Diabetes, Antibiotics & Antivirals Flashcards
What does insulin do?
Regulates blood glucose level & is involved in the metabolism of carbohydrates, proteins, and lipids.
Insulin promotes the movement of glucose from the bloodstream back into the tissues to reduce levels.
What does glucagon do?
Acts as a hormonal antagonist of insulin. Increases blood glucose (rapid breakdown of glycogen) in order to maintain normal levels as a way or preventing hypoglycemia
What is normal fasting blood glucose?
70-110 mg
Type I Diabetes Mellitus
Unable to synthesize insulin due to destruction of pancreatic beta cells
Type II Diabetes Mellitus
Combination of beta cell dysfunction and decreased sensitivity of peripheral tissues to circulating insulin.
Insulin RESISTANCE
What factors can lead to DMII?
Genetics, poor diet, obesity, lack of exercise
Most common symptom of DMI & DMII?
Hyperglycemia – Due to lack of insulin mediated glucose uptake by peripheral tissues
What is used as a replacement for insulin in type I diabetics?
Exogenous insulin
What forms of insulin exist? (3)
Rapid-acting, intermediate-acting, or long-acting.
Can be combined
What acts as an “artificial pancreas”
Implantable insulin pump
What medication schedule is a diabetic typically on?
Intermediate or long-acting 1x/day
Short-acting after meals or when blood sugar rises
Adverse effects of insulin?
Hypoglycemia - Dramatic drop in blood sugar
A patient presents with a headache, tachycardia, and some confusion with additional complaints of being hungry and tired… what could they be experiencing?
Hypoglycemia
S/S: HA, fatigue, hunger, tachycardia, sweating, anxiety, confusion
Type II Diabetes Medications
Exogenous insulin can be used, but others exist that target the stimulation of pancreatic beta cells to increase insulin release and decrease hepatic glucose production
Ex: Insulin Sensitizers
What drug acts on the liver to inhibit glucose production and increase the sensitivity of peripheral tissues to insulin? Also acts as a cornerstone for DMII drug combinations
Metformin (Glucophage) – Insulin Sensitizer
Patients experiencing confusion, lethargy, stupor, shallow rapid breathing, & tachycardia while on Metformin may be developing _________?
Lactic Acidosis
Most important factors to control in diabetes
Weight, diet, exercise
What is the goal of antibacterial drugs?
Selective Toxicity – Selectively kill the growth of an organism without causing excessive damage to other cells
What drugs treat small, unicellular organisms?
Antimicrobial drugs or antibiotics
Drugs that kill or destroy bacteria
Bactericidal Drugs
Drugs that limit bacteria growth
Bacteriostatic Drugs
What determines antibiotic prescription?
Spectrum of drug, patient tolerance, bacterial resistance, type/location of infection, & physician preference
Three main MOAs for antibacterial drugs
- Inhibit bacterial cell wall synthesis/function
- Inhibit bacterial protein synthesis
- Inhibit bacterial DNA/RNA function
Adverse Effects of Antibiotics
Hypersensitivity reactions (rashes, itching, wheezing)
GI problems (N/V, diarrhea)
What is one of the most serious problems associated with antibiotics?
Resistance - Development of bacterial strains that are resistant to one or more antibacterial agents
Most common drug resistances
VRSA, MRSA, VRE, PRSP
Rehab Implications for Antibiotics
Will encounter MANY INFECTIONS (bone, wounds, UTIs, pneumonia) - Stop the spread of infection
How do viruses function?
They are small microorganisms that rely on the human host cell for metabolic processing
True or False - A majority of antiviral agents are selective to only virus cells
FALSE - Difficult to treat viruses since only a limited number of antivirals are FDA approved as selective agents
Do antivirals cause resistance like antibiotics?
Not to the same degree, but antivirals can mutate and cause resistance as well. It is a growing concern
A group of proteins that are part of the immune system response to viral infections and control some forms of cancer by acting as an early preventive mechanism – NOT antiviral drug
Interferons
Can help treat Hep B/C, some cancers, & MS
Adverse effects of interferons
Fever, sweating, chills, muscle aches, malaise, depression
What are the two goals of HIV management?
Control proliferation of HIV
Treat/Prevent opportunistic infections
True or False - There are only antivirals available to inhibit replication of HIV, but none to kill the virus
True
Drugs that inhibit HIV protease enzyme and prevent the synthesis/maturation of HIV
Protease Inhibitors
Adverse effects of protease inhibitors
Abdominal fat deposition, increased cholesterol, insulin resistance, increased cardiovascular disease, diarrhea, HA, fatigue
Drugs used to inhibit replication and proliferation of HIV by targeting the key step. Do NOT eliminate virus, but do stop the spread
Reverse Transcriptase Inhibitors
Adverse effects of reverse transcriptase inhibitors
Anemia, fever, chills, diarrhea, HA, fatigue, myopathy, atrophy
Highly Active Antiretroviral Therapy (HAART)
At least 3 anti-HIV drugs administered simultaneously for optimal inhibition. Shown success in delaying progression and sustaining immune function.
Poor adherence due to side effects and dosage
Examples of opportunistic infections
Pneumonia, Hepatitis, Necrotizing lesions, Vesicular eruption of skin, TB, CNS infections
