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Pharmacology 2 > Antibiotics Basic Info > Flashcards

Antibiotics Basic Info Flashcards

1
Q

Prophylaxis

A

Preventive treatment for a disease and health maintenance. Only use ABX in this situation when absolutely necessary because it can result in resistance

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2
Q

Empiric therapy

A

Therapy based on experience that begins based on educated guess in the absence of complete or perfect info

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3
Q

Definitive therapy

A

Therapy that is accepted as a specific cure for a disease

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4
Q

Normal flora

A

Bacteria that are found in the bodies normally that don’t typically cause disease unless a decrease in the immune system occurs. Most normal flora are found on the skin and in the gut

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5
Q

Colonization

A

Large scale migration or spread of a bacteria in a certain area of the body that DOES NOT make you sick

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6
Q

Infection

A

Is a spread of the bacteria that results in sickness and signs and symptoms like pus, fever, high WBC

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7
Q

Superinfection

A

An infection occurring after or on top of an earlier infection, especially following broad-spectrum ABX.

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8
Q

Contamination

A

Presence of any unwanted organism in the body

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9
Q

Bactericidal

A

Drugs that actually kill the invading organism

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10
Q

Bacteriostatic

A

These are drugs that inhibit the growth and replication of an organism

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11
Q

How do you select a drug in an empircial state

A 
Collect data regarding
1. site of infection
2. recent travel hx
3. is it gram+/-
4.
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12
Q

What is meant by susceptibility of an organism

A

Once the organism is know, must pick an ABX that is most specific in treating that bacteria

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13
Q

MIC

A

Minimum inhibitory concentration. This is the lowest concentration of the drug that results in 99.9% decline in colony count after 24hrs (inhibits growth)

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14
Q

MBC

A

Minimum bactericidal concentration. This is the minimum amount of ABX that kills the bacteria under investigation by up to 99.9%

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15
Q

What are two ways of determining antimicrobial susceptibility of the infecting organism

A
  1. MIC

2. MBC

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16
Q

Susceptible

A

Means the organism is responsive to the drug at the recommended dosage

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17
Q

Moderately susceptible

A

Means the organism is responsive to the drug at much higher doses (or the drug is concentrated in a specific area of treatment

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18
Q

Resistant

A

Means the organism is not expected to respond to the ABX regardless of the dose or location of delivery.

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19
Q

Intermediate susceptibility

A

Similar to moderately susceptible, but is more of a buffer between susceptible and resistant

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20
Q

Why is site of infection important

A

Because it changes what type of drug will be administered

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21
Q

How do most drugs get to site of infection

A

Through slit junctions in the tissue walls

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22
Q

What does the blood brain barrier do

A

Blocks many substances because of the single layer of endothelial cells that are fused by tight junctions.

23
Q

What types of molecules can pass into the BBB

A

Very small lipophilic drugs and ones that are unbound to plasma proteins

24
Q

What is an example of a drug that passes easily into the CNS

A

Chloramphenicol, because they are lipophilic

25
Q

What drugs have poor CNS penetration

A

B-lactam

26
Q

Name patient characteristics that affect the selection of an ABX

A
  1. Immune system
  2. Kidney/liver function
  3. Poor perfusion
  4. Age
  5. Pregnancy
  6. Lactation
27
Q

What effect does immunocompromised have on ABX administration

A

Can result in more infection and/or the necessity for longer periods of drug administration

28
Q

What would happen in a pt with poor kidney function when given ABX

A

May result in a build up of the drug (note—the # of nephrons decreases with age!)

29
Q

What effect does poor perfusion have when administering ABX

A

Reduces the amount of ABX that reaches the infected area. Ex: diabetic patients with leg ulcerations

30
Q

What drug is not give to pregnant women

A

Tetracycline - causes decrease in bone growth in children

31
Q

How are drugs categorized with pregnant women

A

A, B, C, D, X

32
Q

Category A

A

no risk to fetus

33
Q

Category B

A

Animal studies do not indicate risk, but no human studies

34
Q

Category C

A

Shows effects in animals, no studies in women

35
Q

Category D

A

Postive evidence of human fetal risk exists, but if benefits outweigh the risk may be necessary

36
Q

Category X

A

Extreme animal and human fetal risk, risk outweighs the benefit

37
Q

What are the spectrum of activity

A

Narrow, extended, broad, bactericidal, bacteriostatic

38
Q

Narrow spectrum

A

Act on a single or limited group of organisms (isoniazid)

39
Q

Extended spectrum

A

Drugs are effective against gram + and a fair amount of gram - (ampicillin)

40
Q

Broad spectrum

A

Works on many different organisms. Gram +/-, spirochetes, mycoplasma, chlamydia. (tetracycline and chloramphenicol)

41
Q

What is the preferred route of ABX administration

A

Oral, unless it is something like vancomycin that is poorly absorbed

42
Q

What is rational dosing based on

A

The kinetics and dynamics of the ABX

43
Q

What are the 3 properties that have significant influence on dosing frequency

A
  1. Concentration dependent killing
  2. Time dependent killin
  3. Postantibiotic effect
44
Q

Concentration dependent killing

A

Drugs that show a significant increase in the rate of bacteria killing. As concentration increases, so does organism death (aminoglycocides) - bolus dosing

45
Q

Time dependent killing

A

Drugs that have blood concentrations above the MIC for a good % of time. Usually done as a continues dosing schedule

46
Q

What is meant by synergism

A

Means that two ABX can be given to a pt and the combo is more effective than treatment with just an individual drug

47
Q

Why is it better to treat with just one ABX

A
  1. Reduces resistance
  2. Reduces possibility of superinfection
  3. Minimizes toxicity
48
Q

What is an example of a combo ABX administration

A

Amoxicillin and clavulanic acid (Amox stops the growth of the bacteria, clavulanic acid prevents the bacteria from destroying or resisting amox). Often used in treatment of TB

49
Q

When is it good to use combo treatments

A

When the synergistic effects are good and possibly when the infection is of unknown origin

50
Q

What happens if a patient is taking an ABX that inhibits CYP450

A

It may have an adverse effect on another drug in the system. Meaning, if the patient is taking both an ABX and something else, and one drug blocks the metabolism action (CYP450), then you end up with a higher concentration of drug than would be wanted.

51
Q

What does CYP450 do

A

Metabolizes drugs

52
Q

What are two examples of CYP450 inhibiting ABX

A

Ciproflaxacin and erythromycin

53
Q

What is cross resistance (sensitivity)

A

Means that if the bacteria is resistant to a certain drug, it may also be resistant to other drugs that share the same MOA.

54
Q

What percent of people have a cross sensitivity of penicillin and cephalosporins

A

8-10&

Pharmacology 2 (8 decks)

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