Pharmacology /Pharm Y2S2 - Cystic Fibrosis and Resistance Part 2
Pharm Y2S2 - Cystic Fibrosis and Resistance Part 2
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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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 |
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 |