This PDF deals with important guidelines, with respect to usage of antibiotics. This PDF outlines the important strategies involved while using antibiotics, and important factors involving antibiotic selection.
For proper use of medication rational drug use (RDU) is raised. Requirements of rational drug use and it's different steps and roles of pharmacists are described here.
For proper use of medication rational drug use (RDU) is raised. Requirements of rational drug use and it's different steps and roles of pharmacists are described here.
Rational use of antibiotics by M. Jagadeesh, Creative Educational Society's C...Dr. Jagadeesh Mangamoori
Rational use of antibiotics is extremely important as injudicious use can adversely affect the patient, cause emergence of antibiotic resistance and increase the cost of health care.
Introduction to daily activities of clinical pharmacist.
Drug therapy monitoring,
Medication chart review
Clinical Progress
Pharmacist intervention
Detection and management of ADRs
Patient medication adherence, Medication adherence, Causes of medication non-adherence, Problems linked with Medication Non-adherence, Factors affecting medication adherence, Patient related factors, Social and Economic factor, Disease related factor, Health care provider related factors, Therapy related factors, pharmacist role in the medication adherence, role of pharmacist in the medication adherence, monitoring of patient medication adherence, Direct method, Indirect method
Rational use of antibiotics by M. Jagadeesh, Creative Educational Society's C...Dr. Jagadeesh Mangamoori
Rational use of antibiotics is extremely important as injudicious use can adversely affect the patient, cause emergence of antibiotic resistance and increase the cost of health care.
Introduction to daily activities of clinical pharmacist.
Drug therapy monitoring,
Medication chart review
Clinical Progress
Pharmacist intervention
Detection and management of ADRs
Patient medication adherence, Medication adherence, Causes of medication non-adherence, Problems linked with Medication Non-adherence, Factors affecting medication adherence, Patient related factors, Social and Economic factor, Disease related factor, Health care provider related factors, Therapy related factors, pharmacist role in the medication adherence, role of pharmacist in the medication adherence, monitoring of patient medication adherence, Direct method, Indirect method
CDC Key Prevention Strategies for Antimicrobial Resistance Prevent Infection Step 1: Vaccinate Fact:
Influenza and pneumococcal vaccination of at-risk hospital patients and influenza vaccination of healthcare personnel will prevent infections.
Step 2: Get the catheters out Fact:
Catheters and other invasive devices are the # 1 exogenous cause of hospital-onset infections.
Diagnose & Treat Infection Effectively Step 3: Target the pathogen
Fact:
Appropriate antimicrobial therapy saves lives.
Step 4: Access the experts Fact:
Infectious diseases expert input improves the outcome of serious infections.
•
Use Antimicrobials Wisely
Step 5: Practice antimicrobial control Fact:
Programs to improve antimicrobial use are effective. (Antimicrobial Stewardship)
•
Step 6: Use local data
Fact:
The prevalence of resistance can vary by locality, patient population, hospital unit, and length of stay.
•
•
Step 7: Treat infection, not contamination Fact:
A major cause of antimicrobial overuse is “treatment” of contaminated cultures.
Step 8: Treat infection, not colonization Fact:
Step 9: Know when to say “no” to vancomycin Fact:
Vancomycin overuse promotes emergence, selection,and spread of resistant pathogens.
•
Step 10: Stop antimicrobial treatment Fact:
Failure to stop unnecessary antimicrobial treatment contributes to overuse and resistance.
Prevent Transmission
Step 11: Isolate the pathogen Fact:
Patient-to-patient spread of pathogens can be prevented.
•
Step 12: Break the chain of infection Fact:
Healthcare personnel can spread antimicrobial-resistant pathogens from patient to patient
Antimicrobial stewardship; is an activity that includes appropriate selection, dosing, route, and duration of antimicrobial therapy…..
Why is Antimicrobial Stewardship Important?
200-300 million antibiotics are prescribed annually….45% for outpatient use
25-40% of hospitalized patients receive antibiotics
10-70% are unnecessary or suboptimal
5% of hospitalized patients who receive antibiotics experience an Adverse reaction.
Health insurance companies will no longer reimburse for hospital acquired conditions deemed preventable.
Why is an antibiotic policy necessary?
To improve patient care by considered use of antibiotics for prophylaxis and therapy.
To rationalize the use of antibiotics.
To prevent or retard the emergence of resistant strains.
To improve education of junior doctors by providing guidelines for appropriate therapy
What are the clinical uses of antibiotics :
1. Therapeutic use:-
It is administration of an antimicrobial agent where substantial microbial infection has occurred.
2. Prophylactic Use:-
It is the use of antimicrobial agent before any infection has occurred to prevent a subsequent infection.
The Antimicrobial Stewardship Program (ASP) should be administered by multidisciplinary team (AST) composed of:
an infectious diseases (ID)physician
a clinical pharmacist with ID training,
a clinical microbiologist,
an IC professional,
Antibioti
For decades microbes, in particular bacteria, have become increasingly resistant to various antimicrobials.
The World Health Assembly’s endorsement of the Global Action Plan on Antimicrobial Resistance (AMR) in May 2015, and the Political Declaration of the High-Level Meeting of the General Assembly on AMR in September 2017, both recognize AMR as a global threat to public health.
These policy initiatives acknowledge overuse and misuse of antimicrobials as a main driver for development of resistance, as well as a need to optimize the use of antimicrobials.
The Global Action Plan on AMR sets out five strategic objectives as a blueprint for countries in developing national action plans (NAPs) on AMR:
Objective 1: Improve awareness and understanding of AMR through effective communication, education and training.
Objective 2: Strengthen the knowledge and evidence base through surveillance and research.
Objective 3: Reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures.
Objective 4: Optimize the use of antimicrobial medicines in human and animal health.
Objective 5: Develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.
Antimicrobial stewardship programmes optimize the use of antimicrobials, improve patient outcomes, reduce AMR and health-care-associated infections, and save health-care costs amongst others.
Today, AMS is one of three “pillars” of an integrated approach to health systems strengthening. The other two are infection prevention and control (IPC) and medicine and patient safety.
Linking all three pillars to other key components of infection management and health systems strengthening, such as AMR surveillance and adequate supply of quality assured medicines, promotes equitable and quality health care towards the goal of achieving universal health coverage
CDC has defined “Antimicrobial stewardship” as-
The right antibiotic
for the right patient,
at the right time,
with the right dose, and
the right route, causing
the least harm to the patient and future patients
Why AMSP is needed?
Antimicrobial Resistance (AMR)
Misuse and Over-use of Antimicrobials
Widespread Use of Antimicrobials in Other Sectors
Poor Antimicrobial Research
IMPLEMENTATION OF ANTIMICROBIAL STEWARDSHIP PROGRAM
Administrative Support (Leadership)
Formulating AMS Team
Infrastructure Support
Framing Antimicrobial Policy
Implementing AMS strategies
Education and Training
Should be publicly committed to the program.
Provide necessary funding and infrastructure support.
Multidisciplinary committee - responsible for framing, implementing and monitoring the compliance to antimicrobial policy of the hospital.
Led by the antimicrobial steward - infectious disease physician or infection control officer or clinical microbiologist.
Other members of AMS team - stewardship nurses
This presentation deals with pathophysiology of Parkinson's Disease.
Important headings, including normal physiology, etiological factors and clinical manifestations have been elucidated.
This powerpoint, deals with HIV pathophysiology, signs and symptoms, mode of transmission and diagnostic parameters.
Purely based on clinical pharmacist perspective.
This presentation deals with buprenorphine drug profile, from a clinical pharmacist perspective.
Summarized version of drug, including chief ADRs, interactions, and patient and health-care professional counselling tips have been mentioned.
This PDF deals with important catchpoints regarding the use of 5-alpha reductase inhibitors, their safety and efficacy stats, and important counselling tips.
This word document deals with summarized drug profile of cotrimoxazole. Important pharmacological headings, along with important counselling tips and drug catchpoints have also been elucidated.
This is my first word document, converted into pdf format!
This document deals with AMOXICILLIN drug profile in brief.
It includes significant pharmacological headings, including an additional heading, stating important catchpoints with respect to amoxicillin!
Food drug interactions with penicillins: by RxVichuZ!RxVichuZ
This is my 107th powerpoint...it deals with significant drug-food interactions when taking specific penicillins.
This is my first powerpoint that deals with drug interactions.
Do support!
Snake bite poisoning and its treatment by RxVichuZ!RxVichuZ
My 106th powerpoint...that deals with snake bite poisoning.
Different types of venomous snakes, their characteristics, envenomation features and treatment strategies have been explained in a summary.
Hope it is effective for the readers involved.
This powerpoint is a case presentation, that explains the case of ADCHF, with comorbidities, comprising HTN, CAD and DLP.
A summary on the recent advancements in HF management, along with justification of therapy provided, has been elucidated.
A note on home remedies and counselling tips has also been provided.
Directly acting antivirals and Visceral Leishmaniasis: A case reportRxVichuZ
This presentation deals with visceral leishmaniasis induced by directly acting antivirals in a patient with Hepatitis C infection.
Case details in summary, along with case report publication details have been summarized.
References have been provided below each slide.
...and this is my 100th powerpoint.....!!
Sincerely thanking everyone who have supported me in my journey till now :) :)
This powerpoint deals with drug mnemonics, easy to remember mnemonics, that can be helpful for easy memory of some aspects of Pharmacology!!
Happy reading!!
Acute coronary syndrome management by RxVichuZ! ;)RxVichuZ
This is my 99th powerpoint...
Deals with ACS(Acute coronary syndrome), its clinical features, and management strategies, based on standard guidelines and literatures.
RNTCP guidelines for tuberculosis management: Extended versionRxVichuZ
This presentation is an extension of the already made presentation before, that deals with RNTCP guidelines for some special aspects encountered during tuberculosis management, other than management of individual diagnoses alone.
Have a look!
Journal club presentation: by RxVichuZ!! ;)RxVichuZ
My 97th powerpoint... deals with the comparative study of efficacy of piperacillin-tazobactam, as compared to meropenem in the treatment of ESBL(Extended spectrum beta-lactamases) infections.
A summarized insight has been provided, using research article from JAMA.
PPI-INDUCED BICYTOPENIA: MATTER OF CONCERN by RxVichuZ! ;)RxVichuZ
This presentation deals with bicytopenia induced by proton pump inhibitors, that were reported and published as a Case Report by researchers from China.
References have been provided as a separate textbox under each slide, for extensive referencing into the same.
Dipeptidyl peptidase inhibitors(DPP-IV): A deep insightRxVichuZ
This presentation deals with DPP-IV inhibitors, that are implicated for use in diabetes mellitus. Generalized pharmacology, including a precise insight into individual drugs have been elucidated.
Principles of cancer chemotherapy: a deep insight by RxVichuZ!RxVichuZ
This powerpoint deals with principles of cancer chemotherapy, that includes headings regarding cancer definition, its etiology, diagnostic measures and general considerations to be observed while initiating anti-cancer regimens in patients.
Sulfonylureas for Diabetes: A deep insightRxVichuZ
This powerpoint presentation solely deals with Sulfonylureas, that come under Insulin secretagogues. Their complete pharmacological profile, with pharmacovigilance parameters, important catchpoints and mnemonics have been explained.
RNTCP guidelines for tuberculosis management by RxVichuZ! RxVichuZ
This powerpoint deals with RNTCP guidelines for TB management. Chiefly grouping of drugs for therapeutic utilities, cases involving RR-TB,INH-resistant TB,MDR-TB, CDR-TB,PDR-TB and Mono drug resistant TB management strategies has been elucidated in precise form.
This word document deals with the drug profile of amikacin. Important headings, with respect to its pharmacology, along with a note on important dosage regimens and antimicrobial spectrum, have also been mentioned, with reference to standard textbooks, guidelines and relevant articles.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
1. RATIONAL USE OF ANTIBIOTICS: A BRIEF
SUMMARY OF WHAT GUIDELINES SAY
- Dr. Vishnu R. Nair
WHAT IS AN ANTIBIOTIC?
“An antibiotic is a chemical, derived from microbes or synthetically, that has the
potential to either INHIBIT the growth of susceptible organism
(BACTERIOSTATIC EFFECT), or KILL them (BACTERICIDAL EFFECT),
at low concentrations.”
INDICATIONS FOR ANTIBIOTIC THERAPY: WHAT DO
GUIDELINES SAY?
Basically antibiotics can be administered to patients, on 3 different conditions:
1. Definitive therapy:
- Indicated for proven bacterial infections, in which the culprit microbe is
identified, by means of:
Staining of secretions/ fluids/ exudates
Culturing & sensitivity testing
Serological tests
- Based on test reports administer:
Narrow spectrum
Least toxic antibiotic
Cheap
2. 2. Empirical therapy:
- Indication is restricted to CRITICAL CASES ONLY
- CRITICAL CASE: Clinical situation, where time is insufficient for
bacterial test diagnosis, & strong doubt/affirmation of bacterial
infection exists
- Critical cases may include:
Septic shock
Immunocompromised patients, with severe systemic infections
High temperatures
Neutrophilic leukocytosis
High ESR, etc.
In such cases focus on broad-spectrum antibiotics, aiming at
covering maximum probable infective agents.
3. Prophylactic therapy:
Indicated for “susceptible patients, with the intention of preventing
specific infections, that can cause detrimental effects”
Prophylactic therapy for antibiotics includes situations like:
- Anti-rheumatic prophylaxis
- Prophylactic use of antibiotics in invasive medical procedures
(surgical prophylaxis)
- Prophylactic use of antibiotics in children suffering from viral
bronchiolitis.
FACTORS AFFECTING ANTIBIOTIC SELECTION:
3. Include:
Efficacy
Cost
Toxicity
Availability
Culture sensitivity
Least disturbance to normal flora (less risk of SUPERINFECTION)
Prevents development of drug resistance.
GENERAL GUIDELINES FOR ANTIBIOTIC USE:
Start antibiotics ONLY if there is evidence of infection
On starting antibiotic therapy better avoid new medications in the first
case (on proven reduced familiarity)
Never start antibiotics in response to patient pressure
Never prescribe antibiotics for viral infections (like common cold) for the
sake of patient satisfaction
Use antibiotics for sufficiently long periods
Avoid inadequate duration & dose of therapy
Do not change an antibiotic before giving the current one a fair trial
Consider cost-effectiveness of therapy, especially when changing antibiotics
(calculate cost for full duration of treatment)
Acquire sufficient information about limited number of drugs of proven
efficacy & their associated ADRs
Do not give single dose antibiotic therapy for fevers, without justifiable
localizing signs
Conduct culture sensitivity test of samples before therapy, whenever
possible
Avoid using too many antibiotics & drug combinations prevents poor
diagnosis & mismanagement
Avoid use of multiple antibiotics, except when TUBERCULOSIS is
diagnosed
Reserve new antibiotics for SERIOUS INFECTIONS
Prefer COMBINATION THERAPY, ONLY under the following
conditions:
- To extend covering spectrum of mixed infections
4. - To achieve synergistic bactericidal effects
- To prevent emergence of resistance organism
While focusing on combination therapy, care must be taken so as to prevent
concurrent usage of BACTERICIDAL and BACTERIOSTATIC drugs.
Concurrent use of both can nullify the bactericidal effects of responsible
drug.
Example: Concurrent use of PENICILLIN (bactericidal) and
CHLORAMPHENICOL (bacteriostatic) results in diminished bactericidal
of penicillin.
WORK WELL AND SMART!!
DR. VISHNU R. NAIR