ANTIMICROBIALS HIGH YIELD I Flashcards
1849, who was responsible for finding cholera, communicable disease via water supply
John Snow
1860, fermentation, rabies, anthrax, etc..
who was this?
Louis Pasteur
19th century, postulates developed
who was this?
Robert Koch
- Natural or synthetic
- Antibiotics, antifungal, antiviral, and antiparasitic drugs
- Interfere with the physiological pathways
antimicrobials
subset of antibacterial drugs that are natural products
antibiotics
this refers to the chemical moiety of the drug that binds to the microbial receptor
pharmacophore
rifampin is a strong inducer/inhibitor?
inducer
azoles chloramphenicol macrolides ciprofioxacin metronidazole protease inhibitors
these are inhibitors or inducers
inhibitors
this paradigm considers these variables?
drug
pathogen
patient
affect of drug on patient is called?
affect of patient’s body on drug?
affect of drug on patient?
pharmacodynamic
pharmacokinetics
pharmacodynamic
how to approach a patient with possiblility of using antimicrobials?
suspect infection culture suspected sites gram stain identification susceptibility
baseline fever discussed in class?
> 38.3 degrees celsius
best diagnostics to use?
WBC
differential
inflammatory markers
procalcitonin
name this hormone?
increases in response to inflammatory and noninflammatory mediators
specific for bacterial infections and severity for infection
plasma levels increase within 6-12 hours, 25-30 hours as a half-life in plasma
levels for healthy individuals?
procalcitonin
<0.05 micrograms/L
how to ID the pathogen?
examine infected material antigens gram stain culture make determination
susceptibility testing measures?
minimum inhibitory concentration (MIC)
lowest concentration of the agent that prevents visible growth after 18-24 h of incubation known as?
minimum inhibitory concentration (MIC)
name this antimicrobial test?
cheap but difficult to interpret
larger zone of inhibition=greater antibiotic effectiveness
diameter ozone is measured and used for interpretation
can’t determine MIC and determining trends can’t either
Kirby bauer disk diffusion
what is this method for antibiotics?
determines MIC antibiotics
traditional agar and broth dilution provides accurate MIC determination
labor intensive
broth microdilution tests multiple antibiotics simultaneously
dilution methods
this is a PK/PD relationship
time dependent antibiotics where fraction of time is above the MIC?
B lactam (penicillin, cephalosporin) clindamycin
this is a PK/PD relationship
time dependent antibiotics where the area under the curve measures total body exposure and so we take the integral between two time points, what are examples?
fluoroquinolone
vancomycin
azithromycin
this is a PK/PD relationship
concentration dependent
ratio of peak to MIC
dosed intermittently
what is the example of this?
aminoglycosides
what is the post antibiotic effect (PAE)?
effectiveness of the antimicrobial continues after the concentrations decline below the MIC
these kill pathogens disrupting the cell wall
MBC/MIC <4
beta lactams
bactericidal
inhibits growth like protein synthesis
MBC/MIC >4
macrolides
tetracyclines
relies on immune system to clear the infection
bacteriostatic
antibiotic selection based on empirical therapy?
best guess based on evidence though pathogen not identified
antibiotics active against a large range of microorganisms?
examples?
used for empiric coverage
broad spectrum
carbapenems
fluoraquinolones
antibiotics active against a limited group of micro organisms?
examples?
narrow spectrum
penicillin
aminoglycosides
aztreonam
treatment approach to microbes?
prophylactic therapy
surgical prophylaxis
prophylaxis is immunocompromised
