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PHM 114
Chapter's 3 and 4
| Question | Answer |
|---|---|
| What is the body's built in defense mechanism against invading pathogens? | Immune System |
| What are foreign organisms that cause infection? | Pathogens |
| What are the 2 levels of the immune system? | Local and Systemic |
| The localized process of the immune system is also called what? | Nonspecific immunity, Innate response, and Inflammation |
| What involves mast cells, complement, and mediator chemicals such as histamine, leukotrienes, and prostaglandins? | Inflammation |
| Leukocytes are also referred to as? | White blood cells |
| Lymphocytes are also referred to as? | White blood cells that detect specific pathogens such as viruses * T and B cells |
| What cells are responsible for cellular immunity? | T cells |
| What is the process of detecting cells that are infected with viruses and initiating the immune response? | Cellular Immunity |
| What are the cells that attack cells of the body that have already been infected with a virus? | Killer T cells |
| What are the cells that release lymphokines that stimulate B cells to go into action? | Helper T Cells |
| What cells provide humoral immunity? | B cells |
| What is the process of making antibodies to prevent further infections? | Humoral Immunity |
| What are the cells that mature into plasma cells that release antibodies, which fight off viruses before the viruses infect the cells? | B cells |
| What helps our bodies to remember specific pathogens in case we encounter them again? | Antibodies |
| What are single celled micro organisms that live practically everywhere? | Bacteria |
| What is bacteria that is harmful wherever they invade? | Pathogenic |
| What is bacteria needing oxygen to live? | Aerobic |
| What is bacteria that can survive in environment without oxygen? | Anaerobic |
| If bacterial cells grow in chains or lines, their name begins with what? | Strep |
| If bacteria grow in clusters their name begins with what? | Staph |
| What is used to treat bacterial infections? | Antibiotics |
| What is a drug that does not necessarily kill the pathogen but hinders its growth and progression, allowing the body's immune system to fight it off? | Bacteriostatic Antibiotic |
| What drug kills the pathogen and is used on most difficult to treat infections? | Bacteriocidal Antibiotic |
| What is bacteria that has developed defense mechanisms that resist or inactivate antibiotics used on them? Most common with RTI's (Amoxicillin) | Antibiotic resistance |
| What are infections that are acquired while in the hospital or nursing home? They are often drug resistant and difficult to treat. | Nosocomial Infections |
| What auxiliary label should be on all antibiotics? | "Take medication until it is gone" |
| What does the choice of oral vs. IV antibiotic therapy depend on? | Severity of the infection and the organism suspected to be causing it |
| When are antibiotics best given? | At even intervals throughout the day |
| How are antibiotics dosed for children? | For the entire day based on their weight, but are best given in divided doses |
| What are penicillin's used for? | RTI's. Strep throat. Syphilis. Gonorrhea. Tooth/Gum infections. Ear infections. Endocaditis. Skin infections. Meningitis. Bacteremia |
| When do penicillin's work best? | When they are taken on an empty stomach. Do not take with fruit juice or cola because the acid deactivates the drug |
| What are the side effects of penicillin? | Stomach upset. Diarrhea. Mental disturbances. Seizures. Kidney Damage. Bleeding abnormalities |
| What are some cautions and considerations while taking penicillin? | 10% of the people allergic to penicillin are also allergic to cephalosporins. Oral penicillins in liquid form should be shaken well and refrigerated. Suspensions prepared with water are only good for 14 days. Left over medications should be thrown away |
| What are drugs that kill bacteria by inhibiting the formation of their cell wall? | Cephalosporins |
| What are the 4 groups of cephalosporins called? | Generations |
| What are cephalosporins used for? | Upper and lower RTI's. Skin infections. UTI's. Infection prophylaxis during surgical procedure. Deep seated infections |
| What generation works best on gram positive bacteria? | First generation |
| What generation is used for severe gram-negative infections? | Third generation |
| What generation is used for respiratory infections and for otitismedia? | Second generation |
| What generation is used for Pseudomonas infections that are difficult to treat? | Forth generation |
| How should cephalosporins be taken? | Some can be taken with food while others need to be taken on an empty stomach |
| What are the side effects of cephalosporins? | Nausea. Vomiting. Diarrhea. Headache. Dizziness. Mental disturbances. Seizures. Heart palpitations. Bleeding abnormalities |
| What are some cautions and considerations of cephalosporins? | Allergy is common. Omnicef is high in sugar content so patients with diabetes should be informed. Oral liquids should be shaken and refrigerated. Only good for 14d after mixed with water. Some should be take 2x instead of 3x a day |
| What are common penicillins? | Amoxicillin. Amoxicillin + Clavulanate |
| Generic: Amoxicillin + Clavulanate | Brand: Augmentin |
| Generic: Amoxicillin | Brand: Amoxil. Trimox |
| What are common 1st generation Cephalosporins? | Cefazolin. Cephalexin |
| Generic: Cefazolin | Brand: Ancef |
| Generic: Cephalexin | Brand: Keflex |
| What are common 2nd generation cephalosporins? | Cefaclor. Cefdinir |
| Generic: Cefaclor | Brand: Ceclor |
| Generic: Cefdinir | Brand: Omnicef |
| What are common 3rd generation cephalosporins? | Cefditoren. Cefotaxime. Cefepime |
| Generic: Cefditoren | Brand: Spectracef |
| Generic: Cefotaxime | Brand: Claforan |
| What are common 4th generation cephalosporins? | Cefepime |
| Generic: Cefepime | Brand: Maxipime |
| What is vancomycin? | The drug class that has activity against gram positive bacteria and probably works by inhabiting cell wall formation |
| What is vancomycin used to treat? | MRSA infections |
| What form is vancomycin used in? | IV form because oral is poorly absorbed |
| What are some side effects of vancomycin? | Pephrotoxicity (kidney damage). Ototoxicity (hearing loss) |
| What are cautions and considerations for vancomycin? | Must be administered slowly over 60 min. to avoid red man syndrome which involves hypotension, flushing, redness in neck and face, and rash. Make sure to use proper infusion rates and display them on IV bag label |
| What are macrolides? | The drug class that works by blocking bacteria's ability to produce needed proteins for survival |
| What is the most commonly used macrolide? | Erythromycin |
| What are macrolides used for? | Respiratory infections. Pneumonia. Also used with other drugs to treat heicobacter pylori |
| What is bacteria found in stomach ulcers? | Helicobacter pylori |
| What are macrolides that has unusually short but convenient length of therapy. Usually 3-4 days opposed to 7-14? | Azithromycin |
| What are macrolides that are used for acne, female genital infections, intra abdominal infections, and dental procedure prophylaxis? | Clindamycin |
| What are some side effects of macrolides? | Stomach upset. Nausea. Vomiting. Heartburn. Abdominal pain. Diarrhea. Liver toxicity w/ erythromycin. Jaundice could also occur |
| What are cautions and considerations for macrolides? | Heed any interaction warning that appears in computer system and alert pharmacist. Oral suspensions should be shaken well and refrigerated |
| What are common macrolides? | Azithromycin. Clarithromycin. Clindamycin |
| Generic: Clarithromycin | Brand: Biaxin |
| Generic: Azithromycin | Brand: Zithromax |
| Generic: Clindamycin | Brand: Cleocin |
| What is the drug class that kills bacteria by blocking their ability to make essential proteins for life? | Aminoglycosides |
| How are aminoglycosides often used? | In conjunction with other antibiotics |
| What is synergistic drug therapy? | When 2 or more drugs are used together because they can employ different mechanism of action that work better together rather than alone |
| What is gentamicin and tobramycin used to treat? | Eye infections in patients with immunodeficiency |
| What are some side effects of aminoglycosides? | Nephrotoxicity. Ototoxicity. You should properly monitor blood levels and lab tests |
| What are cautions and considerations with aminoglycosides? | Can cause neuromuscular blockade. Patients w/ muscular disorders should not take. Caution must be used if given after surgery. Should not be mixed in same IV bag as other antibiotics. Ophthalmic preparations must be kept sterile |
| what are common aminoglycosides? | Gentamicin |
| Generic: Gentamicin | Brand: Garamycin. Genoptic |
| What is Tetracyclines used for? | Acne treatment. Lyme disease. Rocky mountain spotted fever |
| What is doxycycline used for? | Gonorrhea. Chlamydia. RTI's. Abdominal infections |
| What are some side effects of tetracyclines? | Stomach upset. Nausea. Vomiting. Photosensitivity. Skin burn faster in sun. Rash may develop |
| What are cautions and considerations for tetracyclines? | Bind w/ metals and ions which cannot be absorbed into blood stream. Apply warning label for patients to avoid anything w/ these substances. Discoloration of teeth and bones. Breaks down overtime to cause toxicity. Never save. Permanent teeth problems |
| What are common tetracyclines? | Doxycyclilne. Tetracycline |
| Generic: Doxycycline | Brand: Vibramycin. Doryx |
| Generic: Tetracycline | Brand: Sumycin |
| What are fluoroquinolones? | Also called quinolones. Kill bacteria by inhibiting the enzyme that helps DNA to coil |
| What are fluoroquinolones used for? | Bone and joint infection. Eye infection. Serious RTI's and UTI's. Special treatment for anthrax |
| Why are fluroquinolones not used in ordinary common infections? | They have developed resistence |
| What are side effects of fluroquinolones? | Nausea. Vomiting. Dizziness. Diarrhea. Unpleasant taste. Photosensitivity. Liver toxicity and alterations in glucose metabolism. Tendon ruptures |
| What are cautions and considerations for fluoroquinolones? | Many drugs interact with it. Should not be taken w/ antacids, dairy products, or calcium fortified juices because it reduces absorption. Mental function and convulsions have been reported |
| What are common Quinolones? | Ciprofloxacin. Levofloxacin |
| Generic: Ciprofloxacin | Brand: Cipro |
| Generic: Levofloxacin | Brand: Levaquin |
| What are Sulfonamides used for? | UTI's. MRSA. AIDS |
| What are Nitrofurantoin used for? | UTI's |
| What are some side effects of sulfonamides? | Nausea. Vomiting. Fever. Phosensitivity. Rarly jaundice and stevens-johnson syndrome. Kidney damage. * Drink 6-8 glasses of water a day |
| What are some side effects of Nitrofurantoin? | Nausea. Vomiting |
| What are cautions and considerations of sulfa drugs? | Allergy. Disulfiram reaction if taken with alcohol which causes flushing, nausea, vomiting, sweating. Patients should not drink alcohol or any OTC containing alcohol while taking and for a few days after |
| What are cautions and considerations for nitroflurantoin? | Turns urine brown. Warn patients of this |
| What are common Sulfonamides and Nitrofurantoin? | Nitrofurantoin. Trimethoprim/Sulfamethoxazole |
| Generic: Nitrofurantoin | Brand: Macrobid. Macrodantin |
| Generic: Trimethoprim/Sulfamethoxazole | Brand: Bactrim. Cotrim. Septra |
| What is Metronidazole? | The drug class that is structured like an antifungal drug but works like an antibiotic |
| What are metronidazole used for? | Giardia. Amebic dysentery. bacterial vaginosis. Trichomoniasis. Rosacea. H pylori ulcers |
| What are some side effects of Metronidazole? | Headache. Anorexia. Vomiting. Diarrhea. Abdominal Cramps |
| What are cautions and considerations for metronidazole? | Interacts with alcohol to cause severe reaction such as vomiting, nausea, flushing, sweating, and headache |
| What are infections that are not whole cell organisms like bacteria? | Viruses |
| What do the signs and symptoms of a viral infection depend on? | The type of cells destroyed by the virus. For example a cold attacks cells in the respiratory mucosa causing runny nose, sinus congestion, and coughing |
| What are common viral infections? | Influenza. Herpes. Chicken pox. Shingles. STD's. Hepatitis A,B,C. Measles. Mumps. Rubella. West nile. Rabies |
| What prevents viruses from entering cells or alter their ability to replicate? Drug therapy should start as soon as 1st symptoms begin | Antiviral agents or drugsHow |
| What are some common side effects of antivirals? | Headache. Malaise. Fatigue. Nausea. Vomiting. Diarrhea. Cough. Rash |
| How are agents for hepatitis and genital herpes taken? | On a chronic basis to suppress the virus and prevent or lessen outbreaks |
| What is HIV? | a retrovirus that attaches to receptors on the surface of T cells and injects its contents |
| What are Nucleoside and Nucleotide Reverse Transcriptase Inhibitors? | HIV agents that inhibit reverse transcriptase, which forms pro DNA molecules inside of T Cells |
| What are side effects of NRTIs and NtRTIs? | Nausea. Vomiting. Lactic acidosis with liver enlargement. Pancreatitis. Peripheral neuropathy. Alcohol increases the incidence and severity of these toxicities |
| What are cautions and considerations for NRTIs and NtRTIs? | They are metabolized in the liver |
| What are some Antiviral Drugs for Common infections? | Acyclovir. Amantadine. Famciclovir. Oseltamivir. Valacyclovir. |
| Generic: Acyclovir | Brand: Zovirax |
| Generic: Amantadine | Brand: Symmetrel |
| Generic: Famciclovir | Brand: Famvir |
| Generic: Oseltamivir | Brand: Tamiflu |
| Generic: Valacyclovir | Brand: Valtrex |
| What are common NRTIs and NtRTIs? | Zidovudine |
| Generic: Zidovudine | Brand: Retrovir |
| What are Non Nucleoside Reverse Transcriptase Inhibitors used for? | Exclusively for HIV infection |
| What are common NNRTIs? | Efavirenz. Nevirapine |
| Generic: Efavirenz | Brand: Sustiva |
| Generic: Nevirapine | Brand: Viramune |
| What are Protease Inhibitors? | Work by blocking the enzyme that affects the assembly of proteins into working HIVs |
| What are some side effects of PIs? | Severe diarrhea. Headache. Fatigue. Dizziness. nausea. Vomiting. Bleeding problems. Pancreatitis. Depression. Stevens Johnson Syndrome. Allergic Reactions. Weight Gain |
| What are cautions and considerations for PIs? | Have numerious drug interactions. One interaction involves antihistamines, a common OTC |
| What are common PIs? | Atazanavir |
| Generic: Atazanavir | Brand: Reyataz |
| What are fungal Infections? | Fungi, Yeasts, and molds which are one celled plant organisms |
| What is dermatophytes? | Fungi of the skin which cause some of the most frequent and ordinary infections such as athletes foot and ringworm |
| What is Candidiasis? | Fungus that causes vaginal yeast infections and oral thrush |
| What do most antifungal drugs work on? | Ergosterol. Which is a substance in the cell wall of fungi |
| What is pulse dosing? | where a drug is given one week a month. Its used to reduce the amount of time the drug comes in contact with the liver |
| What drug is particularly toxic to the liver and kidneys? | Amphotericin B. It should never be mixed or piggybacked with other drugs. Precipitation will occur if mixed with normal saline |
| What are common systemic antifungal drugs? | Itraconazole. Ketoconazole. |
| Generic: Itraconazole | Brand: Sporanox |
| Generic: Ketoconazole | Brand: Nizoral |
| What are common skin/nail antifungal Drugs? | Clotrimazole. Clotromazole/Betamethasone. Nysstatin |
| Generic: Clotrimazole | Brand: Lotrimin AF. Desenex |
| Generic: Clotrimazole/Betamethasone | Brand: Lotrisone |
| Generic: Nystatin | Brand: Mycostatin |
| What are common vaginal antifungal drugs? | Fluconazole. Miconazole |
| Generic: Fluconazole | Brand: Diflucan |
| Generic: Miconazole | Brand: Monistat |
| What are parasites? | Organisms that live off of a host. They do not kill their host. But can create great discomfort and severe symptoms |
| What are some examples of parasites? | Pinworms. Hookworms. Roundworms. Tapeworms |
| What is protozoa? | Single celled parasites that cause infection, usually through the oral fecal route. These parasites are passed along when hands, food, or water are contaminated with feces from an infected human or animal |
| What is Giardia? | An intestinal infection cause by protozoa in humans and dogs, can be carried in bird poop, deposited in water or on vegetation, and cause diarrhea when ingested |
| What is used for several common intestinal infections cause by protozoa such as Giardia? | Methronidazole |
| What disease in the US do Pharmacy techs not dispense perscriptions for unless a patient is traveling to or from another country where it is common? | Malaria |
| What is the immune response? | A complex system that protects and fights against infectious disease |
| What happens in acquired immunity? | Pathogens are carried to the lymph nodes where lymphocytes detect and destroy them. |
| What do helper T cells do during acquired immunity? | They detect specific antigens and stimulate killer T cells and B cells to become active |
| What do killer T cells do during acquired immunity? | They start killing any cells of the body infected with foreign antigens. Killer T cells can also help rid the body of cancerous cells. |
| Which body's immune system has to do with organ transplantation to keep it from attacking new tissue? | Acquired Immunity |
| Immunoglobulins are also called? | B cells that produce antibodies |
| What do Autoimmune disorders include? | Systemic lupus erythematosus, myasthenia gravis, rheumatoid arthritis, and multiple sclerosis |
| What do the autoimmune disorders affect? | specific tissues, depending on the type of antibodies produced and the cells they attack |
| What is Type 1 diabetes caused by? | An autoimmune process that destroys the beta cells that produce insulin in the pancreas |
| What treatment therapy is used for MS? | Immunologic therapy |
| What are allergic reactions? | Cases of hypersensitivity |
| 1st type of Hypersensitivity? | The worst. Anaphylactic reactions that can be life threatening |
| What is Anaphylaxis? | Process mediated by antibodies, basophils, and mast cells and causes swelling of the airways, blood vessel dilation, and shock, if not treated quickly |
| 2nd type of Hypersensitivity? | Reactions that stimulate the complement system. Occurs when the wrong blood is given to a patient |
| 3rd type of Hypersensitivity? | Involves toxins and antibodies. Usually occurs in the spleen but if severe enough can cause inflammation of the blood vessels |
| 4th type of Hypersensitivity? | The immune response mediated by killer T cells. Reactions are called delayed responses because they take 12-72 hrs to occur. PPD skin test is an example. Not harmful if drug is stopped |
| What is immunization? | Process that uses acquired immunity to fight and protect against specific diseases |
| What is natural immunization? | Occurs when your body is exposed to foreign antigens in normal daily life and produces antibodies against them |
| What is artificial immunization? | Occurs when an antigen is intentionally introduced to the body via vaccination. it builds a defense in advance of disease exposure |
| What is active immunity? | Exposes the body to an antigen or part of an antigen, which then uses the body's natural immune response to make antibodies. Vaccines use this to prevent disease |
| What is passive immunity? | Occurs when antibodies themselves are introduced into the bloodstream. This occurs either naturally or artificially |
| What do vaccinations do? | Reduces and prevents life threatening diseases such as polio when used widely |
| Who publishes a schedule for childhood and adult vaccines? | Centers for Disease Control and Prevention - CDC * |
| How are many vaccines administered? | In the physicians office or inpatient settings |
| What are travel immunization clinics? | Where they provide immunizations and advice about what vaccines are appropriate for various areas of the world (Hepatitis and Cholera) |
| When must travel vaccines be given? | Well in advance of travel to allow the immune system enough time to mount the appropriate response and confer full immunity |
| What are some side effects of Vaccines? | Fever. Headache. Stomach upset. Local injection site irritation. Mild rash. Irritability. Tired and achy feeling |
| What are cautions and considerations of vaccines? | None without risk. Patients must receive written info about risks before getting vaccine. Also must receive vaccine information sheet |
| What is the influenza vaccine grown in? | Chicken eggs. Person with allergy to eggs should not receive vaccine |
| What training should those administering immunization have? | CPR- In case an anaphylactic reaction occurs |
| What should the storage and preparation requirements be? | Temp. range for storing is tight and strict. Most require storage in refrigerator or freezer. Cannot be given frozen. Get to room temp. Don't reuse. Rub hands together to get to room temp. |
| When should vaccines that come as powder be used? | Within minutes to hours |
| What are interferons? | A therapy used for a variety of conditions affecting the immune system including MS and Hepatitis. They are quite costly (1000's) and only dispensed in specialty pharmacys. They are easily degradable protein products |
| What is MS? Multiple Sclerosis | Autoimmune disorder in which antibodies destroy the myelin sheath surrounding many nerve cells. Damaged myelin tissue forms scars that interfere with coordinated signal conduction along these nerves |
| What are symptoms of MS? | Starts with numbness in the limbs. Loss of nerve axons and white matter in the brain. Vision loss to paralysis. Difficult to predict |
| What is the most frequently diagnosed type of MS? | Relapsing-remitting MS. Where severe symptoms flare up followed by period of remission |
| What happens in secondary progressive MS? | Remissions disappear and symptoms steadily worsen |
| What are the main drugs used to treat MS? | Interferons used to prevent progression and relapse of MS so as to postpone disability and preserve cognitive function. Only treatment option but does not work with everyone. Injectable. Cant take flu shot if taking this therapy |
| What is hepatitis? | Inflammation of the liver. Caused by viral disease, alcohol use, medications, poisons, or autoimmune diseases |
| What is hepatitis A? | transmitted through ingestion of contaminated food or liquids. Short term acute infection that does not become a chronic disease. Common in less developed countries |
| What is hepatitis B? | Transmitted via sexual activity; use of contaminated needles, or receipt of blood products infected with hepatitis B; or from mother to infant. In some patients it can lead to chronic infection of the liver. (Cirrhosis,Liver cancer,Liver failure) |
| What is hepatitis C? | Spread by blood to blood contact. High risk populations include injection drug users, homeless, and prison inmates. Very high rate of mutation.Nearly all patients develop chronic infection |
| What are common drugs for Hepatitis? | Hepatitis A- No treatment. Vaccines available for A and B but not if patient already has infection. Routine vaccination of Hepatitis B is recommended for Children and healthcare prof. B and C can be treated using interferon therapy(boost patients ImS) |
| What is immunosuppression? | The treatment that is used during organ transplants so the body doesn't reject organ |
| What is graft versus host disease? | T cells remaining in the transplanted organ can mount an attack against the recipient's body after transplant |
| How long do immunosuppressants have to be taken after a transplant? | For life |
| What are the side effects of immunosuppressants? | Sore throat. Cough. Dizziness. Nausea. Muscle aches. Fever. Chills. Itching. Headache. Effects are mild to moderate. Rare effects are change in heart rhythm or blood pressure. Chest pain. Unusual bleeding. Bruising.Anemia. Hyperlipidemia. |
| What does immunosuppressant use increase the risk of? | Cancer. Close monitoring for cardiac function and periodic blood tests are needed |
| What are cautions and considerations of Immunosuppressants? | Increased risk of infection.Patients directed to wear face masks and stay out of crowded public areas and frequently wash hands. Do not shake. Keep refrigerated and some out of light. Serious drug interations |
| What must Cyclosporines be prepared in? | Glass containers |
| What are Oral Corticosteroids? | Used for their anti inflammatory and immunosuppressant properties. They are glucocorticoids that have potent ati inflammatory effects. Modify immune response |
| What do oral corticosteroids do? | Slow leukocyte function and decrease fever, redness, and swelling. They are frequent choices for hypersensitivity and allergic reactions. They are used for organ transplant as well |
| How are oral corticosteroids dosed when used for asthma? | Short term in high doses |
| what are the side effects of coricosteroids? | Headache. Dizziness. Insomnia. Hunger |
| When should you take coricosteroids to minimize side effects? | First thing in the morning |
| How does corticosteroids affect you if taken long term? | Affects normal metabolism in the body involving facial swelling. ** Moon Face ** Significant weight gain. Fluid retention. and fat redistribution to the back and shoulders ** Buffalo Humps ** |
| What are the severe side effects of coricosteroids? | High blood presure. Loss of bone mass. Electrolyte imbalance. Cataracts or glaucoma. Insulin resistance. Steroid induced psychosis |
| What are cautions and considerations of coricosteroids? | If taking longer than a couple of weeks should slowly decrease the dose over time when stopping therapy. Changing corticosteroid levels can cause untoward and be life threatening. Pharmacy techs should apply warning label stating this. Swallow whole. |
| When are immunoglobulins administered? | When rapid immunity is needed for a specific disease for a defined period of time. Onset is quick and does not require repeated boosters. Length is short and only a few months. Treat rabies. tetanus. chickenpox. shingles. and respiratory syncytial virus |
| What are antitoxins and antivenoms used for? | Injected antibodies to reduce effects from toxins and venom's in the bloodstream. Combined with venom and neutralize it. |
| What are anivenoms mostly used for? | Spider bites and snakebites. Have to be administered intravenously within 4 hours of bit to be effective. Kept in ER |
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