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23 Cards in this Set
- Front
- Back
Selective Toxicity
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exploiting differences between host and infectious agent.
-cell structures -biochemical pathways -pathways mediated by evolutionarily distinct analogs -growth characteristics |
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chemotherapy efficacy, host determinants
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determined by patient immunocompetency, drug pharmacokinetics, patient age, pregnancy
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chemotherapy efficacy, target determinants
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bug species, body burden, growth rate, location of infection
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bactericidal
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kills bacteria
-better for immunocompromised patients -concentration and time dependent |
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bacteriostatic
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stops growth
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antimicrobial resistance
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1. misdiagnosis
2. inherent resistance 3. acquired resitance |
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acquired antimicrobial resistance
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-genetic: mutations, chromosomal resistance, horizontal gene transfer
-non-genetic: growth latency, protplasms |
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>70%
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nosocomial infectious agent's rate of resistance to drugs commonly used against them
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antimicrobial resistance in a health-care setting promoted by:
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extensive antimicrobial use, transmission of infection, presence of susceptible hosts
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empiric treatment
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diagnosis and treatment based on profile of presenting clinical signs
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in vivo MIC considerations
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1.infection sight drug concentration
2.anatomic location of infection - e.g. cross BBB? in urinary bladder? |
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broad spectrum agent
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works against both gram positive and gram negative bugs.
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disadvantage to using broad spectrum antibiotic
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especially if taken orally, these agents indiscriminately kill off pathogenic bugs and normal flora - may be even allowing overgrowth of some species leading to secondary pathogenesis. e.g. C. Difficile pseudomembranous colitis.
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narrow spectrum
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antibiotic effective against limited range of bacteria
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drug administration routes
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1.oral
2.IM (parenteral) 3.IV (parenteral) 4.Topical |
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Drug-drug interactions
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1.synergistic (0+0=1)
2.antagonistic(1+1=) 3.antimicrobial and other |
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synergistic interaction
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antimicrobial and antimicrobial
1.drugs block sequential steps in pathway 2.enhance uptake of other antimicrobial 3.inhibit other drug's inactivating enzyme |
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antagonistic interaction
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antimicrobial and antimicrobial
1.admin of -cidal and -static together 2.induction of drug metabolizing enzyme. |
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anti-microbial and other drug interaction modes
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1. induction or inhibition of CYP450
2. cytotoxic or immunosuppresive agent 3. enterohepatic cycling. |
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combination anti-biotic therapy
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1.mixed bacterial infecs
2.unknown bacterial infecs (cover bases) 3.prevent emergence of resistance against any one agent 4.anti-viral, anti-fungal, anti-cancer regimens |
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combination antibiotic therapy risks
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-supetoxicity (spread out organ toxicity)
-emergence of multi-resistance -cost -antagonism |
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prophylactic antibiotic use
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1.pre-surgery to counter risk of infect from gut flora
2.pre-surgery to counter risk of wound infection 3.sexual contacts of someone with STD |
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superinfection
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When you discover evidence a second infection has emerged on top of the infection you initially began treating, maybe an adverse effect of your antibiotic choice.
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