Pharmacology notes

Apr 15th, 2015
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Pharmacology notes

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ANTIMICROBIAL THERAPYPrinciples of Drug Management;Antimicrobial prescription consideration;Patient factorsOrganismDrugDocumentation of infectionFactors altering kinetics;Age, renal / hepatic functionPrevious drug sensitivityGeneral health (resistance toinfection)pregnancyCulture /identificationAdverse drugreactionDrug interactionAntimicrobialsusceptibilityabsorptionTissue distributionRoute ofeliminationPatient factors; Documentation of infection;Whenever possible, the clinical suspicion of infection should be supported bylaboratory diagnosis. The appropriate specimens e.g. sputum, urine, pus, bloodetc. should be obtained before treatment is commenced. Age;o drug kinetics are influenced by age dependent pathways of elimination.Clinically important examples involving antimicrobial agents include;o relative deficiency of hepatic glucuronyl transferase in neonates leadingto accumulation of chloramphenicol.o Physiological decrease in renal function with age leading to anaccumulation of aminoglycosides in the elderly with a likelihood oftoxicity. Dose modification is necessary.o Tetracyclines in growing children (tooth discoloration) Renal and hepatic function;o Many commonly used antimicrobials are eliminated by the kidneys while afew undergo hepatic metabolism.o Dose modification is necessary in renal function impairment Drug sensitivity; Always ask about previous exposure to drugs. Sulphonamides, penicilli

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