Infection Flashcards
Animal/human bites prophylaxis options
Co-amoxiclav 1st line
doxy+ metro if penicillin allergy
for up to 5 days
Antibiotics of choice in pregnancy
Penicilling
Cephalosporins
1st line for community-acquired septicaemia
Tazocin
Cefuroxime
Antibiotics associated with C.diff infection (5)
Amoxicillin, Co-amox, Ciprofloxacin, Clindamycin, Cephalosporins
C.diff treatment (2)
Metronidazole, Vancomycin
COPD exacerbation treatments (3) and duration
Doxycycline/Clarithromycin/Amoxicillin for up to 5 days
CAP treatments and duration
Low-severity: Amoxicillin 1st line
Clari, Doxy - alternatives if penicillin allergy
for 7 days
Medium-severity: Amoxycycline + Clari OR Doxycycline alone (if pen allergy) for 7 days
High-severity: Benxylpenicillin + Doxy/Clari 7-10 days
HAP treatments and duration
5< days from admission: Co-amoxiclav or Cefuroxime for 7 days
> 5 days from admission: Tazocin for 7 days
Aminoglycosides examples
Gentamicin, Amikacin, Tobramycin, Streptomycin
Describe TDM for Gentamicin
For multiple daily dosing regimen - take lvl after 3rd or 4th dose
Take both peak and trough lvls
Nomogram read by body weight and renal function
Main side-effects of Gentamicin & other aminoglycosides (3)
Ototoxicity, nephrotoxicity, neuromuscular toxicity
Main side-effect of Carbapenems to look out for
Increased risk of seizures
Unique side-effect of Ceftriaxone
Calcium precipitates in gall bladder - discontinue if symptomatic
Glycopeptides examples
Teicoplanin, Vancomycin
Glycopeptides main SEs (3)
Red man syndrome, ototoxicity, nephrotoxicity
Which glycopeptide is less nephrotoxic?
Teicoplanin
What can happen if you give IV Vancomycin too rapidly?
Cardiac arrest
Describe TDM for Vancomycin and target lvls
Taken on day 2, just before 2nd dose (trough lvl).
Target 10-20 mg/L
Lincolsamide example
Clindamycin
When would you discontinue Clindamycin immediately
Bloody or prolonged severe diarrhoea
Macrolides examples
Clarythromycin, Erythromycin, Azithromycin
Main SEs of Macrolides to look out for
QT prolongation, electrolyte disturbances
Usual Clarithromycin dose
500mg BD
Usual Metronidazole dose
400mg TDS
Warning and cautionary labels for Metronidazole
Avoid alcohol, take with food, take with full glass of water
Is diarrhoea common for penicillins?
Yes
Which electrolyte can be deranged with Tazocin and Benzylpenicllin use?
Sodium - hypernatremia can occur
Admin direction for PenV
Take on empty stomach
Why Co-amoxiclav and Flucloxacillin treatments should not exceed 2 weeks?
Risk of cholestatic jaundice and hepatitis
How should Flucloxacillin be taken?
On empty stomach
SEs of quinolones to look out for (2)
QT prolongation, psychiatric disorders
Warning label for Ciprofloxacin
Do not take milk, indigestion remedies, zinc or iron 2hrs before/after
Example of Quinolones
Ciprofloxacin
Sulfonamide example
Co-trimoxazole
Main serious SEs of Co-trimoxazole (2)
Rash (SJS)
Blood disorders
Warning labels for tetracyclines (2)
Protect skin from light
Do not take indigestion remedies, zinc or iron 2hrs before/after
Usual doxycycline dose
100mg OD/BD
Which antibiotic is associated with grey baby syndrome
IV chloramphenicol
When should Trimethoprim be avoided?
Pregnancy - especially 1st trimester
Usual doses of Trimethoprim
100mg OD - prophylaxis
200mg BD - treatment
TB treatment choices
First 2 months: Isoniazid, Rifampicin, Ethambutol, Pyrazinamide
Another 4 months: (usually) Rifampicin + Isoniazid
Which TB medicine is preferable in liver toxicity
Ethambutol
What can Isoniazid cause and what is the treatment/prevention
Peripheral neuropathy
Pyridoxine can be given
Major SEs of TB treatment (5)
Flu-like symptoms, GI disturbances, renal impairment, thrombocytopenic purpura, respiratory symptoms
Special SE of Ethambutol
Ocular toxicity
Antibiotics for UTI in pregnancy
Penicillins/Ce[halosporins
Nitrofurantoin can be given, but NOT in 3rd trimester
Which UTI treatments should be avoided in renal impairment
Nitrofurantoin, tetracyclines
Usual Nitrofurantoin dose
100mg BD
Fluconazole main SEs (3)
Liver toxicity, QT prolongation, rash
What can rapid infusion of Amphotericin B cause?
Arrhythmias
Which antimalarials are suitable in epilepsy?
Doxycycline, proguanil with atovaquone
Which antimalarials should be avoided in epilepsy?
Quinolones
Which antimalarials should be avoided in pregnancy?
Tetracyclines, proguanil with atovaquone
Special SE of Chloroquine
Ocular toxicity
Special SE of Mefloquine
Psychiatric reactions
Symptoms of Quinines overdose?
Convulsions and arrhythmias
Examples of direct-acting antivirals (Hep C treatments)
Elbasvir, Sofosbuvir, Velpatasvir
Main SE of aciclovir
Photosensitivity
HIV treatment
2 Nucleoside reverse transcriptase inhibitors + 1 from another class
eg Emtricitabine + Tenofovir (NRTIs) + Ritonavir/Darunavir (PIs)
What can happen with prolonged exposure to HAART and/or advanced HIV?
Osteonecrosis
Usual dose of Oseltamivir
75mg OD for 10 days
