Infection (Chapter 5) + Ambrose Paper Flashcards
with what kind of drugs would we combat auto-immune disease ?
anti-inflammatory drugs
with what kind of drugs would we combat not auto-immune disease ?
pro-inflammatory drugs
what is a pathogen ?
a micro organism that is invasive and can cause sickness and death
What is the Gram stain ?
Used to determine whether bacteria is Gram + or -
Since Gram + does not have a membrane, it picks up the stain which usually binds to the peptidoglycan layer
Gram + : purple
why does it matter whether a bacteria population is gram + or - ?
because certain drugs will be ineffective for certain sorts of bacteria
for example, drugs that work by damaging the outer membrane would not work on gram + bacteria since they dont have one ?
which type of bacteria has an outer membrane ?
gram -
what are the two types of antibiotics ?
bacteriocidal and bacteriostatic
what is a bacteriocidal drug ? pro and con
Kills bacteria
pro: punches holes in membranes and compromises metabolic pathways
con: bacteria contain toxins and this could cause toxic shock syndrome
what is a bacteriostatic drug ? pro and con
slows down bacteria, for example by inhibiting DNA synthesis
more safe alternative, this allows the immune system to catch up
what is the difference in prescribing antibiotics and antifungals ?
bacteria are prokaryotic, very different from mammals, therefore medication against them usually does not affect human tissue. this is harder in the case of antifungals
what is the main reason we are in an anti-biotic resistant age ?
agriculture
overuse of antibiotics
what are narrow spectrum antibiotics? example
effective only against a few types of bacteria, like one of the gram categories.
ex penicillin G
what are broad spectrum antibiotics ? example
against a wide array of bacteria, in both of the gram categories
ex doxycycline
how do bacteria avoid the effects of a drug ?
they change by mutating
what are the four reasons a microbe becomes resistant ?
1) it makes an enzyme that destroys the drug
2) it changes the target site of the drug so the drug can’t work
3) it alters the point of entry of the drug
4) it pumps the drug out so it can’t be effective
what are the considerations in prescribing an antibiotic ?
first, use clinical information . for example, knowing that ear infections are often bacterial…
if it seems risky, treat with broad spectrum
then, after lab results come in, can prescribe more precise antibiotic
what are the most common adverse effects from antibiotics ?
GI disruption, diarrhea, caused by killing of normal gut flora
what is the most common upper respiratory tract infection?
pharyngitis
associated with the common cold virus
what is pharyngitis treatable with ?
usually associated with the common cold virus therefore antibiotics are inappropriate
are otitis and sinusitis viral or bacterial ?
bacterial
what is bronchitis ?
lower respiratory tract infection
usually viral but can be bacterial
what is pneumonia ?
lower respiratory tract infection
can be viral, fungal, bacterial
how does the curve look of sports and risk of upper respiratory tract diseases?
a J
as intensity of exercise increases, immune system receives a boost, makes it easier to fight infections
however, if intensity too high then immune system suppressed
higher risk of URTI
why is the immune system suppressed if very high exercise intensity ?
reduced flow of lymphatic fluid, and actions of NE and cortisol
what is a super infection ?
when bacteria resistant to all antibiotics
what are the three antibiotics that are cell wall inhibitors ? what structure do they have in common
penicillin, cephalosporins, carbapenems
they all have a beta-lactam ring structure
what are the 4 antibiotics that are protein inhibitors ?
tetracyclines, macrolides, aminoglycosides, fluoquinolones
what is the therapeutic index of penicillin?
pretty high, although 10 % of people are allergic
what is the mechanism of action of penicillin?
bactericidal, attack the cell wall (cell wall inhibitor)
what is penicillin limited by ? how do drugs answer this problem ?
limited by digestion in stomach and by penicillinase
new drug version is resistant to penicillinase
which penicillin is sensitive to penicillinase ? which isn’t ?
Penicillin G is sensitive to it
Nafcillin is not
What is special about amoxicillin ?
it is more acid stable than the others, so it survives the stomach acid better
Which types of bacteria are treated by penicillin ?
more effective for gram positive bacteria
how are cephalosporins usually taken ?
intravenous or intramuscular injections
not effective taken orally
what in the generic name will indicate that a medication is a cephalosporin ?
it will start with cef or ceph
what are carbapenems usually used for ?
gram negative bacteria that are resistant to other antibiotics
how do carbapenems work ?
they avoid bacterial lactamase enzymes which destroy other similar antibiotics
what is the next antibiotic people take after penicillin if they’re allergic ?
tetracylines
are tetracyclines bactericidal or bacteriostatic ?
inhibit protein synthesis, limiting growh, so bacteriostatic
are tetracycline broad spectrum ?
yep
what are intake recommendations for tetracyclines ?
taken after food or milk due to array of GI events
what are macrolides called (generic name)
-mycin
how are macrolides usually taken ?
orally
which antibiotic is taken topically ?
aminoglycosides
which antibiotic is injected ?
cephalosporins
are aminoglycosides bactericidal or bacteriostatic ?
both
kills (disrupts cell wall) but also inhibits protein synthesis
why aren’t aminoglycosides the best antibiotic ?
low TI, due to high toxicity potential
what are the risks in taking fluoquinolones ?
can cause tendonitis and rupture of tendon in older patients or ppl on steroids
can increase sensitivity to sun
how do anti-fungals usually function ?
by attacking the cell wall of the fungus
how is taking anti-fungals different in terms of side effects ?
more risk of adverse reactions: nephrotoxicity, fever, chills, nausea, vomiting, headache
what do most anti-fungal names end with ?
zole
how does one get athlete’s foot ?
sweaty feet and poorly ventilated shoes
what could happen in athlete’’s foot after the initial fungal infection ?
secondary bacterial infection
how is athlete’s foot usually diagnosed ?
by visual inspection of the skin
if not sure, KOH (potassium hydroxide) test rules out other causes
is tea tree oil a good cure for athlete’s foot ?
no. it improves the symptoms but does not cure the underlying infection
are antivirals usually broad or narrow spectrum ?
narrow
what virus causes mono?
Epstein-Barr
what diseases do protozoa cause usually ?
dysentery, malaria
what diseases do ringworms, nematodes cause ?
river blindness, ringworm disease
what drugs get rid of ringworms, nematodes ?
anti-helmintic drugs
what are antiseptics ?
chemicals with broad spectrum effects. can be germicidal or germistatic
what can happen if you apply antiseptics too much ?
inhibits wound healing
if an athete is training hard by running 12 hrs in bad weather, what are they risking of getting ?
Pharyngitis of the URT
what is the most important medication for athlete’s foot ?
anti-fungal
are drug interactions good or bad ?
depends
what is a receptor antagonist ?
when two drugs have an affinity for the same receptor, and one drug displaces the other and diminishes the response of the other, especially if one is an agonist and the other an antagonist
give an example of a receptor antagonist
propanolol
what is enzyme induction ?
when a drug increases the synthesis of one or more metabolizing enzymes that is responsible for metabolizing a second drug. enzyme induction therefore decreases the response from the second drug.
what are the types of enzymes that are most sensitive to enzyme induction
cytochrome p450
what are examples of liver enzyme inducers ?
alcohol and some anticonvulsants
what are drugs that are very affected by enzyme inducers ?
estrogen contraceptives, antidepressants, oral anticoagulants
is there drug interaction between tylenol and alcohol ?
yes, increases toxicity
what interacts with antihypertensive drugs ?
nasal decongestant, herbs can decrease antihypertensive effect (some herbs increase)
what is enzyme inhibition ?
2 drugs bind to the same metabolizing enzyme, but one drug is the substrate and the other is an inhibitor of the enzyme
inhibition of enzyme increases
increased bioavailability of substrate drug
what is an ADR ?
adverse drug reaction
what medication may cause urticaria in 1% of general population ?
aspirin and other NSAID
what medication may cause asthma attacks ?
aspirin and other NSAID
what are three drugs that may cause hepatotoxicity ?
NSAIDs, acetaminophen, sulfonamide antibiotic
what are two drugs that may cause nephrotoxicity
NSAID and aminoglycoside antibiotic
is pregnancy considered a drug interaction ?
yes
what are side effects ?
predictable, dose-related adverse effects
what are the 5 ratings for drug use in pregnancy ?
A (controlled studies show no risk), B, C, D, X (contraindicated)
what happens if you mix CNS depressants and alcohol ?
increased effectiveness
what is an adverse interaction ?
an unwanted one
what is more effective- bactericidal or bacteriostatic medication ?
bactericidal
which drug would have a physiological antagonism with corticosteroids, which are antiinflammatory and inhibit immune system ?
antibiotics, since they fight off infections
if you combine a beta-agonist and beta-antagonist, what kind of interaction would it be ?
receptor antagonist
if drug A induces enzyme that metabolises drug B, what would increase in urine ?
metabolite of B since enzyme that creates metabolites is increased by A
what would increase the duration of an oral drug ?
reduced kidney excretion function and a higher dose
what are the four categories of drugs ?
banned, not banned, not specifically banned, and specifically banned for rifle
in the Ambrose paper, who submitted the majority of questions ?
athletic trainers (54%)
in the Ambrose paper, who submitted the most (in second place) questions ?
athletes (36%)
in the Ambrose paper, who submitted the least amount of questions ?
parents 3%
coaches <1%
and directors of athletics <1%
in the Ambrose paper, how many inquiries out of 5000 regarded street drugs ?
5, 4 regarding marijuana and 1 gamma-hydroxybutyric acid
in the Ambrose paper what was the most queried sport ? why ?
football
maybe because the sizes of the teams are bigger
Which antibiotics target mostly solely gram positive bacteria?
Penicillin and macrolides
Which antibiotics work better only on gram negative?
Carbapenems and aminoglycosides
Which drugs cure gram positive bacteria ?
Penicillin
Macrolides
Cephalosporins
Tetracyclines
Fluoroquinolones
Which drugs cure gram negative bacteria ?
Carbapenems
Aminoglycosides
Cephalosporins
Tetracyclines
Fluoroquinolones
