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PRE-REG-Thuri > INFECTIONS - TETRACYCLINES + QUINOLONES > Flashcards

INFECTIONS - TETRACYCLINES + QUINOLONES Flashcards

1
Q

MOA of tetracyclines?

A

prevents protein syntheiss by binding to 30S subunit of ribosomes.

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2
Q

Are tetracyclines bacterostatic or bactericidal?

A

Bacteriostatic

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3
Q

What spectrum is tetracyclines?

A

Broad

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4
Q

What are 4 uses of tetracyclines?

A

Chlamydia, malaria prophylaxis, Resp tract Infection

Acne, Rosacea

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5
Q

List 7 tetracyclines?

A

Demeclocyline

Doxycline

Lymecycline

Minocycline

Oxytetracycline

Tetracycline

Tigecycline

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6
Q

What is the 2 indications of doxycycline?

A

Malaria prophylaxis

Chlamydia

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7
Q

Why is minocycline rarely used?

A

Due to broader spectrum - more harsh SEs

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8
Q

What is common dose of doxycycline?

A

200mg OD

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9
Q

What are 5 SEs of tetracyclines?

A

Benign Intracranial hypertension

Tooth discolouration

Dental hypoplasia

hepatotoxic

photosensitivity

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10
Q

What to do if patient has headache and is on tetracycline?

A

Stop med

report to doctor

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11
Q

What is a contraindication of using tetracyclines?

A

Can’t be used in children under 12 years

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12
Q

Which tetracycline is contraindicated in children under 8?

A

Lymecycline

causes teeth staining + dental hypoplasia

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13
Q

Which tetracycline is caution in children between 8-11 + can be only used for severe acute infections?

A

Doxycycline

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14
Q

Which tetracycline can ONLY be used in life-threatening infections (rocky mountain spotted fever) in under 8 years old?

A

Doxycycline

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15
Q

Can tetracyclines be used in pregnancy?

A

NO avoid

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16
Q

Can tetracyclines be used in renal impairment?

A

Avoid usually

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17
Q

What tetracycline has high risk of irreversible pigmentation/ LE syndrome?

A

Minocycline

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18
Q

What are the 2 tetracyclines which can be used in renal impairment (exemptions)?

A

Doxycycline

Minocycline

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19
Q

Can tetracyclines be used in hepatic impairment?

A

Avoid

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20
Q

What 6 drug classes interact with tetracyclines to increase hepatotoxicity?

A

Antibiotics (co-amoxiclav, flucloxacillin, isoniazid)

anti epileptics ( carbamazepine, valproate)

Fluconazole, itraconazole

Methotrexate

Statins

Sulfasalazine

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21
Q

What 2 counselling points to let patients who are taking tetracyclines know?

A

Avoid sunlight or sun lamps - photosensitivity

Avoid antacids, iron or zinc- - leave 2 hr gap

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22
Q

What 3 things should be avoided or given in 2 hr gap in patients taking tetracyclines?

A

Antacids , iron, zinc

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23
Q

How long to leave gap when taking antacids, iron or zinc when taking tetracyclines?

A

2 hr gap

24
Q

What 3 tetracyclines to avoid drinking milk + to take on empty stomach due to reduced absorption? (DOT)

A

Demeclocycline

Oxytetracycline

Tetracycline

25
Q

Which 3 tetracyclines can you have with milk (DLM)?

A

Doxycycline

Lymecycline

Minocycline

26
Q

What 3 tetracyclines are used for oesophagitis (ulcers, dysphagia)? (DMT)

A

Doxycycline

Minocycline

Tetracycline

27
Q

What is label for tetracycline regarding milk?

A

Do not take milk, indigestion remedies, meds containing iron or zinc 2 hours before or after you take this medicine.

28
Q

What advice to give patient taking tetracycline for oesophagitis?

A

Swallow whole with plenty of fluid sitting or standing.

29
Q

MOA of quinolones?

A

Inhibits nucleic acid + DNA synthesis

Bactericidal

30
Q

What condition to AVOID giving quinolones?

A

MRSA

31
Q

Spectrum of quinolones?

A

Broad

32
Q

What are 2 uses of quinolones?

A

RTI

UTI

33
Q

What is MHRA warning about quinolones and side effects?

A

Long term irreversible SEs

DO NOT prescribe for non severe infections (not for normal UTIs)

34
Q

What are 4 drugs in quinolone class?

A

Ciprofloxacin

Levofloxacin

Moxifloxacin

Ofloxacin

35
Q

How often to take ciprifloxacin?

A

BD

36
Q

What quinolone drug is the most dangerous - increased QT prolongation + life-threatening hepatotoxicity?

A

Moxifloxacin

37
Q

What are 5 main SEs of quinolones?

A

Psychiatric disorders

Arthropathy (in children), aortic aneurysm, antacids reduce absoprtion

Tendon damage
CNS disorders

Heart valve regurgitations, hypersensitivity (QT prolongation too)

Seizures

38
Q

What abx lowers seizure threshold?

A

Quinolones

39
Q

Can quinolones be used in pregnancy?

A

No - causes joint issues in animal studies

40
Q

Interaction between quinolones + antacids?

A

Antacids reduce quinolone absorption.

Give Abx 2 hrs before antacid OR take Abx 4 hours after antacid

41
Q

What is a risk factor for quinolones since they cause QT prolongation?

A

Patients with hypokalaemia

42
Q

What is an MHRA warning regarding heart valve regurgitation when using systemic or inhaled fluoroquinolone + how to counsel patients?

A

Valve doesn’t close properly - blood leaks out.

Counsel patient on symptoms like oedema, palpitations, dyspnoea.

43
Q

Who is arthropathy common in?

A

children/ teenagers

44
Q

What is arthropathy?

A

Joint disease

45
Q

What are the 5 MHRA warnings for quinolones?

A

Suicidal tendencies

QT prolongation + heart valve regurgitation

Life long threatening SEs

Aortic aneurysm

Tendon damage + Seizures

46
Q

What 3 patient counselling points to tell patients taking quinolones?

A

1.Avoid sunlight

2.Reduced absorption - no indigestion meds + no dairy products, iron or zinc 2 hrs before or after taking med.

  1. Driving - may impair

*(Give MHRA advice sheet too)

47
Q

dairy + quinolones?

A

reduces absorption

48
Q

What does UV radiation do to patients on quinolones

A

mild rash

49
Q

Is ciprofloxacin an enzyme inducer or inhibitor?

A

Inhibitor

50
Q

What 2 drugs/classes interact with ciprofloxacin to increase seizure risk?

A

NSAIDs

Theophylline

51
Q

What anticoagulant increases bleeding when used with quinolones?

A

Warfarin

52
Q

What 10 drugs can increase QT prolongation when given with quinolones?

A

Antispychotic drugs,

Anti-arrhythmic drugs - amiodarone, sotalol

Macrolides Abx

Lithium

SSRIs

Clomipramine

Domperidone

lithium

methadone

5HT1 antagonists - triptans

53
Q

What condition does hypokalaemia increase risk of?

A

Torsade de pointes

54
Q

What 4 drugs/classes can increase risk of hypokalaemia + QT prolongation?

A

B2 agonists

Corticosteroids

Loop + thiazide diuretics

Theophylline

55
Q

What tetracylcine does not need to be taken with plenty of fluid while sitting or standing ?

A

demeocycline

PRE-REG-Thuri (44 decks)

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