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BNF Infection > Infection > Flashcards

Infection Flashcards

1
Q

Example of an antiprotozoal used in amoebic infections

A

Mepacrine hydrochloride

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2
Q

Safest antibiotic classes in pregnancy

A

Penicilins and Cephalosporins

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3
Q

Signs and symptoms of infection

A

fever, inflammation, drowsiness in children, confusion in elderly, worsening of renal function

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4
Q

Clinical markers of infection

A

Raised CRP, Low BP, High ESR, temperature, Resp rate, pulse

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5
Q

what antibiotic classes must be avoided in children?

A

Tetracyclines (<12)

Quinolones cause arthropathy

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6
Q

What antibiotic has the largest risk of C diffe

A

Clindamycin

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7
Q

What type of antibiotics are related to adverse reactions e.g. fungal infections and antibiotic associated collitis/

A

Broad spectrum e.g. Cephalosporins

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8
Q

Examples of notifiable diseases

A
  • Anthrax -Cholera
  • Botulism -Brucellosis
  • Diarrhoea (infectious/bloody)
  • Diptheria -Encephalitis(acute)
  • Food poisoning
  • haemolytic uraemic syndrome
  • viral hepatitis -Legionnaires
  • Leprosy -Malaria -measles
  • meningitis -meninigococcal septicaemia - mumps
  • paratyphiod fever -plague
  • polio -rabies -rubella -SARS
  • scarlet fever -Smallpox
  • Strep (group A) -tetanus -TB -typhoid fever -typhus -whooping cough -yellow fever
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9
Q

What antibiotic is used in rheumatic fever to prevent recurrence?

A

Phenoxymethylpenicillin or sulfadiazine

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10
Q

What antibiotic is used in invasive strep A infection to prevent recurrence?

A

Phenoxymethylpenicilin (if pen allergic -> erthyromycin or azithromycin

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11
Q

What antibiotcs are used to prevent secondary menigococcal infection to exposed people?

A

Ciprofloxacin or Rifampicin

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12
Q

What antibiotic is used in haemophilus influenza type B to prevent secondary cases?

A

Rifampicin - if therre are vunlerable occupants in household

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13
Q

What antibiotic is used for diptheria in non immunocompromised patients to presvent secondary cases?

A

Erthyromycin - treat for further 10 days if swab +ve after 7 days of treatment

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14
Q

Antibiotic therapy used for prophylaxis of pertussis

A

Clarithromycin

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15
Q

Asplenia prophylaxis antibiotic of choice

A

Phenoxymethylpenicilin

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16
Q

Antibiotic of choice following animla bites

A

co-amoxiclav (or doxy + metro)

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17
Q

If a patient is having a GI procedure, what antibiotic should be given as a single STAT dose

A

Gent / cefuroxime / Co-amox up to 30 mins before procedure

If MRSA +ve - vanc/teic

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18
Q

Examples of antipseudomonal antibiotics

A

Pip-Taz, ticarcillin with clavulanic acid

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19
Q

What first line antibiotics should be given to suspected Meningococacal septicaemia patients

A
  • Benz pen OR cefotaxime OR chloramphenicol
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20
Q

What antibiotics are used to eliminate nasipharyngeal carriage of meningitis?

A

Ciprofloxacin or rifampicin

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21
Q

Antibiotics that can cause cholestatic jaundice

A

Co-amoxiclav + flucloxacillin

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22
Q

Antbitocs contraindicated in pregnancy

A

tetracyclines, trimethoprim, nitrofurantion (causes nausea; avoid at term)

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23
Q

Antibiotics to avoid in pregnancy

A

Metronidazole, Chloramphenicol, aminoglycosides and Tetracyclines, Quinolones and sulphonamides

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24
Q

Generally, what antibiotic is used for staphylococci infection?

A

Flucloxacillin

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25
Q

Generally, what antibiotic is used for MRSA infection?

A

Vancomycin

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26
Q

Generally, what antibiotic is used for Anaerobic infection?

A

Metronidazole

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27
Q

Generally, what antibiotic is used forpseudomonas taphylococci infection?

A

Gentamicin

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28
Q

Generally, what antibiotic is used for streptococci infection?

A

Phenoxymethylpenicilin or Benpen

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29
Q

If menigitis is caused by listeria, how should it be treated?

A

Amoxicilin + Gentamicin for 21 days

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30
Q

If a patient is over 50yrs and has meningitis, how do we treat them?

A

/Cefotaxime (or ceftriaxone) + AMOXICILLIN

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31
Q

Antibacterial of choice for otitis externa

A

flucloxacillin ( or clari if pen allergy. If pseudomonas suspected, give Cipro)

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32
Q

Signs of otitis media

A

Effusion, common in children, can be systemically unwell

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33
Q

When should antibiotics be offered to patients with OE

A

if systemically unwell e.g. fever or if there is otorrhoea or if pt <2 with bilateral OE
Give amoxicilin or clari if pen allergic

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34
Q

Ear symptoms that would requrie referral

A 
Dizziness or tinnitus
Pain in the middle ear
Fever and malaise in children (signs of systemic infection)
 Foreign body
Deafness
 Inflammation of the pinea
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35
Q

What is the active ingredient in Sofradex

A

Framycetin 0.5%, Dex 0.05% and Gramicidin 0.005%

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36
Q

Active ingredient in locorten vioform

A

Flumetasone / ciloquinol 0/02%

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37
Q

What is the brand ofr neomycin + dexamethasone + acetic acid ear spray?

A

Otomize

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38
Q

antibiotic choice in Salmonella

A

Cipro or ceftotazidime

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39
Q

Antibiotic choice in campylobacter

A

clarithromycin

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40
Q

Treatment of C diffe

A

metronidazole PO for 10-14 days

OR Vanc PO OR Fidaxomicin

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41
Q

Antibioti choice for chlamydial infection

A

Doxycyline or Azithromycin for 7 days

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42
Q

Organisms that can cause sinusitis

A

Strep pneumoniae, Heam.influenzae, Moraxella catharrhalis

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43
Q

Should antibiotics be offered to all patients wiht ? sinusitis?

A

No - only those systemicall unwell with symptoms for 10 days or morer

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44
Q

First line antibiotics for Bronciesctasis or COPD acute exacerbations or

A

Doxy or Clari or amox

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45
Q

First line antibiotics for non severe CAP

A

Amoxicillin

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46
Q

First line antibiotic for moderate severity CAP

A

Amoxicilin + Clarithromycin or Doxy alone

47
Q

High severity CAP treatment

A

Benzpen + clari

48
Q

Atypical pneumonia first line antibiotic

A

Clari

49
Q

HAP early onset natibiotic choice

A

co-amoxiclav

50
Q

Treatmet for Impetigo if small areas of skin infected

A

Fusidic acid topical ( 7 days) or if MRSA mupirocin topical

51
Q

Treatmet for Impetigo if widespread infection

A

PO flucloxacillin

52
Q

Treatment for cellulitis

A

High dose flucloxacillin

53
Q

Examples of aminoglycosides

A

Neomycin, amikacin, tobramycin, gentamicin, streptomycin

54
Q

What type of bacteria is Gentamicin active against

A

many gram -ve (inc. P aeruginosa) and some gram +ve –> inactive against Anaerobes

55
Q

Side effects of aminoglycosides

A

Nephrotoxic
Otoxic
Hypocalcaemia + hypokalaemia + hypomagnesaemia
May impair neuromusculae transmission (CI in MG)

56
Q

If a patient has renal impairment and is prescribed an aminoglycoside, what must be done to the dosage interval?

A

increase the interval so there is more time for the drug to be excreted

57
Q

What condition is AG contraindicated in?

A

Myasthenia Gravis

58
Q

Why is IBW used to calculate Gentamicin doses>

A

AG are hydrophilic - to avoid excessive dosing in obese patinets

59
Q

When should Gentamicin levels be taken and what is the aim?

A

For OD dose regimes: pre dose <1mg/mL

For multi dose regimes: take 1 hour after dose (5-10mg/mL) and trough levels (<2mg/mL)

60
Q

If a gentamicin pre-dose conc is high, what should be done

A

increae the dosing interval

61
Q

If an aminglycoside post dose level is high what should be done?

A

Reduce the dose of AG

62
Q

MHRA alert for histamine related reaction was associated with which aminoglycoside?

A

Gentamicin

63
Q

What antibiotics are broad spec and beta lactams?

A

Carbapenems

64
Q

Are carbapenems active against methicillin resistant staph aureus?

A

No

65
Q

Examples of Carbapenems

A

Meropenum and Imipenem

66
Q

What antibiotics are cautioned in penicilin allergy?

A

Carbapenems

67
Q

Which carbapenem is not active against P.aeruginosa?

A

Ertapenem (used for CAP, abdominal and gynae infection)

68
Q

Why is imipenem given with Cilastatin?

A

Cilastatin is an enzyme inhibtor that blocks imipenems renal metabolism as kidneys partially inactive imipenem

69
Q

Which carbapenem has the least seizure inducing potential?

A

Meropenem

70
Q

What is the interaction between carbapenem and sodium valporate?

A

Carbapenems decrease the concentration of sodium valp as low as 10% - increasing sodium valp dose does nto counteract the interaction

71
Q

What spectrum are cephalosporins?

A

Broad spec

72
Q

Example of 1st gen cephalosporin

A

Cephalexin (often used in UTI, safe in pregnancy)

73
Q

Example of 2nd gen cephalosporin

A

Cefuroxime (more activity against gram -ve bacteria)

74
Q

Example of 3rd gen cephalosporin

A

Ceftriaxone and Ceftazidime (ceftazidime is active against pseudomonas)

75
Q

Which cephlasporin can cause gall bldder stones?

A

Cetriaxone - caution in history of hypercalciuria

76
Q

Examples of glycopeptides

A

vanc + Teic

77
Q

What spectrum are glycopepetides active against

A

Gramm +ve only

78
Q

Side effects of glycopeptides

A

Red man syndrome ( if infused too fast), nephrotxocitiy and otoxicity

79
Q

What is the aim for Vancomycin trough levels?

A

10-20mg/L

80
Q

Which antibiotic is well concentrated into bone and exreted in bile and urine?

A

clindamycin

81
Q

Which antibiotic is most liley ot cause antibiotic associated colitiis?

A

Clindamycin

82
Q

What is a caution associated wiht Macrolides?

A

Can prolong QT

83
Q

Which macrolide is QDS dosing and which is BD?

A 
QDS = erythromycin (more GI s/e) 
BD = clarithromycin
84
Q

Macrolides can cause drug interactions. Why?

A

They are enzyme inhibitors so can increase levels of warfarin, statins, CCBs, Apixaban, digoxin etc

85
Q

What condition can Azithromycin be sold as a max 1g dose for OTC?

A

Asymptomatic chlamydia trachomatis gential infection

86
Q

Counselling points with metronidazole

A

Take with food, avoid alcohol and for48 hours after treatment, may darken urine

87
Q

Which antibiotics are penicillinase resistant?

A

Flucloxacillin and Temocillin

88
Q

what antibiotics are antipseudomal penicilins?

A

Pip-taz (4.5g TDS)

89
Q

Amoxicilin peadiatric doses

A

Age 1-11months: 125mg TDS
Age 1-4 years: 250mg TDS
Age 5-17 years: 500mg TDS

90
Q

What is the only oral antibiotic agaisndt P..aeruginosa

A

Ciprofloxacin

91
Q

What drug in conjunction to a quininole can increae the risk of convulsions

A

NSAIDS

92
Q

What is the MHRA alert regarding quinolones

A

Tendon ruptue and damage - CI if history of tendon disorders following quinolone use

93
Q

Concomittant therapy with what drug increases the risk of quinolone induced tendon rupture?

A

Corticosteroids

94
Q

what antibiotic class is associated with an MHRA alert regarding increased risk of Aortic anerusym and dissection?

A

Quinolones

95
Q

What conditions are quinolones cautioned in

A

QT prolongation, arthropathy in children, epilepsy, G6DP deficiency, excessive exposure to sunlight

96
Q

What medication interacts with Trimethoprim / co-trimz>

A

Methotrexate

97
Q

Dose of trimethoprim for UTIS

A

200mg BD (occassionally 100mg ON for UTI prophylaxis)

98
Q

What is the name for trimethoprim + sulfamethoxazole

A

Co-trimoxazole

99
Q

What antibiotic is used ofr PCP infection

A

Co-trimox 120mg/kg/day for treatment and 960mg for propylaxis dose (noramally M/W/Fri)

100
Q

What must you monitor for with trimethoprim/co-trimox?

A

Blood disorders (leucopenia, thrombocytopenia, aneamia)

101
Q

How should tetracyclines be taken?

A

Swallow whole, avoid exposure to sunlight, indigestion remedies/zin iron 2 hours before or after

102
Q

Which tetracycline holds the greatest risk of SLE?

A

Minocycline

103
Q

Why should chloramphenicol be avoided in babies?

A

Grey baby syndrome risk

104
Q

What needs to be monitored during daptomycin therapy

A

Creatine phosphokinase - before and then at least weekly during treatment + renal function

105
Q

What are the mhra warnings associated wiht Linezolid?

A
  1. Optic neuropathy

2. Blood disorders

106
Q

What is the risk of using linezolid in combination wiht SSRIS

A

Serotonin syndrome

107
Q

What is Rifaximin used for?

A

Travellers diarhorrea and recurrence of hepatic encepthalopathy

108
Q

Nitrofurantoin has the risk of what neuropathy?

A

Peripheral neuropathy

109
Q

When is antiviral treatment needed for children with chickenpox?

A

If <1 month i.e. neonate

110
Q

What is herpes Zooster more commonly known as

A

Shingles

111
Q

What drug is used for herpes zooster (systemically) and herpes simplex (topically)

A

Aciclovir

112
Q

Valaciclovir can be used for what form of herpes?

A

Genital herpes

113
Q

What is Ganciclovir used to treat?

A

CMV

114
Q

What is Oseltamivir licensed for use for?

A

flu - start within 48 hours

BNF Infection (3 decks)

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