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Clinical PK > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Define post-antibiotic effect (PAE)?

A

Continued suppression of bacterial growth after a short exposure to antimicrobial agents

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2
Q

Define synergism

A

Together ABX have enhanced inhibition of organisms than either agent alone (may see decrease MIC)

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3
Q

Define antagonism

A

Together ABX have decreased inhibition or killing than when either agent is used alone

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4
Q

Define time-dependent

A

The amount of bacterial killing depends on time the drug stays above MIC

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5
Q

What are the PK/PD parameters for time-dependent?

A

T (time) > MIC (minimum inhibition concentration)

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6
Q

Name 5 examples for time-dependent antimicrobial killing?

A 
Beta-lactams
Macrolides
Clindamycin
Linezolid
Vancomycin
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7
Q

Define concentration-dependent

A

The amount of bacterial killings depends on Cmax above the MIC

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8
Q

What are the PK/PD parameters for concentration-dependent?

A

Peak/MIC

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9
Q

Name 4 examples for concentration-dependent antimicrobial killing?

A

Aminoglycosides
Fluoroquinolones
Daptomycin
Metronidazole

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10
Q

Name the antibiotic(s) of this classification

  • Pattern of activity = time-dependent and minimal PAE
  • Goal of therapy = Maximize duration of exposure
  • PK/PD = T > MIC
A

Beta-lactams

Linezolid

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11
Q

Name the antibiotic(s) of this classification

  • Pattern of activity = time-dependent and minimal PAE
  • Goal of therapy = Maximize amount of drug
  • PK/PD = 24h-AUC/MIC
A

Vancomycin

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12
Q

Name the antibiotic(s) of this classification

  • Pattern of activity = time-dependent and moderate to prolonged PAE
  • Goal of therapy = Maximize amount of drug
  • PK/PD = 24h-AUC/MIC
A

Azithromycin

Clindamycin

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13
Q

Name the antibiotic(s) of this classification

  • Pattern of activity = concentration-dependent and prolonged PAE
  • Goal of therapy = Maximize concentration
  • PK/PD = Peak/MIC
A

Aminoglycosides
Fluoroquinolones
Daptomycin
Metronidazole

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14
Q

What are 3 advantages for using extended infusions?

A
  • Superior PD profile (more f T > MIC)
  • Allows time between doses for administration of drugs through the same IV line
  • Cost
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15
Q

What are 5 reasons for using antibiotic combinations?

A
  • Broad spectrum empiric therapy
  • Polymicrobial infections
  • Decrease resistance
  • Decrease dose-related toxicity
  • Increase inhibition or killing
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16
Q

Name 3 types of antibiotic combinations that have a synergistic mechanism?

A

TMP/SMX
Beta-lactams/Beta-lactamase inhibitors
PCN and gentamycin

17
Q

Name 3 types of antibiotic combinations that an antagonistic mechanism?

A

Vancomycin and linezolid
PCN and TCNs
2 beta-lactams

18
Q

What is the synergistic mechanism of TMP/SMX?

A

Blockade of sequential steps in a metabolic sequence

19
Q

What is the synergistic mechanism of beta-lactams/beta-lactamase inhibitors?

A

Inhibition of enzymatic inactivation

20
Q

What is the synergistic mechanism of PCN and gentamycin?

A

Enhancement of antibiotic uptake

21
Q

What is the antagonistic mechanism of vancomycin and linezolid?

A

Inhibition of cidal activity by static agents

22
Q

What is the antagonistic mechanism of PCN and TCNs?

A

Inhibition of cidal activity by static agents

23
Q

What is the antagonistic mechanism of 2 beta-lactams?

A

Induction of enzymatic inactivation

24
Q

Explain the rationale of extended infusions

A

The amount of time the free or non-protein drug concentration exceeds the MIC (f T > MIC)

25
Q

(T/F) - Beta-lactams are a good example for extended infusions

A

TRUE

26
Q

Which beta-lactam effects near-maximal bactericidal when free drug concentration exceeds MIC for 50% of dosing interval?

A

PCNs

27
Q

Which beta-lactam effects near-maximal bactericidal when free drug concentration exceed MIC for 60-70% of dosing interval?

A

Cephalosporins

28
Q

Which beta-lactam effects near-maximal bactericidal when free drug concentration exceed MIC for 40% of dosing interval?

A

Carbapenems

Clinical PK (11 decks)

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