cueFlash

Glossary of Block 4: Antibiotics- clinical aspects

Start Studying! Add Cards ↓

penetration into interstitial fluid/lymph is proportional to
antibiotic protein binding
what type of agents are more likely to penetrate the BBB
lipid soluble -> produce better CSF levels
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
__ show superior efficacy in treatment of bone and prostate infection
quinolones
___ can be inactivated by purulent material and low pH in abscesses
aminoglycosides
___ can be degraded by the presence of beta lactamase producing anaerobes
penicillin
hemoglobin in hematomas can bind ___ and ___, decreasing their activity
penicillin and tetracycline
what role do prosthetic joints, heart valves, Hickman catheters, and debris impaled in trauma play in infection
they provide a nidus to which the organism can adhere, and impair local host defenses
can pyelonephritis in the face of an impacted kidney stone in the ureter be treated by antibiotics alone
no, the stone must be removed
what special type of antibiotics are required to kill Listeria, Brucella, Legionella, Salmonella?
ones that can achieve intracellular concentrations...erythromycin, rifampin, quinolones, tetracyclines
penicillin cross reacts with...
cephalosporins and penems
decreased gastric acidity in...
decreased creatinine clearance in...
impaired hepatic function in...
children/elderly

elderly (even in the face of "normal" serum creat)

neonates
binds to developing teeth and bone, causing discoloration and enamel hypoplasia
tetracycline
two drugs contraindicated in renal insufficiency
tetracyclines (except doxycycline)

long acting sulfonamides
six drugs requiring dose modifications in renal insufficiency
penicillins (except anti-staph penicillins)
aminoglycosides
trimethoprim-sulfa
quinolones
vancomycin
carbapenems

(Please Alter The Quantity Very Carefully)
six drugs contraindicated in hepatic insufficiency
Rifampin
Clindamycin
Metronidazole
Tetracycline
Chloramphenicol
Macrolides

(Real Country Music Truckers Can't Mosh)
if bacteriostatic action is reversible at the MIC, and you eventually take the antibiotic away, what is killing dependent on?
host defenses eradicating the bugs
MLC ~ MIC?
vs.
little killing at MIC
bactericidal
vs.
bacteristatic
name three infections where you would use bactericidal antibiotics
endocarditis
febrile neutropenia
meningitis
combo for enterococcal endocarditis
1. penicillin (or ampicillin) to induce change in cell wall of enterococcus
+
2. aminoglycoside to enter and kill bacteria
=> synergy against the organism
combo for pseudomonas aeruginosa
extended spectrum antipseudomonal penicillins
+
aminoglycosides
=> synergy against the organism
inhibition of successive steps in folic acid metabolism (one by competitive inhibition of aminobenzoic acid, the other by enzymatic reduction of dihydrofolate)
trimethoprim/sulfa
(=Septra, Bactrim T)
combo addition that can maintain the efficacy of otherwise hydrolyzable penicillins against staph a. and various gram neg rods
clavulanic acid and sulbactum
(potent beta lactamase inhibitors)
two drugs with poor GI absorption so they are not used orally unless to treat GI infections
aminoglycosides
vancomycin
three drugs that can cause injection site necrosis and are not given i.m.
erythromycin
tetracycline
1st generation cephalosporins
absorption of i.m. antibiotics in which patient population can be impaired
diabetics
in which two medical conditions do i.m. injections not result in reliable blood levels, and should not be used
shock
hypotension
in cases of poor BBB penetration, antibiotics (aminoglycosides) must be placed in the ___ directly by ___
CSF

intrathecal or intraventricluar insertion
length of time to treat strep throat
10 days
UTI length of tx (cystitis, pyelonephritis, prostatitis)
3 days for cystitis
14 days for pyelonephritis
21 days for prostatitis
viridans Streptococcal endocarditis length of tx
2-4 weeks
staph osteomyelitis length of tx
4-6 weeks

Add Cards

You must Login or Register to add cards