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Infections Flashcards

1
Q

What is used in guiding selection of antibiotic

A

Kirby-Bauer method

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2
Q

What is used to determine lowest conc. of antibiotic that inhibits visible bacterial growth vs conc. that kills >99.9% bacteria

A

Dilution test

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3
Q

How do antibiotics that inhibit cell wall synthesis act?

A
  • Inhibits synthesis of peptidoglycan
  • bind irreversibly to penicillin binding protein
  • leads to cell death
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4
Q

What class of antibiotics don’t need b-lactamase inhibitors

A
  • Monobactams
  • Carbapenem
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5
Q

General side effects of b-lactactame antibiotics

A

Nausea and diarrhoea

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6
Q

Examples of b-lactamase inhibitors

A

Tazobactam
Clavulanic acid

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7
Q

What class of drugs interfere with bacteria cell wall

A

‘PCCM’
- penicillin
- cephalosporins
- carbapenems
- monobactams

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8
Q

Side effects of fosfomycin

A

Nausea
Diarrhoea
Dizziness
Headache

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9
Q

Side effects of cycloserine

A

Neurological and psychological disturbances

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10
Q

Side effects of vancomycin

A
  • Hypotension
  • Flushing (red man syndrome)
  • Nephrotoxicity
  • Ototoxicity
  • Blood disorders
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11
Q

What drugs are used in tuberculosis

A

Isaniazid
Ethambutol

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12
Q

Side effects of isoniazid

A

Hepatotoxicity
Peripheral neuropathy
(tingling, constipation, numbness, diarrhoea)

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13
Q

Side effects of ethambutol

A

Vision loss

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14
Q

What drugs are CI in penicillin allergy

A

Cephalosporins

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15
Q

Which cephalosporins are excreted by the liver

A

Ceftriaxone
Cefoperadone

the rest are excreted by the kidney

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16
Q

What drug interferes with the absorption of penicillin and cephalosporins

A

Probenecid - used in gout and gouty arthritis

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17
Q

Side effects of cephalosporins

A
  • hypersensitivity
  • GI distress - C.Diff & Diarrhoea
  • Rare haemolytic anaemia
  • Severe bleeding
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18
Q

What is used as an alternative to cephalosporin

A
  • gram +: Monobactams
  • gram -: Macrolides
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19
Q

What cephalosporins have disulfiram like action

A

Cefoperazone
Cefotitan

intolerance to alcohol

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20
Q

Examples of first gen cephalosporins

A

’cefa’

  • Cefazolin
  • Cefalexin
  • Cefradine
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21
Q

Examples of second gen cephalosporins

A
  • Cefaclor
  • Cefuroxime
  • Cefotetan
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22
Q

Examples of third gen cephalosporins

A

’ime, one, ten, ir except cefuroxime’

-Ceftriaxone
- Cefotaxime
- Cefixime

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23
Q

Does the third gen cephalosporins cross BBB

A

Yes

and cefuroxime

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24
Q

What cephalosporin can be used for surgical prophylaxis

A

Cefazoline

long half life

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25
Q

What cephalosporin can be used in meningitis

A

Cefuroxime

crosses BBB

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26
Q

What cephalosporins are used in resistant infection

A

Cefuroxime
Cefoxitin

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27
Q

Symptoms of infection

A
  • Fever, aches and pains
  • Pus, swelling or inflammation
  • Drowsiness in children
  • Confusion in elderly
  • Worsening renal function
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28
Q

Clinical markers of infection

A
  • Low blood pressure
  • Raised blood glucose (hyperglycaemia)
  • High ESR, C-receptive protein, temperature, respiratory rate, pulse
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29
Q

What are the cell membrane integrity disruptors

A

Daptomycin
Polymyxins

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30
Q

Side effect of daptomycin

A

Skeletal muscle toxicity

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31
Q

Side effect of polymyxins

A

Nephrotoxicity
Neurotoxicity

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32
Q

What type of bacteria do cell wall synthesis inhibitors work on?

A

Rapidly dividing bacteria

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33
Q

Which penicillin is resistant to b-lactamase

A

Flucloxacillin

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34
Q

Route of administration of Pen G and why

A

Benzylpenicillin

IV / IM

They are destroyed by gastric acid when given orally

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35
Q

What infection are Pen G and Pen V used to treat

A

Syphilis - T.pallidum
Jaw infections

the ‘cocci’ infections
- Streptococci (Depot)
- Pneumococci
- Meningococci

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36
Q

What type of penicillin are amoxicillin and ampicillin

A

Broad spectrum b-lactam sensitive

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37
Q

Between amoxicillin and ampicillin, which has the least GI side effects

A

Amoxicillin

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38
Q

Does amoxicillin have a food interaction?

A

No

ampicillin does

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39
Q

What is the main use of amoxicillin in infections

A

Lungs: COPD, pneumonia, bronchiectasis

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40
Q

When is ampicillin used

A

Listeria (meningitis)

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41
Q

When are PipTaz used? (Extended spectrum penicillin)

A

UTIs
Burns
HAP

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42
Q

How are penicillins excreted?

Exception?

A

Renally

Except; Nafcillin & Oxacillin which is excreted by the liver

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43
Q

What penicillin drugs are excreted by the liver?

A

Naficillin
Oxacillin

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44
Q

Side effects of penicillin

A
  • Hypersensitivity reaction
  • GI distress
  • Jarisck herxheimer (siphylis)
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45
Q

When shouldn’t Broad spectrum penicillin (amoxicillin and ampicillin) be given

A

Blindly for sore throat - glandular fever (causes rash that can be mistaken for hypersensitivity)

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46
Q

How should ampicillin be taken

A

Before food

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47
Q

Main side effect of amoxicillin

A

Cholestatic jaundice- do not exceed 14 days

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48
Q

Main side effect of Flucloxacillin

A

Cholestatic jaundice
Hepatitis

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49
Q

How should Flucloxacillin be taken

A

Before food

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50
Q

What type of infections are vancomycin used to treat

A

MRSA
Enterococci
Also C. diff

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51
Q

Trough target for vancomycin

A

10-15 mg/ml

15-20 mg/ml in endocarditis

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52
Q

Drugs that target nucleic acid synthesis

A
  • Metronidazole
  • Quinolones
  • Rifampicin
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53
Q

Use of metronidazole

A

Dental infections
Vaginal trichomoniasis

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54
Q

Side effects of metronidazole

A
  • Taste disturbances
  • Furred tongue
  • Oral mucositis
  • GI disturbance
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55
Q

Counselling for metronidazole

A

Avoid alcohol
Take with it after food

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56
Q

What to do if peak level is high?

A

Reduce dose
Maintain interval

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57
Q

What to do if trough is high but peak is okay

A

Maintain dose
Increase interval

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58
Q

When should patient report illness after visiting a malaria region

A

Within 1 year
Especially within 3 months of return

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59
Q

What is used to treat externa otitis

A
  • Flucloxacillin
  • Clarithromycin/ azithromycin/ erythromycin - Pen allergy
  • Ciprofloxacin/ aminoglycoside
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60
Q

A woman is one week away from giving birth and has contracted UTI. What is the best treatment and why?

A

Cefalexin

Trimethoprim - teratogenic
Nitrofurantoin - Avoid at term

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61
Q

What age is tetracycline CI

A

< 12 years

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62
Q

What age should quinolones be avoided

A

< 18 years

Cause disease of the joint - arthropathy

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63
Q

What class of antibiotics should be avoided in renal impairment

A
  • Aminoglycosides (gentamicin, amikacin,etc)
  • Glycopeptides (vancomycin)
  • Tetracyclines
  • Nitrofurantoin

Nephrotoxicity

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64
Q

What antibiotics should be avoided in Hepatotoxicity

A
  • Tetracycline
  • Rifampicin
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65
Q

What antibiotics cause cholestatic jaundice

A

Amoxicillin
Flucloxacillin

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66
Q

What antibiotics are contraindicated in pregnancy

A

‘Carrying **M*others Cannot Take Antibiotics’

  • Clarithromycin
  • Metronidazole
  • Chloramphenicol (grey-baby syndrome)
  • Tetracycline (affects skeletal development, risk of discolouration of child’s teeth - 2nd/3rd trimester)
  • Aminoglycosides (auditory or vestibular nerve damage - 2nd/3rd trimester)
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67
Q

General antibiotic cautionary and advisory label

A

Space the doses evenly throughout the day
Keep taking this medicine until the course is finished, unless you are told to stop.

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68
Q

Antibiotics associated with C.diff (antibiotics associated colitis) and thrush (Candida) eg. Vaginal thrush

A
  • Clindamycin
  • Broad spec penicillin (amoxicillin & ampicillin)
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69
Q

What is used to treat infections caused by staphylococcus

A

Flucloxacillin

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70
Q

What is used to treat infections caused by MRSA

A

Vancomycin
Linezolid

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71
Q

What is used to treat infections caused by streptococcus

A

Benzylpenicillin (Pen G)
Phenoxymethylpenicillin (Pen V)

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72
Q

What is used to treat infections caused by anaerobic bacteria

A

Metronidazole

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73
Q

What is used to treat infections caused by pseudomonas aeruginosa

A

Gentamicin

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74
Q

What is the causative agent of Community Acquired Pneumonia (CAP)

A

Staphylococcus - Flucloxacillin

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75
Q

What is the causative agent of impetigo or cellulitis (skin)

A

Staphylococcus - Flucloxacillin

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76
Q

Warning sign of C.diff and what to do

A

Diarrhoea

STOP antibiotic and see a GP

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77
Q

When is linezolide used?

A

As an alternative to vancomycin in MRSA infection

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78
Q

Side effect of linezolid

A
  • Blood disorders (STOP if bone marrow suppression)
  • Optic neuropathy especially when used over 28 days. (Report visual symptoms)
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79
Q

Linezolid interaction with food

A

Tyramine (cheese, soya beans)

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80
Q

Linezolid drug interactions

A

Antidepressants
SSRIs, TCAs or MAOi

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81
Q

Wash out period of linezolid

A

2 weeks

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82
Q

Trimethoprim dose

A

200mg BD

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83
Q

Side effect of trimethoprim

A

Blood dyscrasias: long term use
Hyperkalaemia

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84
Q

When is co-trimoxazole used

A
  • pneumocystis jirovecii pneumonia
  • Leg ulcer - pen allergy
  • diabetic foot infection
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85
Q

Side effects of co-trimoxazol

A
  • Rashes
  • SJS
  • Photosensitivity
  • Blood dyscrasia (long term use)
  • Hyperkalaemia
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86
Q

Side effects of chloramphenicol

A
  • Blood dyscrasias
  • Grey baby syndrome (avoid in pregnancy)
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87
Q

What type of bacteria is metronidazole active against

A

Anaerobic bacteria
Bacterial vaginosis

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88
Q

Side effects of metronidazole

A
  • Furred tongue
  • Dark urine
  • Taste disturbances
  • Liver enzyme increase
  • Nausea/ vomiting
  • GI disturbances (take with or after food)
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89
Q

Nature of interaction: Metronidazole and alcohol

A

Disulfriam-like reaction
Avoid alcohol during the course for at least 48 hours after

90
Q

How is metronidazole taken?

A

With or after food
Avoid alcohol

91
Q

Side effect of nitrofurantoin

A
  • Blood dyscrasias
  • Acute pulmonary reactions
  • Cholestatic jaundice
  • Peripheral neuropathy
92
Q

When should nitrofurantoin be avoided?

A
  • Renal impairment eGFR <45
  • Infants < 3 months old
  • Acute porphyria
93
Q

How is nitrofurantoin taken?

A

With or after food

94
Q

Nitrofurantoin and urine

A

Yellow / brown

95
Q

Nitrofurantoin dose

A

IM tx: 50mg QDS
IM Prophylaxis: 50-100mg ON

MR Tx: 100mg BD

96
Q

Examples of aminoglycosides

A

Gentamicin
Tobramycin (via inhaler in cystic fibrosis)
Amikacin (gentamicin resistant gram - bacilli)
Streptomycin (tuberculosis)

97
Q

How are aminoglycosides given?

A

Parenteral route
Not absorbed by the gut

98
Q

How is gentamicin used in blind therapy?

A

With metronidazole and/or penicillin

99
Q

When to avoid OD gentamicin

A
  • Renal impairment <20ml/min
  • HACEK or gram(+) endocarditis
  • Burns cover > 20% of body
100
Q

When to monitor gentamicin

A

After 3 or 4 doses
After dose change

101
Q

Target plasma levels of gentamicin

A

Peak: 5-10mg/ml (3-5mg/ml for endocarditis)

Trough: <2mg/ml (<1mg/ml)

sample taken 1 hour after dose

102
Q

What do you do to gentamicin dose in renal impairment

A

Increase intervals

Severe: reduce dose

103
Q

Side effects of gentamicin

A

Nephrotoxicity
Ototoxicity (report hearing loss, tinnitus, or vertigo)

104
Q

Drugs that increase risk of nephrotoxicity with gentamicin

A
  • Ciclosporin
  • Tacrolimus
  • Vancomycin
105
Q

Aminoglycosides in pregnancy

A

Avoid
Auditory and vestibular damage in 2nd and 3rd trimester

risk small with gentamicin

106
Q

Duration of treatment with aminoglycosides

A

7 days

107
Q

Aminoglycosides with loop diuretics counselling

A

Ototoxicity
Separate by long period as possible

108
Q

When is gentamicin contraindicated

A

Myasthenia gravis - muscle weakness

109
Q

Electrolyte imbalance of aminoglycosides

A

HypO K, Ca and Mg

110
Q

MHRA warning with gentamicin

A

Histamine related adverse drug reactions

111
Q

Examples of glycoproteins

A
  • Vancomycin
  • Teicoplanin
  • Telavacin (only in HAP when other antibiotics are unsuitable)
112
Q

How are glycoprotein given

A

Parenteral rout
Not by mouth in systemic infections

113
Q

When is vancomycin used?

A
  • Antibiotic associated colitis
  • MRSA infections
114
Q

Target trough concentration of vancomycin

A

10-15 mg/ml
15-20 mg/ml for endocarditis

115
Q

When should vancomycin be stopped?

A

Tinnitus
(Ringing sound in ears)

116
Q

Most common side effect associated with vancomycin

A

thrombophlebitis
Pain and inflammation at injection site

117
Q

Examples of tetracycline

A
  • Democycline
  • Doxycycline (used in malaria and chlamydia)
  • Lymecyline
118
Q

Side effects of tetracycline

A

’POST’

  • Photosensitivity
  • Oesophageal irritation
  • Severe headaches (benign intracranial hypertension)
  • Tooth discolouration
  • Visual disturbances
119
Q

When to stop tetracycline

A

Headache or visual disturbances

120
Q

When are tetracyclines contraindicated

A
  • Children under 12
  • Pregnancy and breastfeeding
    Deposits in growing bone and teeth and cause tweety discolouration and dental hypoplasia
121
Q

Side effect of minocycline

A
  • Irreversible pigmentation
  • Greater risk of lupus-erythematosus-like syndrome
  • Dizziness and vertigo
122
Q

What two tetracyclines can be used in renal impairment

A

’DM’

Doxycycline
Minocycline

123
Q

Tetracyclines in hepatic impairment

A

Avoid - hepatotoxicity

124
Q

What tetracyclines cause photosensitivity

A

‘Double Ds’

Doxycycline
Democycline

125
Q

What tetracyclines do you avoid ingestion remedies with

A

‘Dox Like Milk’

Doxycycline
Lymecycline
Minocycline

+ Azithromycin (tabs)

2 hours before and after

126
Q

What tetracyclines are avoided with milk

A

‘DOT’

  • Democlocycline
  • Oxytetracycline
  • Tetracycline
127
Q

What tetracyclines need to be swallowed whole and taken standing with a full glass of water

A

‘DMT’

  • Doxycycline
  • Minocycline
  • Tetracycline

+ clindamycin

128
Q

When to avoid quinolones

A

MRSA - Innate resistance

129
Q

When are quinolones used?

A

Lower RTI
UTIs

130
Q

Examples of quinolones

A

Ciprofloxacin
Levoflaxacin
Moxifloxacin
Nalidixic acid

131
Q

Main side effect of quinolones

A

QT prolongation
Esp. Moxifloxacin (associated with life threatening hepatotoxicity

132
Q

Side effects of quinolones

A
  • QT prolongation
  • Seizures
  • Tendon damage
  • Heart valve regurgitation
  • Aortic aneurysms
133
Q

Quinolones in pregnancy

A

Avoid - Arthropathy

134
Q

When to discontinue quinolones

A
  • Psychiatric, neurological and hypersensitivity reactions occur
  • Tendonitis
135
Q

When should quinolones be avoided

A
  • Pregnancy
  • Children / adolescents
136
Q

Drug interaction with quinolones that increase risk of QT prolongation

A
  • SSRI
  • quinine
  • Amiodarone
  • macrolides
  • antipsychotic
137
Q

Drug interaction with quinolones that increase risk of seizures

A
  • ciproflaxacin
  • theophylline
  • NSAIDs
138
Q

Main drug interactions with quinolones

A
  • QT Prolonging drugs - increased risk of QT prolongation
  • Corticosteroid - risk of tendonitis or tendon damage
  • Methotrexate - increase methotrexate levels
  • NSAIDs - increased risk of seizures
  • Theophylline - increased theophylline levels
139
Q

Counselling points for quinolones

A
  • Driving; can impair performance of skilled task (enhanced by alcohol)
  • Antacid and zinc/iron; Leave 2 hours before or after taking
140
Q

How is azithromycin taken

A

OD
Before food/ indigestion remedies: 2 hour gap

141
Q

How is ezithromycin taken

A

QDS/BD
Before indigestion remedies: 2 hour gap

142
Q

How is clarithromycin taken

A

BD

143
Q

Common side effect of clarithromycin

A

Taste disturbances

144
Q

When is azithromycin commonly used?

A

Chlamydia
1g STAT - OTC

Gonorea

145
Q

Side effects of macrolides

A
  • GI effect (most common with erithromycin)
  • QT prolongation
  • Hepatotoxicity
  • Ototoxicity
146
Q

How to take macrolides
exception?

A

Take with or after food

(Azithromycin before food)

147
Q

What is used in treating H.pylori infections

A

Macrolides (clarithromycin BD)

148
Q

Nature of interaction between clarithromycin and warfarin

A

Increased risk of bleeding

149
Q

Nature of interaction between clarithromycin and statin

A

Increased risk of myopathy
Stop statin while on clarithromycin - no need to refer

150
Q

When is benzylpenicillin used?

A

Meningitis

151
Q

When is phenyl penicillin used?

A

Respiratory tract infection in children

eg. Sore throat, tonsillitis

152
Q

How is Flucloxacillin given?

A

Before food

153
Q

What type of infection is Flucloxacillin inactive against?

A

MRSA

154
Q

When are PipTaz used?

A

Serious infections
- septicaemia
- complicated UTI
- HAP

155
Q

How is stomach bug treated?

A

Self limiting
So not typically treated

156
Q

How is C.Diff treated

A

Vancomycin
Fedoxamicin

10 - 14 days

157
Q

What it contraindicated in diarrhoea related to colitis

A

Loperamide - worsens infection

158
Q

How is endocarditis treated

A

Amoxicillin/ ampicillin + low dose gentamicin

- if pen allergy; low dose gentamicin + vancomycin

159
Q

Treatment: endocarditis with staphylococci origin or streptococcus

A

Staph: Flucloxacillin
Strept: Benzylpenicillin

160
Q

Treatment: community acquired pneumonia

A

-Amoxicillin - 7 days
- Alt. Clarithromycin or doxycycline

161
Q

Treatment: hospital acquired pneumonia

A

Early onset; co-amoxiclav
Alt: Doxycycline, Cefa, co-trimoxazole, levoflaxacin

tx for 7 days

162
Q

Treatment: blind tx of meningitis

A

Benzylpenicillin or Cefotaxime
Chloramphenicol - pen allergy

163
Q

Treatment: pneumococci meningitis

A

Cefotaxime (+ dexamethasone)
Benzylpenicillin
Cephalosporin + vancomycin - pen allergy

164
Q

Treatment: meningitis listeria

A
  • amoxicillin / ampicillin + gentamicin
  • Co-trimoxazole - pen allergy
165
Q

Treatment: osteomyelitis (bone infection)

A

Flucloxacillin - 10 - 14 days
Clindamycin - pen allergy

166
Q

Treatment: septic arthritis

A

Flucloxacillin 4-6 weeks

167
Q

Treatment: impetigo (skin)

A
  • Hydrogen peroxide
  • fuscidic acid

Wide spread: Flucloxacillin

7 days tx course

168
Q

Treatment: cellulitis

A

Flucloxacillin

Near eye: co-amoxiclav
Clarithromycin + metronidazole

Severe: Clindamycin

169
Q

Treatment: leg ulcer

A

Flucloxacillin
Clar/ erythro/ doxy - pen allergy
Co-trimoxazole

170
Q

Treatment: animal and human bite

A

Co-amoxiclav - 14 days
Doxycycline + metronidazole - pen allergy

171
Q

Treatment: mastitis during breast feeding

A

Flucloxacillin - 10-14 days
Erythromycin - pen allergy

172
Q

Treatment: dental infection

A

Metronidazole 200mg TDS for 3 days
Alt. Amoxicillin

173
Q

Treatment: bacterial sore throat

A

Phenoxymethylpenicillin

174
Q

Symptoms of sinusitis

A

Pain in the hollow of cheekbones
Nasal congestion

175
Q

Treatment: diabetic foot infection

A

Flucloxacillin
- PO 7 days in mild
- IV for >48 hours in severe

Alt - clarithromycin/ doxycycline/ erythromycin

176
Q

Treatment: otitis external

A
  • Flucloxacillin
  • Clarithromycin/ Azithromycin/ erythromycin
177
Q

Treatment: otitis media

A
  • Amoxicillin
  • Co-amoxiclav (worsening symptoms)
  • Clarithromycin/ erythromycin - pen allergy
178
Q

How long does tuberculosis treatment last for?

A

6 months

Split into 2 phases

179
Q

What is involved in first phase of TB treatment and how long does it last

A

‘RIPE’ - 2 months

  • Rifampicin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol
180
Q

Pt counselling: Rifampicin

A
  • report signs of hepatotoxicity
  • colours soft contact lenses
  • urine red/ orange
181
Q

Pt counselling: Isoniazid

A
  • report signs of hepatotoxicity
  • peripheral neuropathy (overcome with pyridoxine)
182
Q

Pt counselling: Ethambutol

A

Report visual changes

183
Q

Which TB drug is not hepatotoxic

A

Ethambutol

184
Q

Side effect of ketoconazoles

A

Fatal hepatotoxicity

  • not used in fungal infections
185
Q

Side effect of itraconazol

A
  • heart failure
  • hepatotoxicity

interacts with antacids

186
Q

Side effect of voriconazole

A
  • Phototoxicity and hepatotoxicity
  • Skin cancer (avoid direct sunlight and sunlamps. Use high factor SPF and carry alert card)
187
Q

Side effect of amphoteracin B

A

Nephrotoxicity
specify brand

Used in serious fungal infections and may cause anaphylaxis

188
Q

Treatment: oral thrush

A
  • Nystatin (POM)
  • Miconazole (daktarin oral gel) - OTC
189
Q

Treatment: vaginal thrush

A
  • Oral fluconazole (single dose)
  • topical imidazole (clotrimazole)
190
Q

Treatment: tinea

A
  • miconazole
  • clotrimazole
  • terbinafine (athlete foot)
191
Q

What is used to treat athletes foot

A

Terbinafine

192
Q

Treatment: fungal nail infection

A

Amorolfine

193
Q

Treatment: herpes

A

Aciclovir

194
Q

Prophylaxis of influenza virus

A

Oseltamivir

start with 48 hours of exposure and reduces symptoms by 1 day

195
Q

Bites prevention

A
  • NETS impregnated with permethrin is most effective
  • DEETS 20-50% (applied to the skin eg. Spray or lotion) - safe and effective in adults and children > 2 months
  • Apply sunscreen first and use SPF 35-50
196
Q

Doxycycline counselling in malaria

A
  • Take 1-2 days before entering area and continue for 4 weeks after leaving
  • Protect skin from sunlight
  • Do not take indigestion remedies
  • Swallow whole with plenty water while sitting or standing
  • Take with meals
197
Q

Side effect of mefloquine

A
  • Serious neuropsychiatric reactions - STOP
  • Dizziness (care with driving)
198
Q

Length of malaria prophylaxis before travel and exceptions

A

1week before

Exception:
- **Mefloquine **; 2-3 weeks
- Malorone & Doxycycline; 1-2 days

199
Q

Length of malaria prophylaxis before travel and exceptions

A

4 weeks after

Exception:
- Malarone; 1 week after

200
Q

Long term prophylaxis duration of malaria

A
  • > 5 years: chloroquine and proguanil
  • 2 years: doxycycline
  • 1 year: mefloquine, malarone
201
Q

What is malarone made of

A

Atovaquone
Proguanil

202
Q

Malaria drugs to avoid in epilepsy

A

Chloroquine
Mefloquine

203
Q

Malaria drugs to avoid in renal impairment

A
  • proguanil
  • malarone and chloroquine (eGFR <30)
204
Q

Choice of malaria drug in renal impairment

A

Doxycycline
Mefloquine

205
Q

Malaria drugs to avoid in pregnancy

A
  • Mefloquine
  • Malarone (may be given in 2nd/3rd trimester if no other option)
  • Doxycycline - Contraindicated
206
Q

Anti malaria in pregnancy

A
  • Chloroquine
  • Proguanil (give 5mg folic acid)
207
Q

Anti malaria and warfarin

A
  • Start 2-3 weeks before
  • INR should be stable before departure
  • Monitor INR before, after 7 days of prophylaxis and after completing course
  • For prolonged stay, check INR frequently
208
Q

What is used to treat falciparum malaria

A
  • Quinine
  • Malarone
  • Riamet
209
Q

What is used to treat non-falciparum malaria

A

Chloroquine

210
Q

When is quinine used in malaria treatment

A
  • Only if medical care is not accessible in 24 hours of fever onset
  • Give with written instructions that urgent help is required of fever >38 degrees, 7 days or more after arriving in malarious zone
211
Q

Nature of interaction between carbapenems and valproate

A

Decrease blood concentration of valproate

higher risk of seizure - Avoid

212
Q

What is the most effective barrier protection against mosquitoes

A

Mosquito nets impregnated with permethrin

213
Q

What penicillins should be taken on an empty stomach

A

an hour before food or 2 hours after

  • Phenoxymethylpenicillin
  • Ampicillin
  • Flucloxacillin
214
Q

Sildenafil and doxycycline

A

Space dose at least 2-3 hours apart

215
Q

Antibiotic safe to take with quetiapine in Pen allergy

A

Doxycycline

216
Q

What is used to treat conjunctivitis in eye

A

Chloramphenicol
Fusidic acid if pen allergy

217
Q

Scarlet fever

A

Strawberry tongue
Sand paper rash

phenoxymethylpenicillin

218
Q

Thread word tx

A

Mebendazole

219
Q

Cause of menengitis

A

Strept pneumonia

220
Q

Chloramphenicol OTC

A

2+ years

Conjunctivitis

Random Pre Reg Questions (12 decks)

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