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OD2 S2 > wk6:AED - Antibacterial 2 > Flashcards

wk6:AED - Antibacterial 2 Flashcards

1
Q

Name 5 antibiotics that can be given orally

A

penicillin
cephalosporin
macrolides
fluorooquinolones
tetracyclines

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2
Q

How commonly is penicillin used in eye care?

A

rarely

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3
Q

How does penicillin work?

A

inhibits bacterial cell wall synthesis

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4
Q

Is penicillin bacteriostatic or cidal?

A

bactericidal

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5
Q

Are most staphylococci sensitive or resistant to penicillin?

A

resistant (they produce an enzyme penicillinase that degrades the clinical efficiency of penicillins)

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6
Q

What is special about dicloxacillin (in relation to penicillins)?

A

penicillinase resistant

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7
Q

What is amoxycillin?

A

is a classic synthetic penicillin

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8
Q

How can we improve the spectrum of activity of amoxycillin?

A

Combine with potassium clavulanate (a beta lactase inhibitor)

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9
Q

How does the spectrum of activity of amoxycillin-clavulanate compare with amoxycillin?

A

Extended coverage of gram positives, some gram negatives

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10
Q

How good of a choice is amoxycillin-clavulanate for common eye and eyelid infections?

A

excellent choice

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11
Q

What is the standard dosage of diicloxacillin treatment? Why?

A

250mg qid. due to short half life.

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12
Q

Is dicloxacillin taken with meals?

A

Doesn’t have to be

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13
Q

What are the standard doses for amoxycillin-clavulanate treatment? (3)

A

Depends on severity.
Mild = 500mg
Most = 875mg
Severe = 1000mg

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14
Q

List 6 potential side effects of penicillins

A

Hypersensitivity reactions
Up to 20% reported
Most limited to skin rashes
Severe anaphylaxis (uncommon)
May also alter normal flora in resp. tract (super infections)
Gastrointestinal upset

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15
Q

What 3 alternative antibiotics might you use if your patint is allergic to pnicillin?

A

Cephalosporin
Macroliides
Fluoroquinolone

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16
Q

Name a common first choice ophthalmic antibiotic

A

Cephalosporin

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17
Q

What part of bacteria is targeted with cephalosporin tx?

A

Bacterial cell wall synthesis (so similar to penicillins)

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18
Q

Do cephalosporins contain a beta lactam group?

A

yes, but derived from different amino acids than the penicillin beta lactam group

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19
Q

How long is a standard course of cephalexin (a type of cephalosporin, also known as keflex)?

A

1 week (lenght can change based on severi or condition)

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20
Q

What is the usual dosage of cephalexin?

A

500mg bid or 500mg qid

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21
Q

Why are cephalosporins contraindicated in hemophiliacs?

A

Because they can destroy intestinal bacteria which are necessary for the synthesis of vitamin K which can result in impaired blood clotting

22
Q

What is the primary adverse reaction to cephalosporins?

A

hypersensitivity

23
Q

What percentage of patients allergic to penicillin are also allergic to cephalosporin?

A

5-10%

(this is known as cross sensitivity)

24
Q

Under what circumstances would cephalosporin be a suitable alternative for a penicillin allergy?

A

Only if minor adverse reaction to penicillin

25
Q

What suitable alternatives can be used if a patient has a hx of penicillin anaphylaxis? (2)

A

Macrolides or Fluoroquinolones

26
Q

Do fluoroquinolones have a broad or narrow spectrum?

A

broad

27
Q

When are fluoroquinolones mainly used?

A

mainly reserved for when penicillin allergy

28
Q

What is norfloxacin used for? (1)

A

tx of UTI

29
Q

Provide an example fluouroquinolone, dose, and duration?

A

ciproflaxacin 500mg qd x 1 week

30
Q

Are macrolides used as first line antibiotics?

A

usually NOT

31
Q

Name 2 uses for macrolides

A

chlamydial infections
pregnancy

32
Q

What part of bacteria do macrolides target?

A

inhibit protein synthesis

33
Q

Are macroliides bacteriostatic or cidal?

A

mainly bacteriostatic but can be bactericidal in higher concentrations

34
Q

What gram stain of bacteria are macrolides active against?

A

Gram +ve and some gram -ve

35
Q

What properties do macrolides possess at low doses?

A

anti inflammatory properties

36
Q

When might macrolides be used by clinicians?

A

As an alternative when tetracyclines are contraindicated

37
Q

When is erythromycin (a macrolide) commonly used? (2)

A

Commonly used as a second choice antibiotic
Common choice in pregnancy

38
Q

What is the ideal use for azithromycin?

A

excellent against chlamydial infections

39
Q

What are the standard options when considering tx with macrolides? Outline procedure

A

Lab test
azithromycin 1gm p.o single dose
alternative or if unresponsive
erythromycin 500mg qid, 7 days
doxycycline 100mg bid 1 to 3 weeks

40
Q

Out of the different tetracyclines, which one has the fewest potential side effects?

A

doxycycline

41
Q

Describe how doxycycline affects cytokines?

A

reduces bioactivity of major inflammatory cytokines

42
Q

In terms of the anti-inflammatory action of doxycycline, describe its effects (2) and describe at what dose (1)

A

at sub-optimal antibiotic doses
modify and enhance lipid metabolism
alter gland function, tear film function

43
Q

How does doxcycline interact with MMPs?

A

inhibits theme

44
Q

How do MMPs relate to eye problems? (1)

A

mmp is an enzyme implicated in corneal damage including recurrent erosion

45
Q

Name 3 conditions where mmp is inhibited

A

mgd, dry eye, RCES

46
Q

When would you prescribe doxycycline? (4)

A

topical medications ineffective
need repeat topical anti-inflammatory tx
severe inflammation ocular surface
significant lid disease

47
Q

List 3 potential side effects of doxcycline

A

GI (drink full glass of water)
Yeast infections
Photosensitivity

48
Q

How can we minimise the potential side effects of doxycycline?

A

use low dose

49
Q

Describe 1 important interaction that doxycycline has that affects the medication

A

Ineffective when taken with dairy products or antacids
because calcium chelates the medication
do not take for at least 2 hours after dairy products

50
Q

When is docycyline contraindicated? (3)

A

children under 8 years (may discolour teeth or hinder bone development)
pregnant or nursing women
renal function problems

51
Q

What factors should you consider when deciding what antibiotic to prescribe to a patient? (8)

A

Age
Weight
General Health
Mental status
Allergy Hx
Liver+Kidney function
Current medications
Pregnancy status

52
Q

What are the 2 most important things to remember about doxycycline?

A

Function dependent on dose. One is antibiotic and other is MMP-9 inhibitor

OD2 S2 (63 decks)

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