What antibiotics cause nephrotoxicity?
aminoglycosides
Glycopeptides
What antibiotics should be avoided in renal impairment?
Tetracyclines
Nitrofurantoin
What drugs cause hepatotoxicity?
Rifampicin
Tetracyclines
What drugs should be reduced dose in hepatic impairment?
Metronidazole
Match these bacteria to their most effective antibiotics? Staphylococcus: MRSA: Streptococcus: Anaerobic: Pseudomonas:
Staphylococcus: Flucloxacillin MRSA: vancomycin Streptococcus: Benzypenicillin Anaerobic: Metronidazole Pseudomonas: gentamicin
Which antibiotics affect protein synthesis?
Clindamycin Linezolid Chloramphenicol Aminoglycosides Macrolides Tetracyclines
Which antibiotics affect DNA synthesis?
Nitrofurantoin
Metronidazole
Trimethoprim
Quinolones
Which antibiotics affect cell wall?
Penicillins
Cephalosporins
Glycopeptides
What are the notable side effects of clindamycin?
C. difficile
What are the notable side effects of linezolid?
Blood disorders
Optic neuropathy if use over 28 days
What are the notable interactions with linezolid?
MAOI: Hypertensive crisis
What are the side effects of Trimethoprim?
Anti-folate: Blood disorders
Hyperkalemia
Teratogenic in first trimester
What’s the standard dose of Trimethoprim?
200mg BD
What are the side effects of Co trimoxazole?
SJS
Photosensitive
What are the side effects of chloramphenicol?
Blood disorders
Grey baby syndrome
What are the side effects of Metronidazole?
GI disturbance
Taste
Oral mucositis
What are the side effects of nitrofurantoin?
Nausea, neuropathy in renal impairment
What’s the age limit in nitrofurantoin?
3 years
What are the side effects of Aminoglycosides?
Nephrotoxicity
Ototoxicity
Neuropathy
Hypokaelemia, calcaemia and magnesium
What’s the MHRA concerning Aminoglycosides about?
Histamine reaction
When should ‘Once daily regimen’ with gentamicin be avoided?
Renal impairment <20
Burns covering 20% of body
Gram positive endocarditis
When should ‘multiple dose regimen’ with gentamicin be monitored?
After 3/4 doses and after dose changes
More in renal impairment
What’s the range for the post dose ‘peak level’ and pre dose ‘trough level’ with gentamicin therapy?
5-10mg/ml (3-5mg/ml in endocarditis)
<2mg/ml (1mg/ml in endocarditis)
What’s the course of action if gentamicin peak level after 1hr is too high?
Reduce dose
What’s the course of action if gentamicin trough level is too high?
Increase interval
How should gentamicin therapy be adjusted in renal impairment?
Increase interval
Severe (reduce dose)
What are the key side effects with vancomycin?
Red man syndrome
Blood disorders
Skin disorders
Thrombophlebitis
Which Tetracyclines can be used in renal impairment?
Doxycycline
Minocycline
Which tetracyclines cause phototoxicity?
Doxycycline
Demecleocyline
Which tetracyclines must milk be avoid with?
Demecleocycline
Oxytetracycline
Tetracycline
Which tetracyclines cause oesophageal irritation?
Doxycycline
Minocylcine
Tetracycline
What side effects are notable with quinolones?
Seizures Tendon damage QT prolongation Athropathy Psychiatric reactions
What side effects are most associated with Moxifloxacillin?
Qt prolongation
Hepatotoxicity
Which CNS infection can penicillin be used on ?
Meningitis
Which penicillins are broad spectrum?
Amoxicillin
Ampicillin
Which narrow spectrum penicillin is not gastric stable?
Benzypenicillin (G)
Which penicillin can cause cholestatic jaundice and when does it cause it ?
Flucloxacillin (2 months after course)
Co amoxiclav also
What conditions are antipseudomonal penicillin used in?
Septicaemia
Hospital acquired pneumonia
Pseudomonas aeruginosa
Name some first generation cephalosporins?
Cefalexin
Cefudroxil
Cefradine
Which cephalosporins are 2nd generation?
Cefuroxime
Ceflaclor
Which cephalosporins are 3rd generations ?
Cefixime (oral)
Cefrioxone
Cefotaxime
Ceftazidine
Which cephalosporins should be given in penicillin allergy?
3rd gen and Cefuroxime
Which antibiotics are safe in pregnancy?
Penicillins
Cephalosporins
Clindamycin
Erythromycin