PHRM 1006 Week 9 Notes

Virtual Class Overview

  • Course: PHRM 1006
  • Week: 9
  • Key Topic: Antibiotics and Patient Safety

Kahoot Activity

  • Engaging quiz platform used to reinforce learning points on beta-lactams and beta-lactamase inhibitors.

Learning Point: Beta-lactams vs. Beta-lactamase Inhibitors

  • Beta-lactams:

    • A class of antibiotics that includes penicillin and its derivatives (e.g., amoxicillin).
    • Mechanism of action: Inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs).
    • Common indications: Treating infections caused by susceptible bacteria.

  • Beta-lactamase Inhibitors:

    • Compounds that inhibit the enzyme beta-lactamase, which some bacteria produce to resist the effects of beta-lactam antibiotics.
    • Often administered in combination with beta-lactams to enhance efficacy.
    • Examples: Clavulanic acid (combined with amoxicillin to form amoxicillin/clavulanate).

Application Question: Amoxicillin Prescription

Scenario: A new patient has been prescribed amoxicillin for a sinus infection but reports an allergy to penicillin that caused an itchy rash.

Concerns to Report to the Pharmacist:

  • Patient Allergy:

    • Allergy to penicillin is significant as amoxicillin is a derivative. Risk of cross-reactivity exists, potentially leading to adverse effects.

  • Severity of Reaction:

    • Determine if the allergic reaction was mild (itchy rash) or severe (anaphylaxis, etc.). Important for risk assessment.
Factors to Consider When Choosing an Antibiotic:

  1. Allergy History:

    • Definition: Assessment of patient's previous reactions to antibiotics.
    • Application: Avoid drugs with similar structures (e.g., amoxicillin if allergic to penicillin).

  2. Type of Infection:

    • Definition: Nature and site of the infection (e.g., respiratory, urinary, etc.).
    • Application: Match antibiotic spectrum of activity with the causative organism.

  3. Bacterial Resistance:

    • Definition: The prevalence of resistant strains in the community or specific patient history.
    • Application: Choose an antibiotic that is effective against resistant bacteria when necessary.

  4. Patient Factors:

    • Definition: Considerations such as age, renal function, liver function, and other comorbidities.
    • Application: Adjust dosage or drug selection based on patient's individual health status and potential contraindications.

  5. Drug Interactions:

    • Definition: Existences of potential interactions with other medications the patient is taking.
    • Application: Assess for possible adverse effects on therapy effectiveness or increased toxicity.
Defining Factors for the Patient:
  • Provide individualized assessment for each factor based on the patient's profile and history, ensuring a safe and effective choice of antibiotic treatment.