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Beta-lactam antibiotics

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turlough's version from 2017-10-30 14:38

Section 1

Question Answer
Typical uses of amoxicillin Infections of the ear, nose, upper and lower respiratory tracts, skin and genitourinary system
Mechanism of amoxicillin Amoxicillin inhibits the synthesis of peptidoglycan, thereby weakening bacterial cell walls and causing cell lysis and death.
Is it necessary to adjust the amoxicillin dose in renal impairment? Yes
Discuss how you would adjust the amoxicillin dose in renal impairmentIn moderate renal impairment, increase the intervals to every 12 hours (i.e. 500 mg bd). In severe renal impairment, increase the intervals to every 24 hours (i.e. 500 mg od).
Can amoxicillin be used in pregnancy and breast-feeding? Yes but consider the risks and benefits.
One contraiindication to the use of amoxicillin Hypersensitivity to beta-lactam antibiotics (e.g. penicillins, cephalosporins, carbapenem or monobactam).
Does food affect the absorption of amoxicillin? No
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Section 2

Question Answer
5 interactions with amoxicillin 1) Warfarin. 2) Methotrexate. 3) Allopurinol. 4) Venlafaxine. 5) Tetracyclines.
Explain the interaction between amoxicillin and warfarinThis combination increases the risk of bleeding
Explain the interaction between amoxicillin and methotrexate. Amoxicillin reduces methotrexate clearance, thereby increasing the risk of side effects.
Explain the interaction between amoxicillin and allopurinol This combination increases the risk of allergic skin reactions
Explain the interaction between amoxicillin and venlafaxine Increased risk of serotonin syndrome
3 common side effects of amoxicillinNausea, diarrhoea and skin rash
3 counselling points for amoxicillin 1) Symptoms should improve within 2-3 days but be sure to finish the course. 2) Amoxicillin can be taken without respect to food. If you experience nausea then take it with a meal to alleviate this. 3) For the suspension, store it in the fridge and shake well before use.
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Section 3

Question Answer
What is the purpose of combining amoxicillin with clavulanic acid?Clavulanic acid is a beta-lactamase inhibitor which protects amoxicillin from degradation by these enzymes.
Mention 2 indications for which amoxicillin/clavulanate is preferred to amoxicillin alone1) Community Acquired Pneumonia. 2) Acute bacterial rhinosinusitis.
Discuss the timing of co-amoxiclav administration with respect to food?Co-amoxiclav is best taken at the start of a meal in order to maximise absorption and to minimise GI intolerance.
What side effect is more likely to occur with amoxicillin/clavulanate than with amoxicillin alone?Diarrhoea. It is a very common side effect of co-amoxiclav (affecting more than 10% of patients) whereas it is just a common side effect of amoxicillin (affecting 1 to 10% of patients).
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