Pharm Exam 2

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Pharm Exam 2
2011-10-01 20:02:01
Drugs used pain antirheumatic agens antigout agents immune system

Drugs used for pain, antirheumatic agens, antigout agents, drugs affecting immune system
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  1. Chemotherapy
    using chemicals to fight agents
  2. selective toxicity
    • toxic only to targeted microbe
    • not toxic to host
    • this is the goal; not always achieved
  3. narrow spectrum antibiotic
    • very specific antibiotic
    • fights just certain bacteria
  4. broad spectrum antibiotic
    • not specific
    • fights a wide range of bacteria
  5. gram negative bacteria
    Has an outer membrane
  6. classification of antibiotics
    drugs work on:
    • cell wall synthesis
    • cell membrane permeability
    • protein synthesis
    • synthesis of nucleic acids
    • antimetabolites (disrupt metabolic rxns)
    • viral enzyme inhibitors
  7. Antibiotic resistance
    • Caused by overuse of antibiotics
    • Spontaneous mutation
    • Conjugation: transfer of resistance between bacteria
    • Food and animal industry
  8. Resistant forms of staphyloccoccus aureus & staphylococcus epidermis
    • Methicillin-resistant S. aureus (MRSA)
    • Methicillin-resistant S. epidermis (MRSE)
    • Treatment is with vancomycin
  9. Supra/super infections
    • Secondary infection caused by opportunistic infection resistant to current antiobiotic treatment
    • Normal flora keep each other in check
    • Antibiotics can kill off good bacteria
    • Other bacteria which may be antibiotic resistant flourish
  10. Suprainfection: C. diff (Clostridium difficile)
    • Caused by C. diff toxin following antibiotics (e.g., ampicillin, cephalosporins, clindamycin)
    • S/S: fever, adb cramping, watery diarrhea, blood or mucous in stoll
    • Tx: metronidazole (Flagyl) PO or vancomycin (Vancocin) PO
    • Tough to treat
    • Long course
  11. Selection of antibiotics
    • Id the organism
    • Drug sensitivity of organism
    • Host factors
    • Allergy
    • Penetration to site of infection
    • Patient variables (age, pregnancy, previous allergic rxn, genetic factors)
  12. Combination Therapy
    • Used for more complicated or severe infection (e.g., TB)
    • Synergy-increased effect
    • Prevents resistance (but could also lead to more resistance)
  13. Prophylactic Therapy
    • Surgery (cardiac, abdominal)
    • Bacterial endocarditis (often treated before dental procedures)
    • Patients that are immunosuppressed (HIV, neutropenic (low white cell count), recurrent UTI)
  14. Misuse of antimicrobial drugs
    • Untreatable infection
    • fever of unknown origin
    • improper dosage
    • lack of id of organism
    • omission of surgical drainage
  15. Every 8 hr ATC (around the clock)
    • Before you go to bed
    • when you wake up
    • 8 hrs later
  16. Culture and sensitivity (C/S)
    • Get sample from wound
    • Lab grows bacteria, treats with several antibiotics
    • Give general antibiotic until lab results
    • Treat with specific antibiotic
  17. Penicillins
    • Weaken bacterial cell wall causing bacteria to take up excessive water and rupture
    • Have beta lactam ring
    • Bactericidal
  18. Penicillin resistance
    • Inability of penicillin to reach target
    • Particularly a problem with gram neg bacteria
    • Inactivation of penicillins by bacterial enzymes
  19. Penicillinases
    • Enzymes that render penicillins and other beta lactam ring antibiotics inactive
    • Penicillins are combine with a beta-lactamase inhibitiors.
    • The antimicrobial spectrum is extended