HIST250 Exam4

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  1. What do bacteria look like?
    Classified by shape and arrangement:

    • - Spherical (Cocci)
    • - Rod-like (Bacilli)
    • - Curved Rods (Spirilla)
    • - Pairs (Diplo)
    • - Chains (Strepto)
    • - Clusters (Staphylo)
  2. Where do Antibacterials come from?
    • Sources:
    • - Soil microorganisms (mold - Penicillin)
    • - Chemical synthesis (Antimicrobials)
  3. An agent or drug that destroys bacteria
  4. Drugs that slow or retard the multiplication of bacteria
  5. Drug Resistance
    • - Antibiotics can lose their effect
    • "Battle of the Bugs"

    - Bacteria can acquire resistance genes through exchanging genes with other bacteria
  6. How were Sulfonamides discovered?
    Discovered as a byproduct of the dye industry in the 1930s but limited use since the discovery of Penicillin.
  7. Actions of Sulfonamides
    • Primarilary bacteriostatic
    • Blocks synthesis of folic acid and thus bacteria cannot grow
  8. What are Sulfonamides used for?
    • Used to control urinary tract infections
    • Used in second- and third-degree burn treatments
  9. Examples of Sulfonamides
    • Sulfadiazine
    • Sulfamethizole
    • Sulfisoxazole
  10. Adverse reactions of Sulfonamides
    • Managing adverse reactions of Sulfonamides may require discontinuation of drug
    • Stevens-Johnson Syndrome- serious and sometimes fatal hypersensitivity beginning with hive-like lesions on the face and head
    • Loss of appetite, nausea, and vomiting
    • Diarrhea, abdominal pain, chills, fever
    • Fairly normal for skin and urin to be orange-yellow and crystals may form in the urine
    • For burn victims, may note a stinging when medication is applied
  11. What is Stevens-Johnson Syndrome?
    Serious and sometimes fatal hypersensitivity to Sulfonamides beginning with hive-like lesions on the face and head.
  12. Action of first generation Penicillin
    • Narrow antibacterial spectrum
    • - Mechanism of action involves interference with cell wall synthesis
  13. How can Penicillin G Benzathine (Bicillin) be administered and produces what type of effect?
    • It can be administered IM
    • Produces effects that last approximately 1 month
  14. Adverse effects of first generation Penicillin
    Hypersensitivity (allergic) reaction within the body
  15. How are first generation Penicillin drugs usually administered?
    IV, IM, or PO
  16. Actions of second generation Penicillin
    • Extended or broad spectrum
    • Works on E. coli
  17. Examples of second generation Penicillin drugs
    • Ampicillin (Omnipen)
    • Amoxicillin
  18. How are second generation Penicillin drugs administered?
    All can be taken orally
  19. Actions of third generation Penicillin
    Broader spectrum than the second generation Penicillin
  20. Examples of third generation Penicillin drugs
    • Carenicillin (Geocillin)
    • Ticarcillin (Ticar)
  21. What is the third generation Penicillin drug, Carenicillin (Geocillin) used to treat?
    Only used to treat UTI
  22. What is the third generation Penicillin drug, Ticarcillin (Ticar) used to treat?
    Used to treat more serious respiratory, urinary, and bacteremic infections.
  23. Actions of fourth generation Penicillin
    Even wider specturm than third generation Penicillin
  24. Example(s) of fourth generation Penicillin drugs
    Monosodium salts
  25. Administration of fourth generation Penicillin drugs
    Require parenteral administration (i.e. IV, IM, SC)
  26. What are fourth generation Penicillin drugs used to treat?
    Often combination therapy of the generations will be used for an especially resistant bacteria.
  27. Adverse reactions of Penicillins
    • Nausea, vomiting
    • Diarrhea
    • Sore tongue or mouth
    • Fever
    • Pain at site of injection
    • Superinfection
  28. Hypersensitivity reactions of Penicillins
    • Anaphylactic shock - severe form of hypersensitivity which occurs more often after IV administration than oral
    • Once a patient is allergic to penicillin, it will always continue and patient may also be found to be allergic to Cephalosporin
  29. Allergy to drugs in the same or related group
  30. Synonymous with cross-allergenicity
  31. Contraindications and Precautions of Penicillins
    • Contraindicated if allergic to Penicillin
    • Used cautiously with:
    • - Renal disease or gastrointestinal pain
    • - Pregnancy or lactation
    • - Patients with allergies
    • - Asthma
    • - Bleeding disorders
  32. What is the action of all generations of Cephalosporins?
    Affect the bacterial cell wall, making it defective and unstable.
  33. What are first generation Cephalosporin drugs used to treat?
    • Used as a penicillin substitute in common Gram-positive infections
    • Drug of choice for treating infections caused by Gram-negative Klebsiella pneumoniae
  34. Examples of first generation Cephalosporin drugs
    • Kefzol - most widely used
    • Keflex
    • Duracef
    • Kantrex
  35. What are second generation Cephalosporin drugs used to treat?
    • More potent than first generation Cephalosporins
    • Often used to treat gonorrhea
  36. Examples of second generation Cephalosporin drugs
    • Mefoxin - good example
    • Ceftin
    • Ceclor
  37. What are third generation Cephalosporin drugs used to treat?
    • More potent and longer duration
    • Used to treat meningitis because able to cross the blood-brain barrier
  38. Example of a third generation Cephalosporin drug
    Cefixime (Suprax)
  39. Adverse Reactions of Cephalosporins
    • Gastrointestinal effects are most common
    • Similar effects as penicillin allergies:
    • - Fever
    • - Diarrhea
    • - Impaired skin integrity
  40. Actions and Uses of Tetracyclines
    Interfere with bacterial protein synthesis to produce bacteriostatic effect.
  41. Example of Tetracyclines
    Doxyxyxline (Vibramycin)
  42. Adverse Reactions of Tetracyclines
    • Stains teeth if given to children 9 or younger
    • Fanconi Syndrome - Kidneys
    • - Polyuria
    • - Proteinuria
    • - Acidosis
    • - Leads to failure to thrive, stunted growth, and bone disorders, such as rickets
  43. Actions and Uses of Macrolides
    • Isolated from soil fungus
    • Used particularly for infections of the respiratory and genital tract
  44. Examples of Macrolides
    • Erythromycin and Tylosin
    • Sithromax
    • Biaxin
    • Dynabac
  45. Adverse Reactions of Macrolides
    • Generally related to the gastrointestinal system:
    • - Nausea, vomiting, and abdominal pain
    • - Pseudomembranous colitis may range in severity from mild to life-threatening
  46. Example of a Fluoroquinolone drug
    Cipro - "resurrected" by anthrax scare
  47. Two groups of broad-spectrum antibiotics that resulted as various microorganisms became resistant to antibiotics and researchers sought to develop more powerful drugs.
    • Fluoroquinolones
    • Aminoglycosides
  48. Explain the studies and publications of "gold standard" antibiotic, Fluoroquinolones.
    • Extensively studied and documented in more than 37,000 publications
    • More than 100,000 patients enrolled in double blind trials around the world
    • Prescribed for more than 340 million patients worldwide
    • Extensive and unprecedented safety profile
  49. Contraindications, Precautions, and Interactions of Aminoglycosides
    • Contraindicated for long-term use because of potential for ototoxicity and nephrotoxicity (exception is when used for tuberculosis)
    • Used cautiously in patients with kidney failure
    • Increased risk for ototoxicity when used in diuretics
    • Risks for respiratory paralysis when used with anesthetic
  50. A disease caused by Mycobacterium tuberculosis bacillus
  51. Actions of Antitubercular Drugs
    • Most are bacteriostatic(slow or retard the growth of bacteria) against the M. tuberculosis.
    • Usually act to inhibit bacterial cell wall synthesis, which slows multiplication rate of the bacteria.
  52. Examples of Antitubercular drugs
    • Isoniazid
    • Rifampin
    • Ethambutol
    • Pyrazinamide
  53. Contraindications, Precautions, and Interactions of the Antitubercular drug, Rifampin.
    • Used with caution during pregnancy and lactation or for patients with kidney or liver problems
    • Decreases effect of digoxin
    • When used with isoniazid, may increase risk of damage to liver
    • May decrease effect of anticoagulant or hypoglycemic drug
    • Decrease effect of birth control pills, chloramphenicol, phenytoin, and verapamil
  54. Adverse Reactions of Antitubercular drug, Streptomycin.
    • Kidney damage
    • Damage to the organs of hearing
    • Ringing in the ears
    • Nausea, vomiting, dizziness
    • Paresthesia around the mouth
  55. Contraindications, Precautions, and Interactions of the Antitubercular drug, Streptomycin
    • Can cause fetal harm if used in pregnancy
    • Used cautiously in patients with hearing difficulties
    • Ototoxic effect increased with taken with ethacrynic acid, furosemide, or mannitol
  56. Chronic, communicable disease spread by prolonged, intimate contact with an infected person.
  57. Contraindications, Precautions, and Interactions of the Leprostatic drug, Clofazimine.
    • Used cautiously in patients with gastrointestinal disorders, diarrhea, and during pregnancy and lactation
    • If used during pregnancy, infant may be born with pigmented skin
    • No known drug-drug interactions
  58. Actions the Miscellaneous Anti-Infective drug, Spectinomycin
    • Trobicin is chemically related to but different from the aminoglycosides
    • Exerts its action by interfering with bacterial protein synthesis
  59. Uses the Miscellaneous Anti-Infective drug, Spectinomycin
    Used to treat gonorrhea
  60. Adverse Reactions the Miscellaneous Anti-Infective drug, Spectinomycin
    Hives, dizziness, rash, chills, and fever
  61. Contraindications, Precautions, and Interactions the Miscellaneous Anti-Infective drug, Spectinomycin
    • Contraindicated for use in infants
    • Additional anti-infectives may be needed in conjunction if other sexually transmitted diseases are present
    • Not yet determined if safe during pregnancy or lactation
    • No known food or drug interactions
  62. Actions the Miscellaneous Anti-Infective drug, Vancomycin
    Mainly used for C. difficile
  63. Adverse Effects the Miscellaneous Anti-Infective drug, Vancomycin
    • "Red man syndrome" from histamine reaction
    • - chills and/or fever
    • - Fainting
    • - Tachycardia
    • - Hives and itching
    • - Hypotension
    • - Nausea or vomiting
    • - Rash or redness of the face, base of neck, upper body, back, and arms
  64. Why are viruses difficult to eradicate?
    • Bactericidals and antivirals cannot kill all viruses
    • Drugs potent enough to kill viruses also damage host cells
  65. Uses for Antiviral Drugs
    • Initial and recurrent herpes
    • AIDS
    • Inflammation of the retina of the eye
    • Influenza A respiratory tract illness
    • RSV - severe lower respiratory tract illness
  66. Actions of Antiviral Drugs
    Inhibit viral DNA and RNA replication in the virus, causing viral death
  67. Unlabeled Uses of Antiviral Drugs
    • Treatment of cytomegalovirus
    • Use of ribavirin for influenza A and B
    • Used for chronic hepatitis
    • Used for genital herpes
    • Used for measles
  68. General Adverse Reactions of Antiviral Drugs
    • Rapid IV administration can cause crystals in the urin
    • When administered systemically, can cause GI disturbances
    • When administered topically, can cause burning, stinging, and pruritus at the application site
  69. General Contraindications, Precautions, and Interactions of Antiviral Drugs
    • Contraindicated in patients with CHF, seizures, kidney disease, or during lactation
    • Given with caution to children or during pregnancy
    • Ribavirin is NOT to be used during pregnancy or lactation
    • Numerous interactions have been noted
  70. Uses of the Antiviral drug, Acyclovir (Zovirax)
    • Used to treat herpes infections of the skin, lips, and genitals; herpes zoster (shingles); and chickenpox
    • It does NOT cure herpes infections but decreases pain and itching and promotes healing
    • Given as soon as the symptoms first appear
  71. Uses of the Antiviral drug, Famciclovir (Famvir)
    • Used to treat the first episode of genital herpes and recurrent severe genital herpes
    • Reduces the pain and the number of sores with the first episode and decreases the frequency and severity of episodes
    • In treatment of shingles, reduces pain, shortens the time in which sores heal, and limits the spread of virus and the formation of new sores
    • Can be used to treat chickenpox to reduce healing time, limit the number of sores (pox), and reduce fever if used within the first 24 hours after the onset of the disease.
  72. Uses of the Antiviral drug, Amantadine (Symmerel)
    • Influenza
    • It is used to prevent or treat certain influenza (flu) infections (type A)
    • It may be given alone or along with flu shots
    • Will NOT work for colds, other types of flu, or other virus infections
  73. A colorless plant that lacks chlorophyll
  74. What type of fungus can cause diseases in humans
    • Molds
    • Yeasts
  75. Actions and Uses of Antifungal Drugs
    • Destroy fungi or slow their growth
    • Drugs have an effect on the cell memebrane of the fungus
  76. OTC Antifungal Drug, Amphotericin B
    Amphocin, Fungizone
  77. OTC Antifungal Drug, Fluconazole
  78. OTC Antifungal Drug, Griseofulvin
    Fulvicin P/G, Grifulvin V, Gris-PEG
  79. OTC Antifungal Drug, Ketoconazole
  80. OTC Antifungal Drug, Nystatin
  81. OTC Antifungal Drug, Terbinafine
  82. OTC Antifungal Drug, Terconazole
  83. General Adverse Reactions of Antifungal Drugs
    • Few adverse effects
    • Irritation or burning may occur with topical use
    • Redness, stinging, or abdominal pain possible with vulvovaginal antifungal drugs
  84. General Patient Management Issues with Antifungal Drugs
    • Fungal infections respond slowly and patient and family need to be reminded to be patient with therapy
    • Kidney function may need monitoring
    • Lesions may be present which will be at risk for infection
  85. Most effective drug available for systemic fungal infections
    Amphotericin B
  86. Adverse Reactions for the Antifungal drug, Amphotericin B
    • Serious reactions such as fever, shaking, chills, headache, malaise, joint and muscle pain, abnormal kidney function or damage, nausea, vomiting, and anemia
    • Aspirin, antihistamines, or antiemetics may help the symptoms
  87. Uses for the Antifungal drug, Amphotericin B
    Given mainly for serious and potentially life-threatening fungal infections
  88. An organism that lives in or on another organism (the host) without contributing to the survival or well-being of the host.
  89. Invasion of the body by helminths (worms)
  90. Examples of Antihelminthic Drugs
    • Albendazole
    • Mebendazole
    • Pyrantel
    • Thiabendazole
  91. Patient Management Issues with Antihelmintic Drugs
    • Pinworms are common everywhere
    • Other helminth infections can be found where sanitary conditions are substandard
  92. Action of an Antihelmintic Drug
    To kill the parasite (i.e. worms)
  93. Actions and Uses of Antimalarial Drugs
    • Interferes with life cycle of the plasmodium developing and reproducing in the mosquito
    • Used to treat Malaria
  94. Examples of Antimalarial Drug
    • Chloroquine
    • Doxycycline
    • Quinine sulfate
  95. Pharmacological treatment of Malaria is directed towards what?
    • Preventing the diesease (prophylaxis)
    • Eliminating protozoa from all tissues (radical cure)
    • Interfering with protozoal metabolism
  96. Adverse Reactions of the Antimalarial Drug, Chloroquine
    Hypotension, electrocardiographic changes, visual disturbances, headache, nausea, vomiting, anorexia, diarrhea, and abdominal cramps
  97. Action and Uses of the Antimalaria Drug, Chloroquine
    • Destroys Plasmodia that invade the human red blood cells
    • Can be used to prevent malaria
    • Sometimes is ineffective against Plasmodia falciparum
  98. Contraindications, Precautions and Interactions of the Antimalaria Drug, Chloroquine
    • Effects during pregnancy unknown
    • Increase risk of hepatotoxicity
    • Certain foods may decrease its effect: cranberries, plums, prunes, meat, cheese, eggs, fish, cheese
  99. Adverse Reactions of the Antimalaria Drug, Doxycycline
    • Fanconi Syndrome - Kidneys
    • - Polyuria
    • - Proteinuria
    • - Acidosis
    • - Leads to failure to thrive, stunted growth, bone disorders, such as rickets
  100. Contraindications, Precautions, and Interactions of the Antimalaria Drug, Doxycycline
    • Contraindicated during pregnancy
    • Cautiously used in patients with kidney or liver impairment and during lactation
    • Absorption is decreased with taken with antacids or iron
    • Decreased effect when taken with barbiturates, phenytoins, and carbamazepins
    • Increases risk of digoxin toxicity
  101. Action of the Antimalaria Drug, Quinine
    Has a selective action against parasites that invade red blood cells
  102. Contraindication of the Antimalaria Drug, Quinine
    Contraindicated for use during pregnancy
  103. Side Effects of the Antimalaria Drug, Quinine
    • CNS stimulation
    • Ringing in the ears
    • - Cinchonism
    • Headache
  104. Actions and Uses of Amebicides
    • Kills amebas
    • Used to treat infections caused by these susceptible microorganisms
  105. One-celled organism found in soil and water
  106. Adverse Reactions of the Amebicide Drug, Iodoquinol
    Various types of skin eruptions, nausea, vomiting, fever, chills, abdominal cramps, vertigo, and diarrhea
  107. Precautions of the Amebicide Drug, Iodoquinol
    Caution is used during pregnancy or for patients with thyroid disease
  108. Adverse Reactions of the Amebicide Drug, Paromomycin
    • Few adverse reactions but the most common are nausea, vomiting, and diarrhea
    • Nephrotoxicity and ototoxicity have also occurred
  109. Precautions for the Amebicide Drug, Paromomycin
    Given with caution during pregnancy or for patients with bowel disease
  110. The ability of the body to identify and resist microorganisms that are potentially harmful
  111. Immune system mechanisms with which it fights invading organisms include:
    • Cell-mediated defenses (cellular immunity)
    • Antibody-mediated defenses (humoral immunity)
  112. Types T Lymphocytes (T Cells)
    • Helper T4 Cells
    • Helper T1 Cells
    • Helper T2 Cells
    • Suppressor T Cells
    • Memory T Cells
  113. T Cell that identify and destroy antigens
    Helper T4 Cells
  114. T Cell that increase B lymphocyte antibodies
    Helper T1 Cells
  115. T Cell that increase killer T cells
    Helper T2 Cells
  116. T Cell suppress the immune response
    Suppressor T Cells
  117. T Cell that recognize previous contact with antigens and activate immune response
    Memory T Cells
  118. A substance, usually a protein, that stimulates the body to produce antibodies
  119. A globulin (protein) produced by the B lymphocytes as a defense against an antigen
  120. When a person is exposed to a disease, experiences the disease, and the body makes antibodies for future immunity to the disease.
    Naturally Acquired Active Immunity
  121. When a person is given a killed or weakened antigen which then stimulates the formation of antibodies against the antigen (i.e. vaccine).
    Artificially Acquired Active Immunity
  122. Available vaccines or immunizations
    • Cholera
    • Diphtheria
    • Haemophilus influenzae type B
    • Hepatitis A
    • Hepatitis B
    • Influenza
    • Japanese encephalitis
    • Lyme disease
  123. A type of immunity occurring from the administration of ready-made antibodies from another individual or animal
    Passive Immunity
  124. What does Passive Immunity provide?
    Provides immediate immunity but lasts for only a short time
  125. Example of Passive Immunity
    Hepatitis B immune globulin which is used in an attempt to prevent Hepatitis B after the indvidual has been exposed to the virus
  126. Actions of Vaccinations
    They cause antibody-producing tissue to react to an antigen, even a dead or weakend one.
  127. Actions of Toxoids
    They are capable of stimulating bacteria to produce toxins.
  128. Uses of Vaccines and Toxoids
    Both are used to stimulate bacteria to produce toxins.
  129. Adverse Reactions of Vaccines and Toxoids
    Usually mild and include chills, fever, muscular aches and pains, rash, and lethargy
  130. A toxin that is attenuated (or weakened) but still capable of stimulating the formation of antioxins
  131. Contraindications for MMR (measles, mumps, rubella) and Varicella Vaccines
    Anyone allergic to gelatin, neomycin, or to a previous injection of the vaccine, and during pregnancy
  132. Contraindications and Precautions of Vaccines and Toxoids
    • During acute fevrile illnesses, leukemia, lymphoma, immunosuppressive illness or drug therapy, and nonlocalized cancer
    • Used with extreme caution in individuals with a history of allergies
  133. Risk for Reye's Syndrome when aspirin used along with what vaccine?
    Varicella Vaccine
  134. Proteins present in blood or plasma that contain antibodies.
  135. Solutions obtained from human blood containing antibodies that have been formed by the body to specific antigens
    Immune Globulins
  136. Antitoxin specific for an animal or insect venom
  137. Actions and Uses for Immune Globulins
    • Provide passive immunization
    • Working rapidly but for a short duration
  138. Actions and Uses of Antivenins
    Used for passive, transient protection from bites of spiders and snakes
  139. Adverse Reactions of Immune Globulins
    Rare and, if they occur, only last several hours.
  140. Adverse Reactions of Antivenins
    • Usually in the form of hypersensitivity
    • If patient is allergic to horse serum, serious reaction and death may occur
  141. Contraindications, Precautions, and Interactions of Immune Globins
    • Contraindicated in patients with a history of a prior allergic reaction to the drug
    • Caution is used with patients who are pregnant or lactating
  142. Contraindications and Precautions with Antivenins
    • Contraindicated in patients allergic to horse serum
    • Caution is used with patients who are pregnant or lactating
  143. Educationg Patients and Family about Immunologic Agents
    • Parents are encouraged to have their children vaccinated
    • Those traveling to a foreign country are urged to have immunizations well in advance of their departure date
    • All are encouraged to report any adverse reactions
  144. Actions of Antineoplastic Drugs
    • Used in the treatment of cnacer for cure, control, or palliative therapy
    • May affect normal and malignant cells
  145. What is the common term used for Antineoplastic Drugs?
  146. How is Chemotherapy usually administered?
    In a series of cycles to allow for recovery of normal cells
  147. Actions of Alkylating Drugs
    • Interfere with the process of cell division of malignant and normal cells
    • Drug binds with DNA, causing breaks and preventing DNA replication
    • Malignant cells appear more susceptible to alkylating drugs
  148. Actions of Antineoplastic Antibiotics
    • Do not have anti-infective (against infection) abilities
    • Actions are similar to the alkylating drugs, interferes with the process of cell division of malignant and normal cells
    • Interferes with reproductions of DNA and RNA
  149. Examples of Antineoplastic Antibiotics
    • Bleomycin (Blenoxane)
    • Doxorubicin (Adriamycin)
    • Plicamycin (Mithracin)
  150. Actions of Hormones
    • Exact mechanism is unclear
    • Appear to counteract the effect of male or female hormones in hormone-dependent tumors
    • Appear to alter the hormonal enviroment of the cell
  151. Examples of Hormone Drugs
    • Testolactone (Teslac)
    • Conjugate Estrogens
    • Megestrol (Megace)
    • Goserelin (Zoladex)
  152. Actions of Mitotic Inhibitors
    Interfere with or stop cell division
  153. Examples of Mitotic Inhibitor Drugs
    • Paclitaxel (Taxol)
    • Vincristine (Oncovin)
  154. Actions of Miscellaneous Antineoplastic Drugs
    Mechanisms of action not clear.
  155. Examples of Miscellaneous Antineoplastic Drugs
    • Cisplatin (Platinol)
    • Hydroxyurea (Hydrea)
  156. Uses of Antineoplastic Drugs
    • Given alone or in combination
    • May share similar activities but have different uses
  157. Adverser Reactions of Antineoplastic Drugs
    • Wide variety of adverse reactions, most of which are dose dependent
    • Bone marrow suppression, nausea, vomiting, stomatitis, diarrhea, and hair loss, tissue integrity, anxiety, alopecia, anorexia
  158. Contraindications, Precautions, and Interactions of Antineoplastic Drugs
    • Vary for individual drug although generally contraindicated in patients with leukopenia, thrombocytopenia, anemia, serious infections, serious renal disease or during pregnancy
    • Use cautionsly with kidney or liver disease, active infections, or other debilitating illnesses
  159. Contraindications, Precautions, and INteractions of Alkylating Drugs
    • May antagonize effects of antigout drugs by increasing serum uric acid levels
    • May increase risk for nephrotoxicity and ototoxicity when used with aminoglycoside
    • Increased risk of ototoxicity when used with loop diuretics
    • May decrease antibody response of live viral vaccines
  160. Interactions of Antineoplastic Antibiotics
    • Digoxin levels may decrase when used with bleomycin
    • Increased risk of bleomycin toxicity when used with cisplatin
    • Pulmonary toxicity may occur with bleomycin and other antineoplastic drugs
    • Increased risk of bleeding when plicamycin given with aspirin, warfarin, heparin, or NSAID
  161. Contraindications and Precautions of Antineoplastic Antibiotics
    • Plicamycin, Mitomycin, Mitoxantrone, and Dactinomycin have an additive bone marrow depressant effect
    • Mitomycin, Mitoxantrone, and Dactinomycin decrease antibody response to live virus vaccines
    • Dactinomycin can reactivate skin or gastrointestinal reactions of radiation therapy
  162. Contraindications and Precautions of Antimetabolite Drugs
    • Can antagonize effects of antigout drugs
    • Methotrexate toxicity can be increased by oher nephrotoxic drugs
    • When given with antineoplastics, can suppress bone marrow
  163. Interactions of Antimetabolite Drugs
    • Vitamins containing folic acid may decrease the effects of methotrexate
    • Live viral vaccines may be ineffective with fluorouracil
    • Severe cardiomyopathy with left ventricular failure can occur with the use of fluorouracil and cisplatin together
  164. Contraindications, Precautions, and Interactions of Hormones
    • Bicalutamide may increase the effect of oral anticoagulants
    • Flutamide enhances the action of leuprolide
    • Additive effects noted when leuprolide used with megestrol or flutamide
    • Estrogens decrease the effectiveness of tamoxifen
  165. Contraindications, Precautions, and Interactions of Mitotic Inhibitors
    • Additive bone marrow depressive effects
    • Vincristine and digoxin result in decreased effect of digoxin
    • Decreased in serum concentration of phenytoin when given with vinblastine
  166. Interactions of Miscellaneous Antineoplastic Drugs
    • Increased risk for bone marrow suppression when levamisole or hydroxyurea are given with another antineoplastic drug
    • Levemisole used with phenytoin increases risk of phenytoin toxicity
    • Procarbazine may potentiate hypoglycemia if given with insulin or oral antidiabetic drugs
    • Pegaspargase may alter response of anticoagulant
  167. Contraindications and Precautions of Miscellaneous Antineoplastic Drugs
    • Asparaginase increases the risk for hyperglycemia in patients with diabetes
    • Glucocorticoids decrease the effect of aldesleukin
    • Aldesleukin given with antihypertensive will result in additive hypotension
    • Etoposide may decrase immune response to live viral vaccine
    • Additive CNS response when procarbazine given with depressants
  168. Administration of Antineoplastic Drugs
    • Orally or parenterally (most common)
    • Zoladex given subcutaneously with a dry pellet implanted in the soft tissue of belly
  169. Educating the Patient and Family of Antineoplastic Drugs
    • Compliance can be an issue because the patient may wish to skip a dose in an effort to feel better
    • Anxiety issues always surround chemotherapy and family counseling will be imperative
  170. Natural Remedies for Antineoplastic Drugs
    • Green Tea
    • - Polyphenols or flavonoids have antioxidant properties
    • - Benefits include cancer prevention and maintenance of heart and liver health
    • - Does contain caffeine so should be avoided during pregnancy and used with caution in those with hypertension, anxiety, insomnia, diabetes or ulcers
  171. Actions of Gold Compounds
    • Suppresses or prevents but does not cure arthrititis and synovitis
    • Exact mechanism is unknown
    • Therapeutic effects occur slowly
  172. Uses of Gold Compounds
    Used to treat active juvenile or adult rheumatoid arthritis not controlled by other anti-inflammatories
  173. Adverse Reactions of Gold Compounds
    • Dermatitis and stomatitis
    • Photosensitivity
    • Chrysiasis pigmentation of skin
  174. Contraindications of Gold Compounds
    • Parenterally contraindicated in patients with uncontrolled diabetes, liver disease, uncontrolled hypertension, uncontrolled CHF, SLE< or blood dyscrasias, or who have had recent radiation therapy
    • Orally contraindicated in patients with necrotizing enterocolitis, pulmonary fibrosis, or hematological disorders
    • Contraindicated during pregnancy or lactation
  175. Drugs used in the treatment of Gout
    • Allopurinol (Zyloprim) - reduces uric acid and thus reduces deposits of urate crystals in joints
    • Probenecid (Benemid) works in a similar manner and may be combined with colchicine as combination therapy
  176. Adverse Reactions of drugs used in the treatment of Gout
    • Skin rash followed by hypersensitivity
    • - Exfoliative dermatitis
    • - Stevens-Johnson Syndrome: nausea and vomiting, diarrhea, abdominal pain, hematological changes
  177. Precautions of drugs used for Gout
    Used cautiously in patients with kidney or liver disease, during pregnancy and lactation, and in older adults
  178. Interactions of the Drug, Allopurinol, for the treatment of Gout.
    • Increased risk of skin rash when allopurinol and ampicillin used together
    • Allopurinol and theophylline increase risk of theophylline toxicity
    • ACE inhibitors or thiazide diuretics given with allopurinol increase the risk of hypersensitivity reactions
    • Aluminum salts decrease the action of allopurinol
  179. Action and Uses of Skeletal Muscle Relaxants
    • Mode of action not clearly understood as they relieve muscle spasm and pain
    • Used in various acute, painful musculoskeletal conditions such as a muscle strains and back pain
  180. Adverse Reactions of Skeletal Muscle Relaxants
    Drowsiness is the most common reaction
  181. Contraindications and Precautions of Skeletal Muscle Relaxants
    • Various contraindications by specific drug
    • Caution for patients with history of stroke, cerebral palsy, parkinsonism, or seizure disorder
    • Caution during pregnancy and lactation
  182. Interactions of Skeletal Muscle Relaxants
    • Increased CNS depressant effect when used with alcohol, antihistamines, opiates, and sedatives
    • Additive anticholinergic effect when used with another drug with anticholinergic effect
  183. Action and Uses of Bisphosphonates
    • Used to treat osteoporosis in postmenopausal women and Paget's disease as well as postop total hip replacement
    • Inhibits normal and abnormal bone resorption which increases bone mineral density
  184. Contraindications, Precautions, and Interactions of Bisphosphonates
    • Alendronate and risedronate contraindicated in patients with hypocalcemia
    • contraindicated during pregnancy
    • Use with hormone replacement therapy is NOT recommended
  185. Actions and Uses of Corticosteroids
    • Hormones secreted from the adrenal cortex
    • Used to treat rheumatic disorders such as ankylosing spondylitis, rheumatoid arthritis, gout, bursitis, and osteoarthritis
  186. Adverse Reactions of Corticosteroids
    Given in high doses for some arthritic disorders, and steroid effects are generally noted
  187. Miscellaneous Drugs that are used to treat rheumatoid arthritis
    • Penicilliamine
    • Methotrexate
    • Hydroxychloroquine
  188. Action of Miscellaneous Drugs that treat rheumatoid arthritis
    Exact mechanisms of these drugs are unknown
  189. Adverse Reactions of Miscellaneous Drugs that treat rheumatoid arthritis
    • They are all similar
    • - Methotrexate is reserved for severe, disabling disease that is not responsive to other treatment because it is a potentially toxic drug
    • - Penicillamine may also cause a severe toxic reaction
  190. Patient Management Issues with Miscellaneous Drugs that treat rheumatoid arthritis
    Patients are closely observed for any adverse reactions such as skin rash, fever, cough, easy bruising or unusual bleeding, or complaints of sore throat, visual changes, mood change, loss of hair, tinnitus, or hearing loss
  191. Contraindications or Interactions of Miscellaneous Drugs that treat rheumatoid arthritis
    • Methotrexate is contraindicated during pregnancy because it may cause birth defects in a developing fetus
    • Patients should be aware that penicillamine is contraindicated if they are allegic to penicillin
  192. Natural Remedies for Osteoarthritis
    • Glucosamine - from marine invertebrates and other lower animals and memebers of the plant family
    • Chondroitin - derived from shark cartilage
  193. Solutions Used in the Management of Body Fluids
    • Blood Plasma
    • Plasma Protein Fractions
    • Protein Substrates
    • Energy Substrates
    • Plasma Expanders
    • Intravenous Replacement Solutions
  194. Liquid part of blood
    Blood Plasma
  195. What does Human "Pooled" Plasma contain?
    • Water
    • Sugar
    • Electrolytes
    • Fats
    • Gases
    • Proteins
    • Bile Pigment
  196. Action and Use of Plasma Protein Fractions
    • Critical in regulating volume of circulating blood
    • Used to treat shock from low blood volume
  197. What does Plasma Protein Fractions include?
    • Human Plasma Protein
    • Normal Serum Albumin
  198. What is the action of the part of Plasma Protein Fractions, Albumin?
    • Maintains plasma colloid osmotic pressure
    • Carries metabolites
  199. Precautions of Plasma Protein Fractions
    Caution used if patient is allergic to albumin
  200. Actions and use of Protein Substrates
    • Amino acid preparations that promote production of proteins
    • Enhance tissue repair and wound healing
    • Reduce the rate of protein breakdown
    • Used in total parenteral nutrition solutions
  201. What do Energy Substrates include?
    • Dextrose solutions:
    • - Available with electrolytes
    • - Available with alcohol
    • Fat emulsions of soybean or safflower oil (not given if allergic to eggs)
  202. Action of Energy Substrates
    Provides source of nonprotein calories and fluid
  203. Adverse Reactions of Energy Substrates
    Mainly caused by administration equipment or vein irritation
  204. Uses of Plasma Expanders
    • To expand plasma volume as an emergency measure only
    • - Hetastarch (Hespan)
    • - Dextran
    • Prophylaxis of venous thrombosis or thromboembolism
  205. Adverse Reactions and Precautions of Plasma
    • Allergic reactions possible
    • Cautiously used during pregnancy and lactation
  206. Uses of Intravenous Replacement Solutions
    • Used for hydration
    • Used to facilitate amino acid utilizations
    • Used to maintain electrolyte balance
  207. Intracenous Replacement Solutions are the source of what?
    • Source of electrolytes and water
    • Source of calories in parenteral nutrition
  208. Managing Adverse Reactiosn with Solutions used in Management of Body Fluids
    • Requires close monitoring
    • Fluid overload is a concern, especially in an older patient
    • Patient and family member must be cautioned not to tamper with or adjust the rate of flow of the IV set
  209. Electrically charged substance essential to the normal functioning of cells
  210. Examples of Electrolytes
    • Bicarbonate (HCO3)
    • Calcium (CA++)
    • Magnesium (Mg++)
    • Potassium (K+)
    • Sodium (Na+)
  211. Action and uses of the Electrolyte, Bicarbonate (HCO3)
    • Plays a vital role in the acid-base balance in the body
    • Used in IV treatment of metabolic acidosis secondary to shock, diabetes, severe diarrhea, kidney disease, or heart attack
    • Used orally as a gastric and urinary alkalinizer
    • - ingredient in baking soda as sodium bicarbonate NaHCO3
  212. Actions of the Electrolyte, Calcium (CA++)
    • Necessary for the functioning of nerves and muscles
    • Needed for clotting of blood
    • Needed for building of bones and teeth
  213. Uses of the Electrolyte, Calcium (CA++)
    • Used to reduce muscle cramping from black widow spider bite
    • Given for CPR if epinephrine fails
  214. Action and Uses of the Electrolyte, Magnesium (Mg++)
    • Transmission of nerve impulses
    • Controls seizures in obstetric patients
    • Used in carbohydrate metabolism
  215. Action of the Electrolyte, Potassium (K+)
    • Needed for transmission of impulses
    • Needed for contraction of smooth, cardiac, and skeletal muscles
  216. Action of the Electrolyte, Sodium (Na+)
    • Essential for maintence of normal heart action and in osmotic pressure in body cells
    • Available with dextrose also
  217. Precaution with the Electrolyte, Sodium (Na+)
    Caution used when water retention is a problem
  218. Solution containing 0.9% NaCl
    Normal Saline
  219. Solution containing 4.5% NaCl
    Half-Normal Saline
  220. Uses of combined electrolyte solutions
    • Used to replace fluid and electrolytes
    • Used to provide calories
  221. Lactated Ringer's belong to what Fluid and Electrolyte group?
    Combined Electrolyte Solutions
  222. How are Combined Electrolyte Solutions available?
    • Oral Solutions
    • - Pedialyte
    • - Rehydralyte
    • IV
  223. Low blood calcium
  224. Low blood potassium
  225. Low blood sodium
  226. Overload of sodium
  227. Action and Uses of Total Parenteral Nutrition
    • Needed until normal eating can be resumed
    • Used to prevent nitrogen and weight loss
    • Used to treat negative nitrogen balance
  228. Administration of Total Parenteral Nutrition
    • Rate of administration is slowly decreased when discontinued
    • Dose depends on patient's condition
  229. What is the primary use of fluoroquinolones?
    For lower respiratory infections, skin infections, and urinary tract or sexually transmitted disease
  230. What are Clofazimine adn Dapsone used to treat?
  231. Which of these microorganisms may respond to penicillin therapy?
    • Staphylococci
    • Streptococci
    • Pneumococci
  232. What is true about the drug Amantadine?
    You should not drive a car until the effect of the drug is apparent
  233. What would be a reason to use an antifungal?
  234. Examples of Immunological Agents include:
    • Vaccines
    • Toxoids
    • Immunoglobulins
  235. With their ready-made antibodies, what do Immunoglobulins provide?
    Passive immunity against disease
  236. Where are Immune Stem Cells formed?
    Bone Marrow
  237. Why is chemotherapy administered in a series of cycles?
    To allow for recovery of the normal cells
  238. What symptoms may indicate Thrombocytopenia?
    • Bleeding gums and easy bruising
    • Tarry stools
    • Bloody urine
    • Coffee-ground emesis
  239. Allopurinol is used to reduce the production of uric acid.
    True or False?
  240. Plasma Protein Fractions are critical in regulating the color of circulatind blood.
    True or False?
  241. What is the most common adverse reaction associated with Intravenous Fat Emulsion?
    Sepsis caused by administration equipment
  242. What is Calcium used for?
  243. When is total parenteral nutrition used?
    To prevent nitrogen and weight loss
  244. Common adverse reactions to antibiotics include:
    • Nausea
    • Vomiting
    • Diarrhea
Card Set:
HIST250 Exam4
2012-05-01 02:21:27
HIST250 Exam

HIST250 Exam4
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