pharmacology + microbio

Question 1

When must trimethoprim NOT be used? why?

Answer 1

first trimester of pregnancy

folate antagonist -> congenital malformations (spina bifida)

Question 2

When must nitrofurantoin NOT be used? why?

Answer 2

3rd trimester, breast feeding + kids <3

causes neonatal haemolysis

Question 3

treatment of uncomplicated female lower UTI

Answer 3

trimethoprim or nitrofurantoin orally 3 days

Question 4

treatment of UNcatherised male UTI

Answer 4

trimethoprim or nitrofurantoin orally for 7 days

Question 5

treatment of complicated UTI or pyelonephritis (GP)

Answer 5

co-amoxiclav or co-trimoxazole 14days

Question 6

treatment of complicated UTI of pyelonephritis (hospital)

Answer 6

amoxicillin AND gentamicin IV for 3 days

cotrimoxazole AND gentamicin pen allergy

Question 7

antibiotics to treat an enterococci infection

Answer 7

amoxicillin

cotrimoxazole

Question 8

antibiotic against ESBL producing bacteria

Answer 8

nitrofurantoin

Question 9

pseudomonas Tx

Answer 9

ciprofloxacin
- not in kids or pregnant

not a coliform, resistant to oral abx except cipro, assoc with catheters

Question 10

MoA of ciprofloxacin

Answer 10

inhibits bacterial DNA gyrase - prevents supercoiling of bacterial DNA

Question 11

gram pos causes of UTI

Answer 11

staph saprophyticus (young, sex active woman) –> staph (nitrofurantoin)

enterococcus faecalis (hospital, GI tract) –>strep

Question 12

proteus associations

Answer 12

smells like burnt chocolate
produces urease which turns urea to ammonia - increases urinary pH
struvite stones - STAG HORN