lecture 3 Flashcards
empiric treatment is what?
based on most likely microbes
what describes what the drug does to the body ?
PD
what are the PD parameters?
time dependent or concentration dependent
penicillins, cephalosporins, and carbapenems are all what type of antibiotic?
beta lactams
penicillins, cephalosporins, carbapenems and vancomycin are all antibiotics that work through what?
cell wall synthesis inhbition
MOA of cell wall synthesis inhibitors
inhibiting PBP, or cell lysis through osmotic pressure
penecillin and amoxicillin primarily excreted by what?
kidney
which has longer half life, amox or pen?
amox
do amox and pen have higher or lower half lives vs others?
lower
does amox or pen have better abilities to reach high serum concentrations?
amox
do you want a drug that is more or less protein bound/
less
why is probenecid a problem with penicillin?
can block renal excretion, therefor increased serum levels of pen
penecillin has cross-reactivity with what other beta lactam?
cephalosporins
prophylaxis for dental treatment is only for patients with what?
underlying cardiac conditions associated with highest risk of adverse outcome from IE
some high risks which would need antibiotics for dental treatment
prosthetic cardiac valve, prior history if IE, CHD, unprepared cyanotic CHD< completely repaired during first 6 months after procedure,repaired CHD with residual defects, Cardiac transplantation recipients who develop cardiac valvulopathy
characteristics of the drug prevent reaching the target site or the drug is inactivated
intrinsic
resistance which develops horizontally or vertically
aquired
3 mechanisms of resistance
drug cannot reach target, drug is inactivated, target site is altered
what does clavulanic acid do?
prevents destruction of beta lactase, sometimes given with penicillins
cephalosporin more helpful for what two things?
gram negative and MSSA
alterations in membrane permeability or efflux
drug cannot reach target site
target site is altered
MRSA and PRSP
drug is inactivated
penicillinases, cephalosporinases, and extended spectrum beta lactamases
which beta lactam is reserved for last resort? broad spectrum agent
carbapenems
AE of carbapenems?
increased risk of seizure
which antibiotic is only given IV?
carbapenems
are beta lactams time dependent or concentration dependent?
time
are beta lactams primarily bacteriostatic of cidal?
cidal
benefit of cefpodoxime vs cephalexin?
better gram negative effects
