Quiz 3 study guide

-Drug resistance: mutant bacteria pathogens that resist action of antiobiotics

-Aquired resistance: "Mutant" bacteria pass along their DNA to other bacteria which makes them resistant as well

-glucocorticoids prepare body for long term stress

-Increase breakdown of proteins into amino acids

-breakdown of lipids

-suppression of imflammatory and immune responses

Cortisol is secreted in the highest amount

-Used to treat "Addison's disease" (inadequate secretion of corticosteroid by adrenals

-inadequate secretion of ACTH (Adrenal corticotropic hormone) from pituatary so cortisol production decreases

-treats:

inflammation

allergies

neoplasms (tumor)

hypotension

renal impairement

lack of energy

arthritis

Inflammatory bowel disease (IBD)

Crohns Disease (Inflammation of GI tract)

Asthma

Allergies

Transplant rejection prophylaxis

Edema

-Ototoxicity: damage to the inner ear (sensory cells in cochlea)

-may cause unborn child in late pregnancy to become deaf

-Must be given parentally to treat systematic infection

-Used with prosthetic heart valve

Example: Coumadin

-Antiulcer drug/H2 receptor antagonist

-reduces gastric acid secretion by blocking histamine-2 receptor sites

-receptors located in the gastric parietal cells lining stomach

-gastric and peptic ulcers

-GERD

-Hypersecretory conditions (Zollinger-Ellison Syndrome)

-prevention of stress ulcers

-combination with antibiotic for treating Helicobacter pylori

-Hypersensitivity

--use with caution with pts with an impaired renal or hepatic function

-Somnolence, diaphoresis, rash, headache

-taste disorder, diarrhea, constipation, dry mouth

-Arrythmia

-Neutropenia (bone marrow that doesnt make enough neutrophils)

-Pancytopenia: (low red blood Cells, WBC's, and platelets)

-Aplastic anemia (bone marrowdoesnt make enough blood cells)

-Anaphylaxis

-IV administration should not be mixed with any other IV medications

-Avoid antacid use within 1 hour of administration

-May be given as a single dose, twice daily, or with meals and at bedtime

-May increase diazepam absorption

-Increase hypoglycemic effects of glypizide

-Increase procainamide levels and increase warfarin effects

-Active TB: Treated usually with more then one drug due to increased drug resistance

-Myobacterium (microorganism that causes TB), has a cell wall that is resistant to penetration of anti-infectives

-Drug combinations must be switched to decrease risk of resistance

-GI upset and bleeding

-overdose may cause hepatic failure

-damage to GI mucosa

-Hepatoxicity

-Salcilates: hypersensitivity reaction (bronchospasm, laryngeal edema, anaphylaxis)

-Stomach pain

-Nephrotoxicity (salcilates combined with Acetaminophen)

-Salcylate toxicity

-(Ibuprofen) pose increased risk for MI, Heart Failure

-Older anti-infective (1963)

-Resistance uncommon

-Treats:

peptic ulcer disease -pathogen in Gi tract (helicobacter pylori)

-Anaerobic bacteria (cause gangrene, diabetic skin ulcer, deep wound infections)

-Serious in tro-abdominal infections/septicemiadue to bacteriodes, Clostridium, Streptococci

Interferes with viral synthesis of DNA

-HSV-1 (eye, mouth, lips) and HSV-2 genitalia

-CMV (Cytomegalovirus) high doses

-Herpes zoster (shingles) -High dose

-Epstein-Barr (EBV)

-Hypersensitivity

-Renal/Hepatic disease (severe)

-N & V

Diarrhea

headache

tremors

lethargy

rash

pruritus

increased bleeding time

Anemia

seizures

nephrotoxicity

BUN & Creatinine and CBC

-Probenecid (Benamid-gout)-decreases elimination of acyclovir and causes nephrotoxicity

-Inhibit synthesis of prostaglandins

-Block enzyme COX-1 and COX-2 which are necessary to form prostaglandins

-Block the enzyme cyclooxygenase that form prostaglandin

-prostaglandins= Hormone found throughout body which cause:

vasodialation and pain

protect stomach mucosa from acid

help maintain blood flow through kidneys

-Cause bronchodilation or bronchoconstriction

-Increase platelet aggregation

- low doses have few side effects

--immune response- susceptibiltiy to infection

peptic ulcers

osteoporosis- 50% will have a fracture

-Behavioral changes- nervous, moody, hallucinations, suicidal

-eye changes: cataracts and open angle glaucoma

-Metabolic changes- hyperglycemic action

-myopathy_ muscle wasting

Do not use if:

pregnant women

breast feeding

1st choice drugs:

-Isoniazid (INH)-treated prophylactically for 9 months/DOT mainstay

-Pyrazinamide

-Rifampin

-Rimactane

-Rifapentine (Priftin)

-Streptomycin

-2nd choice of drugs can be more toxic

only used when 1st choice drugs are ineffective

-Moderate to severe asthma may not be adequately treated using an inhaled steroid

-Rinse mouth after use to prevent Candida (Thrush)

-Works on the surface of parietal cells

-inhibits gastric acid secretion

-Inhibits hydrogen-potassium ATPase (enzyme responsible for secreting hydrochloric acid in stomach

-Blocks formation of gastric acid

-Treatment of gastric and duodenal ulcers for 4-8 weeks

-Gerd

Zollinger- Ellison syndrome maintenance therapy

-Children <18 years old

-Nursing mothers

-Injection site reaction

-headache

hyperglycemia

dizziness

pruritus

dry mouth

Pancreatitus

liver necrosis

hepatic failure

Agranulocytosis (dangerously low WBC'S)

MI

Shock

CVA

GI hemmorage

-Activated by food intake

-Take 20-30 minutes before 1st major meal of day

-Suppress acid for 24 hours-irreversible inactivation of proton pumps

May alter absorption of ketoconazole (Anti-fungal)

digoxin

iron

ampicillan

-Note: All these drugs are dependent on gastric PH for absorption

neutralizes stomach acid by raising PH of the stomach contents

constipation

-long term use may deplete Phosphate in the GI tract especially in pts who are:

malnourished

alcoholic

renal disease

-Avoid prolonged use in pts with low serum phosphates

-DO not use in pts with suspected bowel obstruction

assess for bowel changes

monitor pt for worsening symptoms

Opiod antidiarrheal

Diphenoxylate

-Slows peristalsis

Schedule IV controlled substance

Acts on smooth muscle of intestine

Dizziness

lethargy

drowsiness

High doses:

Antocholinergic effects of atropine

Drowsiness

Flushing

Dry Mouth

Tachycardia

Antiulcer drug

Proton pump inhibitor

-Reduces acid secretion in stomach by binding irreversibly to enzyme H+, K+, and ATPase

-Inhibits final pathway involved in acid secretion

Inhibits proton pumps

May inhibit/ delay metabolis of:

Carbamazepine

Diazepam

Phenytoin

Warfarin