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PRE-REG-Thuri > INFECTIONS - MACROLIDES, PENICILLINS + CEPHALOSPORINS, CARBAPENEMS + MONOBACTAMS > Flashcards

INFECTIONS - MACROLIDES, PENICILLINS + CEPHALOSPORINS, CARBAPENEMS + MONOBACTAMS Flashcards

1
Q

MOA of Macrolides?

A

Similar to penicillins

Prevent protein synthesis by binding to 50s subunit of ribosome (bacteriostatic)

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2
Q

Spectrum of Macrolides?

A

Broad

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3
Q

List 3 drugs within macrolide class?

A

Azithromycin

Clarithromycin

Erythromycin

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4
Q

What are 5 cases/conditions macrolides can be used for?

A

RIT

Chlamydia

If patient has penicillin allergy

H pylori

Skin + soft tissue infections

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5
Q

What Macrolide is given ONCE DAILY?

A

Azithromycin

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6
Q

What Macrolide is given twice daily?

A

Clarithromycin

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7
Q

What macrolide is safe in pregnancy?

A

Erythromycin

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8
Q

What are 4 SEs of macrolides?

A

GI disturbances

Taste disturbances + tongue discolouration

QT prolongation

hepatotoxicity

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9
Q

What SE happens in large doses of macrolide uses?

A

Ototoxicity

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10
Q

What is an MHRA warning linked to erythromycin risk?

A

Risk of QT prolongation + Cardiotoxicity.

Report any signs of fainting, dizziness, dyspnoea, heart palpitations.

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11
Q

What macrolide is taken before food?

A

Azithromycin

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12
Q

What macrolide is taken after food?

A

Clarithromycin

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13
Q

What 2 macrolides cannot be taken with indigestion meds?

A

Azithromycin + erythromycin

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14
Q

Are erythromycin + clarithromycin enzyme inhibitors or inducers?

A

Inhibitors

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15
Q

What is a caution of macrolides?

A

Myasthenia gravis

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16
Q

What is the interaction between macrolides + statins?

A

Myopathy - stop course duration of statin then continue.

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17
Q

What is the interaction between warfarin + macrolides?

A

Bleeding risk

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18
Q

What is an MHRA warning linked to erythromycin + rivaroxaban?

A

Increased risk of bleeding

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19
Q

What 9 drugs interact with macrolides to increase QT prolongation?

A

Antipsychotics

Anti-arrhythmics e.g. amiodarone, sotalol

SSRIs

TCA

domperidone

Lithium

Methadone

Quinolone

5HT3 antagonists

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20
Q

What 4 drugs can interact with macrolides, cause hypokalaemia + increase risk of torsade de pointes?

A

B2 agonist,

Corticosteroids

Loop + thiazide diuretics

Theophylline

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21
Q

MOA of penicillins?

A

Prevent peptidoglycan cross-linking in bacterial cell walls

Bactericidal

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22
Q

Are penicillins broad or narrow?

A

Both

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23
Q

What are 2 broad spectrum penicillins?

A

Amoxicillin

Ampicillin

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24
Q

How many times is amoxicillin given in a day?

A

TDS

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25
Q

How is amipicillin given?

A

Before food

Taken QDS- high resistance

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26
Q

Which broad spectrum penicillin has high resistance?

A

amipicillin

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27
Q

List 2 narrow spectrum penicillin abxs?

A

Benzylpenicillin (G)

Phenoxymethypenicillin (V)

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28
Q

Which penicillin is given parenterally only?

A

Benzylpenicillin (G) - not GI acid stable

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29
Q

What are 2 penicillins that are antipseudomonal + for serious infections?

A

Piperacillin (parenteral)

Ticarcillin (parenteral)

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30
Q

What is flucloxacillin used for?

A

Staph infections

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31
Q

How to take flucloxacillin?

A

Before food on empty stomach or 2 hours after food

QDS

32
Q

What is a rare SE of flucloxacillin?

A

Cholestatic jaundice - hepatic disorders

33
Q

What condition can penicillins not treat?

A

CNS infections -penetration into the cerebrospinal fluid is poor except when the meninges are inflamed

34
Q

What CNS condition can penicillins treat?

A

Meningitis

35
Q

What are 5 indications of penicillins?

A

RTI

H. pylori

Otitis Media

Oral infection

UTI

36
Q

Why are sore throats not treated with penicillin?

A

Bacteria produces beta-lactamases which inactivate antibiotic?

37
Q

What is co-amoxiclav?

A

Amoxicillin + clavulanic acid

38
Q

What SE does co-amoxiclav cause?

A

Cholestatic jaundice - if treatment over 14 days especially.

39
Q

What is penicillin dose in 1-11 months?

A

125mg TDS

40
Q

What is penicillin dose in 1-4 years?

A

250mg TDS

41
Q

What is penicillin dose in adults?

A

500- 1000mg TDS

42
Q

What are 2 SEs of penicillins?

A

Antibiotic associated colitis - broad spectrum

Penicillin allergy

43
Q

What are 3 true allergy symtpoms?

A

Anaphylaxis

Urticaria

immediate rash

44
Q

What symptoms to abx may mean maybe not allergic?

A

minor rash after 72 hrs (can use penicillin for serious infections)

45
Q

What route are penicillins NOT given by?

A

Intrathecally

46
Q

What drug causes bleeding with penicillins?

A

Warfarin

47
Q

What drug toxicity happens when given with penicillins?

A

methotrexate toxicity

48
Q

What 2 penicillins are more likely to cause hepatotoxicity?

A

Co-amoxiclav

Flucloxacillin

49
Q

What other drug classes can interact with penicillins to increase risk of hepatotoxicity?

A

Anti epileptics

Anti fungals

Methotrexate

Statins

Sulfasalazine

Tetracycline

50
Q

MOA of cephalosporin?

A

It is also beta lactam group
prevent peptidoglycan cross linking in bacterial cell wall

bactericidal

51
Q

Spectrum of cephalosporin?

A

Broad

52
Q

What are 2 indications of cephalosporin?

A

UTI + RTI - serious infections

53
Q

How many groups of cephalasporin?

A

1-5 generations

54
Q

List 3 gen 1 cephalasporins? (fal, fad, frad)

A

Cefalexin

Cefadroxil (BD- longest name so more times)

Cefradine

55
Q

List 3 2nd gen cephalosporins?

A

Cefuroxime

Cefoxitin

Cefaclor

56
Q

What 2nd gen cephalosporins has a SE that is protracted skin reactions?

A

Cefaclor

57
Q

What 2nd gen cephalosporin is taken after food?

A

Cefuroxime

58
Q

List 4 3rd gen cephalosporins? (IME)

A

Cefixime *

Cefotaxime

Ceftazidime

Ceftriaxone

59
Q

Which 3rd gen cephalosporin is the only oral one?

A

Cefixime

60
Q

List 1 4rd gen cephalosporins? (P)

A

Cefepime

61
Q

List 2 5rd gen cephalosporins? (O)

A

Cefatoline

Ceftobiprole

62
Q

Which cephalosporin is used for menigitis?

A

cefotaxime

63
Q

What are 2 SEs of cephalosporins?

A

Antibiotic associated colitis (3rd + 4th).

Cross sensitivity - penicillin allergy

64
Q

What generation cephalosporin to give if patient has penicillin allergy + needs this class?

A

3rd gen or cefuroxime can be used

65
Q

What 5 cephalosporins to avoid if patient has penicillin allergy + needs this class?

A

cefaclor
cefadroxil
cefalexin
cefradine, +
ceftaroline fosamil

66
Q

What 6 nephrotoxic drugs interact with cephalosporins + increase risk of nephrotoxicity?

A

Aminoglycosides

Ciclosporin

Glycopeptides

Mtx

NSAIDs

Tacrolimus

67
Q

What does cephalosporin interact with to cause bleeding?

A

Warfarin -big

68
Q

What are carbapenams?

A

beta-lactam antibacterials

broad-spectrum activity - gram + ve and -ve and anaerobes

69
Q

What 4 indications are Imipenem and meropenem used for?

A

HAP

intra-abdominal infections, skin

soft-tissue infections,

UTIs

70
Q

Which Carbapenem is not active against Pseudomonas unlike others?

A

Ertapenem

71
Q

Why is Imipenem given with cilastatin?

A

Imipenem is partially inactivated in the kidney by enzymatic activity.

Giving it with enzyme blocker stops it from being renally metabolised

72
Q

Which 2 carbapenems are stable against the kidney enzymes + are not broken down?

A

Meropenem and ertapenem

73
Q

Which Carbapenem has less of a seizure inducing potential?

A

Meropenem has less seizure-inducing potential and can be used to treat central nervous system infection.

74
Q

Why are broad spectrum abx not given for glandular fever?

A

Maculopapular rashes

75
Q

Why are penicillins NEVER given intrathecally?

A

Can cause encephalopathy

76
Q

When to reduce flucloxicillin dose?

A

Reduce dose or increase dose interval if creatinine clearance less than 10 mL/minute (consult product literature)

PRE-REG-Thuri (44 decks)

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