AM - Principles of clinical use Flashcards

1
Q

How do we reduce risk of growing antimicrobial resistance?

A
  • Only prescribe them when necessary

- Use narrow spectrum

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2
Q

What patient characteristics must considered when choosing an AM?

A

Age
Renal Function
Hepatic Function
Pregnancy

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3
Q

Why consider age when choosing an AM?

A

Some are contraindicated in kids.

E.g. Ciprofloxacin can cause abnormal cartilage development

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4
Q

How do we adjust during renal impairment?

A

Scale down the drug dose proportionally to the renal insufficiency

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5
Q

What does the liver do to AMs?

A

Metabolises them & excretes them in bile

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6
Q

In what ways are some AMs dangerous to pregnant women?

A
  • Mutagenic, mutate foetal chromosomes
  • Teratogenic, associated with congenital abnormalities
  • Or Both!
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7
Q

What types of prophylactic AM treatment are there?

A

Pre-op when theres a high risk of infection

Post-Exposure to highly communicable diseases

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8
Q

Whats different about a prophylactic AM treatment?

A

Dosage should cover just the period of risk e.g. one pre-op dose instead of a normal course of them

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9
Q

In what case would you commence empiracal AM therapy?

A

If urgent treatments needed & thers no time for culture of antibiotic sensitivity tests

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10
Q

In what cases is combination therapy better then monotherapy?

A
  • If theres mixed infection
  • The AMs have an enhanced effect together
  • To minimise development of strains resistant to any one agent
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11
Q

What are the 3 possible outocomes when using 2 AMs together?

A
  • Additive
  • Antagonistic
  • Synergistic
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12
Q

What does it mean when 2 AMs are antagonistic>?

A

Their combined effect is less than the sum of their individual effects

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13
Q

What does it mean when 2 AMs are synergistic?

A

Their combined effect is greater than the sum of their individual effects.

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14
Q

Example of syneristic antibiotics?

A

Penicillin & Gentamicin for Strep. infections

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15
Q

Examples of drugs whose serum levels must be monitored closely?

A

Vancomycin

Gentamicin

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16
Q

Why is penetrance important when choosing a drug?

A

Great drugs useless if it cant reacht he site of infection