Pharmocology Exam 3 Study Guide

Culture & Sensitivity

  • Culture & Sensitivity (C&S) tests are performed to identify the specific microorganism causing an infection and to determine which antibiotics the microorganism is sensitive (susceptible) or resistant to.
  • A sample (e.g., blood, urine, wound) is cultured to grow the bacteria, and then different antibiotics are tested to see which ones inhibit growth.
  • This helps guide appropriate antibiotic selection for effective treatment.

Broad-Spectrum Antibiotics

  • Broad-spectrum antibiotics are effective against a wide range of bacteria, both gram-positive and gram-negative.
  • They are often used when the causative organism is not yet identified or when treating polymicrobial infections.
  • Example: Tetracycline.

Narrow-Spectrum Antibiotics

  • Narrow-spectrum antibiotics are effective against a specific group of bacteria.
  • They are preferred when the causative organism is known to minimize disruption to the normal flora and reduce the risk of antibiotic resistance.
  • Example: Vancomycin.

MDRO Bacteria

  • MDRO stands for Multi-Drug Resistant Organisms.
  • These are bacteria that have become resistant to many different antibiotics.
  • Examples include MRSA (Methicillin-resistant Staphylococcus aureus), VRE (Vancomycin-resistant Enterococcus), and CRE (Carbapenem-resistant Enterobacteriaceae).
  • Infections caused by MDROs are difficult to treat and require the use of specific antibiotics and strict infection control measures.

Peak and Trough

  • Peak and trough levels are measured to monitor the therapeutic drug levels of certain antibiotics, such as vancomycin and aminoglycosides.
  • Peak level: The highest concentration of the drug in the patient's bloodstream, usually measured shortly after administration.
  • Trough level: The lowest concentration of the drug in the patient's bloodstream, usually measured just before the next dose.
  • Monitoring peak and trough levels helps ensure that the drug concentration is within the therapeutic range (effective) and avoids toxicity.

Prophylaxis Therapy

  • Prophylaxis therapy is the use of antibiotics to prevent infection before it occurs.
  • It is used in specific situations, such as before surgery (to prevent surgical site infections), in patients with weakened immune systems, or after exposure to certain infectious diseases.

Fluoroquinolone

  • Fluoroquinolones are a class of broad-spectrum antibiotics that inhibit bacterial DNA replication.
  • Examples include ciprofloxacin and levofloxacin.
  • They are used to treat a variety of infections, including respiratory, urinary, and skin infections. However, they have potential side effects, including tendon rupture and QT prolongation.

Vancomycin

  • Vancomycin is a narrow-spectrum antibiotic used to treat serious gram-positive infections, especially those caused by MRSA or other resistant organisms.
  • It inhibits bacterial cell wall synthesis.
  • Adverse effects include nephrotoxicity and ototoxicity; therefore, peak and trough levels are monitored.

Tetracycline

  • Tetracycline is a broad-spectrum antibiotic that inhibits bacterial protein synthesis.
  • It is used to treat a variety of infections, including acne, respiratory infections, and Lyme disease.
  • It can cause photosensitivity, tooth discoloration (in children), and should not be taken with dairy products or antacids.

Ciprofloxacin

  • Ciprofloxacin is a fluoroquinolone antibiotic.
  • It is used to treat a variety of bacterial infections, including urinary tract infections, respiratory infections, and skin infections.
  • As a fluoroquinolone, potential side effects include tendon rupture, QT prolongation, and peripheral neuropathy.

Rifampin

  • Rifampin is an antibiotic primarily used to treat tuberculosis (TB).
  • It inhibits bacterial RNA synthesis.
  • A notable side effect is that it can cause body fluids (urine, tears) to turn orange-red.

Isoniazid

  • Isoniazid (INH) is an antibiotic also primarily used to treat tuberculosis (TB).
  • It inhibits bacterial cell wall synthesis.
  • A common side effect is peripheral neuropathy, which can be prevented by taking vitamin B6 (pyridoxine).

Chloroquine

  • Chloroquine is an antimalarial drug used to treat and prevent malaria.
  • It works by interfering with the growth of parasites in red blood cells.
  • It is also used to treat certain autoimmune diseases.

Ketorolac

  • Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID).
  • It is used for short-term pain relief, usually after surgery.
  • It is administered via IV most commonly.

NSAID

  • NSAID stands for Nonsteroidal Anti-Inflammatory Drug.
  • NSAIDs are used to reduce pain, inflammation, and fever.
  • Examples include ibuprofen, naproxen, and ketorolac.
  • Common side effects include gastrointestinal upset and increased risk of bleeding.

Quinolone

  • Quinolone is another name for the class of antibiotics called fluoroquinolones.
  • Examples include ciprofloxacin and levofloxacin.
  • They inhibit bacterial DNA replication.

Sulfonamide

  • Sulfonamides are a class of antibiotics that inhibit bacterial folic acid synthesis.
  • An example is sulfamethoxazole-trimethoprim (Bactrim), often used to treat urinary tract infections.
  • A common side effect is photosensitivity.

Epogen

  • Epogen (epoetin alfa) is a synthetic form of erythropoietin, a hormone that stimulates red blood cell production.
  • It is used to treat anemia associated with chronic kidney disease, chemotherapy, or other conditions.

Cephalosporins

  • Cephalosporins are a class of beta-lactam antibiotics, similar to penicillin.
  • They inhibit bacterial cell wall synthesis.
  • They are divided into generations (1st, 2nd, 3rd, 4th, and 5th) with increasing activity against gram-negative bacteria.

Allopurinol

  • Allopurinol is a medication used to treat gout and hyperuricemia (high uric acid levels).
  • It works by reducing the production of uric acid in the body.

Treatment for Herpes Simplex Genitalis

  • Antiviral medications, such as acyclovir, valacyclovir, and famciclovir, are used to treat herpes simplex genitalis.
  • These medications can reduce the frequency, duration, and severity of outbreaks, but they do not cure the infection.

What Causes Antibiotic Resistance?

  • Antibiotic resistance occurs when bacteria change in a way that reduces or eliminates the effectiveness of antibiotics.
  • Causes include:
    • Overuse and misuse of antibiotics.
    • Incomplete courses of antibiotics.
    • Spread of resistant bacteria between people and in the environment.
    • Use of antibiotics in agriculture.

Antiviral Drugs

  • Antiviral drugs are used to treat viral infections.
  • Examples include acyclovir (for herpes), oseltamivir (for influenza), and antiretroviral drugs (for HIV).
  • They work by interfering with viral replication.

Treatment for Tuberculosis

  • Tuberculosis (TB) is treated with a combination of antibiotics, typically including isoniazid, rifampin, pyrazinamide, and ethambutol.
  • The treatment duration is usually 6-9 months.
  • Directly observed therapy (DOT) is often used to ensure adherence to the treatment regimen.

Allergic Reactions to PCN (Penicillin)

  • Allergic reactions to penicillin can range from mild rash to severe anaphylaxis.
  • Symptoms include rash, hives, itching, swelling, difficulty breathing, and wheezing.
  • Patients with a history of severe allergic reaction to penicillin should avoid penicillin and other beta-lactam antibiotics.

S/S Inflammation

  • Signs and symptoms of inflammation include:
    • Redness (rubor).
    • Swelling (tumor).
    • Heat (calor).
    • Pain (dolor).
    • Loss of function (functio laesa).

Vitamin K

  • Vitamin K is a fat-soluble vitamin that plays a key role in blood clotting.
  • It is used to treat bleeding disorders and to reverse the effects of anticoagulant medications, such as warfarin.

H2 Antagonist

  • H2 antagonists are medications that block the action of histamine at H2 receptors in the stomach.
  • This reduces gastric acid secretion.
  • Examples include ranitidine, cimetidine, and famotidine.
  • They are used to treat heartburn, GERD, and peptic ulcers.

Treatment for Heartburn

  • Treatment for heartburn includes lifestyle modifications (e.g., avoiding trigger foods, elevating the head of the bed), antacids, H2 antagonists, and proton pump inhibitors (PPIs).

Treatment for Shingles

  • Shingles (herpes zoster) is treated with antiviral medications, such as acyclovir, valacyclovir, or famciclovir.
  • Pain management is also important and may include analgesics or nerve blocks.
  • A vaccine is available to prevent shingles.

Treatment for RA

  • RA stands for Rheumatoid Arthritis, a chronic inflammatory autoimmune disorder that primarily affects the joints
  • Treatment for RA includes:
    • DMARDs (Disease-Modifying Antirheumatic Drugs) such as methotrexate
    • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) for symptom relief
    • Corticosteroids to reduce inflammation
    • Biologic Agents for more advanced therapy where patients do not respond well to the above treatments

IBS (Irritable Bowel Syndrome)

  • IBS is a common gastrointestinal disorder characterized by abdominal pain, bloating, gas, diarrhea, and/or constipation.
  • Treatment focuses on managing symptoms and may include dietary changes, medications (e.g., antispasmodics, laxatives, antidiarrheals), and stress management techniques.

Different Types of Hepatitis

  • Hepatitis is inflammation of the liver, usually caused by a viral infection.
  • Different types of viral hepatitis include:
    • Hepatitis A: Spread through contaminated food or water.
    • Hepatitis B: Spread through blood, semen, or other body fluids.
    • Hepatitis C: Spread through blood.
    • Hepatitis D: Only occurs in people already infected with hepatitis B.
    • Hepatitis E: Spread through contaminated food or water.

Neutropenic Precaution

  • Neutropenic precautions are infection control measures used to protect patients with neutropenia (low neutrophil count), who are at increased risk of infection.
  • These precautions include:
    • Strict hand hygiene.
    • Avoiding contact with sick people.
    • Avoiding raw fruits and vegetables.
    • Wearing a mask in public.

Treatment for Motion Sickness

  • Treatment for motion sickness includes medications, such as antihistamines (e.g., dimenhydrinate, meclizine) and scopolamine.
  • Other strategies include focusing on a fixed point, avoiding heavy meals, and staying hydrated.

Treatment for Aids/Candidiasis

  • AIDS (Acquired Immunodeficiency Syndrome) is caused by HIV (Human Immunodeficiency Virus), which attacks the immune system.
  • Treatment for AIDS involves antiretroviral therapy (ART), which helps to control the virus and prevent its progression.
  • Candidiasis (yeast infection) is a common opportunistic infection in people with AIDS.
  • It is treated with antifungal medications, such as fluconazole or clotrimazole.

Antigens

  • Antigens are substances that can trigger an immune response in the body.
  • They can be bacteria, viruses, fungi, toxins, or other foreign substances.
  • When an antigen is detected, the immune system produces antibodies to neutralize or destroy it.

Combination Chemotherapy

  • Combination chemotherapy involves using multiple chemotherapy drugs together to treat cancer.
  • This approach can be more effective than using a single drug because it targets different mechanisms of cancer cell growth and survival.

Active vs Passive Immunity

  • Active immunity: Immunity that develops after exposure to an antigen, either through infection or vaccination.
    • The body produces its own antibodies.
  • Passive immunity: Immunity that is acquired from another source, such as:
    • From mother to baby through placenta or breast milk.
    • From an injection of antibodies (e.g., immunoglobulin).
    • The body receives antibodies from an external source.

Administration of Combination Eyedrops

  • When administering multiple eyedrops, wait 5-10 minutes between each medication to allow for absorption and to prevent washout.

Vitamin K Deficiency

  • Vitamin K deficiency can lead to bleeding disorders because vitamin K is essential for blood clotting.
  • Causes include:
    • Malabsorption
    • Antibiotic use (which can disrupt gut bacteria that produce vitamin K).
    • Liver disease.

HIV Precautions

  • HIV precautions are infection control measures used to prevent the spread of HIV.
  • These precautions include:
    • Standard precautions: Treating all blood and body fluids as potentially infectious.
    • Using personal protective equipment (PPE), such as gloves and gowns.
    • Safe injection practices.
    • Proper handling and disposal of sharps.

Myeloblastic Leukemia

  • Myeloblastic leukemia is a type of cancer that affects the blood and bone marrow.
  • It is characterized by the overproduction of immature myeloid cells (myeloblasts).