wk 5- antimicrobial therapy Flashcards

(37 cards)

1
Q

primary pathogens

A

cause disease in individuals despite immune status

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2
Q

opportunistic pathogens

A

cause disease in individuals whose natural defences are compromised

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3
Q

infectivity

A

ability for pathogen to establish in a host

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4
Q

virulence

A

how harmful pathogens are once established in a host

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5
Q

incubation period

A

time between the invasion by the pathogen and appearance of clinical features of infection (signs and symptoms)

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6
Q

period of infectivity

A

time the patient is infectious to others

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7
Q

bodys normal flora and defence system

A

normal flora: bodys microorganisms living in particular areas of the body

defence: different processes and barriers in the body that prevent infection eg (cilia, skin, mucus, tears, macropahges)

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8
Q

different types of pathogens and how they cause disease

A

virus
bacteria
fungi
protozoa
helminths

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9
Q

signs and symptoms of local and systemic infections

A

local: (involves skin or single organ)
-red
-hot
-pain
-loss of function
-exudate
-delayed wound healing

systemic: (involves whole body)
-fever >37.5C normal tempt is 36-37C
-chills/sweats
-diaarhoea, vomiting, nauesea
-headache
-fatigue
-etc

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10
Q

stages of infection

A
  1. incubation stage: pathogen is replicating. no symptoms
  2. prodromal stage: host begins to feel unwell with nonspecific signs/symptoms, fever, muscle aches, headache, fatigue
  3. acute stage: microbes are destroying specific host cells and systems. more specific symptoms occur
  4. convalescent stage: bodys defence mechanism has confined microbes and healing of damaged tissue has begun. health returns to normal.
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11
Q

ways to diagnose an infection

A
  • no single definitive test
    combination of clinical signs and laboratory tests (WBC count, ESR, CRP, blood, urine, wound culture)
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12
Q

blood tests- WBC what 2 major classes does it include and what are the types of infection you can conclude from the test

A

2 major classes
1. granulocytes: engluf and digest.
-neutorphils, monocytes, basphils, eosinophils

  1. lymphocytes: recognition of microbes

types of infections from WBC count
1. leukocytosis: increase of WBC- most common acute bacterial infection
2. leukopenia: decrease of WBC- long infection
3. increase in eosinophil count- allergic reaction

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13
Q

ESR what does it do when theres an infection, with other populations and when is it used

A

Large increases during infection, inflammation and plasma cell dyscrasias

also increases with age, pregnancy and anaemia

useful for monitoring resposne over time to antibiotics, example lower ESR means theres a response to antibiotics

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13
Q

CRP

A

increase when theres inflammation/ infection

good for determining severity as it reflects disease activity and response to treatment as it rises and falls quickly as response

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14
Q
A
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14
Q

clinical questioning SITDOWNSIR

A

s- site
i- intensity
t- type
d- duration
o- onset
w- with other symptoms?
n- aggrevated by?
s- spread?
i- incidence
r- relieved by

16
Q

what tests to use if you want to monitor treatment (antibiotics)

17
Q

what tests to use if you want to assess if theres an infection and if its longstanding or acute

18
Q

what tests to use for systemically ill patients

A

culture blood, urine, mucus etc before administration of antibiotic

19
Q

gram positive and negative

A

positive: retains only purple stain
neg: retains only red stain

tells us the difference in structure of cell wall

response to antibiotics varies with the type of bacteria

20
Q

how long do wound cultures take

21
Q

bacteria components

A

single celled organisms
unique cell wall
some have flagella (move)
some have fimbria (attachement to host tissue)
DNA

dont have membrane bound organelles
dont have nucleus

22
Q

principles of antimicrobial treatment

A
  • accurate diagnosis
  • empirical treatment initially
  • switch to narrow spectrum after culture/sensitivity testing
  • cost effective
  • shortest duration possible
  • host characteristics
  • adverse effects
  • when to refer
23
goals of AMT
destroy/suppress growth of pathogen with selective toxicity so the normal host defences can control the ifnection
24
pharmocokinetic properties of antimicrobials
PK- concerned with the time course of antimicrobial concentration T>MIC: time that the plasma concentration remains above the Minimum inhibitory concentration
25
pharmacodynamic properties of antimicrobials
PD- concerned with antimicrobial concentration and the antimicrobial effect MIC: minimum inhibitory concentration of the antimicrobial
26
types of killing patterns of antimicrobial drugs
1. concentration dependent (higher the peak blood level, the better the effect, suboptimal dosing can lead to resistance) -ciprofloxacin 2. time dependent (T>MIC for atleast 60% of time to produce a good effect) -penicillin, erythromycin
27
bactericidal and example
cause cell death and lysis -penicllin
28
bacteriostatic
inhibit growth allowing hist defence system time to remove
29
targets of antimicrobial action
1. cell wall synthesis inhibitors (bactericidal) 2. disruption of membrane permeability (bactericidal/static) 3. protein synthesis inhibitors (bctericidal) 4. essential metabolite synthesis inhibitiors (bacteriostatic)
30
unwanted effects of antimicrobial drugs
- superinfection: imbalance of pathogen/non pathogen gut flora which can cause a secondary infection by allowing oathogenic organisms to proliferate area -antibiotic related colitis: inflammtion of wall of colon, dont use anti diarrhoeal medicines -hypersensitivity reactions: preformed antibodies or immune cells with antigens -drug resistance: not enough dosing to kill pathogen but for it to adapt
31
antimicrobial resistance
when pathogens no longer respond to medicine making the infection harder to treat
32
intrinsic v acquired resistance
intrinsic: organisms make up that specifies the resistance (eg cell wall) acquired: organism mutates or acquires new DNA creating a resistance organism
33
mechanisms of antimicrobial resistance
1. barrier to entry- change in cell wall/outer membrane composition 2. efflux pump- antibiotic from inside bacteria to external environment 3. formation of biofilm- protective membrane that prevents penetration 4. enzyme inactiviation 5. alteration of target sites 6. increased synthesis of target 7. target adapation
34
microbes commonly involved in antimicrobial resistance
35
preventing antimicrobial resistance
- correct selection, dose and time for use (misuse, mis prescribing) - AMR stewardship - monitoring - hand hygiene/PPE - disinfecting/cleaning - vaccination