module 12 principles of anti-microbial therapy Flashcards

1
Q

antibiotics

A

agents produced naturally by microorganisms to suppress the growth of or to kill other organisms.

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2
Q

antimicorbials

A

include all antibiotics and synthetic preparations

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3
Q

cidal

A

agents kill bacteria

  • immunocompromised patients
  • hard to reach areas by the hose immune system
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4
Q

static

A

suppress growth of but not kill bacteria

- host defense mechanisms help to eliminate infecting organisms

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5
Q

factors affecting antimicrobial selection

A
identification
susceptibility
anatomic site
pharmacokinetics
allergies
age
pregnancy
host defense
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6
Q

pharacokinetics and abx

A

hepatic vs renal elimination

CYP450 genetic variations: inc. or dec. metabolism

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7
Q

age and abx

A

young and very old have dec. metabolic pathways and greater potential for toxicity

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8
Q

prophylaxis

A

abx given to a “healthy” pt to prevent infection

  • meningitis
  • damaged heart valves
  • immunocompromised
  • neutropenia: cancer
  • GI surgery
  • Recurrent UTI
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9
Q

risks with prophylaxis tx

A

superinfection: fungal
selection of resistant flora
selection of resistant pathogenic organisms

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10
Q

combining abx: indifferent

A

1+1=2

activity together equals sum of separate independent activities.

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11
Q

combining abx: synergism

A

1+1=3

activity together is greater than sum of of independent activities

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12
Q

combining abx: antagonism

A

1+1=1 or <1

activity together is less than the sum of the independent activities

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13
Q

When to consider combo abx

A

life-threatening infections
polymicrobial infection
desired synergistic effect
prevent of emergent resistant organisms: TB

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14
Q

mechanisms of resistance

A
due to altered targets
- abx no longer works at site of action 
due to dec. accumulation 
- organisms creates ways to inhibit abx 
due to enzymatic inactivation of drug
- organism creates enzyme to destroy abx
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15
Q

anti-infective PD

A

relationship between organsim susceptibility and pt-specific PK

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16
Q

peak/MIC

A

ratio of maximum drug concentration to the MIC

17
Q

AUC/MIC

A

ratio of the area under the concentration time curve to the MIC

18
Q

time > MIC

A

duration of time drug concentration is above the MIC

19
Q

MIC

A

minimum inhibitory concentration

- lowest concentration of an antimicrobial that will inhibit growth of a microorganism

20
Q

concentration dependent

A

abx eradicate bacteria the best by achieving high concentrations at the site of infection

  • Peak/MIC
  • best response when concentration is >10 above the MIC
21
Q

Time dependent

A

abx eradicate bacteria best when the time that the drug remains about the MIC is >50% of the dosing interval