Brainscape's Knowledge GenomeTM

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


See full index

A13AMC @ UoN > L04 - General Principles of Treatment & Selection of Antimicrobial Regimens in Medical Practice > Flashcards

L04 - General Principles of Treatment & Selection of Antimicrobial Regimens in Medical Practice Flashcards

1
Q

Define the basic principles of antibiotic therapy

A

Administer antibiotics at a level high enough to inhibit/kill infecting organisms
Continue treatment until the host can complete curing/healing process
Drain infections of closed spaces
Know expected response
Be prepared to re-evaluate

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

In what two situations are antibiotics indicated?

A

Prophylaxis

Treatment

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

Define Prophylaxis

A

Use of antibiotics to prevent infection of a previously uninfected site (can be primary/secondary)

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

Define Treatment

A

Use of antibiotics to eliminate infection from an already infected site (req. clinical/microbiological diagnosis

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

Describe Microbiological Diagnosis

A

Organism defined AND antibiotic susceptibility predictable/lab confirmed

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

Describe Clinical Diagnosis

A

Empirical identification of organism (Best Guess)

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

What five factors should be considered regarding drug safety?

A 
Known hypersenstivity/intolerance
Impaired excretion
Drug interactions
Higher risk of toxicity
Risk of antibiotic-associated diarrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define Bactericidal

A

An agent that kills bacteria

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

Define Bacteristatic

A

An agent that prevents growth of bacteria

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

In what situations are Bactericidal agents preferred?

A

Immunocompromised
Immunodeficient
Difficult sites

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

What possible steps should be taken 48h after starting treatment? (w/ cultures/clinical review)

A 
If no evidence of infection STOP
Switch from i.v. to oral
Change antibiotics (narrow)
Continue and review at 72h
Start outpatient parenteral antibiotic therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Give six reasons to switch from i.v. to oral antibiotics

A 
Reductions in hospital acquired bacteraemias
Saves medical/nursing time
Reduces discomfort/increases mobility
Reduced cost
Greater time control
Reduced risk of ADR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define COMS

A

The criteria for safe i.v. to oral switch:
Clinical improvement observed
Oral route not compromised
Markers normalising
Specific indication/deep seated infection

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

In what time scale to most infections respond?

A

5-7 (10) days depending on severity

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

Give three reasons for longer treatment lengths

A

Specific indicatoin
Deep seated infections
High risk infections

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

Define OPAT

A

Outpatient Paraenteral Antimicrobial Therapy

i.v. therapy at home (carries risks)

17
Q

What three things make treating newborns difficult?

A

Increased risk of infection
Rapidly changing physiology
ADME subject to change

18
Q

What affects drug absorption in newborns?

A

pH
Gut motility
Transit time

19
Q

What affects drug distribution in newborns?

A

High ECF volume gives lower drug plasma concentrations

20
Q

What affects drug metabolism in newborns?

A

Immature hepatic enzymes

Low G6PD concentrations

21
Q

What affects drug excretion in newborns?

A

Renal immaturity

Leads to prolonged T1/2/raised Cmax

22
Q

What are the five main infection risks in pregnancy?

A 
URTI
LRTI
UTI
Intrauterine infection
Amnionitis
23
Q

What five antibiotics are avoided in pregnancy and why?

A

Sulphonamides (Kernicterus)
Streptomycin (Ototoxicity)
Tetracyclines (Interfere w/ bone growth AND tooth discolouration)
Nitrofurantoin/Sulfonamides (Haemolysis)
Chloramphenicol (Cardiovascular collapse)

24
Q

What antibiotic is contraindicated in breast feeding?

A

Metronidazole (1:1 serum:breast milk)

25
Q

What five things make prescribing difficult in the elderly?

A 
Organ/physiological function declining
Often suffering from multiple diseases
Often on multiple long-term medications
Compliance compromised
ADME compromised
Need for written instructions
26
Q

What affects drug absorption in the elderly?

A 
pH alteration (by drug/disease)
GI surgery
27
Q

What affects drug distribution in the elderly?

A

Reduction in total body water (reduced Vd)

28
Q

What affects drug metabolism in the elderly?

A

Hepatic involution

29
Q

What affects drug excretion in the elderly?

A

Reduced GFR w/ age

Impaired renal blood flow

30
Q

Give four examples of antibiotics unchanged in the elderly

A

Ciprofloxacin
Ceftriaoxone
Isoniazid
Rifampicin

31
Q

Give four examples of antibiotics reduced in the elderly

A

Penicillins
Cephalosporins
Aminoglycosides
Vancomycin

32
Q

What are the principles of prescribing in community medicine?

A

Empirical approach to treatment (syndrome based)
Minimising emergence of bacterial resistance
Safe, effective & economic use of antibiotics

A13AMC @ UoN (20 decks)

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