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Pre-Reg 2022 - Infection 1 > Infection 2 > Flashcards

Infection 2 Flashcards

1
Q

When would you not give Clindamycin and what would you give instead

A

STOP

Give Vancomycin

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2
Q

What is clindamycin used to treat (2)

A

Osetomylisis

Skin Bone and Joint Infection

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3
Q

What is the biggest side effect with clindamycin and of which cohort of patients

A

c.diff

Eldery and women

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4
Q

What is the side effect on Linezolid (5)

A 
Serotonin syndrome 
Hypertensive crisis 
Interaction with MOAI’s 
Blood dyscariasia 
Optic Neuropathy
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5
Q

What monitoring with Linezolid is needed

A

Full weekly blood counts

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6
Q

What drug interaction need to be thought of when prescribing vancomycin with people who take SSR1s

A

Serotonin syndrome , patients should stop taking TCA 2 weeks before

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7
Q

Is Linezolid a reversible MOAI

A

Yes – so avoid tyramine rich food

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8
Q

What are the side effects of Trimethoprim (3)

A

Antifolate
Hyperkalaemia
Blood dyscraisas

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9
Q

When is trimethoprim contraindicated

A

1st and 2nd trimester

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10
Q

What are the three uses of co-trimoxazole

A

PCP prophylaxis and treatment
Toxoplasmosis
Nocardiosis

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11
Q

What are the side effects of co-trimoxazole (2)

A

SJS
Photosensitivity
Blood disorders

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12
Q

What is chloramphenicol used for and what do you need to measure

A

Life threatening conditions

Monitor plasma levels

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13
Q

Side effect of chloramphenicol (2)

A

Grey baby syndrome

Haematological side effects

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14
Q

Does metronidazole need to be taken with food

A

YES

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15
Q

What is metronidazole used for

A

Anaerobic infections

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16
Q

What side effects does metronidazole cause (5)

A 
Disulphide reaction with alcohol 
Flurried tongue 
GI disturbances 
Taste disturbances
Oral mucosa
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17
Q

Side effects of nitrofurantoin

A

Peripheral Neurophathy
Pulmonary fibrosis
Jaundice
Nausea

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18
Q

When should you avoid nitrofurantoin

A

In patients with EGFR 45ml/min

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19
Q

Name the five Aminoglycosides

A 
TANGS
Torbomycin 
Aminoglycoside 
Neomycin
Gentamycin 
Streptomycin
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20
Q

What is the aminoglycoside of choice in the UK and what is second line

A

Gentamycin / Amikacin

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21
Q

Which aminoglycoside can only be used via inhaler

A

Turbomycin

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22
Q

Which aminoglycoside can only be used through mucosal layers

A

Neomycin

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23
Q

Which patient group do you need to monitor gentamycin levels especially in (5)

A 
Elderly 
Renal impairment 
Cystic Fibrosis 
High doses 
Obese
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24
Q

What are the side effects of gentamycin (5)

A

Ototoxicity
Nephrotoxicity
Peripheral Neuropathy
Myopathy – Especially in pt. with myasthenia gravis
Electrolyte disturbances (Hypo K / Mg / Ca)

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25
Q

Should you avoid aminoglycosides in pregnancy

A

Yes, causes Ototoxicity

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26
Q

As aminoglycosides can cause ototoxicity what should also be avoided

A

Loop diuretics

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27
Q

As aminoglycosides can cause nephrotoxicity what should also be avoided

A

Cisplatin / Ciclosporin / Vancomycin

28
Q

What should the one hour peak concentration of gentamycin

A

5-10

3-5 with endocarditis

29
Q

What is the target Predose of gentamycin?

A

2

1 with endocarditis

30
Q

When would you avoid once only dosing of gentamycin

A

HACK
Burns more than 20%
EGFR less than 20ml/min
Endocarditis

31
Q

What would you do if the:
o Post dose peak level after 1 hour is too high =
o Post dose trough level is too high before next dose =
o Renal impairment =
o Severe renal impairment =

A

o Post dose peak level after 1 hour is too high = Reduce dose
o Post dose trough level is too high before next dose = Increase interval
o Renal impairment = Increase interval
o Severe renal impairment = Reduce dose

32
Q

Examples of glycopeptides

A

Vancomyin , teolplnaina

33
Q

What is vancomycin used for

A

MRSA and c.diff

34
Q

What is the target level for vancomycin

A

10 -15

15-20 in endo

35
Q

When would you monitor treatment for vancomycin

A

You don’t need to only when trough is too high and you would monitor after every 3-4 doses

36
Q

Does vancomycin have a long half life

A

Yes – so given BD

37
Q

Would you give vancomycin in pregnancy?

A

NO

38
Q

What are the monitoring requirements for vancomycin

A

Ear
Renal
Blood

39
Q

What are the side effects for vancomycin

A 
Ototoxicity 
Nephrotoxicity 
Photosensitivity 
Skin disorders 
Blood disorders 
Red man syndrome (if IV is too fast) 
Thrombophlebitis at the site of the infection
40
Q

What are examples of tetracyclines

A

Demeclocycline / Doxycycline / Oxytetracyline / Tetracycline / Minocycline

41
Q

What are the side effects of tetracyclines

A

Skin
Oesophageal Irritation
Intercranial hypertension
Visual disturbances

42
Q

Do you avoid tetracyclines in renal impairment

A

Yes – apparent from Doxycycline Minocycline

43
Q

What counselling needs to be given with tetracyclines and with which tetracyclines

A

DD - Demeclocycline Doxycycline
(avoid sun)
DOT Demeclocycline Oxytetracyline Tetracycline
(avoid milk)
DMT – Doxycycline Minocycline and Tetracycline
(Oesophageal Irritation)

44
Q

Examples of quinolones

A

Ciprofloxacin / Levofloxacin / Moxifloxacin / Norfloxacin.

45
Q

When are quinolones mostly used

A

Lower RTI and UTIs

46
Q

When would you avoid giving quinolones

A

Pregnancy to arthropathy

47
Q

What are your side effects of quinolones

A
  • Tendonitis
  • Lower seizure threshold
  • QT prolongation – leads to ventricular arrythmia
48
Q

When would you discontinue quinolones

A
  • Psychiatric
  • Neurological
  • Hypertensive reaction
49
Q

What are the interaction of quinolones

A
  • NSAIDs
  • Theophylline
  • QT prolongation
50
Q

What are the counselling points for quinolones

A
  • Impaired driving
  • DO not take with antacids
  • Drink with a full glass of water
  • Protect your skin
51
Q

When would you give macrolides

A

People who can’t take penicillin’s

52
Q

What consideration do you need to take when prescribing quinolones for people who take warfarin

A

Warfarin = Increase risk of bleeding

53
Q

What consideration do you need to take when prescribing quinolones for people who take statins

A

Statins = Increase risk of myopathy

54
Q

What is the dosing of quinolones

A

Azithromycin OD / Clarithromycin BD / Erythromycin QDS/ Telithromycin / Spiramycin

55
Q

What patient group do you avoid macrolides

A

Myesthesia gravis – because it causes electrolyte imbalances

56
Q

What are the side effect of macrolides

A

GI
QT interval prolongation
Hepatoxicity
Ototoxicity

57
Q

What are the four classes of penicillin’s

A
  • Broad
  • Narrow
  • Penicillinase resistant
  • Antipseudomonal
58
Q

What are examples of your narrow-spectrum penicillin’s + Side effects

A
  • Benzylpenicillin (penG)/

- Phenoxymethylpenicillin (penV)

59
Q

What are examples of your Broad spec antibiotics + Side effects

A
  • Ampicillin / Amoxicillin
  • Can cause C/diff
  • Amoxicillin can cause jaundice
60
Q

What are your examples of the penicillinase Resistant + Side effects + Uses + Length of treatment

A
  • Flucloxacillin
  • Used : Staph
  • Side effects: Jaundice
  • Length of treatment: 14 days
61
Q

What are your examples of your antipseudomonal + Side effects?

A
  • Piperacillin / Ticarcillin

- Uses: Serious infection / complicated UTI’s / HAP

62
Q

Can we give penicillin’s intrathecally

A

NO : Can cause encephalopathy

63
Q

Which one is gastric stable PenV or PenG

A

PenV: Phenoxymethylpenicillin (oral use)

64
Q

Examples of cephalosporins

A

Cefixime / Ceftriaxone / Cefotaxime

65
Q

Side effects of cephalosporins

A

C.diff

Hypersensitivity

Pre-Reg 2022 - Infection 1 (4 decks)

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