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BNF crash course > Infections > Flashcards

Infections Flashcards

1
Q

What age are tetracyclines CI under ?

A

12 years

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2
Q

In renal impairment what antibiotics should be avoided?

A
  • Aminoglycosides and Glycopeptides - they are nephrotoxic
  • Avoid tetracyclines except minocycline and doxycycline
  • Avoid nitrofurantoin if eGFR is less than 45
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3
Q

In Hepatic impairment what antibiotics should be avoided?

A
  • Rifampicin and tetracyclines
  • Reduce metronidazole dose if severely impaired
  • Cholestatic jaundice avoid caused by co-amoxi and flucloxacillin
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4
Q

Which antibiotics are not recommended during pregnancy?

A
  • Nitrofurantoin during term i.e. 37 weeks to 42 weeks
  • Diaminopyrimidines i.e. antimalarial drugs and quinolones i.e. “floxacin drugs” should be avoided during pregnancy
  • Trimethoprim should be avoided in the first trimester as its an antifolate
  • AVOID MCAT- metronidazole, Chloramphenicol, Aminoglycosides, Tetracyclines
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5
Q

Community acquired pneumonia which has staphylococci or skin infection or impetigo what is it usually treated with?

A

Flucloxacillin

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6
Q

What is MRSA usually treated with?

A

1st line Vancomycin

2nd line Linezolid

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7
Q

What is Streptococci usually treated with?

A

Benzylpenicillin or Pen V i.e. Phenoxymethylpenicillin

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8
Q

What are anaerobic bacteria usually treated with?

A

Metronidazole

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9
Q

What are pseudomonas aeruginosa usually treated with?

A

Gentamicin

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10
Q

What is caused if chloramphenicol is taken during pregnancy and BF?

A

Grey baby syndrome

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11
Q

Daptomycin is given for gram + bacteria and should be given with other gram - antibiotics if cause is unknown
True or false

A

True

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12
Q

What is fosfomycin used for?

A

Use for persistent uncomplicated lower UTI- 3g one dose

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13
Q

What is fusidic acid mainly used for ?

A
  • Staphylococcal skin infection

- Non-bullous impetigo

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14
Q

What are the warning signs with linezolid?

A
  • Visual impairment usually if treatment is longer than 28 days
  • Blood disorders if treatment longer than 10-14 days
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15
Q

What conditions should be a caution if linezolid is prescribed?

A
  • Bipolar depression
  • Elderly
  • History of seizures
  • Schizophrenia
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16
Q

What is linezolid drug class and what interactions will that have?

A

Reversible monoamine oxidase inhibitor - avoid consuming large amounts of tyramine-rich food —> hypertensive crises

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17
Q

What is trimethoprim commonly used for and what is the dosage?

A

Respiratory tract infection
Prophylaxis of recurrent UTI
Treatment of UTI- 200mg BD

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18
Q

What does co-trimoxazole consist of?

A

Trimethoprim and sulfamethoxazole

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19
Q

What are some trimethoprim SE?

A

Anti-folate i.e. its teratogenic in the first trimester
Blood dyscrasias i.e. fever, sore throat, rash, mouth ulcers, bruising, bleeding
Hyperkalaemia

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20
Q

What class is metronidazole? and what is it used for

A

its a nitroimidazole
Bacterial vaginosis
alternative to penicillin in dental infections
H. pylori eradication

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21
Q

What some side effects of metronidazole?

A 
Furry tongue 
Dry mouth
Nausea
Metallic taste
Vomiting 
GI disturbance
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22
Q

What is the advice given with metronidazole?

A

AVOID alcohol as it causes disulfiram like reaction

Take with or just after food

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23
Q

Which antibiotic commonly used to treat urinary infections should be avoided in the first trimester if the patient suffers from morning sickness ?

A

Nitrofurantoin

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24
Q

What colour does nitrofurantoin change the urine?

A

dark yellow or brown

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25
Q

what action is taken if the peak concentration of a drug is high?

A

The dose must be decreased

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26
Q

When is a peak dose measured?

A

An hour after the drug has been administered through IV/IM

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27
Q

What action if taken if the trough concentration of a drug is high?

A

The dose intervals should be increased

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28
Q

When is a trough dose measured?

A

Right before the next dose

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29
Q

What is gentamicin target concentrations for a single dose treatment?

A 
Peak= 5 to 10mg/L
Trough= <2mg/L
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30
Q

What is gentamicin target concentrations for a multiple dose treatment?

A 
Peak= 3 to 5mg/L
Trough= <2mg/L
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31
Q

What are the warning signs of gentamicin?

A 
Irreversible ototoxicity 
Nephrotoxicity 
Nausea and vomiting 
Antibiotics associated colitis 
Peripheral neuropathy
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32
Q

What are gentamicin interactions and what does it result in?

A
  • Nephrotoxicity with ciclosporin, tacrolimus, and vancomycin
  • Ototoxicity with loop diuretics and vancomycin
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33
Q

What are the cautions / warning signs of vancomycin?

A 
Thrombophlebitis 
Red man syndrome 
Ototoxicity 
Nephrotoxicity 
Blood and skin disorders
34
Q

What is vancomycin target concentrations?

A

Trough concentration is 10 to 15mg/L

15 to 20mg/l for more serious infections

35
Q

What are vancomycin interactions ?

A
  • Nephrotoxicity with ciclosporin, tacrolimus, and gentamicin
  • Ototoxicity with loop diuretics and gentamicin
36
Q

Why are tetracyclines avoided in under 12, pregnancy and BF?

A
  • Affects skeletal development in first trimester
  • Discolouration of child teeth in second and third trimester
  • Maternal hepatoxicity with parenteral administration
37
Q

Which tetracyclines should avoid exposure to sunlight/sunlamps?

A

DD
Demeclocycline
Doxycycline

38
Q

Which tetracyclines should avoid antacids as it decreases their absorption?

A

DOT
Demeclocycline
Oxytetracycline
Tetracycline

Take antacids / Milk 2 hrs before or after

39
Q

Which tetracyclines cause oesophageal irritation?

A

DMT
Doxycycline
Minocycline
Tetracycline

Swallow whole with plenty of fluids and stay sat up right for 30 minutes

40
Q

Which antibiotics should be avoided if the patient has a history of seizures?

A

Quinolones

41
Q

What taken with quinolones can trigger a seizure in patient with history of seizures?

A

NSAIDs

Theophylline

42
Q

What antibiotics can result in tendon damage?

A

Quinolones

Can cause tendon damage within 48hrs
The risk is increased with concurrent use of corticosteroids

43
Q

What are the cautions with quinolones?

A
  • Seizures
  • Tendon damage
  • Diabetes
  • Prolong QT intervals
  • G6PD deficiency
  • Psychiatric disorders - DISCONTINUE
44
Q

Else than tetracyclines what other antibiotics should be taken 2hrs before or after zinc based antacids?

A

Quinolones

45
Q

What class of antibiotics is clindamycin?

A

Lincosamides

46
Q

What is clindamycin highly associated with?

47
Q

What are some SE of clindamycin?

A 
GI disturbances
Oesophageal disturbance 
Jaundice 
Blood disorders
Rash
SJS 
C. DIff
48
Q

Which antibiotic if patient presents with diarrhoea you stop immediately?

A

Clindamycin because its a sign of C. Diff

49
Q

What are the cautions associated with co-trimoxazole?

A
  • asthma
  • avoid in blood disorders
  • avoid in infants under 6 weeks risk of kernicterus (brain damage)
  • in elderly increased risk of serious side effects
  • G6PD deficiency
  • good adequate fluid intake
  • Its teratogenic
50
Q

Which penicillin should be taken with food?

A

PENICLLIN WITH FOOD

Pivmecillinam

51
Q

Which penicillin should be taken on an empty stomach?

A

PENICLLIN AFTER FOOD
Phenoxymethylpenicillin
Ampicillin
Flucloxacillin

52
Q

Which penicillin cause cholestatic jaundice?

A

Flucloxacillin

Co-Amoxiclav

53
Q

What are first generation cephalosproins?

A

“Look out for cefa”

Cefadroxil
Cefalexin
Cefazolin
Cefradine

54
Q

What are second generation cephalsoprins?

A

“Fox Fur for tanning”

Cefoxitin
Cefuroxime
Cefaclor
Cefotetan

55
Q

What are third generation cephalosporins?

A

“Its a Fix T”

Cefixime
Cefotazime
Ceftazidime
Ceftriaxone

56
Q

What are fourth generation cephalosporins?

A

“Quinoa pie”

  • Cefquinome
  • Cefepime
  • Cefpirome
57
Q

What are the fifth generation cephalosporins?

A

“look out for ceft + ol”

  • Ceftobiprole
  • Ceftaroline used in CAP and complicated skin and soft tissue infections
  • Ceftolozane
58
Q

What does trimethoprim interact with ?

A

Methotrexate

59
Q

What does macrolides interact with ?

60
Q

What does Quinolones interact with ?

A

Theophylline- increased risk of seizure

61
Q

What does rifampicin interact with ?

A

combined hormonal contraceptive

62
Q

What is endocarditis usually treated with if its not staphylococci involved?

A

Amoxicillin + gentamicin for 4 to 6 weeks

Gentamicin is stopped after 2 weeks

63
Q

What is endocarditis usually treated with if its not staphylococci involved? and if the patient is penicillin allergic?

A

Vancomycin + Gentamicin

64
Q

What is endocarditis usually treated with if its staphylococci involved?

A

Flucloxacillin + gentamicin + Rifampicin

65
Q

What is acute diverticulitis usually treated with?

A

Co-amoxiclav + cephalosporin if its complicated

66
Q

C. Diff treatment ?

A

mild, moderate or severe
1st line- vancomycin
2nd- Fidaxomicin
3rd line - Vancomycin +metronidazole

67
Q

What is sinusitis treated with?

A

Amoxicillin OR Clarithromycin OR Doxycycline

68
Q

Otitis media treatment?

A

Only treat if symptoms persist longer than 72 hrs
1st line: Amoxicillin
2nd line: Co-amoxiclav
CI: Clarithromycin/ Erythromycin

69
Q

Otitis externa treatment?

A

1st line: flucloxacillin

CI: one of the Macrolides

70
Q

Treatment for localised non-bullous impetigo?

A

1st line: hydrogen peroxide 1% cream
2nd line: Fusidic acid 2% cream
3rd line: Mupirocin 2% cream

71
Q

Treatment for widespread non-bullous impetigo?

A

oral or topical flucloxacillin or macrolide if CI

72
Q

Treatment for bullous impetigo?

A

Oral flucloxacillin

73
Q

Treatment for cellulitis not involving the eyes?

A

Oral/ IV flucloxacillin

74
Q

Treatment for cellulitis involving the eyes?

A

Oral/Iv co-amoxiclav

75
Q

Treatment of animal/ human bites?

A

1st line: Co-amoxiclav

Penicillin allergy: Doxycycline + metronidazole

76
Q

Which anti TB meds are taken for 2 month and then 4 months?

A

RIPE for 2 months
Rifampicin, Isoniazid, Pyrazinamide, ethambutol

RI for 4 months
Rifampicin, Isoniazid

77
Q

Why is pyridoxine i.e. vitamin b6 given with isoniazid?

A

to prevent peripheral neuropathy

78
Q

Which antimalarial should be avoided if a patient has history of psychiatric disorders?

A

Mefloquine

79
Q

Which antimalarial should be avoided if a patient has renal impairment?

A

Proguanil, malarone (combo of atovaquone and proguanil hydrochloride) and chloroquine

80
Q

Which antimalarial should be avoided if a patient is pregnant?

A

Doxycycline, mefloquine, malarone (combo of atovaquone and proguanil hydrochloride )

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