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A. PMF > Penicillins > Flashcards

Penicillins Flashcards

1
Q

Usual Amoxicillin dose?

A

500mg every 8 hours, or 1g twice a day

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2
Q

Name 2 reasons to adjust the dose of amoxicillin

A
  • in severe infections - 1g every 8 hours can be used
  • in renal impairment need to reduce dose if CrCl is <30
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3
Q

Most common ADRs of amoxicillin?

A

Diarrhoea, nausea, rash

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4
Q

MOA of amoxicillin?

A

Forms a covalent bond with PBP, inactivating it. Prevents cell wall synthesis by preventing the cross linking of peptidoglycan chains

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5
Q

Most common dose of Amoxicillin / clavulanate?

A

500 - 875mg every 12 hours for 5-10 days depending on infection

Clavulanic acid = 125mg

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6
Q

MOA of clavulanic acid?

A

Inhibits B-lactamase - the enzyme responsible for breaking down B-lactams.

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7
Q

Purpose of adding clavulanic acid to amoxicillin?

A

Extends its activity - includes more gram negative

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8
Q

ADRs associated with clavulanic acid?

A

Cholestatic hepatitis

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9
Q

Indication for flucloxacillin?

A

Staph, pneumonia, wounds, etc

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10
Q

When should you reduce the dose of flucloxacilin?

A

When CrCl is less than 10

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11
Q

Usual dose of flucloxacillin?

A

250-500mg every 6 hours. Max of 4g a day

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12
Q

When to take flucloxacillin in relation to food?

A

Best absorbed on empty stomach. Half an hour before food or 2 hours after

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13
Q

Indications of phenoxymethylpenicilin?

A

Tonsillitis, rheumatic fever, etc

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14
Q

Dose of phenoxymethylpenicilin

A

250-500mg every 6 hours. Maximum 3g daily

When for tonsillitis to prevent rheumatic fever, 500mg bd for 10 days

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15
Q

Which bacteria is metronidazole most effective against?

A

Anaerobic bacteria such as c. Diff

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16
Q

Penicillins ADRs?

A

Pain at injection site, GIT affects, electrolyte disturbances, rash

17
Q

Main groups of bacteria that amoxicillin is effective against?

A

Gram positive and anaerobes

18
Q

Amoxicillin can be used for CAP. What is the most common causative organism

A

Streptococcus pneumoniae

19
Q

Monitoring required for penicillins?

A

Monitor hepatic and renal function if Tx duration is longer than 10 days

20
Q

Amox + clav can be used for HAP. What is the main causative organism

A

Gram negative - pseudomonas aeruginosa

21
Q

Max dose of Amox + Clav?

A

2g q6h for severe infections

22
Q

When should Amox+clav be taken with respect for food?

A

Take with food

23
Q

IV dosing of flucloxacillin?

A

1-2g every 6 hours, max = 12g (severe infections like staphylococcus pneumonia)

24
Q

Common causative organism for skin infections that flucloxacillin is used for?

A

Staphylococcus epidermidis

25
Q

Spectrum of flucloxacillin vs amoxicillin?

A

More narrow

26
Q

ADR unique to flucloxacillin?

A

Increase in liver enzymes and cholestatic hepatitis

27
Q

Main indication for phenoxymethylpenicilin?

A

Tonsillitis or pharyngitis caused by strep. Pyogenes

28
Q

Treatment for s. Pyogenes tonsillitis?

A

Phenoxymethylpenicilin
500mg bd for 10 days

Dose of phenoxymethylpenicilin can be up to 500mg q6h (max 3G daily)
10 day Tx course is to eradicate s. pyrogenes and prevent development of acute rheumatic fever

29
Q

ADRs for phenoxymethylpenicilin?

A

Same as other penicillins

30
Q

When might antibiotics not be indicated for strep. Tonsillitis ?

A

When the case is mild and in a community with low risk of rheumatic fever.
If risk is high, phenoxymethylpenicilin is used to prevent development of rheumatic fever

31
Q

Should phenoxymethylpenicilin be taken with or without food

A

Without

32
Q

First line treatment for sinusitis?

A

Symptomatic Tx
If persisting for more than 7 days or if there is a fever, first line is amoxicillin (typical pathogen is s. Pneumonaie)

33
Q

Name 2 alternatives to phenoxymethylpenicilin for s. Pyogenes

A

Mild = cefalexin
Severe= Azithromycin, clarithromycin

34
Q

Name 2 alternatives to amoxicillin for CAP

A

Doxycycline or clarithromycin

35
Q

Antibiotics useful for MRSA?

A

Resistant to all B-lactams except newest cephalosporins like ceftaroline
Can use= vancomycin, doxycycline, trimethoprim / sulfamethoxazole

36
Q

Alternatives to flucloxacillin for staph?

A

Cefalexin or clindamycin or trimethoprim with sulfamethoxazole

A. PMF (4 decks)

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