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32 Cards in this Set
- Front
- Back
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penetration into interstitial fluid/lymph is proportional to
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antibiotic protein binding
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what type of agents are more likely to penetrate the BBB
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lipid soluble -> produce better CSF levels
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what do the following have in common:
vegetations on the endocardium, devitalized tissues sequestrum of bone, eye, and meninges |
notorious problem areas for antibiotic delivery
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__ show superior efficacy in treatment of bone and prostate infection
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quinolones
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___ can be inactivated by purulent material and low pH in abscesses
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aminoglycosides
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___ can be degraded by the presence of beta lactamase producing anaerobes
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penicillin
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hemoglobin in hematomas can bind ___ and ___, decreasing their activity
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penicillin and tetracycline
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what role do prosthetic joints, heart valves, Hickman catheters, and debris impaled in trauma play in infection
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they provide a nidus to which the organism can adhere, and impair local host defenses
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can pyelonephritis in the face of an impacted kidney stone in the ureter be treated by antibiotics alone
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no, the stone must be removed
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what special type of antibiotics are required to kill Listeria, Brucella, Legionella, Salmonella?
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ones that can achieve intracellular concentrations...erythromycin, rifampin, quinolones, tetracyclines
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penicillin cross reacts with...
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cephalosporins and penems
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decreased gastric acidity in...
decreased creatinine clearance in... impaired hepatic function in... |
children/elderly
elderly (even in the face of "normal" serum creat) neonates |
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binds to developing teeth and bone, causing discoloration and enamel hypoplasia
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tetracycline
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two drugs contraindicated in renal insufficiency
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tetracyclines (except doxycycline)
long acting sulfonamides |
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six drugs requiring dose modifications in renal insufficiency
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penicillins (except anti-staph penicillins)
aminoglycosides trimethoprim-sulfa quinolones vancomycin carbapenems (Please Alter The Quantity Very Carefully) |
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six drugs contraindicated in hepatic insufficiency
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Rifampin
Clindamycin Metronidazole Tetracycline Chloramphenicol Macrolides (Real Country Music Truckers Can't Mosh) |
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if bacteriostatic action is reversible at the MIC, and you eventually take the antibiotic away, what is killing dependent on?
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host defenses eradicating the bugs
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MLC ~ MIC?
vs. little killing at MIC |
bactericidal
vs. bacteristatic |
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name three infections where you would use bactericidal antibiotics
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endocarditis
febrile neutropenia meningitis |
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combo for enterococcal endocarditis
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1. penicillin (or ampicillin) to induce change in cell wall of enterococcus
+ 2. aminoglycoside to enter and kill bacteria => synergy against the organism |
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combo for pseudomonas aeruginosa
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extended spectrum antipseudomonal penicillins
+ aminoglycosides => synergy against the organism |
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inhibition of successive steps in folic acid metabolism (one by competitive inhibition of aminobenzoic acid, the other by enzymatic reduction of dihydrofolate)
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trimethoprim/sulfa
(=Septra, Bactrim T) |
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combo addition that can maintain the efficacy of otherwise hydrolyzable penicillins against staph a. and various gram neg rods
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clavulanic acid and sulbactum
(potent beta lactamase inhibitors) |
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two drugs with poor GI absorption so they are not used orally unless to treat GI infections
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aminoglycosides
vancomycin |
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three drugs that can cause injection site necrosis and are not given i.m.
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erythromycin
tetracycline 1st generation cephalosporins |
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absorption of i.m. antibiotics in which patient population can be impaired
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diabetics
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in which two medical conditions do i.m. injections not result in reliable blood levels, and should not be used
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shock
hypotension |
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in cases of poor BBB penetration, antibiotics (aminoglycosides) must be placed in the ___ directly by ___
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CSF
intrathecal or intraventricluar insertion |
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length of time to treat strep throat
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10 days
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UTI length of tx (cystitis, pyelonephritis, prostatitis)
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3 days for cystitis
14 days for pyelonephritis 21 days for prostatitis |
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viridans Streptococcal endocarditis length of tx
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2-4 weeks
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staph osteomyelitis length of tx
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4-6 weeks
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