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Infections November 23 > Infection part 5 200 onwards > Flashcards

Infection part 5 200 onwards Flashcards

1
Q

Q200: What is used to treat thread worms and what’s the patient advice?

A

Treatment: • Mebendazole • Treat all members of the family regardless of symptom not present. • If symptoms persist after 2 weeks another dose should be taken.

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2
Q

Q201: What age can mebendazole be given and what is the dose?

A

• 2 and above • Suspension: 5ml and then 2 weeks after • Tablets: 100mg as a single dose now and 2 weeks later • Not safe in pregnancy • Exam tips: always discount patients who aren’t allowed it for supply questions

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3
Q

Q202: What are the 2 most important herpesviruses and which body parts does each type affect?

A

• herpes simplex • simplex 1 → mouth • simplex 2 → genitals • varicella-zoster virus → type of herpes → affects body (chest, back, and face)

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4
Q

Q203: Which virus causes chicken pox?

A

• Varicella Zoster

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5
Q

Q204: What is used to treat chicken pox?

A

• paracetamol • Topical calamine lotion • chlorphenamine for treating itch for people 1 year + • increase fluid intake • wear smooth cotton fabrics • keep nail short • infectious period…

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6
Q

Q205: Which drug should be avoided in chicken pox?

A

• Ibuprofen - causes skin infections • Never use for chicken pox, unless a doctor advises

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7
Q

Q206: What is shingles and what’s used to treat it?

A

• Same thing as chicken pox but appears on the torso and happens later on in life. • Painful rash • Appears on only one side on the back and torso • Main treatments: • paracetamol for the pain…

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8
Q

Q207: What is used to treat herpes?

A

• Memory trick: “clovirs” treat herpes • aciclovir → active against HSV but does not eradicate them • famciclovir → used in herpes zoster and genital herpes • pro drug of penciclovir • valciclovir → used in herpes zoster…

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9
Q

Q208: What are the 2 types of malaria and what’s the difference between them?

A

1) Non-falciparum a) non-fatal b) Caused by plasmodium vivax 2) Falciparum a) fatal b) caused by plasmodium falciparum c) multiplies rapidly d) fatal in pregnancy last trimester

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10
Q

Q209: According to the BNF, what are the main treatment regimes for malaria prophylaxis?

A

• chloroquine and proguanil hydrochloride; • mefloquine; • atovaquone with proguanil hydrochloride or doxycycline.

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11
Q

Q210: What type of malaria is chloroquine used for and when is it used in combo with proguanil?

A

• P. malariae, P. knowles • Non-falciparum malaria • P. falciparum was used previously but now resistant • Chloroquine + proguanil can be for prophylaxis of malaria • Chloroquine can also be used for malaria in pregnancy • proguanil added to prevent resistance

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12
Q

Q211: When should mefloquine be avoided?

A

• history of neuropsychiatric issues (mental health issues) • epilepsy • MT: Meth makes you mental

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13
Q

Q212: Which 2 drugs is proguanil paired up with?

A

• proguanil + chloroquine • proguanil + atovaquone (malarone)

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14
Q

Q213: What types of malaria is quinine used for and what is the main drug interaction it’s associated with?

A

• TREATMENT of non-falciparum malaria and falciparum malaria • QT prolongation • MT: Quinine = QT

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15
Q

Q214: What else can quinine be used for besides use in malaria?

A

• Night-time leg cramps

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16
Q

Q215: Which antibiotic is used for malaria prevention?

A

• Doxycycline • Clindamycin (unlicensed )

17
Q

Q216: What are the age restrictions for each drug used in malaria prevention?

A

• Doxycycline: 12 and above • Mefloquine: 3 months and > 5kg but must be recommended by a doctor. OTC is always adults • Chloroquine: dose for children dependent on body weight and always prescribed…

18
Q

Q217: What advice is given to patients to prevent insect bites?

A

• mosquito nets impregnated with permethrin • mats (repellents) • vaporized insecticides • DEET → safe to use in pregnancy and breastfeeding • wear long sleeves & trousers after dusk to protect from bites

19
Q

Q218: How long should each drug be taken before leaving and after returning?

A

• BEFORE travel into an endemic area take prophylaxis for: • 1 week for chloroquine and proguanil hydrochloride; • 2–3 weeks for mefloquine; • 1–2 days for atovaquone with proguanil hydrochloride or doxycycline. • AFTER leaving the area continue for:…

20
Q

Q219: What dose of proguanil should be taken for malaria prevention?

A

• 1 tablet (200mg) daily • 1 week before travel • 4 weeks after return

21
Q

Q220: What dose of chloroquine should be taken for malaria prevention?

A

• Dose is dependent on body weight, • Taken once weekly, started 1 week before entering endemic area and continued for 4 week after leaving area. • When should chloroquine be avoided?…

22
Q

Q221: When should chloroquine be avoided?

A

• Epilepsy • Acute porphyrias • G6PD deficiency

23
Q

Q222: What advice is given to patients about returning from malaria zones?

A

• any illness occurring within 1 year esp within 3 months of return may be malaria • ADVISE: report any illness to doctor immediately esp if within 3 months of return. symptoms such as: • fever • chills • sweating

24
Q

Q223: Which antimalarial drugs can’t be used in patients with epilepsy?

A

• Both chloroquine and mefloquine • MT: AVOID THE QUINES IN EPILEPSY

25
Q

Q224: Which antimalarial drugs can be used in patients with epilepsy?

A

• doxycycline or atovaquone with proguanil hydrochloride • Doxycycline may interact with some antiepileptics and dose may need adjusting. Drugs such valproate and carbamazepine.

26
Q

Q225: Which antimalarial drugs can be used in pregnancy?

A

safe to use in pregnancy • DEET • Chloroquine and proguanil hydrochloride are safe • MT: PC= PREGNANCY

27
Q

Q226: Which antimalarial drugs can’t be used in pregnancy?

A

Avoid • Malarone, • mefloquine [can be used in 1st trimester with caution] • doxycycline [if using, complete before 15 week gestation - 2nd trimester]

28
Q

Q227: Which antimalarial drugs can’t be used in patients with renal impairment?

A

• Chloroquine proguanil and malarone ; avoid in renal impairment

29
Q

Q228: Which antimalarial drugs can be used in patients with renal impairment?

A

• Give mefloquine and doxycycline

30
Q

Q229: When should patients on warfarin start taking malaria prophylaxis?

A

• They should always take it weeks before travelling. • This means mefloquine is the most suitable as long as: • No mental health problems • No epilepsy • INR should be stable before starting prophylaxis, 7 days…

31
Q

Q230: What drugs are used to treat falciparum malaria?

A

• ORAL • quinine → together or followed by doxycycline or clindamycin • malarone (atovoquone and proguanil) • riamet (artemether + lumefantrine)

32
Q

Q231: What drugs are used to treat non-falciparum malaria and which is safe in pregnancy?

A

• Chloroquine • For chloroquine resistant non-falciparum: • Quinine, Riamet, Malarone • Pregnancy • Chloroquine given weekly • Proguanil is safe as well as long as there’s plenty of folate for mummy.

33
Q

Q232: What is the safety information regarding quinine?

A

• dose dependent QT prolongation • higher doses can cause arrhythmias, especially when given with other drug that can affect QT such as: • lithium • amiodarone • macrolides • quinolones • antipsychotics

34
Q

Q233: What is the safety information regarding mefloquine?

A

• Stop if any mental adverse effects. • Driving and skilled task can be affected while on this drugs.

35
Q

Q234: What is the safety information regarding chloroquine?

A

• Ocular toxicity in doses above 4 mg/kg. • MHRA warnings: • Cardiovascular events when given with macrolides. (Prolonged QT) • Psychiatric reactions

36
Q

Q235: Which 2 antivirals are used to treat influenza?

A

• oseltamivir (tamiflu) • zanamivir (relenza) • Memory trick: “amivirs”

37
Q

Q236: Why are these 2 antivirals used to treat influenza?

A

• Memory trick: “amivirs” • Oseltamivir and Zanamivir • Reduce the replication of influenza A and B

38
Q

Q237: When are oseltamivir and zanamivir not recommended?

A

• NOT recommended for seasonal prophylaxis against influenza

39
Q

Q238: Which patients are eligible for the flu vaccine?

A

• 50 and over • 18 and above with certain health conditions: chronic respiratory, cardiac, liver, CNS and kidney issues. immunocompromised, diabetes, overweight, • Are pregnant • Long-stay residential care…

Infections November 23 (5 decks)

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