rational abx use

Question 1

which drug to use if multiple options are present?

Answer 1

cheapest and most effective as pharmacodynamics

Question 2

what are the factors affecting selection of abx: properties of infections?

Answer 2

location and characteristics of infection

Question 3

what are the factors affecting selection of abx: properties of patients

Answer 3

age
pregnancy
allergy
underlying disease (liver hepatic failure)
before and now used abx

Question 4

what are the factors affecting selection of abx: properties of abx

Answer 4

spectrum
mechanism pharmacologically
interval of dose
route of adminstration
timing
drug interactions
side effects
cost

Question 5

when do we use antibiotics in each of :treatment, empirical, and prophylaxis in management?

Answer 5

RX: if patient has proof of infection(culture)
empirical: if chance of infection is inevitable and more likely(close contact)
prophylaxis: preventing an infection which may develop

Question 6

which abx are more time dependent (frequent adminstration or prolonged infusion dosing)

Answer 6

penicillin
cephalosporins
carbapenems
natural macrolides
clindamycin
oxazolidinones

Question 7

which abx are more concentration dependent(infrequent and high dose)

Answer 7

aminoglycosides
fluoroquinolones

Question 8

which abx are more concentration and time dependent?

Answer 8

fluoroquinolones
aminoglycosides

Question 9

Peripheral nerve pain and numbness?

Answer 9

Aminoglycosides

Question 10

Inner ear hearing imbalance?

Answer 10

Gentamycin/vancomycin

Question 11

Stains in growing bones and teeth+photosensitivity

Answer 11

Tetracyclines

Question 12

Liver damage

Answer 12

Rifampicin/isoniazid

Question 13

Kidney damage

Answer 13

Gentamycin/vancomycin/contrimoxazole
+ aminoglycosides

Question 14

Skin photosensitivity?

Answer 14

Tetracycline and quinolones

Question 15

Hypo/hyperglycemia and tendon rupture +photosensitivity

Answer 15

Quinolones

Question 16

Bone marrow (aplastic anemia)

Answer 16

Chloramphenicol/contrimoxazole

Question 17

Ideal antibiotic using criteria?

Answer 17

Correct abx
Best way(iv, im, po)
Effective dosing
Optimal timing
Appropriate period
After correct dosing

Question 18

True or false: most infections with normal host defenses is treated with multiple antimicrobial agent

Answer 18

false,
most infections with normal host defenses can be treated with a SINGLE antimicrobial agent

Question 19

True or false: correct use of antimicrobial combination may have significant effects

Answer 19

Inappropriate use of antimicrobial combination may have significant effects

Question 20

Indications of combining antibiotics

Answer 20

Treatment of mixed infections

Synergistic effect against pneumoneia aerginosa

Prevent the development of resistance

Reducing the toxicity of antibiotic

Question 21

What are the 3 types of interactions demonstrated when 2 antimicrobial are combined?

Answer 21

Additive
Synergism
Antogonism(opposition)

Question 22

The effect of each of the individual drugs used in combination is more than the effect of them used in combination:

Answer 22

Antagonistic effect (one drug cancels out the other)(1-1=0.5)

Question 23

The sum effect of combining 2 drugs is more than the effect of individual effect of each drug

Answer 23

Synergy(1+1>2)

Question 24

Used in combination from the individual effect of these drugs is the sum effect of the drugs

Answer 24

Additive effect(1+1=2)

Question 25

What r the undesirable effects of combining abx?

Answer 25

Antagonistic affect Resistance and superinfection Toxicity/inc side effect Inc cost

Question 26

Based on what factors do you choose the abx?

Answer 26

Etiological agent Patient factors Antibiotic factor Idnetifying local antibiotic resistance data

Question 27

What are the adverse reactions found in aminoglycoside antibiotic?

Answer 27

Nephrotoxicity Ototoxicity: cochlear and vestibular

Question 28

? What are the antibiotic factors that must be considered

Answer 28

Cost of drug Unit costs/stay in hospital Choice of regimen(oral or parenteral) Duration of tx Monitoring efficacy Early review of response

Question 29

What are the advantages of oral antibiotic over parenteral?

Answer 29

Shorter duration stay in hospital Saving in overall costs Eliminates risk of complications associated with intravascular line

Question 30

What is the only way for prolonging life of antibiotic and lowering resistance?

Answer 30

Appropriate use is the only way of prolonging the useful life of an antibiotic