pharm-antibiotics
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| cell-cycle specific | chemotherapy drugs that are most effective during a particular phase(cycle) of the cell cycle.
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| cell-cycle non specific | chemotherapy drugs that are independent of cell cycles.
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| Antimetabolites | Mimic natural products that are used for DNA and RNA synthesis.
Most effective during S phase and against tumors with a high growth fraction.
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| 5-Flourouracil pharmacodynamics and C/P | PD-Antimetabolite most effective during S phase. Leads to thymine deficiency. IV
C-Poor nutritional status, depressed bone marrow function,serious infection. Platelet count below 100,000 cells/mm3 pyrimidinema
P-use cause if woman is breast-feeding
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| 5-Flourouracil Adverse Effects | myelosuppresion, cardiotoxicity, headaches, disorientation, nystagmus. NVD. GI ulceration. brittle cracking nails, alopeica, hyperpigmentation of skin, rash.
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| Mitotic Inhibitors | interfere with the formation of the mitotic spindle causing metaphase arrest
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| Vincristine(Oncovin) Pharmacodynamics and C/P | PD-treats acute lymphoblastic leukemia Disrupts mitotic spindle.
C-Charcot-Marie-Tooth syndrome (absence of deep tendon reflexes),
P-if bilirubin levels are elevation. High risk of extravasation. IV ONLY
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| Vincristine Adverse Effects | loss of deep tendon reflexes, numbness and tingling, foot drop, jaw pain, weakness, constipation.
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| Cyclophosphamide Pharmacodynamics and C/P | For testicular, ovarian, and bladder cancers alkylating agent with broad spectrum antitumor actitivy. IV and oral. adds alkyl groups to DNA and causes abnormal base pairings.
C-severely compromised bone marrow function. poor renal or hepatic functions.
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| Cyclophosphamide Adverse Effects | leukopenia. High doses=hemorrhagic cystitis-hematuria, pain,burning urination. SIADH and cardiomyophathy. NV alopecia, transverse ridging and hyperpigmentation of nails. gonadal suppression, sterility, and ovarian fibrosis. 2nd malignancy possible
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| Cyclophosphamide interventions | Have patient drink at least 2L/day. monitor urine output 2nd malignancy more likely in younger patients. Discuss reproduction goals with patients.
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| Doxorubicin HCL | antitumor antibiotics-intercalation btw specific base pairs=no new RNA or DNA
C-myelosuppresion,severe CHF, existing cardiomyopathy.
P-Hepatic insufficiency Also secondary acute myelogenous leukemia (AML) can occur
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| Doxorubicin adverse effects | NV, suppression of bone marrow function, mucositis. alopeica and hyperpigmentation of nail beds. cardiotoxicity. risk of local necrosis if extravasation occurs. erythema, blisters, edema, skin loss, and occasionally ulcer formation.
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| Tamoxifen | first line drug against breast cancer. highly protein bound and metabolized. antiestrogen-competes with estrogen for binding sites.
c/p-known hypersensitivity to the drug, myelosuppression and pregnant or lactating
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| Tamoxifen adverse effects | hot flashes, mild nausea, weight gain, headache, vaginal bleeding and discharge, menstrual irregularities, fluid retention, skin rash. endometrial cancer or polyps. strokes, pulmonary embolism
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| tamoxifen intervention | monthly blood counts, annual PAP smears, regular visual tests. Have patients report signs of hypercalcemia
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| Penicillin | used against gram + bacteria. And gram- neisseria meningitidis. Pen G not oral. Pen V oral. binds of PBP and inhibits transpeptidase so cross bridges in cell wall cannot form. C-known allergy to pen, ceph, or imipenem. P-renal disease, pregnancy
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| Penicillin Adverse Effects | most serious-allergic reaction. NVD abdominal pain, stomatitis, sore mouth furry tongue. superinfections possible tetracyclides decrease effectiveness
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| cephalosporins cefazolin | Similar to penicillin. Binds to PBP's and disrupts cell wall synthesis. C-known allergy P-renal failure, pregnant, lactating 5-10% chance of being allergic if also allergic to penicillin
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| cephalorsporin adverse effect | serious-hypersensitivity common-NVD anorexia, abdominal pain, flatulence. superinfections can develop. pseudomembranous colitis potentially dangerous
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| Vancomycin | effective against gram + bacteria. inhibits cell wall synthesis by altering cell's permeability. inhibits synthesis of RNA. C-hypersenitivity or pregnant P-lactating, renal disease,
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| Vancomycin adverse effects | serious toxicities-ototoxicity, nephrotoxicity. "red man" syndrome due to histamine release. infuse IV slowly and avoid extravasation
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| Aminoglycosides-Gentamicin | effective against gram- bacilli. ineffective against anaerobes.binds with 30S ribosomal subunit causes misreadings. C-preg/lact allergy P-renal or hepatic disease or myasthenia gravis
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| Aminoglycosides-Gentamicin adverse effects | neurotoxicity, nephrotoxicity, ototoxicity, depressed bone marrow function, NVD, palpations, hypotension and hpyertension
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| Aminoglycosides-Gentamicin interventions | peak and trough drug levels monitored, monitor for signs of toxicity,
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| Lincosamides-Clindamycin | effective against aerobic gram+ cocci. most anaerobes (gram+/-) also susceptible. Binds to bacterial ribosomes and prevents protein synthesis. C-preg/lact, allergies, heptatic/renal dysfunction P-history of ulcerative colitis or regional enteritis
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| Lincosamides-Clindamycin | pseudomembranous colitis, diarrhea, abdominal cramps, abdominal tenderness, nausea, vomiting. rash reports signs of diarrhea immediately!
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| Macrolides-Erythromycin | more effective against gram+. inhibits RNA-dependent protein synthesis. C-allergy P-hepatic insufficiency preg/lact, cardiac arrhythmias,impaired hearring
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| Macrolides-Erythromycin Adverse Effects | hepatotoxicity, QT prolongation, pseudomembranous colitis, ventricular tachycardia, GI distress.
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| Tetracycline | bacteriostatic, prevent cell division and replication. administered orally C-allergy P-hepatic/renal dysfunction, younger than 8. used for rickettsia, mycoplasma pneumoniae, chlamydia, and acne. Dairy hinders absorption.
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| Tetracycline Adverse Effects | azotemia, discoloration of teeth, nausea, vomiting, and photosensitivity.
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| Fluoroquinolones-Ciprofloxin | effective against gram- bacteria. Not active against anaerobic organisms. Inhibits DNA gyrase so no DNA replication C-prag/lact, allergy, younger than 18. P-GI disease, renal/hepatic dysfunction, dehydration, caffeine and food slow absorption
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| Flouroquinolones-Cipro Adverse Effects | arthropathy (joint disease) in children younger than 18, and GI discomfort (NVD)
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| Sulfamides-SMZ-TMP | UTI, legionella, shigella, or salmonella displaces PABA and blocks synthesis of folic acid in cells C-hypersensitivity, G6PD deficiency, porphyria, urinary obstruction, less than 2 months old
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| Sulfamides-SMZ-TMP | hematopoietic effects, crystalluria, Steven-Johnson syndrome, NVD
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| Antifungal-Amphotericin B | Binds to sterols in fungal cell membranes. Causes cell permeability, leakage, and death. P-renal impairment, hypersensitivity
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| Amphotericin B Adverse Effects | nephrotoxicity, infusion reactions, electrolyte abnormalities, and anemia.
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| Antiviral-Acyclovir | effective against herpesviruses. undergoes phosphorylation and enters DNA chain and terminates DNA synthesis. C-hypersensitivity P-preg/lact, renal disease, pre-existing neurologic disorders (seizures)
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| Acyclovir Adverse Effects | renal dysfunction, seizures, abdominal pain, headache, NV, anorexia, light-headedness
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| Macrodantin-Nitrofurantoin | interferes with bacterial enzyme systems. C-renal impairment, younger than 1 month, preg@term. adverse effects-peripheral neuropathy, NVD, abdominal pain, pancreatitis.
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