Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

old. 232 > Module 2: infection Pharmacology readings > Flashcards

Module 2: infection Pharmacology readings Flashcards

1
Q

nonopioid analgesic given for fever

A

acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mechnism of action: acetaminophen

A
  • Inhibits transmission of peripheral pain impulses by inhibiting prostaglandin synthesis
  • Lowers febrile body temperature by acting on the hypothalamus. Heat is dissipated through resulting vasodilation and inc peripheral blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

is acetaminophen used to treat inflammation?

A

no. it has weak anti-inflammatory properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what has worse side effects, acetaminophen or NSAIDS? like what?

A

NSAIDS. Acetaminophen is usually not assoc w carviovascular effects eg edema, or platelet effects eg bleeding like aspirin and NSAIDS are

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What effects does aspirin cause that acetaminophen doesnt?

A

aspirin causes GI irritiation and bleeding and acid-base changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acetaminophen indications:

A

treatment of mild pain and fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

?what is the antipyretic of choice in kids and adolescents with flu syndromes and why

A

acetaminophen. Aspirin is avoided in those populations because of Reye’s syndrome (brain wasting condition)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Contraindications: acetaminophen

A 
allergy 
hypersensitivity
anemia
severe liver disease
kidney disease
genetic disease (glucose 6 phosphate dehydrogenase enzyme deficiency)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acetaminophen: adverse effects

A 
generally well tolerated
-rash
-nausea
-vomiting
less common but more severe:
-nephrotoxicities
-blood disorders or dyscrasias
-if taken as acute overdose may cause liver necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

?who commonly ODs on acetaminophen

A

adolescents who are depressed, depressed people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

?how might a pt receive a dose thats too high of acetaminophen other than taking too much pure acetaminophen

A

combination tablets eg hydrocodone plus acetaminophen that have some acetaminophen contained within them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Max dose acetaminophen for adults

A

4000mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if pt comes in w acetaminophen OD what do you do?

A
  • they may not tell you accurately how much they took, get a serum level ASAP (no sooner than 4hrs after ingestion)
  • count the pills left in the bottle
  • if cant obtain serum acetaminophen level give acetylcysteine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

antidote to acetaminophen. How does it work?

A

acetylcysteine. Prevents the hepatotoxic metabolites of acetaminophen from forming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

? how do you give antidote to acetaminophen? what if they vomit?

A

give every four hours in 17 doses. if pt vomits within an hr of a dose then give it again. must give all doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Interactions: acetaminophen

A

alcohol (persistent alcoholism).

avoid other hepatotoxic drugs ideally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

patho of fever

A

Body is invaded
Phagocytes release&raquo_space; endogenous pyrogens
Prostoglandins reset Hypothalmic thermostat to a higher setpoint
We make & conserve heat…this is the chill phase
Body reaches temperature setpoint
Stress is removed & thermostat is reset to normal
We lose & produce less heat…this is the desverescence phase
Body returns to normal temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

?when should fever be treated?

A

over 38.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

gram positive

A

• Gram positive (purple) have cell walls with peptidoglycan and a thick outer cell capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

is it easier to treat gram negative or positive? why?

A

easier=gram +

gram - is more difficult to treat because of the molecules difficulty in penetrating the complex wall of the microorg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

gram negative=

A

• Gram negative (stain red) cell wall struct more complex has two cell membrane, smaller outer capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

signs and symptoms of infection

A

• Signs and symptoms of infection: fever, chills, redness, pain, and swelling, fatigue, weight loss, inc WBC count, formation of pus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

do all pts exhibit signs of infection?

A

no, esp older adults and immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

?what is empirical antibiotic therapy?

A

admin of an antibiotic on the Drs judgement of the pathogens most likely to be causing an apparent infection.
Its presumptive Tx of an infection to avoid treatment delay that occurs before specific bacterial culture information is obtained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when should bacterial cultures be obtained in relation to antibiotic Tx?

A

before antibiotics because they may obfuscate the results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

prophylactic antibiotic therapy is given when…

A

to prevent infection

eg before abdominal Sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is a therapeutic response to antibiotics?

A

when theres a dec in the specific signs and symptoms of infection compared w the baseline findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

if pt is having diarrhea and Gi discomfort should they stop taking antibiotics?

A

no, unless severe. these are common side effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

SUBTHERAPEUTIC ANTIbIOTIC THERAPY

A

when the signs & symptoms don’t improve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

SUPERINFECTIONS

2 examples

A
  • can occur when antibiotics completely or reduce normal bacterial flora. eg vaginal yeast infection. occurs when theres an imbalance in vaginal bacterial flora.
  • Or the normal flora will be replaced by other negative ones eg when a second infection thats bacterial (from an external source) closely follows the first which was viral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what colour sputum indicates viral respiratory infection?

A

green or yellow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

? two things that contribute to in antibiotic resistance

A
  • pts not finishing their antibiotic regimens

- inappropriate prescription

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

? antibiotic interactions. food-drug and drug-drug

A

food-drug=milk or cheese with tetracycline

drug-drug=quinolone and antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are host specific factors?

7 exmples

A

factors that relate to a patient and can hav a significant impact on the success or failure of treatment

  • age
  • allergy hx
  • kidney and liver fx
  • pregnancy
  • genetic char
  • site of infection
  • host defenses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

antibiotics; age related host factors for kids

A

-infants and kids cant take: some (eg tetracycline) affects teeth or bones, fluoroquinolones affect bone or cartilage , sulfonamides can cause hyperbiliruninemia in neonates

36
Q

antibiotics; age related host factors for older adult

A

the decline in liver and kidney fx means they should get dec dose

37
Q

? which two classes of antibiotics are people often allergic to?

A

penicillins and sulfonamides

38
Q

what is the worst reaction to an antibiotic?

A

anaphylactic shock

39
Q

4-5 common severe rxns to antibiotics that must be charted

A

• Common severe rxns to medication=
diff breating,
(skin reaction)significant rash, hives,
severe gi intolerance
im sure anaphylaxis is too but its not common

40
Q

two most common genetic host factors that can adversely affect drug actions (antibiotics)

A

both of these are a lack in enzymes:

  • slow acetylators-metabolize the drug more slowly and this leads to toxic buildup
  • G6PD-admin of sulfonamides, nitrofurantoin, and dapsone may result in hemolysis
41
Q

4 most common mechanisms of action for antibiotics

A
  • interference with bacterial cell wall synthesis
  • interference with protein synthesis
  • interference with replication of DNA and RNA
  • antimetabolite action that disrupts critical metabolic reactions inside the bacterial cell
42
Q

T or F: most antimicrobial drugs only have activity against one TYPE of microbe

A

true, most only work on one. eg they only work on bacteria or on fungi or protozoans

43
Q

?when you have a question/concern regarding an antibiotic:what should you keep in mind in terms of sources

A

that the source is up to date because drug indications change frequently as bacterial species become resistant

44
Q

all viruses are obligate intracellular parasites means:

A

viruses can replicate inside host cells

45
Q

? structure of a virus

A
  • genome (|DNA or RNA but not both),
  • capsid (protein coat for protection),
  • envelope (lipoprotein w cell surface antigen proteins which facilitates fusion(when the viral cell attaches to a host cell)
46
Q

viruses can enter the body through 4 routes:

A

viruses can enter the body through 4 routes:

  • inhalation,
  • GI tract,
  • transplacentally
  • inoculation via skin or mucous membranes
47
Q

?CYTOPATHIC EFFECT

A

• CYTOPATHIC EFFECT=the reproduction of viruses etc that usually results in destruction of the host cell

48
Q

?what is VIRAL TRANSFORMATION and what kind of virus would do this?

A

• VIRAL TRANSFORMATION=involves mutation of the host cell DNA or RNA which can resut in cancerous host cells. This would be done by ONCOGENIC VIRUS.

49
Q

?what is another name for a “silent” viral infection?
What is it?
An example

A

• LATENT or dormant infection-more common that transformation
=eg HIV that can lay dormant 10yrs before becoming AIDS

50
Q

?VIRULENCE=

A

the strength of the virus

51
Q

do antivirals generally eradicate the virus within the host?

A

no probably not, they weaken the virus enough that the hosts immune system can take over

52
Q

how rampant is a viral infection before symptoms appear? how does this affect treatment?

A

• Often the virus has replicated thousands to millions of times before symptoms appear-makes it hard to treat

53
Q

are their antivirals for most viruses?

A

no. there are relatively few viruses that can be controlled by current drug therapy

54
Q

how do antivirals work?

A

they either kill or suppress the virions (mature virus particle) or they inhibit their ability to replicate

  • they inhibit the virus fusing with or entering the host cell
  • or interfere w viral nucleic acid synthesis
55
Q

?viruses that can be controlled by drug therapy (6)

A 
o	cytomegalovirus
o	hepatitis virus
o	herpes virus
o	HIV
o	Influenza virus
o	Respiratory syntcytial (RSV)
56
Q

why are viruses difficult to treat?

A
  • active viral infections take place within host cells and the antiviral must get inside the cell to attack the virus
  • it has been historically difficult to develop antiviral drugs that are not overly toxic tothe host cell
  • the virus has usually replicated millions of times before symptoms are apparent
57
Q

an immunocompromised pt is at greater risk of:

who is at greater risk examples

A

opportunistic infections

-AIDS, cancer with leukemia or lymphoma, organ transplant recipients

58
Q

antiviral medications are broadly divided into what 2 major categories?

A

antiviral drus

antiretroviral drugs: for \hiv treatment

59
Q

NSAIDS are generally taken for-

A

inflammation

60
Q

• Signs and symptoms of inflammation

A 
o	Redness
o	Warmth
o	Pain
o	Fever
o	Loss of function
61
Q

what are NSAIDS also taken for other than inflammation

?how is this disorder characterized

A

rheumatism (characterized by inflammation, degeneration or metabolic derangement of connective tissue struct, esp joints and related struct such as muscles, tendons, bursae, fibrous tissue, and ligaments)

62
Q

Nsaids produce what effects

A

o Analgesic
o Anti-inflammatory
o Antiarthritic
o Antipyretic activities

63
Q

negative effects of aspirin

A
  • GI intolerance and bleeding

- kidney impairment

64
Q

?how is arachidonic acid implicated in inflammation?

A

its released from phospholipids in cell membranes in response to a triggering event eg injury. Its then metabolized by either prostaglandin pathway or leukotriene pathway which are both part of the arachidonic pathway. This results in:

  • inflammation
  • edema
  • headache
  • other pain characteristics fo the body’s response to injury or inflammatory illnesses eg arthritis
65
Q

NSAIDS: 4 major categories of carboxylic acids

A

o Acetic acids
o Propionic acids
o Pyranocarboxylic acids
o Pyrrolizine acids

66
Q

acetic acids eg

A

acetylsalicylic acid aka aspirin

indomethacin

67
Q

?aspirin comes in:

A

solid oral dosage forms, chewing gum, enteric coated, rectal suppositories

68
Q

?what has an adjunctive analgesic effect with aspirin?

A

caffeine

69
Q

?aspirin was first introduced in the

A

late 1800s

70
Q

a 325mg or 81mg dose of aspirin is used for?

A

prophylactic therapy for adults w strong risk of dev coronary artery disease or stroke

71
Q

if a pt has strong risk factors for stroke or CAD but no history of either will they be prescribed something for it?

A

yes. they might be

72
Q

contraindication for salicylates

Why is this?

A

kids with flulike symptoms

it is strongly assoc w Reye’s syndrome

73
Q

what is Reye’s syndrome?

A

acute and potentially life-threatening condition involving progressive neurological deficits that can lead to coma and may involve liver damage
-believed to be triggered by viral illnesses like the flu and by salicylate therapy itself in the presence of a viral illness

74
Q

ibuprofen is a type of _______ acid

A

propionic acid

75
Q

ibuprofen aka

A

motrin or advil or naproxen or oxaprozin

76
Q

ibuprofen is often used for:

A
  • rheumatoid arthritis
  • osteoarthritis
  • primary dysmennorhea
  • dental pain
  • musculoskeletal disorders
77
Q

the second most commonly used proprionic acid NSAID is________
does it have gentler side effects than ibuprofen?

A

naproxen

yes. it has fewer interactions with Ace inhibitors given for HTN

78
Q

tylenol aka

A

acetaminophen

79
Q

signs of allergic reaction:

A

hives, swelling, heat, urticaria, rash, pruritus

80
Q

how can you treat a local allergic reaction?

A

give antihistamines for local. Cold cloths are good as well.

81
Q

pregnancy categories of a drug

A
  • A-no risk to fetus of any abn. Has been tested on pregnant women.
  • B-can give. No adverse effects typically. Tested on pregnant animals.
  • C-not enough adequately controlled studies. Not sure if good to give.
  • D-definite risk to fetus. But benefits may outweigh the risks.
  • X- do not use. Causes fetal abn.
82
Q

what drug do you use to treat a fever in a child?

how do you dose them?

A

acetaminophen

mg/kg

83
Q

ibuprofen is pregnancy category__

can you give it to kids?

A

C-not enough adequately controlled studies. Not sure if good to give.
yes

84
Q

diagnostics done for infection

A 
White blood cell count
Differential
C-Reactive Protein
Procalcitonin
Identification of an organism
Gram stain
Culture
85
Q

what kills viruses

A

-disinfectants and immunoglobulins kill viruses

some antivirals may

old. 232 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions