Infection (Chapter 5) + Ambrose Paper Flashcards by Nat L

with what kind of drugs would we combat auto-immune disease ?

anti-inflammatory drugs

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with what kind of drugs would we combat not auto-immune disease ?

pro-inflammatory drugs

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what is a pathogen ?

a micro organism that is invasive and can cause sickness and death

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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

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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 ?

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which type of bacteria has an outer membrane ?

gram -

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what are the two types of antibiotics ?

bacteriocidal and bacteriostatic

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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

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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

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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

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what is the main reason we are in an anti-biotic resistant age ?

agriculture

overuse of antibiotics

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what are narrow spectrum antibiotics? example

effective only against a few types of bacteria, like one of the gram categories.

ex penicillin G

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what are broad spectrum antibiotics ? example

against a wide array of bacteria, in both of the gram categories

ex doxycycline

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how do bacteria avoid the effects of a drug ?

they change by mutating

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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

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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

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what are the most common adverse effects from antibiotics ?

GI disruption, diarrhea, caused by killing of normal gut flora

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what is the most common upper respiratory tract infection?

pharyngitis

associated with the common cold virus

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what is pharyngitis treatable with ?

usually associated with the common cold virus therefore antibiotics are inappropriate

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are otitis and sinusitis viral or bacterial ?

bacterial

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what is bronchitis ?

lower respiratory tract infection

usually viral but can be bacterial

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what is pneumonia ?

lower respiratory tract infection

can be viral, fungal, bacterial

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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

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why is the immune system suppressed if very high exercise intensity ?

reduced flow of lymphatic fluid, and actions of NE and cortisol

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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