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ANTIBIOTICS 101 Infection Preventionists User Guide

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ED50 (median effective dose) is the dose at which 50% of a group of pts show the effect. ... Sometimes something worth doing is worth overdoing. David Letterman ... – PowerPoint PPT presentation

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Title: ANTIBIOTICS 101 Infection Preventionists User Guide


1
ANTIBIOTICS 101 Infection Preventionists User
Guide
  • Susan M. Burns BSMT, CIC
  • SMB CONSULTING LLC
  • Henry Ford Hospital
  • New Center Community Mental Health

2
ANTIBIOTIC BASICS
  • Antimicrobial Any agent that will inhibit the
    growth or kill microorganisms.
  • Antibiotic An antimicrobial agent that is
    either natural or semisynthetic in origin.
  • Antibacterial An antimicrobial that inhibits
    (bacteriostatic) or kills (bactericidal) a
    pathogenic bacteria.
  • Not all antibacterial agents are antibiotics.
  • All have selective toxicity the ability to work
    without damaging host cells.

3
ANTIBIOTIC CHARACTERISTICS
  • SPECTRUM
  • targeted
  • broad
  • ROUTE OF ADMINISTRATION
  • Intravenous
  • Intramuscular
  • Oral
  • PLASMA LEVELS
  • Levels should reach above the MIC to maintain
    effectiveness
  • TISSUE PENETRATION

4
ANTIBIOTIC CHARACTERISTICS
  • PROTEIN BINDING
  • Unbound
  • Protein bound
  • HALF-LIFE
  • Short multiple dosing requirements
  • Long less frequent longer acting
  • ROUTE OF EXCRETION
  • Kidney may be toxic with renal impairment
  • Liver may cause severe diarrhea

5
Antibiotic Targeting
  • 1st generation cephalosporins are more active
    against gram-positives, 3rd generations against
    gram-negatives
  • The 2nd genration chephalosporins cefoxitin,
    cefotetan are active against gram-negative
    anaerobes (B. fragilis)
  • Ceftazidime and cefepime are the most active
    against Ps. aeruginosa

6
Antibiotic Targeting
  • Levofloxacin, gatifloxacin, moxifloxacin are more
    active against Strep pneumoniae
  • Ciprofloxacin is the most active against Ps.
    Aeruginosa

7
Antibiotic Targeting
8
PHARMACODYNAMICS
  • Clinical effect
  • Therapeutic effects are intended
  • (treat or prevent a disease/relieve symptoms)
  • Adverse effects are not intended
    (shakes/fevers/allergic reactions)
  • Mechanism of Action
  • Method that drug exerts its effects
  • Most drugs utilize a receptor site within a cell
  • Cell membranes
  • Enzymes

9
PHARMACODYNAMICS
  • Measurement of Drug effects
  • Dose-response curve
  • (minimum effective dose maximum dose)
  • Potency
  • (relative amount of drug required to produce an
    effect)
  • Time-Response Curve
  • Onset of action
  • Duration of action

10
PHARMACODYNAMICS

DOSE PERCENT CURVE ED50 (median effective dose)
is the dose at which 50 of a group of pts show
the effect.
TIME-RESPONSE CURVE Curve illustrates onset of
action and duration of action
11
PHARMACOKINETICS
  • Absorption
  • Process by which a drug enters the circulatory
    system
  • Intravenous immediate absorption
  • Oral prolonged absorption
  • Drug dosage
  • Acidity/Alkalinity of stomach/intestine
  • Rate of gastric emptying
  • Presence of food in the stomach

12
PHARMACOKINETICS
  • DISTRIBUtion
  • Transport of drug thoughout the body
  • Blood flow to tissues
  • Heart, liver, and kidneys - high amount of blood
    flow
  • Muscle, fat low amount of blood flow
  • Lipid solubility
  • How effective the drug will dissolve cell
    membranes
  • Plasma-protein Binding
  • High protein bound drug has a smaller amount of
    drug free to act at the receptor site
  • Drug interactions can occur if two highly bound
    drugs are administered together they cancel
    the binding and may cause adverse side effects

13
PHARMACOKINETICS
  • METABOLISM
  • Chemical transformation of a drug into another
    form metabolite.
  • Excretion
  • Removal of drug and drug metabolites from the
    body.
  • Liver
  • Kidneys

14
THERAPEUTIC LEVELS OF DRUG
  • Bioavailability
  • Measure of the rate extent of drug absorption

15
THERAPEUTIC LEVELS OF DRUG
  • Drug Elimination
  • Removal of active drug from the blood thru
    metabolism and excretion.
  • Half-life time for ½ of the concentration of
    drug to be eliminated.
  • Steady-state Concentration
  • Drug level in blood becomes relatively stable
  • Loading dose
  • Maintenance dose
  • Dosing time intervals

16
THERAPEUTIC LEVELS OF DRUG
  • Time above the MIC

17
ANTIBIOTIC STEWARDSHIP
  • Choosing the right drug for the patient
  • Antibiotic
  • Administration route
  • Maintain plasma levels of the drug
  • Monitor kidney and liver function
  • Microbiology susceptibility rates monitor
    repeat culture results
  • Narrow antibiotic spectrum whenever possible

18
Sometimes something worth doing is worth overdoing
  • David Letterman
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