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12 Cards in this Set

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What drugs would you use to give to a newly diagnosed HIV patient?
Fuzeon (Fusion), AZT (Reverse transcriptase), Protease inhibitor (protein coat)
HAART - highly active antiretroviral therapy
Nuke (AZT) + Non nuke (Nevirtadine) + Protease Inhibitor
band played on. describe how the disease and the HIV virus came to be understood in the medical community, and how it affected the public
opportunistic diseases/homosexual ptsblood banks/drug users/political ramifications/
Therapeutic approach to life threatening disease emergency room empiric therapy
-broad spectrum (Gr+, Gr- and anaerobic)
-culture
-narrow spectrum discontinue unnecessary antibiotics
how do birth control pills work?
-Progesterone/Estrogen levels.
-negative feedback (hypothalamus, GnRH, FH, LH)
-trick body to think your already pregnant

eg: Mono-, Bi-, Triphasic or patch
define palliative care
-Palliative care: Treatment to relieve, rather than cure, symptoms caused by cancer. Palliative care can help people live more comfortably
-Hospice care always provides palliative care. However, it is focused on terminally ill patients-people who no longer seek treatments to cure them and who are expected to live for about six months or less.
5 clinical situations where prophylactically antibiotics are indicated
-prevent strep infection in pts w/history of rheumatic heart disease (pts may req 20 yrs of trx)
-pretreatment of pts undergoing dental extractions/prosthetics (heart valves) prevent seeding
-prevent meningitis/ tuberculosis or for ppl who work with infected pts
-trx prior to certain surgeries(bowel/GI or joint replacement)
-trx mother with zidovudine to protect fetus from possible HIV infected mother. use AZT
difference between insulin dependent and non insulin dependent and treatment
IDDM-insulin dependent diabetes mellitus. occurs in youth, malnourished, 10-20% of diabetes pts, little genetic link, no working beta cells in the islets of langerhans in the pancreas. U100 insulin injections subQ in the US

NIDDM-noninsulin dependent diabetes mellitus. 35+ yo, overweight, 80-90% of diabetes pts, strong genetic link, few working beta cells in the islets of langerhans in the pancreas. diet/exercise->if not, oral sulfonureas->insulin (or combo)
drug treatment to give a patient with gastric ulcer, and why?
if on aspirin, switch two COX II inhibitor bc less stress on GI

if due to h pylori, then give
a. (anaerobic) antibiotics KILL h pylori tetracyclin/amoxicillin
b. bismuth (pepto), works in combo with antibiotics to kill h pylori
c. antacid/Proton Pump Inhib/H2 receptor antagonist (acid is not the cause of ulcers but can aggravate stomach. so reduce acid flow/neutralize it
define bacteriostatic and bacteriocidal
bacteriocidal kill bacteria (for pts with defective immune systems:cancer/AIDS/diabetes) and for overwhelming infections. pts must take full course of rx regimen

bacteriostatic only inhibits bacterial proliferation while hosts intact immune system does the killing.
describe drug development process 9 steps (preclinical post to FDA)
Average drug 12 years start to finish
10,000 compounds submitted
1:3 chance of approve and make it to market
1:2 chance after Phase I
$500M to get your drug

1.Target a disease

2.Lead compound ($15-35M)
-random
-combinatorial
-target synthesis ie: look at disease and see how it works (1:50)
-drug modeling ie: computer designs molecule that will work(1:15)

3. Discovery testing ($21-41M)

4. Chemical synthesis scale up ($82-110M)
-watch out for chirality (different versions)
5.Safety ie:Animals ($65-91M)
one rodent and one nonrodent that resembles humans (chinchilla for ears)
6.Investigational New Drug Application

7.IRB-Institutional review Boards to protect pts. composed of 5+experts/lay ppl with backgrounds in disease, patients or patient types to ensure adequate review and safety

8.Phase Trials
Phase I Clinical Studies ($9-19M)
-20-80 healthy ppl
-safety (not killing)
-small companies
Phase II Clinical Studies ($21-37M)
-100-300 sick ppl
-effectiveness
Phase III Clinical Studies($88-144M)
-1000's of pts
-double blind (control/uncontrolled/sugar pill)

9.New Drug Application (labeling)
-FDA approves some uses for your drug but not others
-may have to reapply if more data needed
describe how you treat a patient with a newly diagnosed large cancerous tumor. the tumor is accessible to surgical and drug therapies
want to relieve pt of "neoplastic burden"
a. Surgery (debulking if accessible) and/or Radiation
b. Chemotherapy: cell-cycle specific and non-cell cycle specific -like antibiotics
-careful not to overdo, might cause cancer later in life

if cannot achieve manageable level of cancer cells, palliative care to allow normal life while dealing with disease, pt could die within 3-6 mos
in the cancer warrior describe the research done in judah folkmans laboratory and its importance to angiogenesis/cancer treatment?
eye of rabbit
keeping cancer cells alive: angiogenesis-new blood vessels
find the factor that prevents angiogenesis to prevent growth of cancer
Endostatin, inhibitor of angiogenesis
Thalidimide, existing drug, birth defects
Egg research