Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

346 > Intro > Flashcards

Intro Flashcards

1
Q

Antibiotic - Def’n

A

a substance created by a microorganism to inhibit or

kill another microorganism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Antibacterial - Def’n

A

a substance that inhibits or kills bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Antifungal - Def’n

A

a substance that inhibits or kills fungi or spores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Antiviral - Def’n

A

a substance that inhibits the development and

transmission of viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Antiprotozoal - Def’n

A

a substance that inhibits or kills protozoa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anti-infective - Def’n

A

a substance that inhibits, prevents, or kills the

source of an infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Antiseptic - Def’n

A

a substance that is applied to living tissue/skin to

prevent, treat, or reduce infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Disinfectant - Def’n

A

a substance that is applied to inanimate

objects/surfaces to kill microbes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Antimicrobial - Def’n

A

a substance that inhibits or kills microbes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Draw the web showing relationship between infectious diseases term

A

Antimicrobials -> Biocides, antiseptics, anti-infectives -> antibacterials->antibiotics, antivirals, antifungals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

WHO Leading Causes of Death

A
  1. Ischaemic heart disease 2. Stroke 3. Chronic obstructive pulmonary disease 4. lower respiratory infections 5. neonatal conditions 6. Trachea, bronchus, lung cancers 7. Alzheimer’s 8. Diarrhoeal diseases 9. Diabetes mellitus 10. Kidney diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antimicrobial Resistance - what are some examples of antimicrobial resistant bacteria

A

PRSA, MRSA, VRE, VRSA, ESBL, AmpC, KPC, NDM-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bacterial Resistance - 4 types/ways that there is resistance

A

Intrinsic resistance, (Cell wall, mechanism they already have
Some agents target cell wall)

acquired resistance (mutation), selection of resistant strains with antibacterial use (misuse), Spread and Clonal Spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bacterial resistance - ex of decreased permeability

A

Cell wall changes (e.g., vancomycin)
Porin channel changes (e.g., imipenem)
Biofilm production
Prevents antibacterial geint into the biofilm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bacterial resistance - ex of Enzyme modification

A

β-lactamases (e.g., penicillin)
Aminoglycoside-modifying enzymes
Methylation (e.g., clarithromycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Bacterial resistance - Target site changes

A 
Alteration of penicillin binding proteins
Ribosomal modification (e.g., clindamycin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bacterial resistance - Active efflux

A

Tetracycline efflux

Fluoroquinolone efflux

18
Q

Antibacterial Development - economic viability?

A

Antibacterial development is no longer an economically wise investment for pharmaceutical companies.

  • the only drugs that lose benefit by extensive use
  • given in short courses vs drugs like atorvastatin for decades
  • and are relatively cheap (peak charge of $1,000-$3,000/course vs chemotherapy at sometimes > $80,0000 / course)
19
Q

What are some costs to antibiotic resistance?

A
  • Increased use of broad spectrum antibacterials
  • Increased use of IV antibacterials
  • Increased hospitalization
  • Increased costs of hospitalization
  • Increased Infection Control
  • Diminished quality of life
  • Increased morbidity and mortality
20
Q

Antibacterials in Agriculture - how many antibacterials are used (%) and what are they used for?

A

80-88% of all antibacterials sold are administered to food animals
 Used for growth promotion

21
Q

What is the cycle of antibacterials from agriculture?

A

> 90% antibacterials given to animals excreted in urine and stool which is Excreted into soil, surface runoff, and ground water and widely dispersed through fertilizer
Humans consume the animals, and the possibly contaminated water

22
Q

Steps to reduce antibacterial resistance

A
  • Use antibacterials only when necessary
  • Do not use antibacterials for viral infections
  • Use antibacterials for appropriate duration
  • Ensure patient adherence
  • Use antibacterials with the narrowest spectrum of activity possible
  • Prevent the spread of infections – handwashing, cleaning services
  • Prevent Infections - Vaccinate Strict infection control procedures
  • Guidelines
  • Drug formularies
  • Antibacterial Cycling ?
  • Regulatory policies
  • Improved diagnostics
  • Educate the public, health care professionals
  • Reduce agricultural use of antibacterials
23
Q

Relationships in an infected patient - 3 pillars (Host, antibiotic, pathogen)

A

HOST -> PK -> ANTIBIOTIC -> PD -> PATHOGEN -> Infectious Disease. PATHOGEN -> resistance -> ANTIBIOTIC -> toxicodynamics -> HOST -> immune response

24
Q

Factors in Choosing Antimicrobial Therapy - some general ones

A

What disease is being treated? Should it be treated
with antibacterials?
 What are the suspected organisms?
 How ill is the patient?
 Are there cultures to direct antibacterial choice?
 Is the patient immunocompromised?
 What are the current susceptibility patterns by site?
 What are the advantages/disadvantages of the
available choices of susceptible antibacterials?
 What are the cost issues?

25
Q

Administrative factors in Choosing

Antimicrobial Therapy

A

What route of administration should be used?
 e.g., IV, IM, PO, or topical
 Are there any issues limiting route of administration?
 e.g., severity of infection, site of infection, ability to
swallow, ability to absorb drug p.o, I.M, or rectally; do we want the drug to stay in the GI tract
 Are there taste issues with oral medications
 What is the evidence regarding choice of
antibacterial in this particular case?
 Are there good evidence-based guidelines to
support your choice? Are they up to date?
 What is the site and severity of the infection?
 What dose should be used for this patient?
 Does the dose need to be adjusted based on renal
function or hepatic function of the patient?
 Does the drug have any toxicities or allergies or
special circumstances (e.g., pregnancy) that would
preclude use of this drug in this patient?
 Is there any way that this infection could be
prevented or spread of the infection be prevented?
 How long should treatment continue?
 How should progress be monitored in this patient?

26
Q

Site-specific factors - Eye, Brain, and Prostate (why is it difficult site)

A

 non-fenestrated capillaries
 impede drug diffusion (antibacterial delivery difficult)
 Infections difficult to treat
 Need to take into consideration the
pharmacokinetics of the antibacterial
 May require direct injection of antibacterials
 e.g., intravitreal, intraventricular

27
Q

What is biofilm

A

In humans, biofilm frequently forms on foreign
substances inserted or implanted into the body if
they come in contact with bacterial organisms
 IV catheters, urinary catheters, dialysis catheters
 Artificial joints (knee, hip), artificial heart valve
 Biofilm may also form on some tissues in the body
resulting in infections that are very difficult to treat
 e.g., lung tissues in cystic fibrosis

28
Q

What is “sessile” bacteria

A

“Sessile” bacteria within biofilm become resistant
to antibacterial therapy and may require 10 –
1000 higher concentrations of antibacterial than
free “planktonic” bacteria
 We usually cannot achieve these concentrations
clinically

29
Q

Anti-bacterial Combinations (4 reasons why to do it)

A

 To broaden empiric coverage
 For polymicrobial coverage
 To prevent emergence of resistance
 Synergy

30
Q

What is the concept and combination for synergy

A

Superior to the sum of effects of both

antibacterials given separately, 1 + 1 > 2

31
Q

What is the concept and combination for addition

A

Superior to either antibacterial given
separately (but less than the sum of the
effects of both antibacterials), 1+ 1 > 1-2

32
Q

What is the concept and combination for indifference

A

Equal to either antibacterial alone 1 + 1 = 1

33
Q

What is the concept and combination for antagonism

A

Inferior to either antibacterial alone, 1 + 1 < 1

34
Q

What are the 3 graphs showing in vitro combinations for indifference, synergism or antagonism?

A

Draw graphs A,B,C or explain relationships on Slide 51 of Intro.

35
Q

What are some ex of synergistic combinations in the clinical setting?

A

 Penicillin + aminoglycoside against enterococci
 Combination antipseudomonals (e.g., piperacillin +
aminoglycoside)
 Sulfonamides + trimethoprim
 β-lactam + β-lactamase inhibitor

36
Q

Disadvantages of Anti-bacterial Combinations

A 
Antagonism
 Examples:
 Penicillin + tetracycline
 Gentamicin + chloramphenicol
Cost
Adverse effects
37
Q

Drug Interactions of Anti-bacterial Combinations - Oral anticoagulants - things to consider

A

 Antibacterial inhibits Vitamin K synthesis in GI tract
-risk - enhanced anticoagulant effect
 Effect of fever, infection?
 Recommendation – Stockley’s Drug Interaction
-Monitor after 3 – 5 days
-Monitor INR carefully with sulfonamides and reduce dose
-Monitor INR carefully with metronidazole

38
Q

Oral Contraceptives Metabolism

A

Enterohepatic recycling of conjugates (from minor pathway)
 Conjugates excreted into GI tract via bile duct
 Conjugate broken down by bacteria in GI tract
 Free estrogen reabsorbed
 Antibacterials may reduce bacteria in GI tract and interfere with enterohepatic recycling (reduce systemic estrogens and may result in OC failure)
 Some antibacterials increase metabolism of ethinylestradiol (e.g., rifampin, rifabutin)
 Antibacterials frequently cause diarrhea and/or vomiting that may decrease OC absorption

39
Q

Antibacterial/OC Interaction - evidence and conslusion?

A

Likely to reduce birth control pill effectiveness
->  Rifampin, (rifabutin)
Associated with OC failure in > 3 case reports
->  Ampicillin, amoxacillin, griseofulvin, metronidazole,
tetracycline
Associated with OC failure in 1 case report
->  Cephalexin, Clindamycin, Dapsone, Erythromycin,
Isoniazid, Pen V, TMP/SMX
The evidence regarding oral contraceptives and its
effectiveness with concomitant ingestion of antibacterials is conflicting.
 Until evidence becomes clearer, patients should be aware of this possible interaction.

40
Q

Additional Considerations with Antimicrobial Therapy

A

 Allergic Reactions
 Documentation of type of reaction is very important
 Specific Toxicities
 e.g., nephrotoxicity with aminoglycosides
 Antibacterial Resistance !!!!!!

346 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions