Pharmacology /Pharm Y2S2 - Cystic Fibrosis and Resistance Part 2

Pharm Y2S2 - Cystic Fibrosis and Resistance Part 2

Pharmacology26 CardsCreated about 2 months ago

This flashcard deck covers key concepts related to cystic fibrosis treatment and antibiotic resistance, including drug dosages, definitions, and treatment protocols.

What dose of azithromycin improves FEV1?

100mg/kg
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Key Terms

Term
Definition
What dose of azithromycin improves FEV1?
100mg/kg
Definition of infective exacerbation (according to CF trust clinical standards)
reduction in FEV to <50% acute changes on X-ray increased breathlessness or decreased tolerance to exercise
What actions would be taken in CF diagnosis in hospital?
sputum sample IV access admission Empirical antibiotics
Give 2 examples of empirical antibiotics
Ceftazidime: 3rd gen cephalosporin with a large MIC range | - Tobramycin: aminoglycoside with favourable nephrotoxicity
What are cephalosporins?
Beta lactam antibiotics which work in a similar to way to pencillin by blocking cell wall synthesis.
What particular drug class is resistant to beta-lactamases
3rd generation cephalosporins

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TermDefinition
What dose of azithromycin improves FEV1?
100mg/kg
Definition of infective exacerbation (according to CF trust clinical standards)
reduction in FEV to <50% acute changes on X-ray increased breathlessness or decreased tolerance to exercise
What actions would be taken in CF diagnosis in hospital?
sputum sample IV access admission Empirical antibiotics
Give 2 examples of empirical antibiotics
Ceftazidime: 3rd gen cephalosporin with a large MIC range | - Tobramycin: aminoglycoside with favourable nephrotoxicity
What are cephalosporins?
Beta lactam antibiotics which work in a similar to way to pencillin by blocking cell wall synthesis.
What particular drug class is resistant to beta-lactamases
3rd generation cephalosporins
Which bacteria produce 'Extended spectrum beta lactase'?
E.coli and Enterbacter cloacae - the genes for resistance are transferred by plasmid DNA transfer
At what level are aminoglycosides nephrotoxic?
2mg/L
At what level are aminoglycosides ototoxic?
8-12mg/L
What is IVAB therapy?
Given to CF patients experiencing frequent exacerbations. 3 month cycles of 2 weeks treatment and 3 monthly sputum samples. This reduces hospital admission and suppresses the development of infection.
What is MRSA?
A gram negative coccoid bacterium resistant to all beta lactam antibiotics.
Which antibiotics is MRSA resistance to?
penicillins cephalosporins carbapenems some are resistant to: macrocodes, quinolone and clindamycins.
What percentage of the population is colonised with S.aureus?
~30% - most are asymptomatic
What are the usual sites of S.aureus infection?
Anterior nares, axilla and perineum
How can S.aureus infection be reduced?
screening at risk patients, isolating patients with MRSA decontaminating with skin wash, nasal ointment and mouthwash for 5
What symptoms with patients with a S.aureus infection have?
high temp high white cell count inflammation at infection site
What is the 1st line treatment for S aureus ?
IV vancomycin or teicoplanin for systemic infections
What is the 2nd line treatment for S aureus?
Linezolid, daptomycin and tigecycline
What are multi-resistant coliforms?
Gram negative bacilli found in the gut such as E.coli, Klebsiella pneumoniae and enterobacter.
Where are enterococci found?
In the gut
What kind of patients are easily colonised by enterococci?
Patients who take antibiotics frequently - infections are i/v line associated.
How can CDI be acquired?
cross infection or toxigenic strain
What are the symptoms of CDI?
mild diarrhoea ulceration bleeding from the colon
What is mild CDI treated with?
Metronidazole
What is severe CDI treated with?
Vancomycin
Which antibiotics should be avoided in CDI?
Fluoroquinolone, cephalosporins and clindamycin