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Pathophysiology & Pharmacology > Drugs For Treating Infection > Flashcards

Drugs For Treating Infection Flashcards

1
Q

Role for Anti-Inflammatory Drugs

A
  • When infected, the body will initiate both inflammatory and immunological responses.
    ~ Exposure to Pathogen
    ~ Damage Caused by Pathogen
    ~ Damage caused by excessive immune
    response.
  • Drugs that treat inflammation are always good choices to treat many of the signs and symptoms associated with infection.
    ~ Fever
    ~ Headache
    ~ Aches and Pains
    ~ Airway Congestion (with respiratory
    infection)
    > Swollen Tissues
    > Exudate
    > Mucus
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2
Q

Antimicrobials

A
  • Any drug used to treat microorganism infection.
    ~ Bacteria
    ~ Virus
    ~ Fungus
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3
Q

Bacteria

A
  • Forms of bacterial disease
    ~ Directly damaging cells by release of
    exotoxins
    > Initiates inflammatory response
    ~ Binding to cells
    > Initiates an inflammatory
    response by triggering the release
    of HT
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4
Q

Antibiotics

A
  • Substances that kill (bactericidal) or slow the growth of bacteria (bacteriostatic)
    ~ Bacteria are similar to human cells,
    but there are significant differences
    that antibiotics take advantage
    > Cell Wall
    > Protein Synthesis
    > DNA Synthesis
  • Antibiotics are only needed if body can’t kill it on its own
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5
Q

How are antibiotics that only slow growth effective in treatment of infection?

A

It lets the immune system catch up/let it do what it does

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6
Q

Antibiotics General Classes: Narrow Spectrum

A
  • Specific to a specific range or type of bacteria
    ~ Gram + = absorb a dye (“Gram Stain”)
    > Membrane inside cell wall
    ~ Gram - = doesn’t absorb dye
    > Membrane outside cell wall
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7
Q

Antibiotics General Classes: Extended Spectrum

A
  • Effective against gram positive and some gram negative bacteria.
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8
Q

Antibiotics General Classes: Broad Spectrum

A
  • Effective against a wide range of bacteria.
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9
Q

Antibiotics: Sulfonamides (Sulfa-Drugs)

A
  • Bacteriostatic (Broad Spectrum)
  • Interferes with bacteria protein synthesis decreasing reproduction.
  • Not used as first line of treatment due to resistance and side-effects.
    ~ Bacteria is not affected by drug
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10
Q

Antibiotics Sulfonamides: Adverse Reactions

A
  • Crystalization in the kidney
  • Skin Rash
  • Anaphylactic Shock
  • Photosensitivity
    ~ Skin is sensitive to the sun when not
    usually and results in a pretty bad
    sunburn
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11
Q

Antibiotics: Penicillins

A
  • Have a chemical structure (Beta-lactam ring) that allows binding to bacteria cell wall.
  • Bactericidal interrupts synthesis of the cell wall
  • Old form (penicillin-G) effective only against Gram positive bacteria (due to cell wall being the outermost layer)
  • Distributes into most tissues.
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12
Q

Antibiotics: Penicillins Old Form vs New Form

A
  • Most of old form inactivated by stomach acid
  • Can also be inactivated by an enzyme produced by bacteria (penilinase) that breaks down the Beta-lactam ring
    ~ New forms more stable in stomach
    acid, are resistant to penicillinase and
    are wider spectrum
    ~ Some penicillins are combined with
    another drug that inhibits
    penicillinase.
    > Augmentin - Amoxicillin +
    Clavulanate
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13
Q

Antibiotics: Penicillin Allergy

A
  • 10% of population allergic.
    ~ Skin Rash
    ~ Anaphylactic Shock
  • If allergic to one form of penicillin, all others should be avoided
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14
Q

Antibiotics: Macrolides

A
  • Bacteriostatic-narrow to broad spectrum
  • Interferes with bacteria protein synthesis decreasing reproduction.
  • Enter via active transport
  • Erythromycin (E-Mycin)
  • Clarithromycin (Biaxin)
  • Azithromycin (Zithromax)
  • Vancomycin
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15
Q

Antibiotics: Macrolides Adverse Effects

A
  • Heartburn
  • Nausea
  • Vomiting
  • Taking with food can lessen GI problems, but can decrease absorption
    ~ Decrease absorption due to binding
    with minerals
    > Calcium
    > Magnesium
    > Zinc
    > Iron
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16
Q

Antibiotics: Tetracyclines

A
  • Bacteriostatic - broad spectrum
    ~ Intereres with bacteria protein
    synthesis decreasing reproduction.
    ~ Enter bacteria via active transport.
  • Not used as first line of treatment due to resistance and side-effects. Used mostly as an alternative in patients with allergies to more effective drugs.
  • Still used as primary treatment for some diseases:
    ~ Rocky Mountain Spotted Fever
    ~ Cholera
    ~ Lyme Disease
    ~ Some forms of Pneumonia
    ~ Stomach Ulcer Caused by Bacteria
    ~ Acne
17
Q

Antibiotics: Tetracyclines Absorption

A
  • Bind to minerals:
    ~ Calcium
    ~ Magnesium
    ~ Aluminum
    ~ Zinc
    ~ Iron
  • If binding occurs in the Gl tract absorption will be reduced.
    ~ Should be taken 1-2 hours before a
    meal.
  • Can bind to calcium used to build bones and tooth enamel
    ~ Not used for children under 8 or
    pregnant women
  • Taking with food can lessen GI problems, but can decrease absorption
18
Q

Antibiotics: Tetracyclines Adverse Effects

A
  • Heart burn
  • Nausea
  • Vomiting
  • Diarrhea
  • Photosensitivity
19
Q

Antibiotics: Cephalosporins

A
  • Very similar to penicillins:
    ~ Have a chemical structure (Beta-
    lactam ring) that allows binding to
    bacteria cell wall.
    ~ Bactericidal interrupts synthesis of cell
    wall
    ~ Bacteria produce an enzyme
    (cephalosporinase) that breaks the
    Beta-lactam ring
20
Q

Antibiotics: Cephalosporins vs Penicillin

A
  • Cephalosporins are better for people no allergic to penicillin
  • Allergic reaction especially serious reaction is very rare
  • Stomach acid does it break it down as easily
21
Q

Antibiotics: Cephalosporins Generations

A
  • First Generation (oldest)
    ~ Effective against Gram positive
    bacteria.
  • Second Generation
    ~ Extended Spectrum
    ~ Somewhat resistant to
    cephalosporinase.
  • Third Generation
    ~ Broader spectrum and much more
    cephalosporinase resistant.
  • Fourth Generation (newest)
    ~ Broad spectrum and best resistance
    to cephalosporinase (the protein
    bacteria makes) = very good
22
Q

Antibiotics: Fluoroquinolones

A
  • Bactericidal - Broad Spectrum
    ~ Inhibits DNA synthesis.
    ~ Penetrates into most tissues.
  • Highly effective, orally administered.
  • Can bind to certain minerals so should not be taken with food.
23
Q

Antibiotics: Fluoroquinolones Adverse Reactions

A
  • Most are very mild.
    ~ Nausea
    ~ Vomiting
    ~ Headache
    ~ Dizziness
    ~ Photosensitivity
    ~ Rash
  • Musculoskeletal (rare)
    ~ Tendonitis/Tendon Rupture (more
    common in the old or those taking
    corticosteroids)
    ~ Cartilage Defects (especially bad for
    the young)
24
Q

Antibiotics: Selection Factors

A
  • Identification of Microorganisms
    ~ Experience and knowing which types
    of bacteria or other microorganisms
    typically infect certain areas or cause
    specific diseases
    ~ Lab (culture) results especially in the
    case of severe infection.
  • Site of Infection
    ~ Drugs must be able to penetrate site
    of infection.
    > Ex. In the case of cerebrospinal
    fluid infection drug must be able
    to cross blood-brain barrier.
  • The Patient
    ~ Drug Allergy
    ~ Age
    ~ Existence of other diseases.
25
Q

Why are Gram + bacterial infections more common?

A

They’re easier to treat

26
Q

Antibiotic Drug Resistance

A
  • Genetic make-up of an organism changes to give it an advantage when exposed to antibiotics.
    ~ Mutation
    ~ Transfer of genetic material.
    > Bacterium to Bacterium
    > Virus to Bacterium
27
Q

Antibiotic Drug Resistance: Mechanisms

A
  • Production of an enzyme that destroys the beta-lactum ring
  • Modify binding sites so drug cannot bind.
  • Modify transport proteins so drugs cannot enter.
  • Modify protein/DNA production.
28
Q

Superinfections

A
  • It is normal to have a number of bacteria living in and on the human body.
  • When antibiotics are given to treat an infection, they can also kill those that are normally occurring/do not cause infection.
  • If a drug resistant bacterium remains, it can take over and cause a difficulty to treat infection
  • Bad bacteria multiplies because it no longer had to compete for resources with “good” bacteria
29
Q

Virus

A
  • RNA/DNA contained in a protein shell or lipid layer.
  • Do not engage in metabolism or reproduce independently, must attach to living cells.
    ~ Divert cells’ capacities to synthesize
    virus nucleic acids and proteins for
    viral replication.
30
Q

Forms of Viral Disease

A
  • Kill Infected Cells
  • Interfere with a cell’s function.
  • Cause Cells to Proliferate
    ~ Human Papillomavirus/Warts
    ~ Cause Cancer
    ~ Hepatitis - Liver Cancer
31
Q

Antiviral Agents

A
  • Very difficult to develop drugs that kill virus since virus uses a host cell to reproduce and does not take part in living cell processes on its own.
    ~ Cannot exploit differences as easily as
    bacteria
    > If it kills the virus it will likely kill
    normal cells.
    > Few Strategies
    • Keep virus from binding or
    passing genetic RNA/DNA into
    cell
    • Inhibit enzymes virus uses
    within cell to build RNA/DNA
    • Inhibit release of new
    RNA/DNA/virus from cell
32
Q

Antiviral Agents

A
  • Some antiviral drugs have structures similar to RNA/DNA building blocks to stop RNA/DNA production
    ~ Adenine
    ~ Guanine
    ~ Thymine
    ~ Cytosine
  • Drugs are fairly specific and available for;
    ~ Herpes
    ~ Flu
    ~ Hepatitis
    ~ HIV
33
Q

Antiviral Agents Adverse Reactions

A
  • Weight Loss
  • Nausea
  • Anxiety
  • Lightheadedness
  • Insomnia
34
Q

Fungus

A
  • More complex than bacteria.
    ~ Have an actual nucleus.
    ~ Have advanced organelles.
    ~ Also have a cell wall
  • If it looks like our cells = really bad
35
Q

Anti-Fungal Agents

A
  • Fungi processes are very similar to human cells, more so than bacteria.
  • Systemic infections are more rare than superficial (skin) infections, but can be fatal.
36
Q

Anti-Fungal Agents: Systemic Infections

A
  • Systematic infections can occur by
    introducing fungus during invasive
    procedure or is inhaling fungus
    ~ After infecting the lungs the fungus
    can spread to other organs and
    become life-threatening.
    ~ Those who are immunocompromised
    or taking immunosuppressive drugs
    are most susceptible.
37
Q

Anti-Fungal Agents: Drug Action

A
  • Drug action is to disrupt the fungus cell wall causing leakage of cellular content
  • Drugs Available
    ~ Amphotericin B - Fungizone
    ~ Ketoconazole - Mylan
    ~ Fluconazole - Diflucan
    ~ Itraconazole - Sporanox
38
Q

Anti-Fungal Agents: Adverse Effects

A
  • Nephrotoxicity (kidney)
  • Hepatotoxicity (liver)
  • Headache
  • Abdominal Pain

Pathophysiology & Pharmacology (20 decks)

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