Symptoms of Anaphylaxis
Itching, flushing, hives, face swelling, wheezing, profuse sweating, dropping bp, shock, death
How to treat anaphylaxis?
Epinephrine, Hydrocortisone, CPR
What are the 7 major classes of Antibiotics?
Penicillins, Cephalosporins, Tetracyclines, Macrolides, Aminoglycosides, Sulfonamides, Floroquinolonies
Which drugs are bactreriocidal and how does it work?
Penicillin, Cephalosporin, Vancomycin
Inhibits cell wall synthesis
Which drugs are bacteriostatic and how does it work?
Tetracyclines, Macrolides, Aminoglycosides
Inhibits protein synthesis
Which drugs are used for serious sepsis?
Carboapenems, monobactams
What enzyme is produced in penicillin resistant strains of antibiotics?
betalactamase
Name the two most common penicillin antibiotics
Ampicillin, Amoxicillin
Name two suicide substrates
Clavulanate, Sulbactam
What is the rate at which allergy to penicillin has a cross-reactivity with penicillin?
~10%
Penicillin
What is used as early treatment of syphillis
1st Gen Cephalosporins tx
skin, soft tissue infections, UTIs
2nd Gen Cephalosporins tx
Strep pneumoniae, the flu
3rd Gen cephalospoirins tx
Pneumonia, Meningitis, Gonorrhea
Advantage of Cephalosporins vs Penicillins
Cephalosporins treat wider range of bacterial infections
What are the most common side effects of antibiotics?
Nausea, vomiting, diarrhea, rash, photosensitivity
Naming: Penicillins
-illin
Naming: Cephalosporins
cef-/ceph-
Naming: Tetracyclines
-cycline
What are the toxicities of tetracyclines
GI disturbances, superinfections, tooth/bone deposition, expired may cause nephrotoxicity, should be taken alone on empty stomach
What are the toxicities of aminoglycosides?
long half-life, GI upset, ototoxicity, nephrotoxicity, hepatic dysfunction - CYP450 inhibitor
Name a common Aminoglycoside
Gentamycin
What can Tetracyclines treat?
Rickettsias, chlamydia, traveler's diarrhea
Name the most common Macrolide
Azythromycin
Mostly, what do macrolides treat? Hint: generalized system(s)
respiratory and skin infections
Toxicities of Aminoglycosides
Reversible nephrotoxicity - cratinine clearance must be monitored strictly, irreversible ototoxicity, temporary neuroms blockage
Not often used for these reasons
Aminoglycosides treat:
strictly treat gram negative sepsis
Mechanism of Sulfonamides
Inhibit folic acid activity
Side effects of Sulfonamides
NVD, Rash, Stephen Johnson's Syndrome
May cause kidney stones - prevent with lots of fluids
Mechanism of (floro)Quinilones
DNA gyrase inhibitor which create the double helix of DNA structure
Side effects of (Floro)Quinilones
spontaneous tendon ruptures
not recommended for use pt's >16yr
Naming: (Floro)Quinilones
-floxacin
Uses for clindamycin
Acne, Alt to penicillin in dental prphylax, anaerobic pneumonia, bone infections, bowel infections, female genital infections, intra-abdom infections
What severely adverse side effect can metronidazole or clindmycin have?
Nosocomial infection - Clostridium Difficile
immediately stop if have diarrhea w/in 24 hrs
What does metronidazole treat?
Anaerobic bacteria and protozoa infection
What are specific side effects for metronidazole?
metallic taste in mouth, highly bitter, excess tongue fur, not taken with alcohol - may cause severe GI upset
Virus Multiplication Phase 1
absorption, penetration, and uncoating as the virus enters the host cell and sheds its protective coating
Virus Multiplication Phase 2
Synthesis of viral components
Virus Multiplication Phase 3
Assembly and release of the virus which can destroy or permanently change the cell
Hep B and C treated by
interferons
B: and lamivudine
C: and ribavirin
MOA for HIV
NRTI, non-NRTI, Protease Inhibitors, Viral Fusion Hinhibitors
Preferred Regimen of HAART
(1) Protease inhibitor, (1) NRTI combo
Alternative Regimen of HAART
(2) NRTI combo (1) RTI - nevirapine or delavidrine
How to monitor for HIV
monitor RNA levels - if does not fall 10x by week 8 change drug regimen and use 2-3 new agents. Change if CD4s fall or condition deteriorates
Following HAART guidelines, when is anitviral therapy administered
initiated at CD4 count <350
recommended at CD4 count between 350-500
What is the treatment regimen for TB
Mos 1-2: IRPE
Mos 3-6: IR
What kinds of patients are at risk of fungal infections?
diabetes pts and pts who use steroids
What are the two most commonly prescribed anti-fungals?
Ketoconozole, Itraconazole
Metronidazole
used for pre-op surgery prep
Nitrofurantion
Used to treat UTI's - creates formaldehyde in urine as an antibiotic
Drugs used for GI worms
Albendzole, Mebendazole, Thiambendazole, Pyrantel Pamoate