Pharm Exam 2

• Primary: preventing a disease from occurring, finding something upstream
• Secondary: catching a disease early
• Tertiary: Preventing existing diseae from worsening

made in the laboratory

• inactivated
• live attenuated: altered, viral or bacterial

• cant replicate
• less affected by circulating antibodies than live vaccines
• always need multiple doses- youll need more of it to keep the immune response going
• antibody titres deminish with time- may require periodic boosters

• whole cell
• fractional: include subunits and toxiods

• polio, hepa, rabies, flu
• pertusss (not used anymore), typhoid, cholera, plauge

• subunits: hep b, flu, acellular pertussis, hpv, anthrax
• toxoids: diptheria, tetanus

• pure polysaccharides: pnumovax, meningo, salmonella
• congjugate polysaccharides: hib, prevnar, meningo

conjugate polysaccharide vaccines cause a greater more robust immunity- bu can cause discomfort

• not consistently immunogenic in kids under 2
• no booster response
• antibody with less functional activity
• immunogeneration improved by conjugation

• not given to immuno compromised
• live weak
• avoid in preg, asplenia, or chemotherapy
• causes a much better immune response- you dont need multiple
• must replicate to make an immune response
• genetically altered in lab to reduce virulence
• immune response nearly identical to a natural infection
• severe reactions possible
• interference from circulating antibody
• FRAGILE- store and handle carefully

• mmr
• varicella
• yellow fever
• rotavirus
• intranasal flu
• oral polio
• bcg, oral typhoid

• derived from a single type or clone of antibody producting cells  (b cells)
• antibody is specific to a single antigen or closely related group of antigens
• used for diagnosis and therapy of certain cancers and autoimmune diseases as well as prevention of transplant rejection

• Palivizumab 9synagis) 
• a monoclonal antbody but not vaccine
• wont interfere with vaccine
• replication is inhibited

• after injection, macrophages take up the mRNA and present the spike protein that the MRNA codes for which induces an immune response mimiciking the way the immune response would fight the real thing
• no live virus
• no ganetic material enters the nucleous of cells

they dont have to start over but should pick up where they left off

risk of additional vaccinations is less than risk fo disease

• all preg women should get it between weeks 27-36
• father and other house members should gett it too. we need herd immunity
• passive immunity from mom
• active immunity once bby gets vaccine himself

• enclosed in a protective envelope
• have spikes, which help attach to cells
• noncellular
• don respirate, grow or metabolize
• have a capsid proteinc oat
• have a nucleaic acid core with DNA or RNA
• no ribosomes or enzymes
• considered living (when using host cell) and nonliving (inactive outside of host)

• euaryotes
• multicellular (yeast are single)
• hyphae
• heterotrophic
• cant make own food, must get from host- this is why those with diabetes are good hosts they have a lot of sugar

• rhinovirus (most common)
• adenovirus
• rsv
• enterovirus
• coronavirus
• adults get 2.5 per year, kids 6-8
• last 7-9 days

• nasal congestion
• rhinorrhea
• malaise
• scratchy or sore throat
• nasal discharge green or yellow (clear at first)
• muscle aches
• fever(kids only)

• symptomatic care: fluids, antipyretics
• nasal bulb suctioning infants
• decongestants (older kids and younger adults)
• ipratroprium for moderat to sever congestion
• NO ANTIBIOTICS

• sysemic sympathomimetics: pseudophedrine- stimulates aa receptors for vasoconstriciton; phenylepherine
• topical decongestants: phenylephrine, oxymetazoline; NO MORE THAN 48 HOURS or rebound congestion from profound vasodilation- steroid needed to get it down

• aa agonists
• cause vasoconstriction of capillary vessels, theoretically decreasing congestion
• adverse rxn: tachycardia, hypertension, anxiety/irritabiility, rebound congestion for topicals

• no, can be dangerious
• honey can help kids over one

• dextromethophan, codeine
• they act centrally
• little evidence for benefit, high potential for abuse
• if cough is post nasal drip go after the congestion not the cough

• stimulate the respiratory tract secretions, decreases viscocity of them
• no evidence for effectiveness in chonic cough or URI

• must be safe- cant overdose
• low potential for abuse
• can be labeled
• pt must be able to self diagnose
• condition must be able to be managed by the pt

• inaccurate dosing
• overuse
• use in young kids
• gi upset/bleed
• dedation
• impaired driving
• drug interactions

• block entry into cells or are active inside the host
• acyclovir: works against HSV1 and 2, varicella, epstein barr, cmv, herpes 6
• valcyclovir: converted to acylovir after oral absorption works against same viruses
• famciclovir: active against HSV-1 and 2, vzv, ebv, hep b
• ganciclovir: active against CMV

• acyclovir/val: few if oral
• valcy: thrombocytopenia, hemolytic uremic syndrome, purpura in immunocompromised
• famcycl: headache
• gancyclovir: granulocytopenia, anemia, thrombocytopenia, carcinogen
• few drug interactions of all

• for initial outbreak and suppression therapy
• shingles: start therapy within 3 days of the outbreak, if started within 72 hours can reduce virulance and post hepatic neuralgia

• start within 24 hours
• can reduce viral load and decrease outbreaks

• neuraminidases: oseltamivir and peramivir and zanamir for flu a an db
• sensitivity varies by year, most well absorbed
• adamantanes: resistance to amantadine and rimantadine is common- no longer recommended for flu

recommendations for relenza and flu change each year depending on the strain

• over 65, under 5 (esp under 2)
• preg and up to 2 weeks after birth
• natives
• nursing homes

• renal function- esp elderly and debilitated patients
• evaluate elderly for confusion, hallucinations and cognitive impairment
• take full course
• advise flu shot

• cutaneous
• resp
• gi
• systemic

• broad spectrum activity
• often topical or oral
• allyamines active against yeast and dermophytes
• nuclear acid synthesis inhibitors

• effective on scalp infections
• good for true yeast infections
• often in kids
• many drug drug interactions