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Anti-infectives
drug class that targets foreign organisms by the process of selective toxicity (affect proteins or enzymes characteristic of foreign organisms but not used by human cells.
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Mechanisms of action do what?
- 1. Interere with biosynthesis of the cell wall (penicillins)
- 2. Block use of substances necessary for cell growth and development (sulfonamides)
- 3. Interference with protein synthesis so hinders cell division (aminoglycosides)
- 4. Interferes with DNA synthesis so unable to devide (fluoroguinolones)
- 5. Alter cell permeability (antifungals, antiprotozoans)
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Narrow spectrum drug
only works on a few types of infections
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Broad spectrum drug
works on wide range of organisms across many types of infections
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Bactericidal
cause cell death of bacteria
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Bacteriostatic
control growth of the bacteria and then the immune system takes care of it
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prophylaxis
preventative antibiotic
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The goal of a drug is to reduce organisms to the point that
human immune reponse can counter and remove invading organisms
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Natural resistancce
if the mechanism of action of the drug is aimed at a process that the foreign organism does not use
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Acquired resistance
organisms develop over time resistance to drugs that used to be effective
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Methods of Aquired resistance
Bacteria can produce enzyme that deactivate the drug (production of penicillinase by bacteria against penicillin)
Alter cellular permeability
Alter binding sites on membranes or ribosomses
Produce a chemical that antagonizes the drug action
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Steps to effectively treating systemic infection
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- 1. Identify the pathogen through culture
- 2. Determine sensitivity
- 3. Multiple antibiotics sometimes used to treat systemic infection
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Adverse reactions to anti-infectives
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- 1. Kidney toxicity
- 2. GI toxicity (Nausea/Vomiting/Diarrhea)
- 3. Neurotoxicity (dizziness, hearing, lethargy)
- 4. Hypersensitivity/Allergy
- 5. Superinfections
- Multidrug Resistant Organisms (TB, Gonorria , MRSA)
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Antibiotics
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- - drugs that inhibit or kill bacteria
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Gram _____ bacteria are found in infections of respiratory system and soft tissue
positive
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Gram _______ bacteria are found in infections of GI and GU
negative
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Gram _____ responsible for TB, strep throat, strep pneumoniae
positive
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Gram _______ responsible for gonorrhea, aspirate pneumonia
negative
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Bactericidal Cell Wall Inhibitors
- Penicillins (B lactam drugs) and cephalosporings. (Beta Lactam drugs have a beta lactam ring in center and include PCN, cephalosporins, carbapenems)
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DNA inhibitors
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- inhibit needed enzymes, introduce defective building blocks, destroy sequencing of DNA. Quinolones, Metronidazole
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Antimetabolites
- - block folate pathway and inhibit production of DNA, RNA, protein. Sulfonamides
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Protein Synthesis inhibitors
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- target several steps such as copying mRNA code, target actual ribosomal synthesis of mRNA. Can bind to normal human cell ribosomes in rapidly dividing GI, skin, and bone marrow, kidney and liver and cause toxicities. Aminoglycosides, macrolides, TCN.
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Children tend to have a lot of ____ effects from antibiotics. The younger the child, the more problematic that can be.
GI
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the average number of colds in the first year of an infant
8-10
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Amnioglycoside
Gentamicin
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Fluoroguinolones
Ciprofloxacin
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Sulfonamides
Sulfasalzine
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Tetracyclines
tetracycline
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Antimycobacterial
isoniazid
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