Antibacterial, antiviral, antifungal Flashcards
Antimicrobial
drug that is active against bacteria, virus, fungi, or parasite
gram positive bacteria
thicker wall
multiple steps of peptidoglycan synthesis are drug targets
gram negative bacteria
thinner wall
membrane make it harder for drugs to penetrate
entry to aqueous pore
selective toxicity
acts only on bacteria and not on human cells
bactericidal
kill bacteria
concentration dependent
need to get drug to a certain level
time dependent
need to get drug concentration there for a certain amount of time
what is preferred spectrum broad or narrow?
narrow because is treat couple of bacteria and prevent resistance
What are 3 factors when selecting drug treatment?
Bacteria, host specific, and drug specific factors
Cell wall MOA
bind penicillin binding proteins and inhibit linking of peptide chains
Cell membrane MOA
Make gram-negative membrane permeable so compounds can cross cell wall
usually topical due to toxicity
protein synthesis MOA
action at ribosome to block mRNA translation
DNA synthesis MOA
Block DNA so cant correctly form
DNA strand MOA
interact with DNA to cause DNA breaks
aminoglycosides and macrolides ends with
-mycin or -micin
penicillin-
meds?
usage?
AE?
amoxicillin, amoxicillina/clavulante (augmentin), Pipercillin/Tazobactum (Zosyn)
Commonly used for broad coverage
AE: GI, hypersensitivity
Cephalosporins
Cephalexin (Keflex), Ceftriaxone (Rocephin)
Nosocomial infections, surgical prophylaxis
AE: GI, hypersensitivity
Glycopeptide
Vancomycin
Treats MRSA, C. Diff
AE: Hypotension- reduce by not giving it too fast
Aminoglycosides
Gentamicin
AE: Ototoxicity, nephrotoxicity
Macrolides
Azithromycin (Z-pack)
AE: GI issues, QT prolongation, CYP inhibitors (DDI)
Tetracylines
Doxycycline
AE: usually well-tolerated, GI, photosensitivity
Streptogramins AE?
Arthralgia, myalgia
Lincosamide
Clindamycin
AE- GI, can cause C. diff
Fluroquinolones
ciprofloxacin, levofloxacin (Levaquin)
AE: GI, phototoxicity, tendon rupture, significant hypoglycemia
Nitroimidazole
Metronidazole (Flagyl)
GI< metallic taste, less common peripheral neuropathy
Sulfonamide
Sulfamethoxazole/Trimethoprim (Bactrim)
Can cause allergy, Stevens-Johnson syndrome
Innate drug resistance
drug cannot get into the cell
Acquired drug resistance
bacteria has changed over time
What can PT do to prevent drug resistance
discourage antibiotic overuse,
finish the full course of antibiotics,
infection prevention and control protocols
what factors contribute to drug resistance?
misuse of antibiotics, international OTC antibiotics, antibiotics in livestock
Rehab considerations for antibiotics
patient education on compliance with medication dosage,
handwashing, PPE, disinfection equipment
C. diff transmission and symptoms
contact, fecal to oral route (bacteria can survive 5 months in environment.
Symptoms: watery diarrhea, abdominal cramping, fever
C. diff occurs when ?
GI flora interrupted (broad-spectum antibiotics, chemo, immunosuppressive therapy)
Enteric precautions for C. Diff
gloves, gown, chlorine-based cleaner, hand washing
DDI with antibiotics
several classes cause significant interactions with other drugs
erythromycin and warfarin- increase bleeding risk
antibiotics blood cell formation
inhibit RBC, WBC, platelet formation (increase bleeding risk)
what drugs class increase dizziness or vertigo?
doxycycline, aminoglycosides, fluroquinolones
What drug classes cause ototoxicity?
aminoglycosides and vancomycin
box warning for hep A vaccine
thrombosis risk
AE interferon Hep B
flu-like symptoms
most common AE with direct acting antiviral (DDA)?
fatigue, weakness, headache
what to watch out for when taking amiodarone and DAA
bradycardia
What is HAART?
Combination therapy to increase efficacy and decrease resistance
symptoms when taking antiviral meds
NVD, SJS, myalgia, arthralgia, tremors, sizures
other potential manifistations of antiviral drugs
cardiac dysfunction, hyperglycemia, peripheral neuropathy
Rehab concerns about antiviral drugs
exercise tolerance will be affected
interferon drugs may produce flu like symptoms
anemia
reduced max o2 uptake
viral load might increase during periods of intense exercise
prolong intense exercise impairs immune function
class for nystatin
polyenes
fluconazole and ketoconazole class
azoles
what to watch out for when taking Azoles?
cyp interactions
Which Hepatitis does not have a vaccine?
Hepatitis C
Inactivated vaccine
Killed pathogen
Require multi-dose or booster
subunit or conjugated vaccine
piece of the pathogen
may need booster
live attenuated vaccine
weakened pathogen
lifelong for most
toxoid vaccine
pathogen toxin instead of actual pathogen
may need booster
which kind of vaccine shouldn’t take when immune compromised?
live attenuated
Does vaccine immune response happen immediately?
no, it takes 2 weeks
chemotherapy
drugs that inhibit growth and replication of cancer cells
target therapy
damage caner cells by blocking specific genes or proteins
immunotherapy
hormones and drugs that use the immune system to treat cancer
oral chemotherapy precautions
wear gloves when touching laundry or body fluids
extra caution in pregnancy or planning pergnancy
look up the medication
therapeutic concerns with chemo
falls, decrease cognition, peripheral neuropathy, impaired sensation, strength, and balance, cancer related fatigue
Vancomycin drug class
Glycopeptides
Gentamicin drug class
Aminoglycosides
Azithromycin (z-pack) drug class
macrolides
clindamycin drug class
Lincosamides
Fluoroquinolones drug endings
-floxacin
Innate resistance
drug itself cannot get into the cell
acquired resistance
the bacteria has changed over time
bacteriostatic
inhibit growth, require host immune system
not useful for someone with compromised immune system
What antibiotic class are broad coverage
penicillians, Macrolides, Tetracylines, Sulfonamide
TB drugs have potential AE in?
liver and kidney issues, visual disturbances, CN VIII damage, neurologic symtoms
what cause secondary multidrug-resistant TB
noncomliance or received inadequate treatment
HIV therapy is based on
previous treatment, reistance, genetic factors, HIV RNA count, CD4 coutnt
Rehab concerns to HIV
opportunistic infections, neuromuscular problems
2 types of Fungal Infections
superficial, systemic
Azoles AE
arrhythmia, menstrual irregularities
