Term
| antimicrobial agents are vastly __________ |
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Definition
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Term
| availability of antimicrobials without prescription in developing countries has |
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Definition
| facilitated the development of resistance and limit therapeutic options in the treatment of life threatening infections |
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Term
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Definition
| when antimicrobial agents are ussed before the pathogen responsible is known. |
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Term
| justification of empiric therapy |
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Definition
| hope that early intervention will improve the outcome |
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Term
| empiric use of drugs can also be |
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Definition
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Term
| Approach in beginning Empiric therapy |
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Definition
a. formulate a clinical diagnosis
b. obtain lab specs
c.
formulatie microbioloigcal diagnosis
d. determine the necessity of empiric treatment
e. institute treatment |
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Term
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Definition
concominant disease state
prior adverse drug effects
impaired elimination
detoxification of the drug
age of the patient
pregnancy status |
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Term
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Definition
1) the kineetics of absorptiondistribution and elimination
abilit of the drug to be delivered to infection
toxicity
pharmacokinetics and pharmacodynamics. |
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Term
| causes of error in micro diagnosis |
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Definition
sample error (obtaining culture after antibiotics)
noncultivatible
non bacterial cause
needing special culture techniques |
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Term
| susceptibility testing-MIC, MBC |
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Definition
minimal inhibitory concnetration and minimal bactericidal concentration
only MICs routinely measured in most infetions
MBC in cases of bactericidal therapy |
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Term
| The therapeutic response may be monitored |
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Definition
| microbiologically or clinically |
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Term
| bactericidal should be used |
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Definition
| in immunocompromised patients |
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Term
| bactericidal agenst can be divided into two groups |
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Definition
concentration dependent killing
time dependent killing |
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Term
| when you think concentration dependent killing you should think |
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Definition
| aminoglycosides and quniolones |
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Term
|
Definition
| beta lactams and vancomycins |
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Term
| concentration depenent killing |
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Definition
rate and extent of killing increases with increasing drug concentrations
responsible for once daily dosings |
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Term
| time dependent bactericidal |
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Definition
| continues as long as serum concentration is greate rthan MBC |
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Term
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Definition
| [ersistent suppression of bacaterial growth after limited exposure to antimicrobial agent |
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Term
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Definition
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Term
| crossreactions between penicillin nad cephalosporins is |
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Definition
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Term
| cross reaction between penicillin and carbamapens may exceed |
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Definition
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Term
| aztreonam and penicillin cross reaction |
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Definition
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Term
| groups with increased adverse reaction to antimicrobials |
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Definition
| occurs with increased frequency in several groups including neonates geriatric patients, renal failure patients and AIDS patients |
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Term
| dosage adjustment is encessary for patients with_____ failure |
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Definition
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Term
| several drugs are ______ for patients with renal failure |
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Definition
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Term
| AIDS patients have unusually high reactions to certain drugs including |
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Definition
clindamycin
aminopenicillin
sulfonamides |
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Term
| why use combination therapy? |
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Definition
broad specturm empiric therapy in ill patients
trat polymicrobial infections such as abdominal anscesses
decrease the emergence of resistant strain
decrease toxicity of one drug
to obtain enhanced killing or inhibition |
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Term
| fractional inhibitory concentration |
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Definition
| MIC in combination/MIC alone |
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Term
| for what has hte need for synergistic actions been clerly established? |
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Definition
enterococcol endocarditis
bactericidal necessary
penicillin/ampicillin in combination with gentomicing or sterptomucin is better than monotheraopy. |
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Term
| neutropenic cancer patient with gram negative bacteria febrile |
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Definition
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Term
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Definition
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Term
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Definition
| trimethoprinm-sulfamethoxazole |
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Term
| three mechanisms of antimicrobial synergism |
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Definition
blockade of steps in metabolic sequnce trimethoprim sufamethoazole is the best known example of this mechanism
inhibition of enzymatic inhibition
inhancement of antimicrobial agent uptake
penciliion and other cell wall active agents can increase the uptak of aminoglycosides in staph enterococco streptococci |
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Term
| mechanisms of antagonistic action |
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Definition
inhibition of cidal activity by static agent
tetraculcines and cholampneical can antagozinw the action of abactericidal cell wall activ eagents
induction of enzumatic incactivation
pseudonoman, serratia and citrobacter possess inducible eta lactamases.
put a beta lactamase inducer in with an endogenous beta lactam that is hydropzable and you have problems. |
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Term
| guidelines for surgical prophylactic |
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Definition
active against surgical pathogens
proven efficacy
achieve concentrations greater than the MIC
shortest course
narrow
least expensive |
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Term
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Definition
prophylactic of chocie for head neck gastroduodenal biliary gynecologic clean procedures
primarily against staphlococcus
sttaph aureus |
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