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Patho Pharm > Biodefense & Cancer > Flashcards

Biodefense & Cancer Flashcards

1
Q

Leukocytosis

A

WBC count > 10,000
Neutrophils will have L shift:
high # bands/immature cells
Low # segmented/mature cells

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2
Q

Antibacterial: bacteriocidal

A

Kills bacteria

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3
Q

Antibacterial: bacteriostatic

A

Disrupts replication

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4
Q

Antibacterial resistance

A

Bacterial cell divides and one mutates

Mutant cell resistant to antibiotic

Only new resistant cell survives

New resistant bacterium cont to divide

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5
Q

Common antibiotic ADRs

A

Superinfection

Allergy/hypersensitivity (anaphylaxis)

Diarrhea

(Resistance is not ADR)

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6
Q

Clostridium difficile (C. diff)

A

Common superinfection

Pathogen thrives when normal GI flora is destroyed by antibiotics

Worse with high doses, >1 antimicrobial, and broad-spectrum

Leads to pseudomembranous colitis

Can occur days or weeks after start of antibiotics

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7
Q

Client education for antibiotics

A

Take full course of pills (most pts feel better w/in few days)

Don’t stop if sx improve (at this point most susceptible bx have been killed - still many present)

Don’t share, don’t save, don’t take antibx if you don’t need them

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8
Q

Cephalosporins

A

Cephalexin 1st gen
Cefoxitin 2nd gen
Cephtrixone 3rd gen
Cefapime 4th gen

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9
Q

Beta lactam antibiotics

A

All similar structure and fx: Penicillins, cephalosporins, mononbactams, carbapenems

Effective against gram+ and -, affect cell wall (peptidoglycan)

D/t similar structure/function if there’s hypersensitivity reaction to one, incr chance will have reaction to all

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10
Q

Vancomycin (Vancodon)

A 
Monobactam
Bacteriocidal (destroys cell walls) AND bacteriostatic (alters RNA synthesis) = very effective antibiotic

nephrotoxic and ototoxic @ high doses

Active against gram+, incld MRSA

Tx serious UTI, skin infection, lower resp. infection

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11
Q

Penicillin

A

Inhibit cell wall synthesis - bactericidal

Most common antbx used for strep throat so it doesn’t develop into of rheumatic fever, or cause worse complications

high dose causes hyperkalemia

type 1 hypersensitivity immediate onset (w/in 2 mins), anaphylaxis - tx w/ epi pen

If pt allergic to this antbx, 5-10% chance will be allergic to cephalosporins

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12
Q

Cephalosporins

A

Destroy cell wall - bacterialcidal

Nephrotoxic

Gen 1 active against skin and soft tissue infections, gram+ coverage —-cephalexin (Keflex)

Gen 2 active against 1st gen and klebsiella, E. coli, gram+ AND gram- coverage, broad-spectrum —– cefoxitin (Mefoxin)

Gen 3 adds broader coverage for gram- bacteria —— ceftriaxone (Rocephin)

Gen 4 best gram- coverage but only used for serious HAIs (resistant to beta-lactamases) and has fewer ADRs ——cefapime (Maxipime)

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13
Q

Empiric therapy

A

Broad-spectrum antibx prescribed until results from culture sensitivity come back

HCP may prescribe new narrow-spectrum antibx to target specific bacterium

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14
Q

Vancomycin ADRs and interactions

A

ADRs: infusion reaction, thrombophlebitis, chills, fever, hearing loss, nephrotoxicity

Don’t use w/ loop diuretics, digoxin, aminoglycosides (also nephrotoxic)&raquo_space; nephrotoxicity

Rapid IV infusion = “Red man syndrome” red neck, intense itching, upper body rash d/t rapid release of histamine
infusion should be > 1 hr
infusion reaction not allergic reaction
Pre-dose w/ benadryl

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15
Q

Ciprofloxacin (Cipro)

A

Fluoroquinolones: Synthetic broad-spectrum

MOA: alter DNA via DNAgyrase. Active against pseudomonas, gram+, cocci

Tx pneumonia, UTI, gonorrhea, bone, joint, eye, ear infx

ADR: N/V, spontaneous achilles tendon rupture (more common peds)

Cipro only fluoroquinolone approved in peds

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16
Q

Cancer cells break the rules

A

avoids apoptosis

no contact inhibition (grows where ever)

neoplasm (abnormal cell growth/tumor)

malignant: cells can invade and kill nearby tissue; able to metastasize
metastasis: malignant cells spread to other part of body

17
Q

Why are tumors surgically removed

A

Cancer cells don’t die so they are removed

Cells still have enough normal markers that immune sys doesn’t destroy them

18
Q

Why cancer wins

A

self-sufficiency in growth signals

insensitivity to antigrowth signals

evading apoptosis

limitless replication potential

sustained angiogenesis

tissue invasion/metastasis

19
Q

Causes of cancer

A 
tobacco
asbestos
UV light
carcinogens
viruses (HPV)
meds
oncogenes
damaged tumor supressor gene
diet
20
Q

Dysplasia

A

abnormal cells, look abnormal under a microscope but are not cancer; can develop into cx

Occurs in HPV

21
Q

Metastasis

A

Malignant cx cells spread via lymph sys and vascular sys

Common sites are brain, lungs, liver, bones, adrenal glands

22
Q

TNM staging

A 
T = size of tumor
N = # of nearby lymph nodes that have cx
M = whether cx has metastasized
23
Q

BRCA

A

BRCA is a tumor suppressor gene that all humans have

BRCA mutation causes cx

24
Q

BRCA 1 and BRCA 2

A

15% of breast cx pts have gene mutation
15% w/ BRCA mutation will get ovarian cx
BRCA 1 = 55-65% will get cx
BRCA 2 = 45% will get cx

25
Q

Tamoxifen

A

Anti-estrogen
Many ADRs
Prevents relapse in estrogen receptor cx

26
Q

Antiemetics

A

Zofran (ondansetron) prevents N/V caused by chemo

Compazine (prochlorperazine) is an antipsychotic used to control severe N/V

27
Q

Beta lactamase

A

Enzymes that are produced by bacteria which provide resistance to beta lactam antibiotics

If bacteria is resistant to one beta lactam, will likely be resistant to others

28
Q

Desensitization

A

Expose pt to small amt of antibiotic over and over to decrease their hypersensitivity

29
Q

Penicillin route and dose

A

Route: IM
Mod - severe infx: 600k - 1.2 mil units/day
Pneumonia: 600K units q12hr
Gonorrhea: 4.8 mil units divided 1x

30
Q

Cipro route and dose

A

Route: PO, IV
UTI: 250-500 mg q12hr x3-7d
URI: 500-750 mg q12hr x7-14d
Pneumonia: 400 mg q8-12 hr IV x10-14d

31
Q

Vancomycin route and dose

A

Route: PO, IV

Systemic infx: 500 mg q6hr

Patho Pharm (3 decks)

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