Pharmacology notes

Apr 15th, 2015
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ANTIMICROBIAL THERAPYPrinciples of drug managementAntimicrobial prescription considerationPatient factorsOrganismDrugDocumentation of infectionFactors altering kinetics (age, renal/hepatic function)Previous drug sensitivityGeneral health (resistance to infection)PregnancyCulture/identificationAdverse drug reactionDrug interactionAntimicrobial susceptibilityAbsorptionTissue distributionRoute of elimination.I. PATIENT FACTORSDocumentation of infectionWhenever possible, the clinical suspicion of infection should be supported by laboratory diagnosis. The appropriate specimens e.g sputum, urine, pus, blood etc should be obtained before treatment is commencedAgeDrug kinetics are influenced by age dependent pathways of elimination. Clinically important examples involving antimicrobials agents includeRelative deficiency of hepatic glucuronyl transferase in neonates leading to accumulation of chloramphenicolPhysiological decrease in renal function with age leading to an accumulation of aminoglycosides in the elderly with a likelyhood if toxicity. Dose modification is necessaryTetracyclines in growing children (tooth discolouration)Renal and hepatic functionMany commonly used antimicrobials are eliminated by the kidneys while a few undergo hepatic metabolismDose modification is necessary in renal function impairmentDrug sensitivityAlways ask about previous exposure to drugsSulphonamides, Penicilins and cephalosporins are the antimicrobials most f

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