Medicine an Surgery notes

Apr 25th, 2015
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ANTIMICROBIAL THERAPY Principles of Drug Management;Antimicrobial prescription consideration;Patient factorsOrganismDrugDocumentation of infectionFactors altering kinetics; Age, renal / hepatic functionPrevious drug sensitivityGeneral health (resistance to infection)pregnancyCulture / identificationAdverse drug reactionDrug interactionAntimicrobial susceptibilityabsorptionTissue distributionRoute of eliminationPatient factors;Documentation of infection;Whenever 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 commenced.Age; drug kinetics are influenced by age dependent pathways of elimination. Clinically important examples involving antimicrobial agents include;relative deficiency of hepatic glucuronyl transferase in neonates leading to accumulation of chloramphenicol.Physiological decrease in renal function with age leading to an accumulation of aminoglycosides in the elderly with a likelihood of toxicity. Dose modification is necessary.Tetracyclines in growing children (tooth discoloration)Renal and hepatic function;Many commonly used antimicrobials are eliminated by the kidneys while a few undergo hepatic metabolism. Dose modification is necessary in renal function impairmentDrug sensitivity;Always ask about previous exposure to drugs. Penicillins and cephalosporins are the antimicrobials mos

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