INFECTIONS- CLINDAMYCIN, LINEZOLID + CHLORAMPHENICOL, METRO, NITRO + TRIMETHOPRIM

Question 1

What is MOA of clindamycin?

Answer 1

Active against anaerobes + gram +ve cocci (MRSA, streptococci).

Prevents protein synthesis

Question 2

Is clindamycin narrow or broad spectrum?

Answer 2

narrow

Question 3

What are 2 indications for clindamycin?

Answer 3

MRSA

Staphlococcal bone + joint

Question 4

Is clindamycin bacteriostatic or bactericidal?

Answer 4

bacteriostatic

Question 5

What is a common SE of clindamycin?

Answer 5

antibiotic associated colitis

Question 6

What to do if suspecting antibiotic associated colitis with clindamycin use?

Answer 6

Stop using, report any severe, bloody, or prolonged diarrhoea.

Question 7

What is the MOA of linezolid?

Answer 7

Only works on gram + ve bacteria
Prevents protein synthesis.

Question 8

Is Linezolid broad or narrow Spectrum?

Answer 8

Narrow

Question 9

What bacteria type does linezolid work on?

Answer 9

Gram + ve

Question 10

Is linezolid bacteriostatic or bactericidal?

Answer 10

Bacteriostatic

Question 11

What are 2 indications for linezolid?

Answer 11

Complicated skin + soft tissue infections

e.g. pneumonia

MRSA

Question 12

What are 2 SEs of linezolid? (BOT)

Answer 12

Blood disorders

Optic neuropathy

Question 13

What is an interaction that can occur with having tyramine rich food with linezolid?

Answer 13

Hypertensive crisis

Question 14

What 3 drugs can increase risk of hypertensive crisis + serotonin syndrome with linezolid?

Answer 14

MAOI

B2 agonist

Sympathomimetic - adrenaline

Lithium, SSRIs

Question 15

What happens in interaction between MAOI + Linezolid?

Answer 15

Hypertensive crisis

Question 15

What to do if patient on MAOI + Linezolid?

Answer 15

Avoid ABx and for 14 days after stopping the MAOI

Question 16

What is a counselling point for patient regarding linezolid + optic neuropathy?

Answer 16

Report visual impairment - visual defect, eyesight changes

Question 17

What 2 things are monitored for linezolid?

Answer 17

Visual function if abx used longer than 28 days

FBC (weekly)

Question 18

What to check if Linezolid used longer than 28 days?

Answer 18

visual function

Question 19

What 3 criteria to specifically check FBC on linezolid patients?

Answer 19

if treatment 10-14 days, severe RI or

drugs that may have adverse effects on haemoglobin.

Question 20

What is MOA chloramphenicol?

Answer 20

Prevent protein synthesis?

Question 21

What is chloramphenicol spectrum?

Answer 21

Broad

Question 22

What is use for chloramphenicol?

Answer 22

Life threatening infections

Question 23

What is 1 MAIN SE of chloramphenicol? (BG)

Answer 23

Blood disorder

Question 24

What happens if chloramphenicol given during pregnancy in 3rd trimester?

Answer 24

Grey baby syndrome

Question 25

MOA metronidazole?

Answer 25

Active against anaerobic bacteria + protozoa prevents DNA synthesis

Question 26

What spectrum is metronidazole?

Answer 26

Narrow

Question 27

What 3 types of anaerobic infections can be treated using metronidazole?

Answer 27

Oral H pylori Rosacea

Question 28

What is indication of Metronidazole?

Answer 28

Anaerobic infections Protozoal infections

Question 29

What is daily dose for metronidazole?

Answer 29

400mg/500mg TDSq

Question 30

How to take metronidazole?

Answer 30

Take after food or with meal- helps N + V.

Question 31

What is 1 thing NOT to do when on metronidazole?

Answer 31

Don't drink alcohol + avoid 48 hours after treatment

Question 32

What are 2 main SE of metronidazole? (G-MOF)

Answer 32

Gastro intestinal disturbances - N, V Metalic taste Oral mucositis Furry tongue

Question 33

What reaction happens with alcohol and metronidazole?

Answer 33

Disulfiram like reaction

Question 34

What is MOA of nitrofurantoin?

Answer 34

Only works on urinary pathogens Damage DNA in bacteria

Question 35

What is spectrum of nitrofurantoin?

Answer 35

Narrow

Question 36

What is use of Nitrofurantoin?

Answer 36

Lower UTI

Question 37

When to take Nitrofurantoin?

Answer 37

With or after food

Question 38

What are 3 main SE of Nitrofurantoin?

Answer 38

Yellow brown urine Hepatic/pulmonary reactions Nausea Peripheral neuropathy (stop)

Question 39

What happens to patient taking Nitrofurantoin and is harmless?

Answer 39

Yellow brown urine

Question 40

Can Nitrofurantoin be used in pregnancy?

Answer 40

yes but AVOID at term

Question 41

Can Nitrofurantoin be used in renal impairment?

Answer 41

Avoid if eGFR <45.

Question 42

What can use of nitrofurantoin cause in patients with (G6PD) deficiency?

Answer 42

haemolytic Anaemia

Question 43

What is a contra-indication of nitrofurantoin in babies?

Answer 43

Avoid in babies <3 months

Question 44

MOA of trimethoprim?

Answer 44

Prevents DNA synthesis - bactericidal

Question 45

Spectrum of trimethoprim?

Answer 45

Narrow

Question 46

Indication of trimethoprim?

Answer 46

Lower UTI

Question 47

What is dose of trimethoprim?

Answer 47

200mg BD

Question 48

What are 2 SEs of trimethoprim?

Answer 48

Blood disorders Hyperkalaemia

Question 49

What electrolyte imbalance does trimethoprim cause?

Answer 49

Hyperkalaemia

Question 50

Can trimethoprim be used in pregnancy?

Answer 50

NO teratogenic in 1st trimester- as folate antagonist

Question 51

What should patients report in signs of blood disorders if taking trimethoprim?

Answer 51

Report fever, sore throat, mouth ulcer, bruising, bleeding.

Question 52

What is common dose of trimethoprim?

Answer 52

200mg BD

Question 53

What is adult nitrofurantoin MR dose for UTI?

Answer 53

100 mg BD for 3 days

Question 54

What is adult nitrofurantoin MR dose for UTI in males or pregnant women?

Answer 54

100 mg BD for 7 days

Question 55

What drug has a MHRA warning about the risks of pulmonary and hepatic adverse?

Answer 55

Nitrofurantoin.

Question 56

What is dose reduction for patients with hepatic encephalopathy and on metronidazole?

Answer 56

Manufacturer advises dose reduction to one-third of the daily dose in hepatic encephalopathy (dose may be given once daily).