Infections Q3 Flashcards
Aminoglycosides: MOA
- irreversibly binds to 30s ribosome
- Inhibits protein synthesis
Aminoglycosides: SE
- OTO/NEPHRO
- AAC
- NV
- Electrolyte disturbance
- Peripheral neuropathy
Aminoglycosides: CI
- MG
- Pregnancy
- Obese
Aminoglycosides: Pregnancy
- avoid unless essential
- 2/3rd = auditory/ vestibular nerve damage
- Greater risk with strepto and less with gen and tobra
Aminoglycosides: dose
- OD
- multiple daily dose - monitor
- Must not exceed 7 days
Gentamicin: therapeutic range
PEAK: 5-10 (3-5)
TROUGH: < 2 (<1)
Aminoglycosides: monitoring
- Renal
- Auditory/ vestibular
- Cp: renal imp, high doses, obesity, CF
Increased risk of nephrotoxicity with aminoglycosides
- Ciclosporin/ tacrolimus
- Vancomycin
- NSAIDs
- ACEi
- Methotrexate/ sulfasalazine
- Trimethoprim
Increased risk of ototoxicity with aminoglycosides
- Loop
- Cisplatin
- Vinca
- Vanco
- Macrolides (clarithromycin, erythromycin, azithromycin)
GROUP 1 CEPH
CEFAlexin
CEFAzolin
CEFRADoxil
CEFRADine
GROUP 2 CEPH
Cefuroxime
Cefoxitin
Cefaclor
GROUP 3 CEPH
CefixIME
CefotaxIME
CeftazidIME
CeftriaxONE
Cephalosporins: SE
- AAC
- Hypersensitivity (cross sensitivity w penicillins)
Cephalosporins: Interactions
Nephrotoxic drugs
Chloramphenicol: Interactions
- SU: hypo
Chloramphenicol: Pregnancy
AVOID
- IV/PO = risk of grey baby syndrome in 3rd trimester
Chloramphenicol: BF
AVOID
- bone marrow toxicity in infant
- Conc in milk is insufficient to cause grey baby syndrome
Clindamycin: drug class
Lincosamide
Clindamycin: MOA
bacteriostatic
- 50s subunit of bacterial ribosome to inhibit early stages of protein synthesis
Clindamycin: active against
- Gram + aerobes
- Anaerobic
Clindamycin: SE
- AAC
- GI
- Oesophageal disorders/ taste disturbance
- Jaundice
- Blood disorder
Clindamycin: CI
Exhisting diarrhoea
Clindamycin: Monitor
- liver
- renal
if treatment > 10 days
Glycopeptides: examples
Vancomycin
Teicoplanin
Glycopeptides: Activity
Narrow spectrum
Bacteriocidal
Gram + (anaerobic/ aerobic)
MRSA
Glycopeptides: SE
- NEPHRO/OTO
- Skin disorders: SJS, red man, toxic epidermal necrosis
- Blood dyscrasias
- Thrombophlebitis
- Risk of anaphylactoid reaction at site
Glycopeptides: CI
- history of deafness
- Pregnancy
Glycopeptides: Interactions
- Oto/nephro toxic drug
- Suxamethonium- enhances effect of suxa
Glycopeptides: Trough levels
10-15
15-20 (endo)
Glycopeptides: Monitor
- K
- FBC
- Renal
- Hepatic
- Auditory function in elderly
- Urinanalysis
Nephrotox = low urine, high serum creatinine
Glycopeptides: pregnancy
Avoid
Bf- low presence, and absorption insignificant
Linezolid: MOA
selectively inhibits bacterial protein synthesis