Pharmacology - Common infections + Abx

Question 1

CAP (Community acquired pneumonia)
Abx?*

Answer 1

Amoxicillin (Typical - S.Pneumo is amoxicillin susceptible)
/
Clarythromycin (Atypical, eg. Legionella, C.pneumophilia, M.pneumoniae)

Question 2

COPD

Answer 2

Amoxicillin/Clarythromycin
Doxycycline

Question 3

HAP (hospital-acquired pneumonia)

Answer 3

1. Co - amoxiclav
   (3x daily 500 or 125mg for 5 days)

Question 4

TB *

Answer 4

RIPE
Rifampicin (red pee/tears)
Isoniazid (peripheral neuropathy) + {Pyridoxine - prevent vit B6 déficiency sid blastic anémia + peripheral neuropathy)
Pyrazinamide- hepatitis
Ethambutol - optic neuropathy

Question 5

Cellulitis*

Answer 5

Mostly group B strep or S.aureus = Flucloxacillin

If MRSA - give Vancomysin

Question 6

UTI*

Answer 6

1. Trimethoprim or nitrofurantoin

(trimethoprim = teratogenic in first trimester, if considering muscle give folate, in pregnancy, nitrofurantoin preferred)

Question 7

Pyelonephritis

Answer 7

Cefalexin
Coamoxiclav

Question 8

Chlamydia trachomatis (STI)*

Answer 8

Azithromycin or Doxycycline

Question 9

Neisseria gonorrhoeae (STI)*

Answer 9

IM Ceftriaxone + Azithromycin

Question 10

Syphillis (STI)

Answer 10

Benzathine penicillin / benzylpenicillin

Question 11

H.Pylori*

Answer 11

CAP
Clarythromycin + Amoxicillin + PPI (Omeprazole) (for 7 days NICE)

(PPIs irreversible inhibit H+/K+ ATPase pumps of parietal cell)

Question 12

Gastro events

Answer 12

Campylobacter –> Clarythromycin
Salmonella + Shigella –> Ciprofloxacin

Question 13

C.Difficile*
What is it caused by?
Treatment?

Answer 13

caused by Abx beginning with Cs (clindamycin, Cephalosporins, Co amoxiclav, Ceftriaxone, cefotaxime, cefalexin)

Tx = 1. Vancomycin (125mg 4xd, 10 days)
+/- Metronidazole (if very severe)

Question 14

Infective endocarditis

Answer 14

S.Aureus = Vancomycin + rifampicin
S. Viridans = Benzylpenicillin + gentamycin

Question 15

Meningitis*

Answer 15

3rd gen cephalosporin ceftriaxone in hospital
+ amoxicillin if listeria suspected
+ steroids simultaneously

In community = Benzylpenicillin if meningococcal meningitis suspected