREATMENT?

A

Topical antifungal cream
OR
Terbinafine

201
Q

FUNGAL INFECTIONS

Amorolfine nail lacquer, initial terbinafine

AMOROLFINE OTC
Age?

How often?

Max. strength+pack size?

A

AMOROLFINE OTC
Age? 18+

How often? Once weekly

Max. strength+pack size? 5%, 3mL

202
Q

ANTIFUNGAL MEDICATIONS- SIDE-EFFECTS

QT PROLONGATION/HEPATOXICITY? highest to lowest risk… KVIF

A

KETOCONAZOLE
VORICONAZOLE
ITRACONAZOLE
FLUCONAZOLE

203
Q

ANTIFUNGAL MEDICATIONS

CARBONDATED DRINKS CAN IMPROVE BIOAVAILABILITY OF..?

A

ITRACONAZOLE

204
Q

ANTIFUNGAL MEDICATIONS

LIFE-THREATENING HEPATOTOXICITY?

A

KETOCONAZOLE- oral treatment suspended,

*Oral ketoconazole for Cushing’s syndrome and topical products containing ketoconazole are not affected by this advice

205
Q

ANTIFUNGAL MEDICATIONS

PHOTOTOXICITY?

A

VORICONAZOLE- avoid sunlight exposure

206
Q

ANTIFUNGAL MEDICATIONS

AMPHOTERICIN B
Cautioned in?

Anaphylactic risk test for IV amphotericin B?

Why maintain same formulation?

Terbinafine risk?

A

AMPHOTERICIN B
Cautioned in? renal failure

Anaphylactic risk test for IV amphotericin B? Test dose with 30mins obs

Why maintain same formulation? Serious harm/fatal OD, all.

Terbinafine risk? Hepatotoxicity

207
Q

AMOROLFINE

WHEN SHOULD YOU REFER TO GP/DO NOT SELL? x2-DPB

A 
<18 years
>2 nails affected
diabetic
pregnant
breastfeeding
208
Q

VIRAL INFECTIONS

CHICKEN POX (varicella zoster)/ SHINGLES (herpes zoster) TREATMENT?

A

ACICLOVIR
OR
VALACICLOVIR (pro-drug)

209
Q

VIRAL INFECTIONS

CHICKEN POX (varicella zoster)/ SHINGLES (herpes zoster) TREATMENT?

A

ACICLOVIR
OR
VALACICLOVIR (pro-drug)

210
Q

VIRAL INFECTIONS

Chickenpox 14+ years?

A

Can consider antiviral treatment within 24hrs of onset of rash

*NEVER GIVE IBUPROFEN/ASPIRIN U16s-> can mask symptoms of infection

211
Q

VIRAL INFECTIONS

HERPES/SHINGLES SYMPTOMS?

A

Tingling sensation/burning/fluid-filled blisters

Shingles will follow pattern of individual nerves on 1 side of body
Can look like a belt/half belt around rib cage/torso

212
Q

MALARIA

BITE PROTECTION ADVICE (not absolute)?

A

MOSQUITO NETS IMPREGNATED W/ PERMETHRIN

DEET 20-50% protection (50 best)

  • > 2months old
  • Avoid ingestion-> wash hands before eating, foul smell
  • Pregnancy & breastfeeding fine (wash breast pre-feeding)
  • Apply DEET AFTER sunscreen

Note: DEET reduces SPF of sunscreen-> use high SPF lotion

213
Q

MALARIA PROPHYLAXIS TREATMENT

MALORONE (atovaquone w/ proguanil)

BEFORE TRAVEL?

DOSE?

AFTER TRAVEL?

MAX. USE?

A

MALORONE (atovaquone w/ proguanil)

BEFORE TRAVEL? 1-2 days

DOSE? 1 OD

AFTER TRAVEL? 1 WEEKLY

MAX. USE? 1 YEAR

214
Q

MALARIA PROPHYLAXIS TREATMENT

CHLOROQUINE

BEFORE TRAVEL?

DOSE?

AFTER TRAVEL?

MAX. USE?

A

CHLOROQUINE

BEFORE TRAVEL? 1 WEEK

DOSE? 1 WEEKLY

AFTER TRAVEL? 4 WEEKLY

MAX. USE? LONG-TERM

215
Q

MALARIA PROPHYLAXIS TREATMENT

PROGUANIL

BEFORE TRAVEL?

DOSE?

AFTER TRAVEL?

MAX. USE?

A

PROGUANIL

BEFORE TRAVEL? 1 WEEK

DOSE? 1 OD

AFTER TRAVEL? 4 WEEKS

MAX. USE? LONG-TERM

216
Q

MALARIA PROPHYLAXIS TREATMENT

MEFLOQUINE

BEFORE TRAVEL?

DOSE?

AFTER TRAVEL?

MAX. USE?

A

MEFLOQUINE

BEFORE TRAVEL? 2-3 WEEKS

DOSE? 1 WEEKLY

AFTER TRAVEL? 4 WEEKS

MAX. USE? 1 YEAR

217
Q

MALARIA PROPHYLAXIS TREATMENT

DOXYCYCLINE

BEFORE TRAVEL?

DOSE?

AFTER TRAVEL?

MAX. USE?

A

DOXYCYCLINE

BEFORE TRAVEL? 1-2 DAYS

DOSE? 1 OD

AFTER TRAVEL? 4 WEEKS

MAX. USE? 2 YEARS

218
Q

MALARIA PROPHYLAXIS TREATMENT

Which one is long-term?

A

Officer PC Long
Proguanil
Chloroquine

219
Q

Return from malarial region

Any illness that occurs within 1 year and especially within 3 months of return might be malaria–> see doctor asap!

A
220
Q

MALARAIA- PATIENT GROUPS

ASPLENIA?

A

Risk of severe malaria. OK.

221
Q

MALARIA- PATIENT GROUPS

PREGNANCY? REFER!!!

A

AVOID TRAVELLING TO MALAROUS REGIONS. Obvs.
CHLOROQUINE+PROGUANIL can be given; avoid other meds–> Take 5mg folic acid- neural tubule defect risk

400mcg folic acid OTC btw

222
Q

MALARIA- MEDICATION GROUPS

EPILEPTIC PATIENTS SHOULD AVOID..?

A

CHOLORQUINE/MEFLOQUINE- reduces seizure threshold

223
Q

MALARIA- MEDICATION GROUPS

WARFARIN
Treatment?

INR?

WHEN TO MEASURE?

A

WARFARIN
Treatment? 2-3 weeks before departure

INR? Stable before fly

WHEN TO MEASURE?
Measure INR:
Before anti-malaria &
7 days after starting course &
After completing course

Prolonged stays? check INR on the regs

224
Q

MALARIA- MEDICATION CAUTIONS

MEFLOQUINE?

A

MEFLOQUINE?

History of psychiatric disorders. develop? STOP+advice

History of convulsions

225
Q

MALARIA- MEDICATION CAUTIONS

CHLOROQUINE?

A

CHLOROQUINE?

History of convulsions

Can be retinotoxic

226
Q

MALARIA- MEDICATION CAUTIONS

PROGUANIL?

A

PROGUANIL?

RENAIL IMPAIRMENT-> reduce dose

227
Q

MALARIA- MEDICATION CAUTIONS

DOXYCYCLINE?

A

DOXYCYCLINE?

Avoid exposure to sunlight

228
Q

MALARIA- EMERGENCY STANDBY TREATMENT

When to carry standby treatment? what even is this?

WRITTEN INSTRUCTIONS?

A

When to carry standby treatment? what even is this? >24hrs away from medical care

WRITTEN INSTRUCTIONS?

  • Seek urgent medical attention if fever (38°C or more) develops 7 days (or more) after arriving in a malarious area
  • Self-treatment is indicated if medical help is not available within 24 hours of fever onset
229
Q

DOXYCYCLINE SIDE-EFFECTS?

A

PHOTOSENSITIVITY
TEETH DISCOLOURATION
HEADACHE
DIARRHOEA

NOT CONSTIPATION!

230
Q

splenectomy/sickle-cell disease, Abx?

A

Phenoxymethylpenicillin

231
Q

MICONAZOLE–NUMBER OF DAYS

MOUTH?

SKIN?

THRUSH?

A

MOUTH? 2.5ML QDS+7 DAYS AFTER…HALF IN <2

SKIN? BD+10 DAYS AFTER

THRUSH? 7 days?

232
Q

NYSTATIN?

A

7 DAYS+48 HOURS AFTER HEALING

233
Q

Allopurinol labelling?

A

FULL GLASS OF WATER
TAKE WITH FOOD/MEAL
DO NOT STOP TAKING

234
Q

Bacterial meningitis under 3?

A

Give cefotaxime

235
Q

SESPSIS treamtent?

A

piperacillin w/ tazo key

MRSA? Add vanc/tteico

236
Q

WHAT IS ST JOHN’S WORT?

A

INDUCER!

237
Q

Omeprazole?

A

hyponataraemie, increase dose

Hypomagnesaemia (more common after 1 year of treatment, but sometimes after 3 months of treatment)

238
Q

PD/ASTHMA exacerbations + ABX

Amoxicillin 500mg TDS for 5 days

200mg stat doxy and then 100mg OD for 7 days

200mg BD clarithromycin for 7 days

Prednisolone:

40mg OD for asthma for 5 days

30 OD for COPD for 7-14 days

If prophylaxis then Azithromycin Three times per week

A

BNF GPhC (48 decks)

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