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Infectious Disease > Principles of Antimicrobial Therapy > Flashcards

Principles of Antimicrobial Therapy Flashcards

1
Q

When selecting an antimicrobial, what are the 4 principles you must consider?

A
  1. Confirm presence of infection
  2. Identify pathogen
  3. Select presumptive therapy
  4. Monitor therapeutic response
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2
Q

Drug Action and Mechanism is considered to be (pharmacodynamics/pharmacokinetics)

A

Pharmacodynamics

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3
Q

Absorption, Distribution, Metabolism, Excretion is considered to be (pharacodynamics/pharmacokinetics)

A

Pharmacokinetics

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4
Q

What does the body do to the drugs?

A

Affects serum + tissue levels

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5
Q

What reactions occur in phase I metabolism?

A

Dealkylation, hydroxylation, oxidation, deamination

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6
Q

What enzyme system does phase I metabolism occur in?

A

Cytochrome P-450

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7
Q

What does phase I metabolism do exactly?

A

Inactivates substrate into a more polar compound

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8
Q

What reactions occur in phase II metabolism?

A

Glucuronidation, sulfation, acetylation, conjugation

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9
Q

What does phase II metabolism do exactly?

A
  1. Conjugates parent compound with larger molecule to increase polarity
  2. Inactivates parent compound, renally excreted
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10
Q

What is distribution of a drug affected by?

A
  1. Lipophilicity
  2. Partition coefficient
  3. Blood flow to tissues
  4. pH
  5. Protein binding
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11
Q

What is bioavailability?

A

Amount of drug that reaches systemic circulation

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12
Q

Glomerular filtration, tubular secretion, passive diffusion + dialysis is considered (renal/non-renal) clearance

A

renal

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13
Q

Sum of clearance pathways not involving the kidneys is considered (renal/non-renal) clearance

A

non-renal

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14
Q

Steady state concentrations reaches after _____ half lives

A

4 to 5

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15
Q

Half-life is affected by changes where?

A

End-organ function & protein binding

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16
Q

How do you find total body clearance?

A

Renal + Non-renal clearance

17
Q

(Bacteriostatic/Bactericidal) inhibits growth or replication

A

Bacteriostatic

18
Q

(Bacteriostatic/Bactericidal) causes cell death

A

Bactercidal

19
Q

Pharmacokinetics

Concentration vs time
Effect vs time
Effect vs concentration

A

Concentration vs time

20
Q

Pharmacodynamics

Effect vs concentration
Concentration vs time
Effect vs time

A

Effect vs concentration

21
Q

PK/PD

Effect vs time
Concentration vs time
Effect vs concentration

A

Effect vs time

22
Q

What is the therapeutic index?

A

Ratio between toxic and effective dose that shows the normal range of pharmacological effect

23
Q

What is the therapeutic window?

A

Area between low efficacy and high efficacy of the ED50

Where drug concentrations should be maintained for adequate therapeutic effect

24
Q

What is post antibiotic effect?

A

Delayed regrowth of bacteria following exposure to antimicrobial

25
Q

If you’re allergic to penicillin, what else should you avoid?

A

Cephalosporin + Carbapenems

26
Q

Can antimicrobials cross the placenta?

A

Yes

27
Q

Which antibiotics appear to be safe in pregnancy?

A
  1. Penicillins
  2. Cephalosporins
  3. Erythromycin
28
Q

What are some effects of being pregnant + having antibiotics?

A
  1. Fetus at risk for teratogenicity

2. Some AB are cleared more rapidly

29
Q

What genetic/metabolic abnormalities should you look out for when taking AB?

A

G6PD deficiency, risk of increased RBC hemolysis

30
Q

What is the most important factor to consider in antimicrobial selection?

A

Site of infection

31
Q

Is toxicity a concern for using a combination antimicrobial?

A

Yes, but can also benefit pt by decreasing toxicity

32
Q

How much evidence is there for using combination antimicrobials?

A

Theres just weak supporting evidence

33
Q

What kind of effect can you predict from using antimicrobials?

A

Synergistic, Antagonistic, or no change at all

34
Q

Whats an example of an antagonistic combination therapy?

A

Using bacteriostatic + bactericidal

Tetracycline inhibits growth, but penicillin requires bacteria to grow in order to be effective

35
Q

Whats an example of a synergistic combination therapy?

A

Using bactericidal and another bactericidal

Penicillin + aminoglycoside combination work together great

36
Q

What should you monitor when you use antimicrobials?

A

Efficacy + toxicity

Infectious Disease (32 decks)

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