Exam 2 Drugs Flashcards

Question

Acute Viral Hepatitis

Answer 1

Inflammation of the liver that begins suddenly and lasts a few weeks

Answer 2

Inflammation of the liver that lasts at least 6 months

Answer 3

Irreversible inflammatory disease of the liver, a leading cause of death

Answer 4

Incubation Period Prodromal (pre-icteric) Phase: wt loss, fatigue, anorexia, vomiting, and low grade fever Icteric (Jaundice) Phase: Lasts 2-6 weeks -hepatomegaly, dark urine, clay colored stools, itching, jaundice as bilirubin builds up in the blood Recovery Phase: resolution of jaundice

Answer 5

Results from impairment or necrosis of hepatocytes

Answer 6

``` DNA Hepadnaviridae HBsAG - Diagnosis Severe and Chronic Transmission: sexual, Injection-drug use, Perinatal Incubation: 60-180d PX: Hygiene, Vaccine Chronicity: YES Liver Cancer: YES ```

Answer 7

RNA Flaviviridae Family Anti-HCV= diagnosis Mild to severe Transmission = injection-drug use, Sexual Incubation: 35-60 days Hygiene, Blood screen, IFN-a : prophylaxis Chronicity: YES Liver Cancer: YES

Answer 8

dsDNA Chronic HBV carriers- worldwide reservoir of infection Cirrhosis and Hepatocellular Carcinoma = Complications Vaccine is based on Australian Antigen HBV can cause fulminant hepatitis, and irreversible tissue necrosis which requires a liver transplant Has infected 1/3 of population 360 million chronic carriers

Answer 9

ssRNA | Complications = Chronic infection, Cirrhosis, and Carcinoma

Answer 10

Cirrhosis: scarring of the liver marked increase in fibrous connective tissue, resulting in a firm, modular, distorted liver Decompensated Cirrhosis: increase in portal HTN, Ascites (fluid accumulation in peritoneum), splenomegaly, encephalopathy, Jaundice

Answer 11

TB has the highest death toll of any infectious pathogen POE: airborne transmission TB Detection: Tubercle formation, Caseous necrosis, (+) skin test

Answer 12

Acute infection or inflammation of the airways or bronchi Commonly viral pathogen (can become bacterial) Causes similar sx to pneumonia but does NOT demonstrate pulmonary consolidation and chest infiltrates

Answer 13

More common in Children Severe, rapidly progressive, life-threatening infection of the epiglottis and surrounding area -usually caused by Haemophilus influenzae type B Manifestations: high fever, sore throat, inspiratory stridor, and severe respiratory distress Tx: Emergency airway and antibiotics

Answer 14

Inflammation of the urinary epithelium following invasion and colonization by some pathogen within the urinary tract - complicated - uncomplicated - persistent

Answer 15

E. Coli Staphylococcus Saprophyticus Enterobacter spp

Answer 16

Inflammation of the bladder Manifestations: frequency, dysuria, urgency, and lower abdominal and/or Supra pubic pain TX: antimicrobial therapy, increased fluid intake, avoidance of bladder irritants, and urinary analgesics

Answer 17

Seen with dysentery -Causes shigellosis: binds epithelium of GI tract and causes it to die off. Can cause a severe form of diarrhea. (Fecal-oral transmission)

Answer 18

By C. Jejuni (Fungus) -Vibrio cholera: will lose close to 1L/ hour of fluid E. Coli (O107): makes an exotoxin

Answer 19

Disease: Campulobacter enteritis

Answer 20

Disease: Urogenital infections

Answer 21

Disease: Gonorrhea

Answer 22

Disease: Shigellosis

Answer 23

Disease: Syphilis

Answer 24

Caused by microorganisms of the species Neisseria Gonorrheae (aerobic, non-spore-forming, gram -, diplococcus (round)) -presence of pili helps the microorganisms attach themselves to the epithelial cells of mucous membrane Infections can result in: disseminated gonococcal infection (CGI) and Perihepatits, as well as ophthalmia neonatorum. Transmission: requires contact of epithelial surfaces, Gonorrhea also crosses amniotic membranes. Humans are the only natural hosts

Answer 25

Can spread through the blood as well as the lymph: Secondary Cardiovascular syphilis, Neurosyphilis: Tertiary -Latent syphilis: asymptomatic but potential recurrent infections -Congenital (from mother to fetus)

Answer 26

Trachoma-a leading cause of preventable infectious blindness Nongonococcal or nonspecific urethritis: nonreportable STI, Syndrome caused by most commonly by Chlamydia Trachomatis -Trichomonas vaginalis, herpes simplex virus, ureaplasma urealyticum and mycoplasma

Answer 27

Commensal bacteria and opportunistic pathogen Superantigens: enterotoxin and toxic shock syndrome Toxin 1, causes immune overactivation --> toxic shock and food poisoning Children: impetigo and Staph. Scalded-skin syndrome Hospital: MRSA is common Most common cause of food borne outbreaks Can cause SOFT PAINS: Skin infections, Osteomyelitis, Food poisoning, Toxic shock syndrome, Pneumonia, Acute endocarditis, Infective arthritis, Necrotizing fasciitis, and Sepsis

Answer 28

Penicillins and B-Lactamase Inhibitors Cephalosporins & Cephamycins Carbapenems Monobactams ** ALL are active against non-B-Lactamase-producing gram - and gram + bacteria ALL work in the same way/ Time-dependent killing ALL can cause hypersensitivity reactions or seizures at very high doses NONE are active against MRSA

Answer 29

``` Natural Penicillins (Penicillin G): Short t1/2, tx neurosyphilis Antistaphylococcal Penicillin (Nafcillin): resistant to staphylococcal B-lactamases, Hepatic CL, Tx MSSA Extended-Spectrum Penicillins (Ampicillin): aminopenicillins better than others against gram (-), Antipseudomonal Penicillins ```

Answer 30

Inhibit bacterial B-Lactamases Protect hydrolyzible penicillins from inactivation Extends the spectrum of the penicillin to strains that would otherwise inactivate it Predicted on the assumption that the inhibitor is active against the B-lactamase that is produced

Answer 31

More resistant to bacterial B-lactamases than penicillins First generation: do NOT cross BBB, used in hospitals, good antistaph Second Generation: Do NOT cross BBB, have extended gram (-) coverage compared to 1st generation, good for anaerobes in upper respiratory infections, community pneumonia, and gonorrhea Third and Fourth Generations: some cross BBB, expanded gram (-) coverage compared to both 1st and 2nd generations, good for P. Aeruginosa, Enterobacteriacaea, S. aureus, and S. pneumonia AE: allergy, Methylthiotetrazole containing Cephamycins can cause bleeding and disulfiram-like reactions

Answer 32

Broadest Spectrum ABX NOT active against Klebsiella Pneumonia Carbapenemase-producing strains -Imipenem administered w/ an inhibitor of renal dehydropeptidase, Cilastatin (never administered alone) Good for nosocomial infections and B-lactamase producing GN strains

Answer 33

Limited to aerobic gram (-) rods (including P. Aeruginosa) | No activity against gram + bacteria or anaerobes

Answer 34

Active ONLY against gram + bacteria Water soluble and stable. Bind to d-Ala-d-Ala chains on the peptidoglycan wall preventing elongation **Drug of choice for MRSA Can cause red man syndrome due to infusion site rxns (Itching)

Answer 35

Binds to the cell wall synthesis by inhibiting the synthesis of the cell wall building blocks **punches holes in the cell wall Effective against MRSA and VRE Can cause allergic pneumonitis

Answer 36

Inhibits bacterial wall synthesis by inhibiting the synthesis of the cell wall building blocks Primarily used for uncomplicated UTI Same applications as Nitrofurantoin

Answer 37

Good for Rickettsia, Mycoplasma, Chlamydia, some spirochetes, & Plasmodium Resistance: impaired influx or increased effluent, Prod of proteins that interfere w/ tetracycline, Enzymatic inactivation

Answer 38

Used in outpatient settings for respiratory infections, Mycobacterium Avium, Chlamydia Needs to be checked for interactions via P450 **resistance: Impaired influx or increased efflux, Prod of esterases that hydrolyze macrolides, lincosamides, and stretogramin, Modification of the ribosomal binding site by mutation or by macrolide-inducible or constitutive methylase

Answer 39

Derivative of lincomycin Good for skin and soft-tissue infections caused by streptococci and staphylococci Resistance: same as macrolides

Answer 40

Rapidly bactericidal for most susceptible organisms: MSSA, MRSA, and VRE NOT active against: Enterococcus Faecalis, or Faecium Resistance: same as macrolides

Answer 41

Inhibits protein synthesis by preventing formation of the ribosome complex Good for susceptible organisms MSSA, MRSA, VRE, & Enterococcus faecium AE: myelosuppression or thrombocytopenia Resistance: Different from the other classes

Answer 42

Irreversible inhibitors of protein synthesis - blocks the initiation complex - miscoding of amino acids - block of translocation on mRNA

Answer 43

Concentration-dependent killing Synergistic killing w/ cell wall inhibitors in endocarditis Good for: gram (-) pathogens, Mycobacteria AE: nephro and Ototoxicity Resistance: production of an enzyme which inactivates the aminoglycoside

Answer 44

Sulfonamides block dihydropteroate synthase Trimethoprim (pyrimidine) blocks dihydrofolate reductase Used as a combo (TMP/SMX): drug of choice for infections such as Pneumocystis Jiroveci, Toxoplasmosis Good for uncontrolled UTI AE: hematopoietic disturbances, interacts w/ Warfarin

Answer 45

Synthetic fluoridated analogs of nalidixic acid Blocks bacterial DNA synthesis by inhibiting bacterial topoisomerase II (DNA gyrase) and topoisomerase IV Broad activity for: UTI, Upper and Lower RTI (levo), bacterial Diarrhea (foodbourne illnesses) AE: prolonged QTc, Neuropathy, Cartilage degradation, Achilles' tendon rupture, should be avoided during pregnancy Resistance: altered targets, active efflux, bacterial proteins which protect DNA gyrase or which inactivated quinolones

Answer 46

Inhibits the synthesis of mycolic acids (precursors of mycobacterium cell wall)

Answer 47

A derivative of Rifamycin inhibits the mycobacterial RNA polymerase

Answer 48

Also includes Fluoroquinolones, Macrolides, and Streptomycin AE: isoniazid-induced hepatitis and peripheral neuropathy -rifampin colors secretions orange-red (harmless) Resistance: drug unable to penetrate cell wall, Low pH renders drug inactive, drug exported from cell before it reaches target, mutations in DNA repair genes lead to multiple drug resistance, alteration of target protein structure prevents drug recognition

Answer 49

Eukaryotic Cells with rigid walls Can grow as: molds, yeasts, or both (dimorphic) Resistance to bacterial wall inhibitors Pathogenicity: adapts to host environment, Suppresses the immune defenses

Answer 50

Diseases caused by fungi

Answer 51

Diseases they produce are called tine as (ringworm) | -tinea capitis, tinea pedis, and tinea cururis (groin infection)

Answer 52

Most common fungal pathogen Common in nosocomial infections Commensal in skin, GI, vagina Opportunistic Pathogen due to changes in environment -ABX is can cause oropharyngeal (thrush) and vulvovaginal infections (vaginitis) -immunocompromised pts (HIV, hematologic cancers) present w/ disseminated infections -medical devices can lead to invasive candidiasis Candidemia a major cause of fungal sepsis and septic shock (hypotension, tachycardia, DIC)

Answer 53

Binds to ergosterol in the fungal cell membrane forming pores Broad spectrum with good activity against candida, Cryptococcus AE: infusion-related rxns, Nephrotoxicity Very poorly absorbed orally

Answer 54

Blocks DNA and RNA polymerization (blocks further replication of DNA) Converted intracellularly first to 5-FU and then to 5-Fluorodeoxyuridine monophophate and fluorouridine triphosphate, which inhibits DNA and RNA synthesis Cryptococcus associated meningitis AE: bone marrow toxicity w/ anemia, leukopenia, and thrombocytopenia, as well as lactic acidosis

Answer 55

Azoles block ergosterol synthesis from lanosterol Broad spectrum w/ good activity against Candida, C. Neoformans, Endemic mycoses The pharmacology of each of the azoles is unique, some are used topically

Answer 56

Inhibits fungal wall synthesis, good for invasive candidiasis

Answer 57

Oral fungistatic used for dermatophytosis (invasive-penetrates deeper into the skin)

Answer 58

Oral and topical fungicidal that blocks ergosterol synthesis at an earlier step than azoles. (Blocks squalene synthesis)

Answer 59

Polyene macrolide much like amphotericin B | It's too toxic for parenteral administration and is only used topically

Answer 60

Cryptosporidium --> Crytosporidiosis Giardia Lamblia --> diarrheal syndrome (fecal contam water) Entamoeba Histolytica --> Amebiasis (fecal contam water) Plasmodium --> Malaria (mosquito anopheles)- vector borne Leishmania --> Leishmaniasis (sand flies) Toxoplasma --> Toxoplasmosis

Answer 61

Protist, can produce asexually or sexually Plasmodium species - through blood can infect liver) Fever and anemai, splenomegaly RBC get destroyed evolution of Sickle cell trait -when have the HbAA/HbAS forms, they are more resistant to Malaria

Answer 62

Most common causes of waterborne illnesses | Caused by Giardia Lamblia

Answer 63

GI bleeding and hemorrhage, can also cause liver disease and fatality) - caused by Entamoeba Histolytica - most imp parasitic disease - Dysentery as a result of toxin on colonic epithelium - can also cause amebic liver disease

Answer 64

Caused by Trichomonas vaginalis -anaerobic, unicellular, flagellated, parasitic protozoan Adheres to and damages squamous epithelial cells -urethra, vagina, and Skene and Bartholin glands Accounts for 25% of infectious vaginitis cases Often coexists w/ gonorrhea Presence confirmed by microscopic examination of vaginal secretions or urine

Answer 65

Quinolones, Atovaquone, Artemisinins, Doxycyline | -employed prophylactically and as definite therapy

Answer 66

Oldest and highly effective antimalarial blood schizonticide (quinine from the bark of the cinchona tree) Primaquine also has gametocide activity for all Plasmodium species and is also used to tx P. Jiroveci MOA: not clear how they work but they might affect the ability of the parasites to catabolize hemoglobin AE: hematologic abnormalities, hemolysis, prolonged QTc, hypotension -quinine can cause cinchonism: tinnitus, headache, nausea, dizziness, flushing, and visual disturbances

Answer 67

A sesquiterpene lactose endoperoxide

Answer 68

Used in combo w/ proguanil as quinone-folate antagonist combination for malaria -also used for mild to moderate P. Jiroveci pneumonia

Answer 69

Amebiasis is infection w/ Entamoeba histolytica Kill trophozoites but not cysts by causing DNA damage Good for anaerobes including Clostridium For protests: Amebiasis, Giardiasis, and Trichomoniasis AE: nausea, dry mouth, metallic taste Metronidazole: is amebicidal, Bacteriacidal, and Trichomonicidal

Answer 70

Used in African Trypanosomiasis-sleeping sickness and Leishmaniasis Also used for pneumocystosis caused by Pneumoscystis Jiroveci -Highly toxic

Answer 71

Hookworm disease (ancylostoma duodenale or necator americanus) - -> ascariasis - -> enterobiasis - -> filariasis

Answer 72

- -> Neuro Cysticercosis (Tania solium) | - -> Schistosomiasis (schistosoma-blood flukes)

Answer 73

- -> Pediculus humans capitis (head louse) - -> Pediculus humanus corporis (body louse) - -> pthirus pubis ("crabs" louse, pubic louse)

Answer 74

--> Sarcoptes Scabiei

Answer 75

Parasitic worms infect more than 3 billion people worldwide

Answer 76

Caused by the adult female itch mite, Sarcoptes Scabiei Transmission: requires prolonged close skin-to-skin contact -typically occurs b/ family members or sexual partners Burrows through the horny layer of the stratum/day -new larval forms appear in about 10 days Classic sx is intense pruritus

Answer 77

Inhibits the polymerization of microtubules Used in: Intestinal Parasites- cysticercosis (T. Solium), ascariasis, enterobiasis (pinworms), Hydatid disease (echinococcus via dogs), Neurocysticercosis

Answer 78

Caused paralysis by intensifying (GABA)-mediated transmission of signals in peripheral nerves Used in: Onchocerciasis: River blindness (onchocerca volvulus) affects 17-25 million people -microfilaria -and ectoparasties such as scabies