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Qs > Infections Q3 > Flashcards

Infections Q3 Flashcards

1
Q

Aminoglycosides: MOA

A
  • irreversibly binds to 30s ribosome
  • Inhibits protein synthesis
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2
Q

Aminoglycosides: SE

A
  • OTO/NEPHRO
  • AAC
  • NV
  • Electrolyte disturbance
  • Peripheral neuropathy
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3
Q

Aminoglycosides: CI

A
  • MG
  • Pregnancy
  • Obese
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4
Q

Aminoglycosides: Pregnancy

A
  • avoid unless essential
  • 2/3rd = auditory/ vestibular nerve damage
  • Greater risk with strepto and less with gen and tobra
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5
Q

Aminoglycosides: dose

A
  • OD
  • multiple daily dose - monitor
  • Must not exceed 7 days
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6
Q

Gentamicin: therapeutic range

A

PEAK: 5-10 (3-5)
TROUGH: < 2 (<1)

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7
Q

Aminoglycosides: monitoring

A
  • Renal
  • Auditory/ vestibular
  • Cp: renal imp, high doses, obesity, CF
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8
Q

Increased risk of nephrotoxicity with aminoglycosides

A
  • Ciclosporin/ tacrolimus
  • Vancomycin
  • NSAIDs
  • ACEi
  • Methotrexate/ sulfasalazine
  • Trimethoprim
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9
Q

Increased risk of ototoxicity with aminoglycosides

A
  • Loop
  • Cisplatin
  • Vinca
  • Vanco
  • Macrolides (clarithromycin, erythromycin, azithromycin)
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10
Q

GROUP 1 CEPH

A

CEFAlexin
CEFAzolin
CEFRADoxil
CEFRADine

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11
Q

GROUP 2 CEPH

A

Cefuroxime
Cefoxitin
Cefaclor

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12
Q

GROUP 3 CEPH

A

CefixIME
CefotaxIME
CeftazidIME
CeftriaxONE

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13
Q

Cephalosporins: SE

A
  • AAC
  • Hypersensitivity (cross sensitivity w penicillins)
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14
Q

Cephalosporins: Interactions

A

Nephrotoxic drugs

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15
Q

Chloramphenicol: Interactions

A
  • SU: hypo
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16
Q

Chloramphenicol: Pregnancy

A

AVOID
- IV/PO = risk of grey baby syndrome in 3rd trimester

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17
Q

Chloramphenicol: BF

A

AVOID
- bone marrow toxicity in infant
- Conc in milk is insufficient to cause grey baby syndrome

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18
Q

Clindamycin: drug class

A

Lincosamide

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19
Q

Clindamycin: MOA

A

bacteriostatic
- 50s subunit of bacterial ribosome to inhibit early stages of protein synthesis

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20
Q

Clindamycin: active against

A
  • Gram + aerobes
  • Anaerobic
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21
Q

Clindamycin: SE

A
  • AAC
  • GI
  • Oesophageal disorders/ taste disturbance
  • Jaundice
  • Blood disorder
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22
Q

Clindamycin: CI

A

Exhisting diarrhoea

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23
Q

Clindamycin: Monitor

A
  • liver
  • renal

if treatment > 10 days

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24
Q

Glycopeptides: examples

A

Vancomycin
Teicoplanin

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25
Q

Glycopeptides: Activity

A

Narrow spectrum
Bacteriocidal
Gram + (anaerobic/ aerobic)
MRSA

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26
Q

Glycopeptides: SE

A
  • NEPHRO/OTO
  • Skin disorders: SJS, red man, toxic epidermal necrosis
  • Blood dyscrasias
  • Thrombophlebitis
  • Risk of anaphylactoid reaction at site
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27
Q

Glycopeptides: CI

A
  • history of deafness
  • Pregnancy
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28
Q

Glycopeptides: Interactions

A
  • Oto/nephro toxic drug
  • Suxamethonium- enhances effect of suxa
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29
Q

Glycopeptides: Trough levels

A

10-15
15-20 (endo)

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30
Q

Glycopeptides: Monitor

A
  • K
  • FBC
  • Renal
  • Hepatic
  • Auditory function in elderly
  • Urinanalysis

Nephrotox = low urine, high serum creatinine

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31
Q

Glycopeptides: pregnancy

A

Avoid
Bf- low presence, and absorption insignificant

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32
Q

Linezolid: MOA

A

selectively inhibits bacterial protein synthesis

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33
Q

Linezolid: Activity

A
  • GRAM +
  • MRSA
  • Vanco-resistant enterococci
34
Q

Linezolid: SE

A
  • DNV
  • Headache
  • Blood disorders
  • Taste disturbances
  • Severe optic neuropathy
35
Q

Linezolid: MHRA

A

Risk of severe optic neuropathy
- Report visual impairment
- Monitor regularly if > 28 days treatment

36
Q

Linezolid: Interactions

A
  • SS
  • tyramine rich foods
  • MAOi - do not give within 2 weeks of stopping
37
Q

Linezolid: Monitoring

A

FBC weekly
- severe renal
- Myelosuppression
- >10-14 days
- Drugs which affect Hb, platelet

38
Q

Macrolides: MOA

A
  • Binds to ribosomes of susceptible microorganisms
  • Inhibits protein synthesis
  • Bacteriostatic
39
Q

Macrolides: administration - counselling

A
  • with or after food
  • Erythromycin = empty stomach
40
Q

Macrolides: SE

A
  • Hepato/ototoxicity
  • GI SE
  • QT
41
Q

Macrolides: CI

A
  • MG
  • Pregnancy
  • Hypokalaemia - QT
42
Q

Macrolides: Interactions

A
  • QT drugs
  • Hepa/oto drugs
  • CYP enzyme inhibitor = increase the levels of CYP enzyme substrates: warfarin, statins
43
Q

Clarithromycin + solifenacin =

A

increased exposure of solifenacin. 5mg OD max recommended dose

44
Q

Metronidazole: MOA

A
  • pro drug
  • Active form binds to DNA
  • Disrupts helical structure
  • Prevents nucleus acid synthesis = cell death
45
Q

Metronidazole: Activity

A
  • Anaerobic
  • Protozoa - giardiasis, vaginal trichimoniasis
46
Q

Metronidazole: SE

A
  • GI
  • Metallic taste/ furred tongue
  • Oral mucositis
  • Anorexia
47
Q

Metronidazole: counselling

A
  • WITH food
  • No alcohol
48
Q

Metronidazole: pregnancy

49
Q

Metronidazole: Alcohol

A

AVOID
DLR
48hrs

50
Q

Nitrofurantoin: MOA

A

bacteriocidal activity in the urinary tract

51
Q

Nitrofurantoin: SE

A
  • Pulmonary reactions - long term monitor lung function
  • Hypersensitivity
  • N+V
  • Blood disorders
  • PN
52
Q

Nitrofurantoin: Interactions

A
  • PN = PAIM

Phenytoin
Amiodarone
Isoniazid
Metro

53
Q

Nitrofurantoin: CI

A
  • pregnancy at term
  • <45
  • Acute porphyrias
  • G6PD def
  • Pulmonary disease

37-42 weeks

54
Q

Nitrofurantoin: Counselling

A
  • WITH food
  • Urine - brown/yellow this is harmless
55
Q

Penicillins: MOA

A
  • inhibit bacterial cell wall synthesis
  • Inhibit peptidoglycan cross linking
56
Q

Penicillins: SE

A
  • HS
  • Anaphylaxis
  • Allergy
  • Diarrhoea
  • Flu: hep
57
Q

Penicillins: narrow spectrum

58
Q

Penicillins: broad spectrum

A
  • amoxicillin/ ampicillin
  • Co-amo = beta lactamase resistant
59
Q

Penicillins: counselling

A

WITHOUT food = pen v, flu, amp
Doesn’t matter = amoxicillin

60
Q

Quinolones: MOA

A

Inhibits Topoisomerase - enzyme involved in DNA replication

61
Q

Quinolones: SE

A
  • tendinitis (48h, more common in 60+)
  • GI
  • QT (esp moxi)
  • Psychiatric reactions
  • Convulsions
  • Hypersensitivity/rash
62
Q

Quinolones: CI

A
  • QT
  • Children and adolescent - aropathy
  • Pregnancy
  • Epilepsy, diabetes, psychiatric disorder
63
Q

Quinolones: Interactions

A
  • NSAIDs = convulsions
  • Theophylline + ciprofloxacin = increased risk of seizures
  • QT drugs
  • Alcohol
  • Avoid dairy and mineral fortified drinks (reduces absorption)
64
Q

Quinolones: Counselling

A
  • protect from sunlight
  • Impairs skilled tasks- Avoid alcohol
  • Antacids 2hrs
  • Avoid dairy and mineral fortified drinks
65
Q

Quinolones: MHRA

A

Risk of heart valve regurgitation
- Consider other therapeutic options
- Report: SOB, peripheral oedema, heart palps

Risk of aneurysm
- FMHx
- Report: abdo, chest, back pain

66
Q

Tetracyclines: MOA

A
  • inhibits protein synthesis- 30s
67
Q

Tetracyclines: SE

A
  • DNV - AAC
  • Dysphasia, oesophageal irritation
  • Blood disorder
  • Hypersensitivity/ photosensitivity (avoid DD)
  • Teeth and bones
  • LELS (mino)
  • Benign intracranial hypertension
68
Q

Tetracyclines: oesophageal irritation

A
  • Doxy caps
  • Tetra tabs
  • Mino tabs/ caps = swallowed whole with plenty of fluid while standing or sitting
69
Q

Tetracyclines: CI

A
  • hepatic renal
  • Myasthenia gravis
  • Photosensitivity
  • Pregnancy and breastfeeding
  • Under 12
70
Q

Tetracyclines: Renal

A

Avoid all
Except doxy and mino

71
Q

Tetracyclines: Liver

A

Avoid or caution

72
Q

Tetracyclines: Can have with milk

A
  • Doxy
  • Lymecycline
  • Minocycline
73
Q

Tetracyclines: cannot have with milk

A

DOT
- Demeoclocycline
- Oxytetracycline
- Tetracycline

Calcium, milk etc reduces absorption

74
Q

What gap is required between doxycycline and the typhoid vaccine?

76
Q

Trimethoprim: MOA

A

Binds irreversibly and inhibits DHFR and blocks production of THF

77
Q

Trimethoprim: Activity

A
  • Gram +
  • Aerobic gram -
78
Q

Trimethoprim: SE

A
  • HyperK, HypoNa
  • Allergic reaction, anaphylaxis
  • Photosensitivity
  • Aseptic meningitis
  • GI
79
Q

Trimethoprim: CI

A
  • renal
  • Pregnancy
80
Q

Trimethoprim: Interactions

A
  1. Nephrotoxic drugs: NSAIDs, tacrolimus, ciclosporin
  2. HyperK
  3. HypoNa
  4. MOA: methotrexate - bone marrow suppression
81
Q

Trimethoprim: Pregnancy

A

Avoid
Teratogenic

Qs (27 decks)

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