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BNF Chapters > Infection > Flashcards

Infection Flashcards

1
Q

Preventing streptococcal

A

Phenoxymethylpenicillin, (erythromycin, azithromycin)

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2
Q

Meningococcal prevention

A

Ciprofloxacin or rifampicin or ceftriaxone

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3
Q

Influenza prevention

A

Rifampicin if not then ceftriaxone for all household contacts if there is a vulnerable individual

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4
Q

Diphtheria prevention

A

Erythromycin

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5
Q

Pertussis prevention (whoopig cough)

A

Clarithromycin (or azi/ery)

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6
Q

Pneumococcal infection treatment

A

Phenoxymethylpenicillin, (if pen allergic) erythromycin

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7
Q

Animal/human bites treatment

A

Co-amoxiclav (doxycycline+metronidazole if pen allergy)

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8
Q

Stomach/oesophagus operation antibiotics

A

Gentamicin, cefuroxime, co-amoxiclav (teicoplanin/vancomycin added if high MRSA risk, metronidazole added if biliary surgery)

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9
Q

Orthopaedic surgery antibiotics

A

Cefuroxime, flucloxacillin, gent, co-amox, metronidazole (if pen allergy or mrsa risk = teicoplanin/vancomycin)

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10
Q

Urological surgery antibiotics

A

Ciprofloxacin, metro, gent, cefuroxime

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11
Q

Cardio procedure prophylaxis

A

Cefuroxime or flucloxacillin+gentamicin or teic/vanc+gent

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12
Q

Enchinocandin drugs

A

Anidulafungin, caspofungin, micafungin

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13
Q

What are echnicondin used for

A

Only aspergilus (only caspo) and candida

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14
Q

Nystatin indications

A

Oral, oropharyngeal, perioral and candida albicans infection of skin

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15
Q

Polyene antifungals

A

Amphotericin, nystatin

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16
Q

Miconazole use

A

Oral infections, intestinal infections,

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17
Q

Imidazole antifungals

A

Clotrimazole, econazole, ketoconazole, tioconazole

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18
Q

When is voriconazole used

A

Broad spectrum used for life threatening infections

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19
Q

Itraconazole cautions

A

Liver damage

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20
Q

How to treat fungal meningitis and why

A

Fluconazole as it has good penetration into CSF

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21
Q

Triazole antifungals

A

Voriconazole, posaconazole, itraconazole. Fluconazole

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22
Q

Treating pityriasis

A

Itaconzaole or Fluconazole

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23
Q

Treating CNS candidiasis

A

Amphotericin

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24
Q

Vaginal candidiasis treatment

A

Locally (clotrimazole) or fluconazole if not then itraconazole

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25
Q

Oropharyngeal candidiasis treatment

A

fluconazole if not then itraconazole

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26
Q

Aspergillosis treatment

A

Voriconazole if not then amphotericin (itraconzole or caspofungin if refractory/intolerant to voriconazole) (fluconazole not effective)

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27
Q

What treats p aeruginosa

A

Aminoglycosides (tobramycin ideally), carbapenem

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28
Q

What treats pseudomonas

A

Ciprofloxacin

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29
Q

Treating MSRA

A

Vancomycin, Teicoplanin

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30
Q

Treating Staph

A

Flucloxacillin

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31
Q

Treating respiratory infections

A

Amox – clarithromycin/erythro

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32
Q

Treating skin infections

A

Flucloxacillin, co-amoxiclav if serious

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33
Q

Treating anaerobic infections

A

Metronidazole

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34
Q

treatment of acute uncomplicated falciparum malaria

A

Artemether with lumefantrine , Atovaquone with proguanil

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35
Q

prophylaxis acute uncomplicated falciparum malaria

A

Atovaquone with proguanil

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36
Q

When is doxycycline used in malaria

A

When travelling to areas of chloroquine resistance

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37
Q

When is primaquine used

A

To eliminate the liver stages of P. vivax or P. ovale following chloroquine treatment

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38
Q

When can you use quinine

A

if the infective species is not known

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39
Q

Non-pharmacological malaria prophylaxis

A

Net with permethrin, insect repellants DEET,

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40
Q

How long before travel should you take chloroquine+proguanil

A

1 week

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41
Q

How long before travel should you take mefloquine

A

2-3 weeks

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42
Q

How long before travel should you take atovaquone + proguanil/ doxycycline

A

1-2 days

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43
Q

How long should prophylaxis be taken after leaving the area for most antimalarials

A

4 weeks

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44
Q

What antimalarial has a short period of time that the drug should be taken after leaving the area and how long

A

Atovaquone with proguanil 1 week

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45
Q

Antimalarial drugs used in pregnancy

A

Chloroquine and proguanil give folic acid,quinine, mefloquine - weigh up benefits and negatives of all regimens

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46
Q

What antimalarial to use if a patient has epilepsy

A

Atovaquone with proquanil

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47
Q

Atovaquone with proquanil brand name

A

Malarone

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48
Q

Mefloquine brand name

A

Lariam

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49
Q

What to use if malaria infection is not known/mixed

A

Atovaquone with proquanil or Quinine

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50
Q

How to treat malaria if patient is pregnant

A

Quinine then use clindamycin

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51
Q

Treating falciparum malaria

A

Chloroquine, atovaquone with proguanil, primaquine

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52
Q

Treating Trichomonacides

A

Metronidazole

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53
Q

Trichomoniasis symptoms

A

Abnormal vaginal discharge ( yellow-green, fishy smell), soreness, swelling, itching, discomfort in sex or when urinating
men: pain when urinatic/ejaculating, frequent urinating, white discharge, swelling/soreness around head of penis

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54
Q

Treating septicaemia

A

Broad spectrum antipseudomonal penicillin or cephalosporin e.g pip taz, ticarcillin with clavulanic acid, cefuroxime

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55
Q

What to add to community septicaemia if MRSA suspected

A

Vancomycin/Teicoplanin

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56
Q

What to add to community septicaemia treatment if anaerobic

A

Metronidazole

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57
Q

What to use in community septicaemia treatment if resistant

A

Meropenem (broad spectrum beta lactam)

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58
Q

What sort of drug is need to treat hospital acquired septicaemia

A

Broad spectrum antipseudomonal beta lactam e.g. Pip taz, ceftazadime, meropenem

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59
Q

Treating septicaemia related to vascular catheter

A

Vancomycin/teic

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60
Q

Treating meningococcal septicaemia

A

Benzylpenicillin or cefotaxime or chloramphenicol

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61
Q

Covid-19 transmission

A

Respiratory droplets generated

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62
Q

Common COVID symptoms

A

Fever, cough, sob, delirium loss of smell, headache

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63
Q

Who is at risk developing severe pneumonia

A

Impaired immunity or reduced ability to cough/clear secretions

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64
Q

Characteristics of carbapenem

A

Broad-spectrum activity

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65
Q

Carbapenems gram characteristics

A

positive and negative

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66
Q

What carbapenems are active against p aeruginosa

A

Imipenem and meropenem

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67
Q

Common uses of carbapenem

A

Hospital acquired septicaemia and pneumonia, intra abdominal infections, skin and soft tissue ifections and complicated UTIs

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68
Q

Why is imipenem given with cilastatic

A

It is partially inactivated in the kidney by enzymatic activity

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69
Q

Examples of cabapenems

A

Meropenem, ertapenem, imipenem

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70
Q

What is ertapenem used for?

A

CAP, gynae and abdominal infections

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71
Q

Initial blind endocarditis treatment

A

Amoxicilin/ampicillin could add low dose gentamicin (Vancomycin if pen allergic)

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72
Q

Endocarditis staphylococci treatment

A

Flucloxacillin (vancomycin+rifampicin for pen allergy) 4 weeks

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73
Q

Endocarditis prosthetic valve staphylococci

A

Flucloxacillin (vancomycin if pen)+rifampicin+low dose gent - 6 weeks then review (review gent at 2 weeks)

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74
Q

Endocarditis caused by streptococci

A

Benzypenicillin (if less sensitive low dose gent added), vancomycin if pen allergy

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75
Q

When to stop gentamicin

A

Stop gentamicin at 2 weeks if micro-organisms moderately sensitive to penicillin

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76
Q

Endocarditis caused by HACEK treatment

A

Amoxicillin/ceftriaxone + low dose gent

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77
Q

Endocarditis caused by Enterococci treatment

A

Amoxicillin (vanc if pen)+ low dose gent (Benzypenicillin may also be added)

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78
Q

Mild diabetic foot infection treatment

A

Flucloxacillin first line.

If penicillin allergy/ C/I = clarithromycin, doxycycline, erythromycin (pregnancy)

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79
Q

Moderate diabetic foot infection treatment

A

Flucloxacillin+ gentamicin +/or metronidazole if not then amoxicillin + gentamicin or ceftriaxone+metronidazole (pen allergy = co-trimoxazole +gentamicin +metronidazole)

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80
Q

When to treat campylobacter enteritis and how

A

Immunocompromised/severe.

Clarithromycin (macrolide) or ciprofloxacin

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81
Q

First line diverticulitis

A

Co-amoxiclav(pen allergy , cefalexin+metronidazole, trimethoprim, metrondazole, or cipro+metronidazole)

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82
Q

Treating typhoid

A

Cipro or azithromycin

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83
Q

Treating salmonella

A

Cipro or cefotaxime

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84
Q

Treating c diff

A

Metronidazole then vancomycin, then fidaxomicin

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85
Q

Peritonitis treatment

A

Cephalosporin+ metronidazole or gent+metro

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86
Q

Otitis externa cause

A

P aeruginosa, staph a

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87
Q

Treating otitis externa

A

Flucloxacillin or clarithromycin/macrolide (if pen allergy)

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88
Q

Treating pseudomonas otitis externa

A

Ciprofloxacillin or aminoglycoside

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89
Q

Otitis media is

A

Infection in middle ear

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90
Q

Treating ear infection

A

Amoxicillin then co-amoxiclav. (if pen allergy = clarithromycin /erythromycin if pregnant)

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91
Q

Blepharitis cause

A

Staphylococci

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92
Q

Conjunctivitis cause

A

Streptococcus pneumoniae, Staphylococcus aureus, or Haemophilus influenzae

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93
Q

Blepharitis treatmebt

A

Chloramphenicol ointment, oral tetracyclines if >12yo

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94
Q

General HIV treatment strategy

A

2 NRTI+ Integrase inhibitor/NNRTI/Protease inhibitor

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95
Q

HIV backbone treatment

A

Emtricitabine+tenofovir or abacavir+iamivudine

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96
Q

HIV prep treatment

A

Emtricitabine with tenofovir or just tenofovir

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97
Q

Integrase inhibitors

A

bictegravir (BIC), dolutegravir (DTG), elvitegravir (EVG), and raltegravir (RAL).

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98
Q

nucleoside reverse transcriptase inhibitors (NRTI)

A

abacavir (ABC); emtricitabine (FTC), lamivudine (3TC); stavudine (d4T), tenofovir alafenamide fumarate (TAF), tenofovir disoproxil fumarate (TDF), and zidovudine (AZT).

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99
Q

CCR5 antagonist

A

Maraviroc

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100
Q

Protease inibitors

A

atazanavir (ATZ), darunavir (DRV), fosamprenavir (FOS-APV), lopinavir (LPV), ritonavir (RTV), saquinavir (SQV), and tipranavir (TPV).

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101
Q

Why do threadworms cause itching

A

Lay eggs on perianal skin

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102
Q

Treating threadworms

A

Mebendazole, single dose or another after 2 weeks

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103
Q

Treating Hep C

A

Interferon alfa, Ribavirin (not alone)

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104
Q

Treating chronic hepatitis b

A

Peginterferon alfa or interferon alfa(stop after 4 months) entecavir (if unresponsive after 6-9 months), tenofovir (if unresponsibe after 6-9 months)

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105
Q

Herpes labialis is

A

Cold sores

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106
Q

When is aciclovir used

A

Against all herpesviruses

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107
Q

Treating cytomegalovirus

A

Ganciclovir , valganciciclovir

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108
Q

Bacterial vaginosis treatment

A

Metronidazole

109
Q

Syphyllis treatment

A

Benzathine benzylpenicillin

110
Q

Pelvic inflammatory disease trearment

A

Doxycycline+metronidazole or ceftriaxone/ofloxacin+metronidazole

111
Q

Gonorrhea treatment

A

Ceftriaxone if unknown, ciprofloxacin if known or azithromycin

112
Q

Chlamydia treatment

A

Azithromycin or doxycycline

113
Q

Bacterial vaginosis symptoms

A

Thin, gray, white or green vaginal discharge.
Foul-smelling “fishy” vaginal odor.
Vaginal itching.
Burning during urination.

114
Q

Chlamydia symptoms

A

pain when peeing
unusual discharge from the vagina, penis or bottom
in women, pain in the tummy, bleeding after sex and bleeding between periods
in men, pain and swelling in the testicles
not always symptomatic

115
Q

Gonorrhea symptoms

A

unusual discharge from your vagina or penis and pain when peeing.

116
Q

Influenza treatment

A

Oseltamivir and zanamivir, licensed within 48 hours

117
Q

What is post exposure prophylaxis

A

Giving dose post exposure

118
Q

When oseltamivir be used post exposure

A

Within 48 hours

119
Q

Leprosy treatment

A

Dapsone, rifampicin, clofazimine

120
Q

Drugs used to treat lyme disease

A

Doxycycline in most instances and amoxicillin as alternative and azithromycin if not suitable. Ceftriaxone used if CNS involvement

121
Q

Macrolide indications

A

Campylobacter enteritis, respiratory infections (pneumonia, whooping cough, legionella) chlamydia, skin infections (impetigo, cellulitis)

122
Q

Erythromycin indications

A

Syphilis, chlamydia

123
Q

Azithromycin indications

A

Chlamydia , gonorrhoea, typhoid, lyme disease

124
Q

Treating MRSA skin infections

A

Rifampicin+fusidic acid+ tetracycline/ tetracycline/ clindamycin alone/ glycopeptide

125
Q

Treating MRSA Pneumonia

A

Gentamicin

126
Q

MRSA bronchiectasis treatment

A

Tetracycline/ clindamycin

127
Q

MRSA UTI treatment

A

Tetracycline or trimethooprim/nitrofurantoin/glycopeptide

128
Q

MRSA septicaemia treatment

A

Glycopeptide

129
Q

MRSA Surgery prophylaxis

A

Vancomycin/teicoplanin

130
Q

Osteomyelitis treatment

A

Flucloxacillin(clinda if pen, vanc/teic if mrsa) +(fusidic acid+ rifampicin)

131
Q

Sinusitis treatment if needed

A

Phenoxymethylpenicillin, second line = co-amoxiclav. If penicillin allergy doxycycline/clari/erythromycin if pregnant

132
Q

Treating severe bacterial oral infections

A

Penicillin and metronidazole
( Typically metronidazole, amoxicillin, phenoxy, macrolides if pen allergy)
https://bnf.nice.org.uk/treatment-summary/oral-bacterial-infections.html

133
Q

Sore throat with complications like tonsilitis treatment

A

Phenoxymethylpenicillin 5-10 days (clarithromycin/ erythromycin if pen allergy 5 days)

https://bnf.nice.org.uk/treatment-summary/oropharyngeal-infections-antibacterial-therapy.html

134
Q

Treating oropharyngeal viral infections

A

Benzydamine, chlorhexidine

https://bnf.nice.org.uk/treatment-summary/oropharyngeal-viral-infections.html

135
Q

Oral thrush treatment

A

Nystatin, miconazole , fluconazole if topical innappropriate (itraconazole if resistant), refer if not workig 1-2 weeks treatment

https://bnf.nice.org.uk/treatment-summary/oropharyngeal-fungal-infections.html

136
Q

Angular cheilitis treatment

A

Miconazole and fusidic acid or hydrocortisone with miconazole

https://bnf.nice.org.uk/treatment-summary/oropharyngeal-fungal-infections.html

137
Q

Treating tetanus

A

Metronidazole

138
Q

What is pen V used for

A

RTI in children, streptococcal tonsilitis

139
Q

Ampicillin main use

A

Chronic bonchitis and middle ear infections largely due to streptococcus pneumoniae and h. Influenzae

140
Q

Amoxicillin and ampicillin side effect

A

Maculopapular rashes

141
Q

Clavulanic acid purpose

A

Inactivates beta lactamases

142
Q

Antipseudomonal penicillins

A

Piperacillin and ticarcillin (with clavulanic acid)/ Pip Tazobactam

143
Q

Pneumocystis pneumonia treatment - moderate

A

Co-trimoxazole if not then atovaquone, clindamycin and primaquine combination can also be used or dapsone with trimethoprim

144
Q

Pcp severe treatment

A

High dose co-trimoxazole then pentamidine

145
Q

Co-trimoxazole components

A

Sulfamethoxazole and trimethoprim are used in combination (as co-trimoxazole)

146
Q

Preventing PCP

A

Co-trimoxazole , inhaled pentamidine, dapsone, atovaquone

147
Q

Ciprofloxacin is active against

A

Gram Negative = salmonella, Shigella, Campylobacter, Neisseria, and Pseudomonas. moderate activity against Gram-positive = Streptococcus pneumoniae and Enterococcus faecalis. Chlamydia , RTI, GI, bone, joint, gonorrhoea, septicaemia

148
Q

Treating Epiglottitis (Haemophilus influenzae)

A

Cefotaxime/ceftriaxone (chloramphenicol if allergy)

149
Q

Acute bronchiectasis exacerbation

A

Amoxcillin/clari/doxy, (co-amox/piptaz/levoflox if severe IV)

150
Q

COPD exacerbation treatment first line

A

Amoxcillin/clari/doxy if unsuccessful use levoflox (co-amox/piptaz/co-trimox if severe iv unable to take oral)

151
Q

First line serious cough treatment

A

Doxycycline, amox/clari/erythromycin

152
Q

Low severity CAP (community acquired pneumonia) treatment

A

Amoxicillin/clari/doxy/ery in pregnancy

153
Q

Moderate severity CAP treatment

A

Amoxicillin, if atypical pathogens suggested , amoxicillin with clari/erythro
/clari/doxy/ery in pregnancy if pen allergy

154
Q

High severity CAP treatment

A

Co-amoxiclav with clari/erythromycin - levofloxacin used in pen allergy

155
Q

Non severe Hospital Acquired Pneumonia (HAP) tretment

A

Co-amoxiclav, if pen allergy - doxy,cefalexin, co-trimoxazole, levoflox

156
Q

Severe HAP treatment

A

Pip/taz, ceftazidime, ceftriaxone, cefuroxime, levofloxacin, meropenem

157
Q

Severe HAP with MRSA additional treatment

A

Vanc, teic or linezolid

158
Q

Fusidic acid use

A

Staphylococcal, impetigo

159
Q

Metronidazole skin treatment indications

A

Rosacea, reduce odour from anaerobic infections

160
Q

Scalp fungal infection name

A

Tinea capitis

161
Q

Body fungal infection name

A

Tinea corporis

162
Q

Groin fungal infection name

A

Tinea cruris

163
Q

Hand fungal infection name

A

Tinea manuum

164
Q

Foot fungal infection name

A

Tinea pedis, athletes foot

165
Q

Nail fungal infection name

A

Tinea unguium

166
Q

Scalp fungal treatment

A

Systemic , topical in early stages

167
Q

Ringworm treatment

A

Imidazoles

168
Q

Treating onychomycosis/unguium / nail infection

A

Amorolfine or tioconazole

169
Q

Pityriasis tinea versicolor treatment

A

Ketoconazole or selenium shampoo, leave on affected area for 10 minutes then rinse, od 7 days, imidazoles can be used topically but a lot needed, if fails triazole can be used systemically

170
Q

Herpes labialis treatment

A

Aciclovir

171
Q

Scabies treatment

A

Permethrin, malathion

172
Q

Head lice treatment

A

Dimeticone cant use permethriin, shampoo dilutes too much - wet combing

173
Q

Impetigo looks like

A

Dry crusting yellow, contagious

174
Q

If firstline impetigo treatment fails

A

Treat with topical antibacterial if local or oral if widespread if fails then micro

175
Q

Impetigo firstline treatment if topical if hydrogen peroxide fails

A

Fusidic acid or mupirocin

176
Q

Impetigo oral drugs

A

Fluclox or clar/ery if pen allergy

177
Q

Cellulitis first line

A

Fluclox or clar/ery if pen allergy

178
Q

Cellulitis if near eyes/nose

A

Co-amoxiclav - metro/clarithromycin if pen allergy

179
Q

Cellulitis severe treatment

A

Co-amoxiclav, clindamycin, intravenous cefuroxime, or intravenous ceftriaxone (ambulatory care only

180
Q

Treating leg ulcer non-severe

A

Fluclox - doxy, clari, erythromycin then stepped by giving co-amoxiclav (co trimox if pen)

181
Q

Treating leg ulcer severe first line

A

IV fluclox with/without gent and/or metro. Or co-amoxi with/without gent (pen allergy = co-trimox with/without gent and/or metro)

182
Q

Treating leg ulcer severe firstline

A

IV fluclox with/witout gent and/or metro. Or co-amoxi with/without gent (pen allergy = co-trimox with/without gent and/or metro)

183
Q

Treating leg ulcer severe second line

A

Pip/taz or IV ceftriaxone with/without metro

184
Q

What is CURB-65

A

30‑day mortality risk in adults with pneumonia.

185
Q

CURB Points/used for

A

Confusion, urea>7, resp rate>30,

low systolic<90/diastolic<60, age>65

186
Q

What point to consider referring to hospital CURB 65

A

2

187
Q

When to urgently refer to hospital for admission CURB65

A

3

188
Q

CRB65 risk

A

0: low risk (less than 1% mortality risk) 1 or
2: intermediate risk (1% to 10% mortality risk) 3 or
4: high risk (more than 10% mortality risk).

189
Q

UTI common cause

A

E coli

190
Q

Lower UTI symptoms

A

dysuria, increased urinary frequency, urgency, smelly urine, cloudy urine, blood in urine, Lower abdominal persistant pain

191
Q

Upper UTI symptoms

A

Loin pain, fever

192
Q

When are UTIs recurrent

A

2 episodes in 6 months or 3/4 in 12 months

193
Q

Prostatitis symptoms

A

fever, acute urinary retention or irritative voiding symptoms

194
Q

Non drug UTI treatment

A

Drink plenty of fluids to avoid dehydration, wiping from front to back after defaecation, not delaying urination, and not wearing occlusive underwear. D-mannose, cranberry or urine alkalinising products may be used as self-care treatment strategies,

195
Q

Lower UTI first line

A

Nitrofurantoin or trimethoprim

196
Q

Lower UTI second line

A

No improvement after 48 hours into (if not used first line), fosfomycin, pivmecillinam

197
Q

Pregnant women lower UTI 1st line

A

Nitro

198
Q

Pregnant women lower UTI 2nd line

A

Amoxicillin if culture susceptible or cefalexin, consult local micro if not possible

199
Q

Prostatitis first line

A

Ciprofloxacin, ofloxacin or trimethoprim (if not then use fluoroquinolones)

200
Q

Prostatitis second line

A

Levofloxacin or co-trimoxazole

201
Q

Prostatitis treatment if sepsis concern

A

Amikacin, ceftriaxone, cefuroxime, ciprofloxacin, gentamicin, or levofloxacin.

202
Q

Pyelonephritis pregnant treatment

A

Cefalexin (cefuroxime iv)

203
Q

Pyelonephritis non-pregnant women and men treatment

A

Cefalexin or cipro (if sensitivity known trimeth/co-amox ( if sepsis concern: Amikacin, ceftriaxone, cefuroxime, ciprofloxacin, gentamicin, or levofloxacin. Possibly co-amox)

204
Q

Pyelonephritis pregnant treatment

A

Cefalexin (cefuroxime iv)

205
Q

When to refer UTIs

A

refer or seek specialist advice for men, pregnant women, patients with suspected cancer, those presenting with recurrent upper UTI, and those with recurrent lower UTI with an unknown cause.

206
Q

What to use in prophylactic/ reccurent UTI

A

First line = trimethoprim/nitro, second line= amoxicillin/ cefalexin

207
Q

Tetracycline uses

A

Chlamydia, ricketssia, brucella, acne, resp and genital mycoplasma infections , chronic bronchitis exacerbation

208
Q

Initial phase TB drugs

A

rifampicin, ethambutol hydrochloride, pyrazinamide and isoniazid (with pyridoxine hydrochloride) for 2 months

209
Q

Continuation phase TB drugs

A

Rifampicin and isoniazid for 4 months (10 months in active TB in CNS)

210
Q

Flucloxacillin main side effect

A

Hepatotoxicity

211
Q

How should flucloxacillin, amipicillin and phenoxymethylpenicillin be taken

A

Empty stomach (1 hour before food or 2 hours after food)

212
Q

What antibiotics need to be taken ater food

A

Nitrofurantoin , metronidazole

213
Q

What are cephalosporins used for

A

UTI, Pneumonia, meningitis

214
Q

What tetracyclines can’t be taken with milk

A

DOT, demcycline, oxytetracycline, tetracycline

215
Q

What tetracyclines can be taken with milk

A

Doxycycline, lymecycline, minocylcline - DLM (does like milk)

216
Q

Key tetracycline side effect/counselling point

A

Protect skin from sunlight

217
Q

SJS symptoms

A

Hives, facial swelling, tongue swelling, shading of skin, purple/red rash

218
Q

Sulfonamide side effects

A

SJS, blood disorders

219
Q

Vancomycin side effects

A

Ototoxicity and nephrotoxicity
Red man syndrome -
Hypotenstion/anaphylaxis

220
Q

What age can mebendazole be used

A

Over 2

221
Q

What is used to prevent non-falciparum if no resistance

A

Chloroquine

222
Q

What is used to prevent non-falciparum

A

mefloquine/doxycycline

223
Q

Shingles symptoms

A

Sharp stabbing in one side

224
Q

Measles symptoms

A

Koplik spots

225
Q

one-hour (‘peak’) serum concentration of gentamicin and trough

A

5–10 mg/litre; pre-dose (‘trough’) concentration should be less than 2 mg/litre.

226
Q

multiple daily dose regimen in endocarditis, one-hour (‘peak’) and trough of gent

A

3–5 mg/litre; pre-dose (‘trough’) concentration should be less than 1 mg/litre

227
Q

When to measure gent

A

measured after 3 or 4 doses, then at least every 3 days and after a dose change (more frequently in renal impairment).

228
Q

Treating meningitis

A

Benzylpenicillin ASAP then Ceftriazone

229
Q

How long can doxycycline be used as malaria prophylaxis

A

2 years

230
Q

Most effecting barrier against insects when combating malaria

A

Mosquito nets impregnated with permethrin

231
Q

How to apply DEET and sunscreen

A

DEET should be applied after the sunscreen

232
Q

DEET effect on sunscreen

A

reduces the SPF of sunscreen, so a sunscreen of SPF 30–50 should be applied

233
Q

Whose skin can’t DEET be applied to?

A

Under 2s, can be used on anyone else including breastfeeding (wash hands before handling infants)

234
Q

What class of antibiotics decreases the concentration of valproate

A

Carbapenems

235
Q

What antibiotics increase statins effects

A

Erythromycin

236
Q

What antibiotics result in QT prolongation

A

Macrolides

237
Q

Linezolid contraindications

A

tyramine-rich foods

238
Q

Vancomycin typical dose

A

125 QD 10 days for C diff, 15-20mg/kg

239
Q

Vancomycin indications

A

c diff, skin, joint, bone, pneumonia, endocarditis, meningitis, peritonitis

240
Q

Vancomycin side effects

A

Ototoxicity, nephrotoxicity, red man, SJS, hypotension, phlebitis

241
Q

Vancomycin dosing strategy

A

Initial doses should be based on body-weight; subsequent dose adjustments should be based on serum-vancomycin concentrations to achieve targeted therapeutic concentrations

242
Q

What vancomycin concentration is monitored and what is the therapeutic range

A

Pre-dose (‘trough’) concentration should normally be 10–20 mg/litre depending on the site of infection and the susceptibility of the pathogen; trough concentration of 15–20 mg/litre is usually recommended to cover susceptible pathogens with MIC greater than or equal to 1 mg/litre

243
Q

Tazocin (Piperacillin with tazobactam) indication

A

HAP, sepsis, complicated UTI/soft tissue/skin infections, Acute exacerbation of COPD, acute exacerbation of bronchiectasis, diabetic foot, leg ulcer infections in neutropenic patients

244
Q

Tazocin(pip/taz) dose

A

4.5g TDS/QD

245
Q

Unlicensed uses of pip taz

A

Acute exacerbation of COPD and acute exacerbation of bronchiectasis

246
Q

Tazobactam role

A

Beta-lactamase inhibitor

247
Q

Piperacillin role

A

Penicillin

248
Q

Pip/taz side effects

A

Diarrhoea; hypersensitivity; nausea; skin reactions; thrombocytopenia; vomiting

249
Q

Rifampicin indication

A

Brucellosis, legionnaires, staph, endocarditis, TB, meningitis, Haemophilus influenzae prevention, meningococcal meningitis prevention

250
Q

Monitoring checks before starting rifampicin

A

Renal and Liver

251
Q

Rifampicin indications

A

Brucellosis, legionnaires, staph, endocarditis, TB, meningitis, Haemophilus influenzae prevention, meningococcal meningitis prevention, leucopenia

252
Q

Rifampicin side effects

A

Nausea, vomiting, thrombocytopenia, GI, bone pain, flu like symptoms, psychosis

253
Q

Rifampicin counselling points/considerations

A

Hormonal contraceptive effectiveness reduced, discolours (soft) contact lenses, should be told how to recognise liver disorder and seek attention if it occurs, older patients excrete it slower, LFTshould be tested, renal tested, CYP 3A4 inducer, interacts with many drugs

254
Q

Rifampicin contraindications

A

Acute porphyrias ; jaundice

255
Q

Amphotericin side effects

A

hypokalaemia, headache, hyponatraemia, hypocalcaemia, hypomagnesaemia, tachycardia, hypotension, dyspnoea, renal impairment , hepatic impairment , skin reactions, vomiting

256
Q

Amphotericin monitoring

A

Hepatic and renal function tests, blood counts, and plasma electrolyte (including plasma-potassium and magnesium concentration) monitoring required.

257
Q

Amphotericin indication

A

systemic fungal infections, Visceral leishmaniasis, Aspergillosis, Severe invasive candidiasis

258
Q

Flucytosine indication

A

Systemic yeast and fungal infections, Cryptococcal meningitis (adjunct to amphotericin B)

259
Q

Flucytosine MHRA announcement

A

DPD can determine efficacy

260
Q

Flucytosine side effects

A

Agranulocytosis; aplastic anaemia; blood disorder; cardiotoxicity; confusion; diarrhoea; hallucination; headache; hepatic disorders; leucopenia; nausea; rash; sedation; seizure; thrombocytopenia; toxic epidermal necrolysis; ventricular dysfunction; vertigo; vomiting

261
Q

Fluconazole indication

A

Candidiasis ,tiniea pedis/cruris/corporis, Invasive candidal infections, pityriasis versicolor, Dermal candidiasis, Vaginal candidiasis, Candidal balanitis, prevention in immunocompromised patients

262
Q

Amphotericin caution

A

Rapid infusion

263
Q

Fluconazole caution

A

Susceptibility to QT interval prolongation

264
Q

Fluconazole unlicensed use

A

Not licensed for tinea infections in children, or for vaginal candidiasis in girls under 16 years, or for prevention of relapse of cryptococcal meningitis after completion of primary therapy in children with AIDS.

265
Q

Fluconazole side effects

A

Diarrhoea; gastrointestinal discomfort; headache; nausea; skin reactions; vomiting

266
Q

Fluconazole and renal impairment

A

Usual initial dose then halve subsequent doses if eGFR less than 50 mL/minute/1.73 m2.

267
Q

Caspofungin indication

A

Invasive aspergillosis, candidiasis, fungal

268
Q

Caspofungin side effects

A

Arthralgia; diarrhoea; dyspnoea; electrolyte imbalance; fever; headache; hyperhidrosis; nausea; skin reactions; vomiting

BNF Chapters (11 decks)

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