Rational Drug Therapy

Front 1

Decisions in Antibacterial Therapy

Back 1

1) Determine the need for antibacterial therapy
2) Maximize the efficacy of the antibacterial therapy
3) Use an appropriate dosage regimen
4) consider the patient and client
5) monitor results of treatment

Front 2

MIC

Back 2

minimum inhibitory concentration = lowest concentration of antibac agent at which there is no viible growth of bacteria in broth

Front 3

MBC

Back 3

Minimum Bactericidal Concentration = lowest concentration of an antibacterial agent that actually kills all of the bac growth in broth when checked by plating out on agar (not routinely done)

Front 4

Kirby Bauer method of susceptibility testing

Back 4

1) antibacterials diffuse into agar at a known rate, decreasing in concentration w/ the distance from the disk
2) microbial growth inhibited by drug produces a zone of no growth that correlates inversely w/ an MIC of the drug
3) Each drug has its own size standard for the zone of no growth for calling a bacterium sensitive, intermediate and resistant

Front 5

Flexible

Back 5

Category for select antibacterials (fluoroquinolones) in which appropriate dosing modifications are allowed; designed to reach higher tissue concentrations at which the bacterium is susceptible

Front 6

Breakpoint MIC

Back 6

the approximate drug concentration that can reasonably be achieved safely in the plasma using the clinically accepted dose and route

Front 7

Things to consider when choosing an antibiotic

Back 7

1) susceptibility
2) Rte. of administration
3) timing of admin
4) toxicity
5) cost
6) immune status of patient
7) Rte of elimination
8) avoid contributing to resistant bacterial populations

Front 8

Properties of bactericidal agents

Back 8

1) kill susceptible organisms
2) do not rely on host defenses
3) MBC/MIC ratio is low
4) MBC safely attainable in host

Front 9

Properties of bacteriostatic agents

Back 9

1) inhibit growth of susceptible organisms
2) Rely on host defenses
3) MBC/MIC ratio is high
4) MBC not safely attainable

Front 10

Combo therapy: synergism

Back 10

combination therapy enhances performance of both drugs
E.g. B-lactams + aminoglycosides, amoxi + clav, sulfonamides + trimethoprim

Front 11

Combo therapy: Additive

Back 11

E.g. Chloramphenicol + tetracyclines; clindamycin + aminoglycosides; imipenem + vanco

Front 12

Combo therapy: Antagonistic

Back 12

e.g. bactericidal + bacteriostatic; chloramphenicol + clindamycin; B-lactam + B-lactam

Front 13

Depot Form

Back 13

long-acting

Front 14

Aqueous Form

Back 14

short-acting

Front 15

TI: Therapeutic Index

Back 15

Cmax - MIC = TI
TI can be lower in time-dependent drugs; need to be higher in concentration-dependent drugs