Cancer and Antibiotics Pharm Flashcards
Chemotherapty
use of chemical against invading organsims
Antibiotics
A chemical that is produced by one mibcrobe and can harm other microbes
Book definitions for antibiotics
Chemical that can inhibit the growth of specific bacteria or cause the death of susceptible bacteria
Anti-infective/ Anti-microbial drug
Any agent that can kill or suppress pathogens and is classified based on the type of organism they treat
anti neoplastic aka
chemotherapy
pathogens are
Micribes that cause human disease
Pathogen that cause disease categories
bacteria, viruses, fungus, parasites, protozoa and worms
exotoxins
proteins release by bacteria into surrounding tissues that can inactivate or kill host cells
endotoxins are
harmful non-protein chemicals that are part of the outer layer of the normal cell wall of gram negative bacteria. they are released after the bacteria die and cause inflammation, fever and chills
classify bacteria criteria
cell walls (GRAM STAINING!! :D)
shape (bacillli or cocci)
oxyten utilization (anaerobic vs aerobic)
Which bacteria (positive or negative) are harder to treat with antibiotics
Negative
4 general sources with HAI
patient flora
invasive devices (vent)
medical personnel ( us)
medical environment
anti-infectives are created in 3 ways. What are they
using living microorganism
synthetic manufacturing
genetic engineering
Bacterialsidal means
homicidal medications - out right kill the bacteria
bacteriostatic means
Slows down baccterial grown allowing for the body to eliminate the microoransim
Classification of anti-infectives
MOA
Chemical class (what we will focus on)
Spectrum
MOA of anti-infectives
inhibits
1 cell wall synthesis
2 protein synthesis
3 nucleic acid synthesis
4 metabolic pathways
Disrupts plasma membranes
Chemical class of anti-infectives
refer to the fundamental chemical structure shave by a group of anti-infectives
broad spectrum vs narrow spectrum
broad kills a bunch of stuff, narrow less specific
why are anti-infectives not hurtful to the host’s cell walls
different cell walls and process of which cellular metabolism happens
how to select antibiotics
someone grabs a culture to show what is growing, then the sensitivity will show what will work if the bacteria are not resistant
Can some antibiotics cause birth control to become ineffective?
yeaaaaa. tetracycline is notorious
empiric antimicrobial therapy is
the “most likely” microbiological etiology on the clinical presentation.. how we fucking got these superbugs
Prophylactic use of antimicrobials and what circumstances would you use this
agents given to prevent infection rather than to treat an established infection
- specific types of surgery
- prosthetic heart valves - gets them for literally everything like even going to the dentist (endocarditis)
- neutropenia/ suppressed immun system
- dog bites
- retroviral (HIV)
Which antibiotics promote resistance
broad spectrum antibiotics because it wipes out the competition
mechanisms of drug resistance (5)
destruction of the drug
prevention of the drug entry into the pathogen
pump changes
alters drugs target site
development of alternative metabolic pathways
CDC delaying emergence of drug resistance
vaccinate
take catheters out (#1 source of infections)
target pathogens (culture etc)
access the experts (literally the people who studied this fucking stuff - not GP or NP)
practice antimicrobial control
use data
treat infection not contamination
treat infection not colonization
know when to say no to vanco
stop treatment when infection is cured or unlikely (prescribe for the appropriate amount of time)
isolate the pathogen
break the chain of contagion
***EDucation for antibiotics
dont discontinue prematurely, complete full prescription, take at evenly spaced intervals, watch for adverse effects like superinfections
how do people misuse antibiotics
trying to treat an untreatable infections (like a virus)
treatment of an idiopathic fever
improper dose
don’t treat prophylactic
omission of surgical drainage
when old people and kids are sick, they are more sensitive to what adverse effects
GI and CNS effects… so check yo fuckin’ dose
monitoring of antimicrobial treatment
clinical responses and lab results
frequency of monitoring is direct ratio to how bad the infection is
reduction of symptoms
serum drug levels for toxicity
monitor for SUPERINFECTION
most common route of people getting anaphylaxis from antibiotics
parentral
penicilins MOA
Weaken and destroys cell wall
is a bactericidal
cephalosporins MOA
cause baccteria to build weak cell walls when dividing
bacteriostatic or bactericidal dependind on the dose
Carbapenems MOA
inhibits cell membrane synthesis
bactericidal
Vancomycin MOA
Weakens and destroy the cell walls
Bactericidal
Adverse effects of penicillins
Gi Symptoms, superinfections, allergic reactions
Penicillin ending
cillin
what kind of spectrum is penicillin used for
Broad spectrum and most effective against gram positive bacteria
Carbapenems end in
peneum
carbapenems Adverse effects
GI n/v diarrhea, CNS and confusion, seizures, hallucinations, superinfection only through IV site
Vancomycin route and adverse effects
routes IV, po.
Renal failure
ototoxicity (tinnitus)
red-person syndrome - IV too fast and body releases histamine, but its not a histamine. (anaphylaxis with rashe and flushing on face and neck)
thrombophlebitis - rotate those IV sites
vancomycin is usually used with
MRSA
so it is restricted to severe infections
weight based dosing
need serum levels so monitor peak and trough
antibiotics that affect bacterial protein synthesis
tetracyclines
macrolides
aminoglycosides
tetracyclines are used for
chlamydia
skin infections
TB
adverse effects with tetracyclines
photosensitivity and rash
teeth and bones
no one under the age of 8
contraindications and interactions with tetracycline
food decreases absorption especially milk
calcium, iron, mag, aluminum, dairy, antacids
decreases the effect of oral contraceptives
macrolides prototype erythromycin routes
PO, topical, ophthalmic, IV
Adverse effects of macrolides or the mycin
Cardiotoxicity and ventricular dysrhythmias (IV)
Ototoxicity, superinfections (yeast infections)
GI issues (so normally enteric coated)
warfarin gets inhanced
Macrolides or mycin treat what kind of bacteria
Gram + bacteria, and are broad specturm
Aminoglycosides prototype is gentamicin what are the routes
IM, IV, intrathecal, topical
what are aminoglycosides or micins adverse effects
bone marrow suppression, impaired balance, BLACK BOX WARNING: ototoxicity and nephrotoxicity permanently
Fluoroquinolones prototype is ciprofloxacin what do they all end in
floxacin
MOA of fluoroquinolones
inhibits DNA replication and cell division by inhibiting the enzymes
bactericidal
fluroquinolones adverse effects aka ciprofloxacin
tendontoxicity
photosensitivity
cardiotoxicity
BLACKBOX warning Risk of tendonitis and tendon rupture
sulfonamides prototype (TMP-SMZ) is used for
broadspectrum and is commonly used for a UTI
MOA of sulfonamides or TMP-SMZ
inhibit synthesis of folic acid
Adverse effects of Sulfonamides or TMP-SMZ
GI, Skin reactions, bone marrow suppression, kernicterus (Jaundice that is fatal so no one under 2 months or pregnant women), Crystalluria and renal damage
remember to tell people that are taking sulfa meds
to drink 3 liters of water a day and have 1500 mL output because of crystalluria
contraindication and interactions
pregnancy, breastfeeding, children less than 2 months,, folate deficiency, severe renal impairment.
Caution: elderly for CNS
Interacts with warfarin, potassium sparing diuretics, postassium supplements
metronidazole adverse effects
N/v dry mouth, headache, neurotoxicity, BLACKBOX WARNING: cancer in lab animals
metronidazole treats
peptic ulcer disease
and infections caused by obligate anaerobic bacteria
causes harmless darkening of urine
antimycobacterials are used for
TB, atypical mycobacterial infections (leprasy, secondary infections to HIV and AIDS)
prophylactic treatment of TB
2 drugs for 2 months
MOA of anti tubercular drugs
inhibits cycobacterium cell wall and or dna rna synthesis
ACTIVE TB 1ST LINE DRUGS FOR TREATMENT (TEST)
RIPES
Rifampin ** (red orange tint to body fluids and decreases effectiveness to oral contraceptives)
Isoniazid (INH related peripheral neuropathy is treated with vitamin b6)
Pyrazinamide
Ethambutol
Streptomycin
Antivirals are
used with very few viral infections because they dont work on many
Antiretroviral treatment for HIV
HIV targets T4 lymphocytes using reverse transcriptase to make viral DNA.
SO antiretrovirals block this synthesis
why using antiretroviral medications for pregant women
can reduce baby getting hiv by 70% when it is delivered
they take from week 14 to week 34 then IV during labor, and newborn takes antiretroviral for 6 weeks following deliver and has to be given with in 48 hours of birth
PrEP
preexposure prophylaxi of HIV infection
what is PEP and when shoud it start
Post exposure prophylaxis of HIV infection
and should be started 24 - 36 hours after exposure to an HIV+ patient
