Pharm 2

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infections acquired while clients are hopsitalized, many of these infections are caused by drug-resistant bacteria and can prolong hospitalization

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nosecomal

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drugs that inhibit the growth of bacteria

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bacteriostatic

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drugs that kill the bacteria

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bacteriocidal

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two examples of bacteriostatic drugs are

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tetracycline and sulfonamides

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two examples of bacteriocidal drugs are

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penicillins and cephalosporins

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primarily effective against one bacteria type

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narrow spectrum

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effective against gram + and gram -

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broad spectrum

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two examples of drugs that are narrow spectrum

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penicillin and erythromycin

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two examples of drugs that are broad spectrum

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tetracyline and cephalosporins

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the effect is doubled

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additive

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when one antibiotic potentiates the effect of a second antibiotic, increasing the overall effectiveness

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potentiative

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rod shaped bacteria

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bacilli

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spherical bacteria

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cocci

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clusters of bacteria

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staph

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chains of bacteria

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strep

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classification of bacteria involving staining properties of the cell

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gram staining

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cell wall retains purple dye

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gram +

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cell wall does not hold stain

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gram -

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a sample of cells are taken from the pt. and are grown on a petri dish in the lab, then tested with different drugs to see which drug will kill the infection

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culture and sensitivity

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highest plasma concentration of drug at a specific time, indicats the rate of absorption

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peak levels

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lowest plasma concentration of drug at a specific time, measures rate at which drug is eliminated

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trough level

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caused from a too rapid IV injection of vancomycin, red blotching of the face, neck, and chest, this is a toxic effect not allergies

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redneck or red man syndrome

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a class of drugs that inhibit the formation of blood vessels needed for a tumor to grow and matastasis

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angiogeness inhibitors

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used for metastac carcinoma of the colon and rectum, can be combined with other chemotherapy drugs for treatment of some cancers

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avastin

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calss of pharmocologic agents used to enhance the body's own immune system, complex proteins produced by cells of the immune system

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biologic response modifiers

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interferons, colony-stimulating factors, interleukins, and monoclonal antibodies

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types of bmr

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occurs without previous exposure to the antibacterial drug

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inherent resistance

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caused by prior exposure to the antibacterial drug

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acquired resistance

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can also occur between antibacterial drugs that have similar actions, such as penicillins and cephalosporins

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cross resistance

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excessive reaction to direct sunlight or ultraviolet light leading to redness and burning of the skin

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photosensitivity

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two drugs that can cause photosensitivity are

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sulfanomides and tetracyclines

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a secondary infection resulting from drug therapy and the normal flora is killed

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superinfections

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damage to the auditory or vestibular branch of cranial nerve 8, damage can result in permanent hearing loss or temporary or permanent loss of balance

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ototoxicity

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kidney toxicity, can be caused when drugs such as tetracyclines, are given in high doses along with other nephrotoxic drugs

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nephrotoxicity

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british bacteriologists noted that mold was contaminating his bacterial cultures and inhibiting bacterial growth, called it penicillin

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alexander flemming

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a group of drugs that decrease the release of the virus from infected cells, thus decreasing the viral spread and shortening the duration of flu symptoms, must be taken within 48 hours of symptoms

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neuraminidase inhibitors

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activated when a pathogen invades the body, the body recognizes the pathogen as a foriegn substance and promptly begins producing antibodies, immunizations

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active immunity

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receives antibodies against a particular pathogen from another source. ex. newborns naturally receive this through antibodies passing through the placenta

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passive immunity

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anineoplastic plant alkaloids and other compounds derived from natural products that are ccs and block cell division in the M phase

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mitotic inhibitors

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agents that work by interfering with cancer cell growth and division in different ways and at various points in the development, growth, and spread of cancer, ex radiotherapy

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targeted thearpy agents

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cause cross linking of the dna strands, abnormal base pairing, or dna strand breaks, thus preventing the cell from dividing

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alkylating agents

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disrupt metabolic processes and can inhibit enzyme synthesis, classified as ccs and work in the s phase

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antimetabolites

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what is used to treat acute leukemia, breast cancer, head and neck cancer, lung cancer, osteosarcoma, non-hodgkins lymphoma

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antimetabolites

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what are folic acid antagonists, pyrimidine antagonists, purine antagonists, and adenosine deaminase inhibitors

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antimetabolites

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although hormones are not considered true chemotherapeutic agents, several classes are used in the treatment of cancer, such as estrogen and androgens

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hormonla agents

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antiimflammatory agents that suppress the inflammatory process that occur as a result of tumor growth

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corticosteriods

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estrogen, androgen or hormone like agents used to slow the growth of hormone dependent tumors

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sex hormones

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supress the secretion of follicle stimulating hormone and luteinizing hormone from pituitary gland

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gonadtropin releasing hormone analogues

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used for men with prostate cancer that has metastasized

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antiandrogens

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used in postmenopausal females or females who have had ovaries removed to slow tumor growth

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aromatase inhibitors

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prevent cell division in two ways, 1. binding to dna making it unable to seperate, 2 inhibiting rna preventing enzyme, ccns drugs

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anti tumor antibiotics

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agents that recognize proteins on specific cancer cells

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monoclonal antibodies

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whats produced in the lab and designed to recognize and bind to specific antigens on the surface cancer cells, they block the growth of the tumor and alter the body's immune system, use to target specific cancers

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monoclonal antibodies

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why would you not give a vaccine

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history of allergies to the vaccine, or any of its components, or have a moderate to severe illness

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what are the organs that are commonly effected by toxicity and what do you watch for

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ears-ototoxicity, liver-hepatotoxocity, kidneys-nephrotoxicity

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what are the types of infections and where can they occur

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bacteria-bladder, urinary tract, throat
virus- nose, throat, lungs
fungi- integumentary system, hair, nails, moist skin areas, yeast

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a yeast infection that causes white patches in the mouth/tongue, most common in babies

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thrush

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what causes thrush

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fungus-candida, your resistance to infection is low, fungus then grows
certain meds can cause thrush

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how does antineoplastics work

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by inhibiting or preventing the growth or development of malignant cells

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the excretion of crytaliline materials in the urine

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crystalluria

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what are helminths and where do they occur

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parasitic worms that feed on host tissue and found in the intestines

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segmented, enter intestine via food, have hooks, head, or suckers that attach to the tissue,

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cestodes (tapeworms)

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flat, nonsegmented, feed on the hose

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trematodes (flukes)

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whats another name for intestinal nematodes

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round worms

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what worm can you prevent getting if you cook your pork thoroughly

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tissue invading nematodes

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what are ways to encourage adherence to a therapeutic regimen

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pt. understanding of each mes purpose, food and fluid restriction, recommened food choice, storage of meds, appropriate recording sheet, and contact persons for questions

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what is the purpose of chemotherapy

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given in cycles to improve the likely hood that cancer cells will be destroyed and normal cells will recover

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what care and treatment can you give for nausea and vomiting during cancer treatments

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antiematics, sedatives, use soft toothbrush, ice chips, soft foods and IV if necessary

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an exaggerated immune response to a substance that is generally not harmful

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allergy

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signs and symptoms of allergies are

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swelling of nasal mucosa, sinusitis, redness and itching of conjunctiva, sneezing, coughing, bronchoconstriction, dsypnea, pain and impaired hearing, rashes, abdominal pain, bloating, vomiting, diarrhea

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serious life threatening allergy reaction

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anyphylaxis

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large viruses that cause infections

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herpes virus

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what type of herpes is usually associated with cold sores, capable of causing recurrent infections, spread by oral from one individual to another, can spread to genital area

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HSV-1-herpes simplex

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associated with genital herpes, transmitted by contact with infectious lessions or secretions, capable of causing recurrent infections, spread by sexual contact, and an infected mother can transmit the disease to an infant during childbirth

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HSV-2

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contact or respiratory route, also known as chicken pox or shingles

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HSV-3

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very common infectous disease world wide, doesn't require treatment unless immunocompromised, transmitted by body fluids such as saliva, urine, kissing, sexual contact, shared food, pregnant females to their fetus, can lead to fatal pneumonia or blindness

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HSV-5-CMV-HHV-5

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what is caused by damage to dna within a cell

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cancer

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more than one mutation must develop before a malignancy will occur, also is a multistep process and may take years to occur

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cancer

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what drugs are used to treat cancer

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anticancer drugs, cancer chemotherapeutic agents, antineoplastic drugs, cytoxic therapy

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things that can influence cancer development are

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enviroment, infective agents(viruses), diets and genes

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class-anitviral
uses-symptomatic treatment of uncomplicated acute illness caused by influenza A or B in adults and children 1 yr. and older
side effects- frequent nausea, vomitting, diarrhea,
rare abdominal pain, bronchitits, dizziness, headache, cough, insomnia, fatigue, vertigo
precautions- renal impairment

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tamiflu

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class-anticoagulant
uses- mainly to prevent thromboembolic conditions, prolongs clotting time and are monitored by the PT
side effects- bleeding
precautions- do not take aspirin, do not eat green leafy veggies, and reduce vit, k intake

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coumadin

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class- sulfonylureas
uses-synthetic preparations that stimulate insulin release or otherwise alter the metabolic response to hyperglycemia
side effects- agitation, apathy, coma, convulsions, confusion, increased appetite, nausea, nervousness, rapid heartbeat, stupor, sweating, tingling of tongue and lips, tremors
precautions-diabetic ketoacidosis with or without coma, type 1 diabeties mellitus, hypoglycemic reactions, hepatic/renal impairment

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oral hypoglycemic

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class-antispasmodic
uses- relief of symptoms (urgency, incontinence, frequency, nocturia, urge incontinence) associate with uninhibitied neurogenic bladder, reflex neurogenic bladder
side effects- constipation, dry mouth, somnolence, decreased perspiration, decreased salivation, imptence, urinary retention, blurred vision
precaution-GI/GU obstruction, glaucoma, toxic megacolon
cautions- renal/hepatic impairment, hypertension, prostatic hypertorphy

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ditropan

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class- vitamin
uses- prevention of scurvy, acid-ification of urine, dietary supplement

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ascorbic acid

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class- bacteriostatic
uses-alternative drug in persons allergic penicillin, used to treat UTI's, ear infection, newborn eye prophylaxis
side effects-skin rash and itching, blood disorders can result from prolonged use and high dosages, photo sensitivity,
precaution- avoid during 3rd trimester, avoid sunbathing

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sulfonamides

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beta-lactum stucture, interferes with bacterial cell wall sythesis, cephalosporins can inactive this drug and other beta-lactam antibiotics, used to treat lower repiratory infections and uti's

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pencillins

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class-antibiotic
uses-treats infections, rickettsia, m. pneumonieae, acne, lyme disease, gonnorrhea and others
side effects-dizziness, light headedness, diarrhea, nausea, vomitting, abdominal cramps, photosensitvity
precautions- children under 8, hypersensitivity to sulfites

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tetracyclines

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class-macrolides
uses-treatment of moderate to severe infections
side effects- none
precautions- liver toxicity when taken in high doses

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e-mycin

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class-brm
uses-treatment anemia in pts recieving chemo, chronic renal failure, HIV, needed allogenic blood transfusions
side effects- sense of well-being, hypertension, arthralgias, nausea, edema, fatigue, injection site reactions, rash, diarrhea, shortness of breath
precautions-uncontrolled hypertension, history seizures, tumor growth, increased risk for serious cardiovascular reactions

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procrit

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class-anitfungal
uses-vulvovaginal candiasis
side effects-burning, stinging, itching, both in vagina and topical, also causes headaches and skin rash
precautions-aboid vaginal preparations during the 1st trimester

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monistat

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class-anitfungal
uses-treat candida infections and cryptococcal meningitis
side effects-P.O. anorexia, nausea, vomiting, diarrhea, stomach cramps, rash, headaches
precautions- hypersenseitivity to other drugs like fluconazole

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diflucan

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class- antifungal, antiportoal
uses-IV injection, fatal fungal infections
side effects- fever, chills, headache, anemia, hypokalemia, anorexia, malaise, generalized pain, nephrotoxicity
precautions-renal impairments, give only for potential bronchospasm, renal toxicity, hypotension

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fungizone

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class-antiubercular
uses-treat tuberculosis, prophylactic measure againts tb
side effects- drowsiness, tremors, rash, blurred vision, photosensitivity, tinnitus, dizziness, dry mouth, constipation
precautions- renal impairment and chronic liver disease,

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INH

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class- anitubercular
uses- active tb and for selective gram + and gram - bacteria including neisseria meningitidis
side effects- hepatoxicity, turns body fluids orange
precaustions-liver enzymes should be closely monitored

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rifadin

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prevents bascterial growth in kidneys and bladder, but is not effective for systemic infections, lower dosages-bacteriostatic effect, higher doses-bacteriocidal effect

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urinary antiseptics

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used to relieve urinary pain

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urinary analgesics

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class-cholinergic
uses-urinary stimulant, increase bladder tone of detursor muscle
side effects-GI distress, dizziness, fainting, abdominal cramps, nausea, vomiting, diarrhea, flatulence

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urecholine

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class-muscarinic receptor antagonists
uses- treat overactive bladder, urinary frequency, incontinence
side effects-dry mouth, headache, dizziness, fatigue, constipation, syspepsia, uti, dry eys
precautions-gastic retention, uncontrolled angle-closure glaucoma, urinary retention

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detrol

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class- urinary analgesics
uses- relieves pain, burning sensation, frequency, urgency
side effects-Gi upset, red-orange urine, blood dyscrasia, nephrotoxicity, hepatoxicity
precautions-do not use in pts, with hepatic/renal insufficiency

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pyridium

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meds designed to slow or inhibit the three hiv-related enzymes. comb therapy, such as HAART is the current treatment

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antiretrovirals

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combinations of two or three drugs into one convenient pill

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combination therapy

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highly active antiretorviral therapy

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HAART

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goals of HAART are

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decreasing VL to undetectable levels, preserving and increasing the number of CD4+ T cells, preventing resistance, having the client in good clinical condition, and preventing secondary infections and cancer