Diabetes, Antibiotics, and Antivirals Flashcards
T/F the pancreas is both an endocrine and exocrine gland
True:
-exocrine: excretes digestive enzymes into the duodenum of the pancreatic duct
-endocrine: secretion of 2 hormones into the bloodstream (insulin and glucagon)
Which two hormones does the pancreas release into the bloodstream?
- insulin: regulates blood glucose levels
- Glucagon: increases blood glucose in order to maintain normal blood glucose levels and prevent hypoglycemia (insulin antagonist)
What are fasting blood glucose levels?
between 70-110 mg
Insulin and Glucagon release
After meals blood glucose rises- insulin is released to bring levels back down
-if blood glucose levels fall then glucagon is released which release glucose from the liver and levels increase
What is diabetes?
A problem with insulin production and function
-most common: type I and type II
Type I Diabetes
Unable to synthesize insulin due to a destruction of pancreatic beta cells
Type II diabetes
a combination of beta cell dysfunction and decreased sensitivity of peripheral tissues to circulating insulin (insulin resistance)- insulin is present but tissues fair to respond to it
-pts have a genetic predisposition in combination with poor diet, obesity, and lack of exercise
Treatment for Type I and some Type II diabetes
Exogenous insulin is given to help maintain normal glucose levels and proper metabolic function
-can be given in short-acting, intermediate-actin, or long-acting concentrations (can combine 2 forms for optimal control of glucose)
Insulin administration
Must be a subcutaneous injection- cannot be absorbed through GI wall
-dosage based on blood sugar levels, exercise, and dietary modifications
-short-acting are used with meals and if blood sugar rises any other time
-long-acting is often given 1x/day
Insulin adverse effects
hypoglycemia: blood sugars fall dramatically
Medications for Type II diabetes
-insulin may be used
-other agents to prevent hyperglycemia and provide long term glycemic control
-combination often used
-drugs that stimulate insulin secretion and supply
-insulin sensitizers: Metformin- inhibits glucose production and increases sensitivity of peripheral tissues to insulin
-suppressing glucagon secretion
What is the cornerstone for Type II diabetes?
Metaformin when combining with other drugs
Nonpharamcological Interventions for Diabetes
-weight loss
-diet (carbs, fats, proteins)
-exercise: increases sensitivity of peripheral tissues to insulin
What are antibacterial drugs used for?
to treat infectious disease- they must kill the growth of an organism without causing excessive damage to the other cells (selective toxicity)
What do antimicrobial drugs/ or antibiotics treat?
used to treat small, unicellular organisms
How are bacteria categorized?
According to shape and staining of the cell
Examples: gram-positive cocci
What are broad spectrum agents?
drugs that are effective against a variety of bacteria
Bactericidal
drugs that kill or destroy bacteria
Bacteriostatic
drugs that limit bacteria growth
What are the 3 main mechanisms of action of antibacterial drugs
- inhibit bacterial cell wall synthesis and function
- inhibit bacterial protein synthesis
- inhibit bacterial DNA/RNA function
Examples of Antibacterial Drugs
-penicillin
-caphalosporins
-bacitracin
-vancomycin
-erythromycin
-clindamycin
-flouroquinolones
Adverse effects of antibiotics
-hypersensitivity reactions: skin rashes, itching, respiratory difficulty
-GI problems
What is one of the most serious problems with antibacterial drugs?
Resistance to antibacterial drugs
**can be very dangerous especially if cross-resistance to several drugs occurs
How can resistance to antibacterial drugs occur?
- certain bacterial strains have a defense mechanism against certain antibiotics
- the bacterial cell modifies or masks the site where the drug would typically bind within the cell
- if the drug’s ability to penetrate the bacterial cell is reduced
What are the most common drug resistances?
-VRSA
-MRSA
-VRE
-PRSP
T/F antibiotics are effective at treating viruses
false- there are a limited number of FDA approved drugs that act as antivirals because it is hard to selectively destroy the virus without destroying some human cells
Viruses rely on what to function?
they rely on the host cell to function- rely completely on the metabolic processes of the human
Which viruses have drugs for treatment?
-Hep B
-Influenza
-Herpes
-CMV
-warts
-RSV
What is viral resistance?
When the virus mutates and alters their structural characteristics so that drugs that were previously effective will no longer be effective- it is a growing concern!
What are interferons?
a group of proteins that produce pharmacological and physiological effects and help to control viral infections
-all of the body’s cells can produce them to prevent a virus from spreading
**are NOT an antiviral drug but can help treat certain viruses
Which viruses do interferons help treat?
-Hep B and C
-certain cancers
-MS
What are the two goals in pharmacological management of HIV
- to control proliferation of HIV
- treat and prevent various infections that can overwhelm the immune system
T/F there are no drugs available to kill HIV in humans
true- several antiviral drugs can inhibit the replication to reduce mortality and morbidity
What do Protease Inhibitors do?
they inhibit the HIV protease enzyme which helps to prevent HIV replication and the progression of HIV related disease
What do Reverse transcriptase inhibitors do?
are used to inhibit the replication and proliferation of HIV to keep it from spreading
-they inhibit a key step in the HIV replication process
What is HAART?
Highly Active Antiretroviral therapy- when several anti-HIV drugs are administered simultaneously to provide optimal inhibition of HIV replication and proliferation
**involves using at least 3 anti-HIV agents
What are opportunistic infections?
when the immune defenses are down due to untreated HIV and the body is open to infection from other organisms
**aggressive anti-HIV treatment is the best defense
Examples of Opportunistic infections
-pneumonia
-hepatitis
-necrotizing lesions
-vesicular eruption of the skin
-TB
-CNS infections
