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3RD YEAR - Infectious Diseases > ST4 - Antibiotics > Flashcards

ST4 - Antibiotics Flashcards

1
Q

What is the broad spectrum penicillin?

A

Co-amoxiclav

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2
Q

What is the broad spectrum cephalosporin?

A

Cefuroxime

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3
Q

How should penicillin G and V be administered?

A

G - IV V - Oral

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4
Q

Are beta-lactams safe in pregnancy?

A

Yes

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5
Q

In which patients are aminoglycosides (eg. gentamicin) at risk of causing toxicity?

A

Elderly, paediatric and neonatal patients, and those with kidney failure

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6
Q

For the antibiotic to be effective, what to factors come into play?

A

The BREAK POINT (chosen concentration (mg/L) of an antibiotic which defines whether a species of bacteria is susceptible or resistant to the antibiotic) must exceed the MINIMUM INHIBITORY CONCENTRATION (the lowest concentration of a chemical that prevents visible growth of a bacterium)

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7
Q

In which cases might prophylactic antimicrobial therapy be considered?

A
  • Surgery - Prevention of IE - Post exposure prophylaxis eg. N. meningitidis
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8
Q

When prescribing IV antibiotics, how often should they be reviewed?

A

Every 48 hours

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9
Q

What are the indications for gentamicin?

A

Severe gram negative infections and bacterial endocarditis

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10
Q

What antibiotics are used for serious staph. aureus infections?

A

Flucloxacillin

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11
Q

What antibiotics are used for less serious staph. aureus infections?

A

Cephalosporins, clindamycin, erythromycin, lincomycin

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12
Q

What antibiotics are used for MRSA infections?

A

VANCOMYCIN If nosocomial infection: Rifampicin and fusidic acid

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13
Q

Which antibiotic targets the cell membrane, and what is it used for?

A

Colistin - used in infections with multi-resistant bacteria

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14
Q

Which antibiotics target the cell wall?

A

Beta lactams - penicillins, cephalosporins, carbapenems

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15
Q

How do beta lactams work?

A

BACTERICIDAL - Inhibit cell wall formation by preventing cross linking of peptoglycan

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16
Q

How are beta lactams excreted?

A

Renally - alter dose in renal impairment

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17
Q

Name 4 penicillins

A

Amoxicillin Penicillin V Flucloxacillin Piperacillin

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18
Q

What is the best antibiotic for a staph aureus skin/soft tissue infection?

A

Flucloxacillin - only covers gram positives

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19
Q

What antibiotic causes a widespread rash in glandular fever?

A

Amoxicillin

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20
Q

What is co-amoxiclav used for?

A

Gram positive, negative and anaerobic cover - good soft tissue penetration

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21
Q

What is amoxicillin used for?

A

Chest and ear infections Sometimes meningitis as it can cross the BBB

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22
Q

What is tazocin used for?

A

Gram positive, negative and anaerobic cover - used in red flag sepsis, very unwell patients due to broad cover. Doesn’t get into the CNS!

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23
Q

Name 3 cephalosporins

A

1st gen - cefalexin 2nd gen - cefuroxime 3rd gen - ceftriaxone The later the generation the better the GN cover but less GP cover

24
Q

What is cefalexin used for?

A

UTIs

25
Q

What is cefuroxime + metronidazole used for ?

A

Sepsis of unknown origin (IV)

26
Q

What is ceftriazone used for?

A

Meningitis!! Can cross BBB

27
Q

Name 2 carbapenems

A

Meropenem Ertapenem

28
Q

When are carbapenems used?

A

Very broad GN, GP and anaerobic cover Multi-drug resistant infections, and penicillin allergy

29
Q

What are the side effects of beta lactams?

A

Diarrhoea - could give C.diff! (the broader the cover, the higher the c diff risk) Deranged LFTs (coamoxiclav) Rash (amoxicillin)

30
Q

Which antibiotics target the cytoplasm?

A

Metronidazole and daptomycin

31
Q

What is metronidazole used for?

A

Bactericidal against anaerobes (clostridium) and protozoa

32
Q

What does metronidazole react with?

A

Alcohol

33
Q

What antibiotics target the ribosome?

A

Macrolides Clindamycin Aminoglycosides Tetracyclines Linezolid Chloramphenicol

34
Q

Give 3 examples of macrolides

A

Clarithromycin, erythromycin and azithromycin

35
Q

What are macrolides used for?

A

Pneumonia - to cover atypical organisms (give amox + clarithromycin)

36
Q

What are the side effects of macrocodes?

A

Caution in renal and liver failure Prolong QT interval Increase warfarin/phenytoin levels (P450 inhibitors) GI upset Rash

37
Q

What is clindamycin used for?

A

Toxic shock Nec fasc

38
Q

What is doxycycline used for?

A

Travellers diarrhoea, chlamydia

39
Q

When is doxycycline contraindicated?

A

Children under 12 Pregnancy Breastfeeding

40
Q

Give an example of an aminoglycoside, and what is it used for?

A

Gentamicin Wide spectrum but poor - use in combo Use for IE

41
Q

What are the side effects of gentamicin

A

Ototoxicity, renotoxic, myasthenia gravis reaction

42
Q

Which antibiotics target the chromosome?

A

Quinolones Trimethoprim Nitrofurantoin

43
Q

Give an example of a quinolone and its contraindications?

A

Ciprofloxacin Dont use in renal/hepatic failure, epilepsy, children or elderly (c diff risk)

44
Q

What is trimethoprim used for and when is it contraindicated?

A

UTI Not in renal failure, antifolate drugs (methotrexate), pregnancy

45
Q

When is nitrofurantoin used and when is it contraindicated?

A

UTI Not for pyelonephritis (conc not high enough), renal failure, infants, or pregnancy 3rd trimester (haemolysis risk)

46
Q

Which antibiotics require therapeutic monitoring routinely?

A
  1. Gentamicin and vancomycin (IV) - narrow therapeutic index 2. Long term treatment 3. Renal impairment 4. Compliance issues
47
Q

When should gentamicin and vancomycin levels be measured and what is the target?

A

Trough level ie. just before the next dose Gent - aim below 1 or 2mg Vanc - aim between 10-15mg

48
Q

How should a patient with cellulitis be treated: a) hospital b) inpatient

A

a) IV flucloxacillin (+- ben pen) b) IV ceftriaxone Alternatives - clindamycin, daptomycin

49
Q

What is the adverse effect associated with: a) clindamycin b) daptomycin

A

a) c. diff b) rhabdomyolysis

50
Q

What is the most appropriate management of meningitis?

A

GP: IM ben pen Hospital: IV ceftriaxone (stat) Consider corticosteroids if bacterial IV fluids

51
Q

How should household contacts of meningitis be treated prophylactically?

A

Rifampicin over 2 days Ciprofloxacin stat Ceftriaxone stat (in pregnancy)

52
Q

What bacteria cause meningitis in: a) younger patients b) older patients and how does this alter management

A

a) N. meningitidis (5 days abx) b) strep pneumonia (10-14 days abx + steroids)

53
Q

What is the most common pathogen in patients with IE? a) native valve b) prosthetic valve and how should each be treated?

A

a) Strep viridans - benpen + gentamicin b) staph aureus - fluclox + vancomycin

54
Q

Should people get IE prophylaxis, and if so what should they get?

A

Only those with risk factors (heart disease) who are undergoing dental procedure or GI surgery Amoxicillin or clindamycin

55
Q

What are the side effects of vancomycin?

A

Red man syndrome, ototoxicity, GI upset

3RD YEAR - Infectious Diseases (16 decks)

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