Pharmacology Antibiotics and Cancer Flashcards
Are all antibiotics considered antimicrobials?
Yes
Is gram+ or gram- harder to treat and why?
Gram- because it has a outer membrane that makes it harder for drugs to penetrate
What is selective toxicity?
Only target bacteria, not human cells
What is the difference between bacteriostatic and bactericidal antibiotics?
Bacteriostatic antibiotics only inhibit the growth of the bacteria and require the hosts immune system. Bactericidal kill the bacteria and don’t require the host immune system.
Two types of bactericidal antibiotics?
Concentration dependent and time dependent
What are the three considerations when selecting treatment for bacterial infection?
- Bacteria factors(identity and susceptibility)
- Host specific factors(allergies, renal function, etc.)
- Drug specific factors(drug-drug interactions, route, etc.)
What are the two types of drug resistances and their differences
Innate-Drug never worked
Acquired-Something happened to cause the drug to stop working
What factors contribute to resistance?
- Overuse/misuse
- Don’t need or don’t complete full amount
- International OTC
- Use of antibiotics in livestock
Why is TB so hard to treat?
Once inhaled, it goes to alveoli and walls itself off from treatment
What are the symptoms for TB?
Fever, night sweats, malaise, weight loss
Pulm system: productive cough and pleuritic pain
TB treatment goals
- Contain infection
- Cure infection: 2 phases
Main take away: Intensive and long duration drug treatment
Side effects of TB drugs
- liver and kidney issues
- visual disturbances
- CN8 damage (vestibulocochlear)
- neurological symptoms
How is C-diff transmitted?
Fecal to Oral
Also occurs when normal flora is interrupted
C-diff symptoms?
watery diarrhea, abdominal cramping, fever
C-diff precautions
Make sure to wear gloves and wash hands with soap and water, alcohol doesn’t work.
What drug can cause C-diff?
Lincosamide (Clindamysin)
What drug is used to treat C-diff?
Vancomysin (Glycopeptide)
Nitroimidazole (Metronidazole)
What are the side effects of nitroimidazole?
GI, metallic taste
less often:peripheral neuropathy
What is MRSA?
It is a bacteria that causes infection. Known as a “super-bug”.
What drug is used to treat MRSA?
linezolid
What is pneumonia?
Lung infection
What can pneumonia be caused by?
Bacteria 30%
Viral 50%
Mycoplasmas 20%
Antibiotic of choice for pneumonia?
Fluoroquinolone
What are the AE of fluoroquinolone?
GI, phototoxicity
TENDON RUPTURE
Viral Hepatitis Transmission? and Vaccine?
A
B
C
A- fecal-oral
B-blood, bodily fluids
C-blood-borne
A-Yes
B-Yes
C-No
Direct-Acting Antivirals (DAAs) most common AE?
Fatigue, weakness, headache
Also bradycardia in combo with amiodarone
HIV treatment
HAART
adherence is critical
HIV concerns
- oppertunistic infections
- handwashing and infection control are important
PT treatment for HIV
pain management
Rehab concerns for antiviral drugs?
- fatigue
- myolosuppression causing anemia, reduced O2 uptake, and earlier lactic acidosis threshold
Big picture: Monitor patient exercise tolernace with vital signs and get patient feedback with Borg Rating scale
Fungal infections also called what?
mycoses
increased risk after antibacterial use
Most common antifungals
Polyenes and Azoles
Polyenes and azoles common AE?
N/V/D, nephro and hepatotoxicity
Types of vaccines and what they are?
- Inactivated / Killed pathogen
- Subunit / Piece of the pathogen
- Live attenuated / Weakened Pathogen
- Toxoid / pathogen toxin instead of actual pathogen
Which type of vaccine should you avoid if you are immunosupressed?
Live attenuated (weakened pathogen)
At what point in the cell cycle can cancer interfere?
All points (G1,S,G2,M)
Difference between cell cycle specific (CCS) and cell cycle nonspecific (CCN) agents?
CCS agents work at a specific point in the cell cycle and are more effective on rapidly dividing tumors.
CCN agents are working throughout the cell cycle (including G0) and work better on large, slow growing tumors.
Difference between neoadjuvant and adjuvant therapy?
Neoadjuvant therapy is before primary care and adjuvant is after primary care.
Which cells does chemotherapy target?
All cells that arre actively dividing.
Bone marrow, GI tract and buccal mucosa, reproductive organs, hair follicles
What is Nadir?
10-28 days after chemotherapy when WBC count is at its lowest.
Anticancer drugs are withheld at this point, may be given antibiotics.
What are the three types of cancer treatment and define them?
- Chemotherapy: drugs that inhibit growth and replication of cancer cells
- Targeted therapy: damage cancer cells by blocking specific genes or proteins
- Immunotherapy: hormones and drugs that use the immune system to treat cancer
Oral chemotherapy precautions
- Wear gloves when touching laundry or bodily fluids
- Extra caution in pregnancy
Why are chemo patients at an INCREASED RISK FOR FALLS?
Cancer Impairements
- 50-75% of survivors experience a fall
- CANCER RELATED FATIGUE
- DECREASED COGNITION
- PAIN
- CIPN
Chemotherapeutic drug cycles and time of cycles?
6-8 cycles, given every 3 weeks
3 Cancer treament goals
- Cure: chemotherapy, radiation, and/or surgery
- adjuvant therapy
- neoadjuvant
- Control: reduce new cancer growth
- Palliation: cure nor control possible, focus on making patient comfortable
What antibiotic can cause C-diff and what antibiotic can treat it?
Clindomysin
Vancomysin
What two drug classes can cause hypersensitivity
Penacillins (Gram+ and -)
Cephalosporins
What are aminoglycosides AE?
ototoxicity, nephrotoxicity
tetracyclines important AE
photosensitivity
oxazolidinones AE
seretonin syndrome
What drug can cause tendon rupture
fluoroquinolones
What drugs can cause Stevens-Johnson syndrome
Sulfonamide
Direct Acting Antivirals (DAAs) most common AE
fatigue, weakness, headache
can also cause Bradycardia in combi with amiodarone
How does HIV transmit to AIDS?
decrease in CD4 count
Which antifungal causes nephro and hepatotoxicity?
Polyenes
Which antifungal causes photophobia?
Azoles
Primary concern with antifungals?
Liver damage and kidney damage
