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PMP-201 > Overview of Infections and Antibiotics > Flashcards

Overview of Infections and Antibiotics Flashcards

1
Q

What chapter of BNF does it cover

A

5

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2
Q

antimicrobials and antibiotics

A

antimicrobials is more broad > can be antivirals for example

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3
Q

Pathogenic bacteria

A

stain - +ive or -Ive

oxygen - anaerobes

shapes - coccus…

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4
Q

infection markers?

A

systemic
peripheral/ local
vital signs
haematology
Biochemistry
Microbiology tests that can be used to confirm a source of infection
Urinalysis

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5
Q

Systemic

A

fever, rigor, chills myalgia, malaise, headache, anorexia, delirium

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6
Q

peripheral/ local

A

erythema, pain, heat, swelling, pus

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7
Q

vital signs

A

change in body temp, tachycardia, hypotension, tachypnoea

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8
Q

Haematology

A

^ white blood cell count
changes in neutrophils, ^ but low in neutropenic
^ platelets

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9
Q

Biochemistry

A

^ C reactive protein
^ erythrocute sedimentation rate
^ serum creatinine
^ liver func. test
changes to procalcitonin level

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10
Q

Microbiology tests that can be used to confirm a source of infection

A

presence of organism
miscroscopy
culture
serology
polymerase chain reaction

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11
Q

urinalysis

A

presence of leucocyte esterase
presence of nitrates

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12
Q

Which bacteria causes whcih infections?

A
  • most: natural body flora
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13
Q

Tets; CAP

A

community acquired pneumonia

Flora in the nasal cavity and the nasopharynx incl. mixtures of Gram -ve and gram +ve anaerobes

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14
Q

exceptions : clostridium difficle

A

gram +ve anaerobe
minor part of normal gut flora

risk factors:
exposure to broad spec antibiotics

multiple antibiotic exposures

proton pump inhibitor use (PPI)

co-morbidities

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15
Q

Pseudomonas Aeruginosa

A

gram -ve bacillus
not part of naturla flora
able to live in various enviroments
oppurtunistic pathogen
immunocompromised hosts are susceptible

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16
Q

what is an aim of antibiotic?

A
  • trial to kill bacteria - not healthy cells
  • target physiology or biochemistry; bind to target, occupy enough of binding site, remain at binding site for sufficient time period
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17
Q

dose optimisation graph

A

t = time
MIC = minimum inhibitor concentration

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18
Q

What are the 4 types of antibiotics

A
  • narrow spectrum
  • broad spectrum
  • bactericidal
  • bacteriostatic
19
Q

different mechanisms of resistance

A
  • penetration resistance
  • efflux pump
  • hydrolysis
  • mutation of binding site
20
Q

Principles of therapy

A
  1. antibacterial drug choice
  2. antibacterials, before therapy
  3. advice to give to patients/ family/ carers
  4. antibacterials, during therapy
  5. superinfection
  6. notifiable diseases
  7. sepsis and early management (if yes, treat 1 hr)
21
Q

Choice of antibiotic:

A
  1. patient factors
  2. likely causative organism
  3. risk of bacterial resistance
22
Q
  1. pateint factors when choosing an antibiotics
A

history of allergy
ranal/hepatic function
susceptibility to infection
ability to tolerate drugs by mouth
severity of illness
risk of complications
ethnic origin
age
female?
previous antibiotics
previous microbiology results

23
Q
  1. likely causative organism
A

site
likely pathogen
antibacterial activity

24
Q

What if patient has treatment failure:

A

repeated antibacterial courses

previous or current culture with resistant bacteria
higher risk of developing complications

25
Q

viral infections considerations before starting therapy?

A

viral infections
samples should be taken for culture
knowledge of prevalent organisms
dose
route of administration
duration

26
Q

review antibacterials - what to do?

A

review chocie of antibacterial

absense of culture, review and stop on clinical grounds
review Iv antibacterial within 48 hrs

consider stepping down to oral antibacterials where possible

27
Q

Penicillin side effects

A

hypersensitiviy, diarrhoea, antibiotic associated colitis, encephalopathy, thrombocytoenia

28
Q

cephalosporins - generations

A

1st:
cefalexin
cefradine
cefadroxil

2nd cefaclor
cefuroxime

3rd:
cefixime - orally active
ceftiaxone
cefotaxime
ceftazidine

5th:
ceftaroline

29
Q

Cephalosporins - considerations

A

cross sensitivity with other beta-lactam antibacterials
no suitable alternative is avail; cefixime can be used in caution

30
Q

side effects of cephalosporins

A

antibiotic - associated colitis

31
Q

aminoglycosides - drug examples

A

amikacin, gentamicin, neomycin, streptomycin, tobramycin

32
Q

Gentamicin serium concentrations

A
  • 1 hr peak conc
    5-10mg/L
    pre-dose trough concentration
    <2mg/L
33
Q

cautions & contraindications

A

auditory disorders
nephrotoxicity
muscular weakness
dehydration corrected prior to administration

34
Q

side effecst of aminoglycosies

A

irreversible otoxiticy, nphrotoxicity, antibiotic - associated colities, peripheral neuropathy

MHRA/CHM advice ^ risk fo deafness in patients with mitochondrial mutations

35
Q

Glycopeptides

A

vacomycin, teicoplanin, telavacin

cautions & contraindications:
avoid history of deafness, elderly caution, patienst with inflammatory disorder

monitor - trough level 10-20mg/L

interactions
avoid otoxic drugs, loop diuretics

36
Q

Macrolides

A

azithromycin - OD
Clarithromycin - BD
erythromycin - BD/QDS

s.e Gi, rash, otoxicity

clarythromycin; take with or just after food

37
Q

cautions and contraindications of macrolides

interaction between drugs?

A

patients with predisposition of Ot interval, prolongation

interaction between rivaroxoban and erythromycin
= ^ risk of bleeding

38
Q

Quinolones

A

ciprofolaxacin, levofloxacin, moxifoxacin, norfloxacin, olfoaxin

s.e prolongs OT iontervals, seizires, GI s.e, dizziness, headache, eye disorders, dec. in appetite

avoid in pregnancy

39
Q

Tetracyclines

A

s.e diarrhoea, dysphagie, photosensitivity

cautions - headache and virual disturbances

dont give to pregnant women - going to go through placenta

do not give to children udner 12 - stain teeth and growing bones

hypertension? STOP drug

40
Q

trimethoprim

A

cautions - blood dyscrasias

s.e allergic reactions, drug fever, electrolyte imbalance, GI disturbances, fungal overgrowth

monitor
hyperkalaemia, ^ creatine conc, renal funcion

interactions?
not used wiuth potassium evelating drugs (aldosterone atagonist, ACEi, ARBs)
not used with folate antagonists, or durgs that increase folare metabolism (phenytoin)

41
Q

`nitrofurantoin

A

s.e
pulmonary reactions, nausea, hypersensitivity, peripheral neuropathy, blood disorders

minor -
renal func.
avoid if eGFT <45ml/min

long term - monitor liver function

cautionsanaemia, diabetes, elec. oimbalance

pregancy, avoid

taken with or just after food, may discolour urine

42
Q

Clindamycin

A

cautions - shoudl not be used if existing diarrhoea

s.e - antibiotic- associated colitis, GI s.e, taste disturbances, rash, steven johnson syndrome, skin

monitor liver and renal func if treatment exceeds 10 days

counelling
patients should be advised to discontinue if diorrhoea develops

cream - can damage latex condoms

43
Q

Metronidazole

A

s.e Gi se, taste disturbances, furred tongue, oral mucosits, anorexia

do not drink alochol - cause stroke like symptoms

cautions - 10 days vaginal

topical use 18 yrs - avoid sunlight

44
Q
A

PMP-201 (34 decks)

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