This document provides an overview of chapter 5 which discusses therapy for fungi and viruses. It begins by outlining the chapter topics which include fungi/antifungals and viruses/antivirals. The learning objectives are then stated. The document then discusses the characteristics of fungi and viruses, how they infect cells, their classification, and how antifungals/antivirals work. Specific antifungal, antiviral, and antiretroviral drugs are also outlined along with their indications, side effects and important dispensing considerations.
This document provides an overview of antibiotics, including how they work, classes of antibiotics, therapeutic uses, side effects and important dispensing considerations. It discusses major classes of antibiotics such as penicillins, cephalosporins, tetracyclines, macrolides, ketolides and quinolones. Each class is described in terms of representative drugs, mechanisms of action, bacteria targeted, common uses and side effects. The importance of preventing antibiotic resistance through proper use and dispensing is also emphasized.
This document discusses dental pharmacology. It begins by defining pharmacology as the study of drugs and their interactions with living systems. It then discusses the history and development of pharmacology. The rest of the document covers various topics in dental pharmacology including local anesthetics, vasoconstrictors, antiseptics, and sources of drugs. It provides details on specific drugs used in dentistry as well as their mechanisms of action, uses, and important considerations.
The document discusses several classes of anti-infective agents including antibiotics such as sulfonamides, penicillins, cephalosporins, tetracyclines, aminoglycosides, and quinolones. It provides details on the mechanisms of action, therapeutic uses, and common side effects of these antibiotic classes.
This document discusses the role of antibiotics in dental surgery (exodontics). It covers the history of antibiotics, definitions, classifications, mechanisms of action, factors influencing efficacy, rational antibiotic usage, choices of antibiotics, and prevention of misuse and abuse. The key points are:
1. Antibiotics are substances that kill or inhibit the growth of microorganisms. They are classified based on their source, family, spectrum, effect, and gram-positive/negative activity.
2. Antibiotics work by altering bacterial cell membranes, inhibiting cell wall synthesis, and interfering with protein and nucleic acid synthesis. Their efficacy depends on drug binding, bacterial load, host defenses, and ability to reach the infection site.
Tuberculosis is caused by Mycobacterium tuberculosis. Treatment aims to cure the disease and prevent transmission. First line drugs include isoniazid, rifampin, pyrazinamide, and ethambutol. Second line drugs are used if there is resistance or adverse reactions. Treatment follows a two phase regimen to kill actively dividing bacilli and eliminate persisters to cure the disease and prevent relapse. Leprosy treatment includes dapsone with rifampin or clofazimine depending on the type of leprosy for 6-24 months.
The document discusses drugs used for treating tuberculosis and related mycobacterial infections. It provides learning outcomes on first-line and second-line antitubercular drugs, their mechanisms of action, mechanisms of resistance, pharmacokinetics, and management of tuberculosis. The first section introduces commonly used first-line drugs like isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin. The second section covers second-line drugs and new drugs like bedaquiline used for multidrug-resistant tuberculosis. The last section discusses principles of antituberculosis chemotherapy and types of treatment including prophylaxis and therapy for drug-susceptible and drug-resistant tuberculosis.
This document discusses various drugs used in dentistry, including antibiotics, antifungals, and antivirals. It provides information on the classes, indications, contraindications, side effects and precautions for commonly used medications like penicillin, amoxicillin, metronidazole, fluconazole, acyclovir and valaciclovir. Guidelines are also presented on the appropriate use of antibiotics for conditions like dental infections and the prophylactic use of antibiotics for certain medical conditions undergoing dental procedures.
Isoniazid is used for prophylaxis and treatment of tuberculosis. It works by inhibiting the synthesis of mycolic acids in the bacterial cell wall of Mycobacterium tuberculosis. Isoniazid is contraindicated in patients with a history of hypersensitivity reactions or hepatic injury from isoniazid. The typical dosage is 10 mg/kg/day by mouth for the entire treatment course, up to a maximum of 300 mg/day. Common adverse effects include peripheral neuropathy, while liver toxicity is also a risk. Nurses monitor patients for adverse effects and provide education on following the dosage regimen and reporting side effects.
This document provides an overview of antibiotics, including how they work, classes of antibiotics, therapeutic uses, side effects and important dispensing considerations. It discusses major classes of antibiotics such as penicillins, cephalosporins, tetracyclines, macrolides, ketolides and quinolones. Each class is described in terms of representative drugs, mechanisms of action, bacteria targeted, common uses and side effects. The importance of preventing antibiotic resistance through proper use and dispensing is also emphasized.
This document discusses dental pharmacology. It begins by defining pharmacology as the study of drugs and their interactions with living systems. It then discusses the history and development of pharmacology. The rest of the document covers various topics in dental pharmacology including local anesthetics, vasoconstrictors, antiseptics, and sources of drugs. It provides details on specific drugs used in dentistry as well as their mechanisms of action, uses, and important considerations.
The document discusses several classes of anti-infective agents including antibiotics such as sulfonamides, penicillins, cephalosporins, tetracyclines, aminoglycosides, and quinolones. It provides details on the mechanisms of action, therapeutic uses, and common side effects of these antibiotic classes.
This document discusses the role of antibiotics in dental surgery (exodontics). It covers the history of antibiotics, definitions, classifications, mechanisms of action, factors influencing efficacy, rational antibiotic usage, choices of antibiotics, and prevention of misuse and abuse. The key points are:
1. Antibiotics are substances that kill or inhibit the growth of microorganisms. They are classified based on their source, family, spectrum, effect, and gram-positive/negative activity.
2. Antibiotics work by altering bacterial cell membranes, inhibiting cell wall synthesis, and interfering with protein and nucleic acid synthesis. Their efficacy depends on drug binding, bacterial load, host defenses, and ability to reach the infection site.
Tuberculosis is caused by Mycobacterium tuberculosis. Treatment aims to cure the disease and prevent transmission. First line drugs include isoniazid, rifampin, pyrazinamide, and ethambutol. Second line drugs are used if there is resistance or adverse reactions. Treatment follows a two phase regimen to kill actively dividing bacilli and eliminate persisters to cure the disease and prevent relapse. Leprosy treatment includes dapsone with rifampin or clofazimine depending on the type of leprosy for 6-24 months.
The document discusses drugs used for treating tuberculosis and related mycobacterial infections. It provides learning outcomes on first-line and second-line antitubercular drugs, their mechanisms of action, mechanisms of resistance, pharmacokinetics, and management of tuberculosis. The first section introduces commonly used first-line drugs like isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin. The second section covers second-line drugs and new drugs like bedaquiline used for multidrug-resistant tuberculosis. The last section discusses principles of antituberculosis chemotherapy and types of treatment including prophylaxis and therapy for drug-susceptible and drug-resistant tuberculosis.
This document discusses various drugs used in dentistry, including antibiotics, antifungals, and antivirals. It provides information on the classes, indications, contraindications, side effects and precautions for commonly used medications like penicillin, amoxicillin, metronidazole, fluconazole, acyclovir and valaciclovir. Guidelines are also presented on the appropriate use of antibiotics for conditions like dental infections and the prophylactic use of antibiotics for certain medical conditions undergoing dental procedures.
Isoniazid is used for prophylaxis and treatment of tuberculosis. It works by inhibiting the synthesis of mycolic acids in the bacterial cell wall of Mycobacterium tuberculosis. Isoniazid is contraindicated in patients with a history of hypersensitivity reactions or hepatic injury from isoniazid. The typical dosage is 10 mg/kg/day by mouth for the entire treatment course, up to a maximum of 300 mg/day. Common adverse effects include peripheral neuropathy, while liver toxicity is also a risk. Nurses monitor patients for adverse effects and provide education on following the dosage regimen and reporting side effects.
Antitubercular agents are used to treat tuberculosis (TB), which is caused by the Mycobacterium tuberculosis bacterium. The primary agents used are isoniazid, rifampin, ethambutol, and pyrazinamide. These agents work by inhibiting protein wall synthesis, cell wall synthesis, or other mechanisms to kill or stop the growth of the bacteria. Patient education is critical to ensure compliance with the lengthy treatment regimen and to monitor for potential side effects of the antitubercular agents.
This document provides an overview of various classes of antibiotics, including their mechanisms of action, therapeutic uses, adverse effects, and nursing considerations. It discusses penicillins, cephalosporins, aminoglycosides, macrolides, lincosamides, and tetracyclines. For each class, it describes how they work, common drugs in the class, indications, contraindications, side effects, interactions, and the nursing process for safe administration.
General principles of antimicrobial therapyAbialbon Paul
This document outlines several key principles of antimicrobial therapy, including:
- Selecting drugs based on their selective toxicity to pathogens, pharmacokinetics, and whether they are bacteriostatic or bactericidal.
- Considering concentration-dependent vs. time-dependent killing and the post-antibiotic effect.
- Using combination therapy appropriately to enhance effects and delay resistance.
- Choosing drugs based on the infection's spectrum, risk of superinfections, and empirical vs. prophylactic use.
- Accounting for microbial sensitivity, mechanisms of resistance development, and host factors like disease states and organ function.
- Managing adverse effects, drug interactions, and cost considerations.
Superinfections occur when a new infection develops due to antimicrobial therapy weakening the normal microbiota. This allows overgrowth of resistant organisms. Predisposing conditions include corticosteroid use, immunosuppression, and broad-spectrum antibiotics. Common superinfecting organisms are Candida, Clostridium difficile, HCV, HIV, and Aspergillus. Candida commonly causes oral and vulvovaginal infections treatable with antifungals. C. difficile causes diarrhea treatable with vancomycin or fidaxomicin. Aspergillus may complicate lung disease and is managed with antifungals and steroids.
Tuberculosis is caused by Mycobacterium tuberculosis and was once incurable but now treatable with anti-tubercular drugs. These drugs are classified as primary/standard or secondary/reserve drugs and include isoniazid, rifampicin, streptomycin, pyrazinamide, ethambutol, para-aminosalicylic acid, thiacetazone, capreomycin, kanamycin, ethionamide, and cycloserine. The primary drugs are bactericidal while the secondary drugs treat multi-drug resistant strains. A standard short-term regimen involves taking isoniazid, rifampicin, ethambutol, and pyrazinamide daily for 2 months
This document discusses various classes of antibacterial agents including how they work, factors that determine appropriate use, and examples within each class. It covers sulphonamides, nitrofurans, quinolones, beta-lactam antibiotics (penicillins, cephalosporins, other lactams). Penicillins are the most widely used and include natural benzyl-penicillin as well as broad spectrum ones. Cephalosporins are similar but some are resistant to beta-lactamases. Choice of agent depends on infecting organism, ability to reach infection site, and patient considerations.
3. prophylactic use of Anti-microbial agentsJagirPatel3
Prophylactic: A preventive measure. The word comes from the Greek for "an advance guard," an apt term for a measure taken to fend off a disease or another unwanted consequence
1.Antibiotics and analgesics in pediatric dentistryAminah M
This document discusses the use of antibiotics in dentistry. It begins with a quick review of pediatric physiology and important considerations for dosing antibiotics in children. It then covers the classification, mechanisms of action, pharmacokinetics, and uses of various classes of antibiotics commonly used in dentistry, including beta-lactam antibiotics like penicillins and cephalosporins. The document concludes with sections on antibiotic resistance, newer antimicrobials, guidelines for antibiotic usage and prophylaxis, managing drug allergies and toxicity.
This document provides information on antibiotics and analgesics used for periodontal diseases. It defines antibiotics as agents that destroy or inhibit the growth of microorganisms. Various antibiotics discussed that are used for periodontal diseases include tetracyclines, metronidazole, penicillins, cephalosporins, clindamycin, ciprofloxacin, and macrolides. It also discusses local delivery methods for antibiotics. Analgesics are defined as drugs that selectively relieve pain. The classes discussed include non-opioid types like aspirin, acetaminophen, ibuprofen and opioid types like morphine, codeine, synthetic opioids, and their mechanisms and side effects.
Antibiotics used in dentistry
Terminologies
History
Classification of antibiotics
Principles of antibiotics use
Commonly used antibiotics
Drug interaction
Drug combination
Antibiotic resistance
Summary
This document discusses principles of antimicrobial therapy. It covers selecting appropriate antimicrobial agents based on the infecting organism, site of infection, and patient factors. Empiric therapy may be needed before identification. Antimicrobial susceptibility testing guides treatment. Combination therapy has advantages like synergism but also disadvantages like increased resistance. Routes of administration and rational dosing are also discussed.
Antibiotic; introduction & stewardship program in childrenAzad Haleem
This document discusses antibiotics, including their definitions, types, and classifications. It describes how antibiotics can be classified based on their spectrum of activity (broad or narrow), site of action, and type of action (bacteriostatic or bactericidal). The document also addresses antibiotic resistance, factors that contribute to resistance, and the importance of antibiotic stewardship programs in optimizing antibiotic use and limiting resistance.
The document discusses various drugs used in pediatric dentistry, including their routes of administration, mechanisms of action, and side effects. It focuses on local anesthetics like lidocaine, analgesics like aspirin and acetaminophen, antibiotics, and emergency drugs. Local anesthetics work by depressing nerve endings and inhibiting nerve conduction, while analgesics relieve pain either peripherally or centrally. The most common routes of drug administration in dentistry are oral, intramuscular, and intravenous.
This document discusses antiprotozoal agents used to treat common protozoal infections in humans. It begins by listing common protozoal infections such as amoebiasis, giardiasis, malaria, and toxoplasmosis. It then covers the life cycles of Entamoeba histolytica and Giardia lambia. The document classifies antiamoebic drugs as tissue amoebicides or luminal amoebicides. It provides details on nitroimidazoles, alkaloids, chloroquine, diloxanide furoate, and other drugs. For giardiasis, it recommends nitroimidazoles like metronidazole and tinid
This document discusses antibiotics used in pediatrics, including tetracyclines, aminoglycosides, and macrolides. It provides details on specific antibiotics like tetracycline, streptomycin, and amikacin. It describes the sources, mechanisms of action, indications, absorption and excretion, adverse effects, and contraindications of these important antibiotic classes used to treat pediatric infections.
Mycobacteria are slow-growing bacteria that cause tuberculosis (TB) and other diseases. TB is treated using a combination of antimicrobial drugs over several months to years to prevent drug resistance from emerging. First-line drugs include isoniazid, rifampin, ethambutol, and pyrazinamide. For drug-resistant TB, second-line drugs like fluoroquinolones, aminoglycosides, and others are used. Close monitoring of patients and directly observed therapy are important to ensure treatment is completed.
This document discusses tuberculosis (TB), including that it is caused by Mycobacterium tuberculosis and typically affects the lungs but can spread to other areas. TB spreads through the air when people with active infections cough, sneeze, or transmit respiratory fluids. The document also lists and describes first-line and second-line drugs used to treat TB, including isoniazid, rifampicin, pyrazinamide, and their mechanisms of action and side effects. It emphasizes that a combination of two or more drugs is always better than a single drug for TB chemotherapy to prevent resistance.
Here are some things a pharmacy technician can do to help patients manage their medications properly:
- Explain dosage instructions clearly using simple language.
- Demonstrate how to use any devices needed for administration (inhalers, injections, etc).
- Provide written instructions and contact information to refer to later.
- Counsel on drug interactions and side effects to watch out for.
- Set up pill organizers or reminders to help with compliance.
- Offer to answer any future questions by phone.
- Suggest bringing all medications to doctor appointments.
- Encourage signing up for medication syncing or delivery services if available.
The goal is giving patients the knowledge and tools to take their medications safely and as prescribed
This chapter discusses basic concepts in pharmacology including receptors, mechanisms of drug action, pharmacokinetics, and drug effects. Receptors are proteins that drugs bind to, producing effects in cells. Pharmacokinetics describes how the body processes drugs over time through absorption, distribution, metabolism, and elimination primarily via the liver and kidneys. Understanding pharmacokinetics helps determine drug dosing. Drug effects can be beneficial therapeutic effects or harmful side effects. Healthcare practitioners consider factors like indications, contraindications, and interactions when selecting drugs for patients.
Antitubercular agents are used to treat tuberculosis (TB), which is caused by the Mycobacterium tuberculosis bacterium. The primary agents used are isoniazid, rifampin, ethambutol, and pyrazinamide. These agents work by inhibiting protein wall synthesis, cell wall synthesis, or other mechanisms to kill or stop the growth of the bacteria. Patient education is critical to ensure compliance with the lengthy treatment regimen and to monitor for potential side effects of the antitubercular agents.
This document provides an overview of various classes of antibiotics, including their mechanisms of action, therapeutic uses, adverse effects, and nursing considerations. It discusses penicillins, cephalosporins, aminoglycosides, macrolides, lincosamides, and tetracyclines. For each class, it describes how they work, common drugs in the class, indications, contraindications, side effects, interactions, and the nursing process for safe administration.
General principles of antimicrobial therapyAbialbon Paul
This document outlines several key principles of antimicrobial therapy, including:
- Selecting drugs based on their selective toxicity to pathogens, pharmacokinetics, and whether they are bacteriostatic or bactericidal.
- Considering concentration-dependent vs. time-dependent killing and the post-antibiotic effect.
- Using combination therapy appropriately to enhance effects and delay resistance.
- Choosing drugs based on the infection's spectrum, risk of superinfections, and empirical vs. prophylactic use.
- Accounting for microbial sensitivity, mechanisms of resistance development, and host factors like disease states and organ function.
- Managing adverse effects, drug interactions, and cost considerations.
Superinfections occur when a new infection develops due to antimicrobial therapy weakening the normal microbiota. This allows overgrowth of resistant organisms. Predisposing conditions include corticosteroid use, immunosuppression, and broad-spectrum antibiotics. Common superinfecting organisms are Candida, Clostridium difficile, HCV, HIV, and Aspergillus. Candida commonly causes oral and vulvovaginal infections treatable with antifungals. C. difficile causes diarrhea treatable with vancomycin or fidaxomicin. Aspergillus may complicate lung disease and is managed with antifungals and steroids.
Tuberculosis is caused by Mycobacterium tuberculosis and was once incurable but now treatable with anti-tubercular drugs. These drugs are classified as primary/standard or secondary/reserve drugs and include isoniazid, rifampicin, streptomycin, pyrazinamide, ethambutol, para-aminosalicylic acid, thiacetazone, capreomycin, kanamycin, ethionamide, and cycloserine. The primary drugs are bactericidal while the secondary drugs treat multi-drug resistant strains. A standard short-term regimen involves taking isoniazid, rifampicin, ethambutol, and pyrazinamide daily for 2 months
This document discusses various classes of antibacterial agents including how they work, factors that determine appropriate use, and examples within each class. It covers sulphonamides, nitrofurans, quinolones, beta-lactam antibiotics (penicillins, cephalosporins, other lactams). Penicillins are the most widely used and include natural benzyl-penicillin as well as broad spectrum ones. Cephalosporins are similar but some are resistant to beta-lactamases. Choice of agent depends on infecting organism, ability to reach infection site, and patient considerations.
3. prophylactic use of Anti-microbial agentsJagirPatel3
Prophylactic: A preventive measure. The word comes from the Greek for "an advance guard," an apt term for a measure taken to fend off a disease or another unwanted consequence
1.Antibiotics and analgesics in pediatric dentistryAminah M
This document discusses the use of antibiotics in dentistry. It begins with a quick review of pediatric physiology and important considerations for dosing antibiotics in children. It then covers the classification, mechanisms of action, pharmacokinetics, and uses of various classes of antibiotics commonly used in dentistry, including beta-lactam antibiotics like penicillins and cephalosporins. The document concludes with sections on antibiotic resistance, newer antimicrobials, guidelines for antibiotic usage and prophylaxis, managing drug allergies and toxicity.
This document provides information on antibiotics and analgesics used for periodontal diseases. It defines antibiotics as agents that destroy or inhibit the growth of microorganisms. Various antibiotics discussed that are used for periodontal diseases include tetracyclines, metronidazole, penicillins, cephalosporins, clindamycin, ciprofloxacin, and macrolides. It also discusses local delivery methods for antibiotics. Analgesics are defined as drugs that selectively relieve pain. The classes discussed include non-opioid types like aspirin, acetaminophen, ibuprofen and opioid types like morphine, codeine, synthetic opioids, and their mechanisms and side effects.
Antibiotics used in dentistry
Terminologies
History
Classification of antibiotics
Principles of antibiotics use
Commonly used antibiotics
Drug interaction
Drug combination
Antibiotic resistance
Summary
This document discusses principles of antimicrobial therapy. It covers selecting appropriate antimicrobial agents based on the infecting organism, site of infection, and patient factors. Empiric therapy may be needed before identification. Antimicrobial susceptibility testing guides treatment. Combination therapy has advantages like synergism but also disadvantages like increased resistance. Routes of administration and rational dosing are also discussed.
Antibiotic; introduction & stewardship program in childrenAzad Haleem
This document discusses antibiotics, including their definitions, types, and classifications. It describes how antibiotics can be classified based on their spectrum of activity (broad or narrow), site of action, and type of action (bacteriostatic or bactericidal). The document also addresses antibiotic resistance, factors that contribute to resistance, and the importance of antibiotic stewardship programs in optimizing antibiotic use and limiting resistance.
The document discusses various drugs used in pediatric dentistry, including their routes of administration, mechanisms of action, and side effects. It focuses on local anesthetics like lidocaine, analgesics like aspirin and acetaminophen, antibiotics, and emergency drugs. Local anesthetics work by depressing nerve endings and inhibiting nerve conduction, while analgesics relieve pain either peripherally or centrally. The most common routes of drug administration in dentistry are oral, intramuscular, and intravenous.
This document discusses antiprotozoal agents used to treat common protozoal infections in humans. It begins by listing common protozoal infections such as amoebiasis, giardiasis, malaria, and toxoplasmosis. It then covers the life cycles of Entamoeba histolytica and Giardia lambia. The document classifies antiamoebic drugs as tissue amoebicides or luminal amoebicides. It provides details on nitroimidazoles, alkaloids, chloroquine, diloxanide furoate, and other drugs. For giardiasis, it recommends nitroimidazoles like metronidazole and tinid
This document discusses antibiotics used in pediatrics, including tetracyclines, aminoglycosides, and macrolides. It provides details on specific antibiotics like tetracycline, streptomycin, and amikacin. It describes the sources, mechanisms of action, indications, absorption and excretion, adverse effects, and contraindications of these important antibiotic classes used to treat pediatric infections.
Mycobacteria are slow-growing bacteria that cause tuberculosis (TB) and other diseases. TB is treated using a combination of antimicrobial drugs over several months to years to prevent drug resistance from emerging. First-line drugs include isoniazid, rifampin, ethambutol, and pyrazinamide. For drug-resistant TB, second-line drugs like fluoroquinolones, aminoglycosides, and others are used. Close monitoring of patients and directly observed therapy are important to ensure treatment is completed.
This document discusses tuberculosis (TB), including that it is caused by Mycobacterium tuberculosis and typically affects the lungs but can spread to other areas. TB spreads through the air when people with active infections cough, sneeze, or transmit respiratory fluids. The document also lists and describes first-line and second-line drugs used to treat TB, including isoniazid, rifampicin, pyrazinamide, and their mechanisms of action and side effects. It emphasizes that a combination of two or more drugs is always better than a single drug for TB chemotherapy to prevent resistance.
Here are some things a pharmacy technician can do to help patients manage their medications properly:
- Explain dosage instructions clearly using simple language.
- Demonstrate how to use any devices needed for administration (inhalers, injections, etc).
- Provide written instructions and contact information to refer to later.
- Counsel on drug interactions and side effects to watch out for.
- Set up pill organizers or reminders to help with compliance.
- Offer to answer any future questions by phone.
- Suggest bringing all medications to doctor appointments.
- Encourage signing up for medication syncing or delivery services if available.
The goal is giving patients the knowledge and tools to take their medications safely and as prescribed
This chapter discusses basic concepts in pharmacology including receptors, mechanisms of drug action, pharmacokinetics, and drug effects. Receptors are proteins that drugs bind to, producing effects in cells. Pharmacokinetics describes how the body processes drugs over time through absorption, distribution, metabolism, and elimination primarily via the liver and kidneys. Understanding pharmacokinetics helps determine drug dosing. Drug effects can be beneficial therapeutic effects or harmful side effects. Healthcare practitioners consider factors like indications, contraindications, and interactions when selecting drugs for patients.
This document provides an overview of chapter 6 which discusses anesthetics, analgesics, and narcotics. It begins by outlining the chapter topics and learning objectives which include understanding the nervous system, neurotransmitters, anesthesia, pain management, and migraine headaches. It then defines the central and peripheral nervous systems and their divisions. It discusses the major neurotransmitters like acetylcholine, GABA, dopamine, epinephrine, and serotonin. It explains general anesthesia, including goals, types of inhalant and injectable anesthetics. It also covers local anesthesia, neuromuscular blocking agents, and their reversal. Finally, it discusses classifications of pain, narcotic and non-narcotic analgesia, and the risks of addiction.
This document provides an overview of chapter 6 which discusses anesthetics, analgesics, and narcotics. It begins by outlining the chapter topics and learning objectives which include understanding the nervous system, neurotransmitters, anesthesia, pain management, and migraine headaches. It then defines the central and peripheral nervous systems and their divisions. It discusses the major neurotransmitters like acetylcholine, GABA, dopamine, epinephrine, and serotonin. It explains general anesthesia, including goals, types of inhalant and injectable anesthetics. It also covers local anesthesia, neuromuscular blocking agents, and their reversal. Finally, it discusses classifications of pain, narcotic and non-narcotic analgesia, and the risks of addiction with
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Under-reporting of cardiovascular events in the rofecoxib Alzheimer disease studies.
Abstract
Background; In September 2004, rofecoxib (Vioxx) was removed from the market because it was found to produce a statistically doubling of cardiovascularthrombotic (CVT) events in a placebo-controlled study. Its manufacturer stated that this was the first clear evidence of such risk and criticized meta- analyses of earlier CVT risk for focusing on investigator-reported events. We studied contemporaneously adjudicated CVT events to assess the information
Tamiflu is a prescription drug containing the active ingredient oseltamivir that is used to treat influenza virus infections by preventing the virus from spreading. It belongs to a class of antiviral drugs called neuraminidase inhibitors and must be started within two days of flu symptoms appearing. The patent for oseltamivir is held by Gilead Sciences until at least 2016, though it has expired in some countries, and the company has politically well-connected former government officials on its board of directors.
Este documento proporciona instrucciones para completar varias tareas en Excel relacionadas con nóminas, cuentas por pagar, cuentas por cobrar y otros aspectos financieros de una empresa. Incluye instrucciones para autollenar hojas de cálculo con nombres de proveedores, meses, colores de departamentos y más. También describe cómo sumar, restar, calcular porcentajes e IVA, y usar referencias de celdas para tareas como bonos, descuentos y liquidaciones de empleados.
This document discusses influenza (flu), including its causes, symptoms, high-risk groups, diagnosis, treatment and prevention. Some key points:
- Influenza is caused by influenza viruses that infect the respiratory tract and can cause illness from mild to severe. Outbreaks occur yearly.
- High-risk groups include young children, elderly adults, pregnant women and those with underlying health conditions.
- Symptoms include fever, cough, sore throat and body aches. Severe cases can lead to pneumonia or respiratory failure.
- Diagnosis involves virus detection tests on respiratory samples. Treatment focuses on antiviral drugs, rest and fever control. Prevention includes annual flu vaccines and good hygiene practices.
This document summarizes key information about three respiratory medications - Flonase, Cipro, and Mucomyst. It provides details on their generic and brand names, what conditions they treat, how they work, common symptoms they address, dosage forms and administration instructions. The focus is on Flonase for treating allergies and rhinitis, Cipro as an antibiotic for infections, and Mucomyst for thinning mucus in lung conditions like emphysema and bronchitis. References are included from medical sources and a medical terminology textbook.
Typhoid fever is caused by the bacteria Salmonella Typhi and is transmitted through contaminated food or water. It remains a global health issue, causing epidemics in many parts of the world. The document discusses the history of typhoid fever, including the identification of the bacteria in the late 1800s and the development of serodiagnosis. It also describes an infamous typhoid carrier named "Typhoid Mary" who infected many people in the early 1900s. The clinical presentation, pathology, diagnosis and treatment of typhoid fever are explained in detail. Complications can include intestinal bleeding or perforation if left untreated.
This document provides an overview of the history and present practice of pharmacology and drug regulation. It discusses key figures like Hippocrates and Paracelsus who advanced the field. It also outlines the development of drug legislation and organizations like the FDA, and describes the drug approval process including clinical trials. The roles of pharmacists and technicians are changing with emphasis on patient counseling and certification. Controlled substances are categorized based on abuse potential to protect public health.
S. pneumoniae (pneumococcus) is an important cause of pneumonia, bacteremia, and meningitis. It is identified as Gram-positive lanciolate diplococci that are bile soluble, optochin susceptible, and cause fatal infections in mice. The pneumococcus has a polysaccharide capsule that can be typed using the Quellung reaction and is a key virulence factor allowing it to evade phagocytosis. The Viridans streptococci are common throat commensals but can also cause infections, they are α-hemolytic and do not have the identifying features of the pneumococcus such as being bile soluble or mouse pathogenic.
The document discusses repeat breeder syndrome in cows, which is defined as cows that have been bred 3 or more times but not conceived. It outlines various causes of fertilization failure and early embryonic death that can contribute to repeat breeding, including issues with ovulation, sperm and egg quality, uterine infections, nutrition deficiencies, and environmental stresses. Potential treatments discussed include hormones, antibiotics, addressing energy deficiencies, and improving management practices.
Malaria is a life-threatening disease caused by Plasmodium parasites transmitted via mosquito bites. It affects over 300 million people annually and causes over 2 million deaths. The parasite has a complex life cycle involving liver and blood stages. Symptoms include fever, chills, and flu-like illness that occurs in cyclic periods. It can range from uncomplicated to severe cases involving multiple organ dysfunction. Diagnosis involves blood smear microscopy and antigen detection. Treatment depends on the parasite species but may include chloroquine, atresunate, or artemether-lumefantrine. Prevention focuses on mosquito bite avoidance and antimalarial drugs for high-risk groups.
This document summarizes information about NSAIDs (non-steroidal anti-inflammatory drugs) and COX-2 inhibitors for pain management. It defines pain and classifications of pain such as acute vs chronic pain. It describes the mechanisms of COX-1 and COX-2 enzymes and how different NSAIDs and COX-2 inhibitors work. It discusses the use of NSAIDs and COX-2 inhibitors for various types of pain and their potential adverse effects.
Influenza, commonly known as the flu, is a viral infection that affects the nose, throat, bronchi and occasionally the lungs. Common symptoms include fever, sore throat, muscle pains, coughing and fatigue. The influenza virus is classified into types A, B and C. Types A and B are responsible for seasonal flu epidemics and pandemics. The virus undergoes antigenic drift and shift, requiring new vaccines each year. At risk groups like the elderly are recommended for annual flu vaccination to prevent severe complications.
The document provides an overview of malaria epidemiology, prevention, and control efforts in India. It discusses that malaria affects millions of people annually in India, transmitted primarily by Anopheles mosquitoes. Key prevention strategies mentioned include vector control through indoor residual spraying and larviciding, and prompt diagnosis and treatment of cases. Major control programs launched over time aimed to reduce malaria incidence and mortality, through activities like active case detection, radical treatment, and insecticide spraying. National strategies have evolved from eradication to control efforts as challenges emerged.
The document provides an overview of the human reproductive system, including its anatomy, physiology, development and functions. It describes the key structures and roles of the male and female reproductive systems, from gamete production and fertilization to childbirth. Key topics covered include the gonads, hormones, menstrual cycle, sexual reproduction and development from fertilization through the embryonic stages.
The urinary system has several important functions:
1. It filters waste and excess water from the blood and removes it from the body through urine.
2. It maintains the chemical consistency of the blood.
3. Its main organs - the kidneys, ureters, urinary bladder, and urethra - work together to produce, transport, store, and eliminate urine from the body.
This document provides an overview of antiviral pharmacology. It discusses how viruses work, how antiviral drugs target different stages of the viral lifecycle, and summarizes several classes of antiviral drugs including acyclovir, valacyclovir, famciclovir, penciclovir, ganciclovir and others. It covers their mechanisms of action, pharmacokinetics, therapeutic uses, and side effects in treating various viral infections such as herpes simplex virus and cytomegalovirus.
This document provides information on different classes of antifungal medications. It discusses how polyene antifungals disrupt fungal cell membranes, while azoles and allylamines inhibit ergosterol synthesis. Echinocandins inhibit glucan synthesis. Adverse effects, drug interactions, and other antifungals like griseofulvin are also covered.
An infectious disease can be spread from one organism to another through pathogens like bacteria, viruses, fungi and protozoa. An epidemic refers to a sudden increase in a disease in a specific area, an endemic disease is always present in a population, and a pandemic is a global rise in disease incidence. Infectious diseases are combatted through the immune system's non-specific defenses like skin and mucus barriers, and specific defenses like antibodies and lymphocytes that recognize and eliminate pathogens. Vaccines work by exposing the immune system to antigens to produce memory cells that mount a rapid response against the pathogen without causing disease.
Viruses are very small infectious agents that can only replicate inside host cells. They contain genetic material (DNA or RNA) surrounded by a protein coat. There are many types of viral infections that affect different body systems like the respiratory, gastrointestinal, liver, nervous and skin. Respiratory viruses commonly cause infections like influenza and COVID-19. Some viruses are also associated with certain cancers through their ability to insert their genetic material into host cells. Proper hygiene practices, vaccination and antiviral treatment can help prevent and treat viral infections.
This document provides an overview of picornaviruses, with a focus on poliovirus. It begins by outlining the objectives of discussing picornavirus morphology, classification, pathogenesis, and the clinical manifestations, diagnosis, treatment and prevention of poliomyelitis and other diseases caused by echoviruses and rhinoviruses. It then provides details on picornavirus morphology, classification, the history of poliovirus research and discovery, epidemiology, characteristics, cultivation, pathogenesis, and clinical features of poliomyelitis. Key points covered include that poliovirus is an enterovirus that can cause paralysis, replication in the gastrointestinal tract and nervous system, and that infection may be asymptomatic, minor
Viruses are non-cellular microscopic agents that can only replicate inside host cells. They have a protein coat and a nucleic acid core of DNA or RNA. Viruses cause diseases by disrupting normal cellular activities after invading host cells. The influenza virus is one of the most common viral diseases and causes seasonal flu epidemics with symptoms like fever, body aches, and cough. While most flu cases can be managed at home with rest and OTC medications, some high-risk groups may require antiviral treatment to prevent severe complications like pneumonia.
This document provides information about Ebola virus disease (EVD). It begins by defining EVD and listing its specific objectives, which are to define EVD, describe its etiology and transmission, explain the replication of the Ebola virus, describe the pathophysiology and signs/symptoms of EVD, and outline its management, preventive measures, and disease surveillance. It then defines EVD and describes the Ebola virus's etiology, structure, subspecies, and modes of transmission. The document outlines the virus's replication cycle and the pathophysiology of EVD before listing its common signs and symptoms. It discusses investigating and managing EVD through supportive care and preventing future outbreaks through surveillance, vaccination,
Edexcel IGCSE - Human Biology - Chapter 13 - Microorganisms and DiseasesChandima Walpita Gamage
This document discusses microorganisms and diseases. It begins by defining disease and describing the main causes of diseases, including unhealthy activities, genetics, and microorganisms. It then describes the four main types of microorganisms that can cause disease: bacteria, viruses, fungi, and protozoa. For each type, it provides details on their structure, function, and examples of diseases they cause. The document also discusses the general causes and transmission of diseases, important infectious diseases, and the body's defense mechanisms against diseases like immunity and vaccination.
This document defines various types of anti-infective agents and provides examples of each. It discusses antibiotics such as penicillins, cephalosporins, macrolides, quinolones, tetracyclines, and aminoglycosides. It also covers antiviral drugs, antifungal agents, antiparasitic drugs, and anti-tuberculosis agents. For each class, it provides the definition, examples of drugs, and their mechanisms and uses.
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There are many types of antiviral drugs available, including:
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2. Protease inhibitors: These drugs block the activity of viral proteases, which are enzymes that are required for the replication and assembly of some viruses.
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Antiviral drugs can be used to treat a variety of viral infections, including influenza, HIV/AIDS, hepatitis B and C, herpes, and Ebola. However, the effectiveness of these drugs can vary depending on the specific virus and the stage of infection. Antiviral drugs may also have side effects, and it is important to consult with a healthcare provider before taking them.
This document discusses host-microbe relationships and microbial pathogenesis. It begins by defining key terms like pathogenicity, virulence, and toxigenicity. It then describes how most microbes do not cause harm, while a few contribute to health or pose threats. Pathogens can establish infections through various mechanisms like toxin production, tissue invasion, or evading host defenses. Toxins are categorized as exotoxins, endotoxins, or exoenzymes. Exotoxins like AB toxins directly damage tissues. Colonization, invasion, and evasion of host defenses allow pathogens to replicate and spread infection. Microbes cause disease through direct damage by toxins or indirect activation of the host immune response.
Here are suggestions for how each item could decrease antibiotic resistance:
a) Limiting antibiotic use only to necessary cases reduces the number of opportunities for bacteria to develop resistance. Fewer antibiotics means less selection pressure.
b) Regularly changing the prescribed antibiotic makes it harder for bacteria to adapt resistance to a single drug. By rotating antibiotics, bacteria have to develop multiple resistance mechanisms.
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This document provides an overview of antiviral agents, including their general principles and examples of antiviral drugs for specific viruses. It discusses how viruses work, how vaccination protects against viruses, and key aspects antiviral drugs must achieve. Examples of antiviral drugs are then given for HIV, influenza, and the common cold, outlining their mechanisms of action and development histories. The document emphasizes antiviral drugs target specific stages of the viral lifecycle to prevent infection and transmission.
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2. Chapter 5 Topics
• Fungi and Antifungals
• Viruses and Antivirals
• Antiretrovirals
3. Learning Objectives
• Understand the differences between fungi and viruses
and why the drugs to treat them must have very different
mechanisms of action.
• Differentiate antifungals, antivirals, and antiretrovirals
by their indications, therapeutic effects, side effects,
dosages, and administration.
• Use antifungal, antiviral, and antiretroviral terminology
correctly in written and oral communication.
• Define differences in mechanisms of action of
antibiotics, antifungals, antivirals, and antiretrovirals.
4. Fungi and Their Characteristics
Fungus
– Single-cell
organism
– Lack of chlorophyll
– Rigid cell wall and
nucleus
– Reproduction by
spores
6. Discussion
In what ways are fungal cells similar to
human cells? How are they different?
Answer: Human cell membranes
contain cholesterol, and cell
membranes of fungi contain
ergosterol.
7. Fungi and Their Characteristics
Organism Disease
Aspergillus Aspergillosis
Blastomyces Blastomycosis
Candida (yeast) Candidiasis
Coccidioides Coccidioidomycosis
Cryptococcus Cryptococcosis
Histoplasma Histoplasmosis
8. Antifungals
How They Work
– Prevent synthesis of ergosterol
– Because human cells use cholesterol,
human cells are affected minimally
12. Antifungal Side Effects
• Serious side effects have been reported,
even for topical agents.
• Pay close attention to dosing regimen to
avoid overdosing.
13. amphotericin B (Fungizone)
• Used for blood-born, life-threatening fungal
infections
• Infused slowly, not piggybacked, and not mixed
with normal saline
• Blood levels of drug monitored and vitals monitored
during infusion
• During treatment, monitor electrolytes, BUN, serum
creatinine, temperature, CBC, fluid input and output
• Side effects: renal toxicity, anemia, fever, chills,
shaking, headache
14. voriconazole (VFEND)
• Alternative to amphotericin B
• Can be started IV and switched to oral
• Can cause liver toxicity and blurred
vision
15. fluconazole (Diflucan)
• Oral form used for vaginal or oral
candidiasis
• IV used for patients who cannot
tolerate oral
• Commonly prescribed medication
• Side effects: headache, rash, GI upset
16. itraconazole (Sporanox)
• Fungal infections of nails
• Capsule taken twice a day with a fatty meal
and taken with a cola to increase stomach
acidity and increase absorption
• Not in conjunction with antacids or H2
blockers
• Can cause liver toxicity
• Capsules not substituted for oral solution due
to absorption issues
17. terbinafine (Lamisil)
• Kills fungus instead of just inhibiting growth
• Oral form taken once daily
– Six weeks for fingernails
– Twelve weeks for toenails
• Pulse dosing works well
• Topical form for athlete’s foot, jock itch, and
ringworm
– Do not use vaginally
– Do not exceed four weeks
18. Antifungal Dispensing Issues
Lamisil, Lomotil, and Lamictal look alike.
Use dose and dosage form to help keep these
drugs from being dispensed incorrectly.
Warning!
19. grisefulvin
(Fulvicin P/G, Gris-PEG)
• Fungal infections of the hair, skin, and
nails
• Take with a fatty meal
• Avoid exposure to sunlight
• Dizziness and drowsiness are side
effects, as well as passing headache
24. ciclopirox (Loprox, Penlac)
• “Nail polish” treats nail tissue
infections
• Do not take in combination with other
oral antifungals
• Dispensed in amber-colored container
• Apply at bedtime to avoid exposure to
light
25. Viruses and Their Characteristics
Virus
– Does not have
components of a
cell
– Unable to replicate
outside of a living
host cell
A virus infecting a bacterium.
26. Viruses and Their Characteristics
Most viruses are spread through the
following routes:
– Direct contact
– Ingestion of contaminated food and water
– Inhalation of airborne particles
– Exposure to contaminated body
fluids/equipment
27. Viruses and Their Characteristics
• Parts of a virus particle, virion
– Nucleic acid consisting of either DNA or
RNA, not both
– Capsid (protein shell) that surrounds and
protects the nucleic acid
• Naked virus
– Virus without an envelope covering the
capsid
28. Stages of Viral Infection
1. Virus attaches to a cell receptor.
29. Stages of Viral Infection
1. Virus attaches to a cell receptor.
2. Cell membrane indents and closes
around the virus, thus the virus
penetrates the cell.
30. Stages of Viral Infection
1. Virus attaches to a cell receptor.
2. Cell membrane indents and closes
around the virus, thus the virus
penetrates the cell.
3. Virus escapes into cytoplasm.
31. Stages of Viral Infection
1. Virus attaches to a cell receptor.
2. Cell membrane indents and closes
around the virus, thus the virus
penetrates the cell.
3. Virus escapes into cytoplasm.
4. Virus uncoats, shedding its
covering and releasing DNA or
RNA into cell nucleus.
32. Stages of Viral Infection
1. Virus attaches to a cell receptor.
2. Cell membrane indents and closes around
the virus, thus the virus penetrates the cell.
3. Virus escapes into cytoplasm.
4. Virus uncoats, shedding its covering and
releasing DNA or RNA into cell nucleus.
5. Virus thus converts nuclear activity in
the cell to viral activity and reproduces
new viral particles.
34. Discussion
Provide an example of a common viral
infection and the symptoms of this
condition.
Answer: The flu (influenza).
Symptoms include malaise, myalgia
(muscle pain), headache, chills, fever.
36. Viral Classification
• Duration and severity
– Acute: quickly resolves with no latent
infection such as common cold and flu
– Chronic: protracted course with long
periods of remission interspersed with
reappearance such as herpes virus
infection
– Slow: progressive course, ultimately
ending in death
37. Viral Classification
• Infection
– Local: affects tissues of a single system,
such as the respiratory tract, the eye, or
the skin
– Generalized: has spread or is spreading to
other tissues by way of bloodstream or
tissues of the CNS
38. Virus and Cell Interaction
A virus can damage a host cell in the
following ways:
– Kill the host cell
– Alter the cell
– Incorporate into the genetic material of the
host cell
– Divide when the host cell divides
39. Virus and Cell Interaction
Immunoglobulin
antibody that may prevent an organism from
attaching to a cell receptor and may destroy
the organism
40. Virus and Cell Interaction
Interferon
a substance that exerts virus-nonspecific but
host-specific antiviral activity by inducing
gene coding for antiviral proteins that
inhibit the synthesis of viral RNA
41. Virus and Cell Interaction
Vaccination
– Exposes the patient to a component of a
virus or a similar strain that does not
produce infection.
– When a vaccinated patient encounters the
actual virus, the infection cannot develop.
43. Discussion
Who should receive an influenza vaccine?
Answer: High-risk patients such as
healthcare workers, nursing home
residents, public safety workers,
individuals over 65 years old,
immunocompromised patients.
50. Antiviral Dispensing Issues
Amatadine, rimantadine, and ranitidine can be
easily confused.
Dosing and indications will help keep them
straight.
Warning!
51. acyclovir (Zovirax)
• Treatment of
– Genital herpes
– Herpes zoster (shingles)
– Varicella (chicken pox)
– Herpes encephalitis (in IV form)
• Range of short- and long-term side
effects reported
52. famciclovir (Famvir)
• Treatment of
– Acute herpes zoster
– Herpes simplex in immunocompromised
patients
– Genital herpes
• Dosed less frequently than acyclovir
• Prodrug
53. valacyclovir (Valtrex)
• Treats herpes zoster in immunocompetent
adults and genital herpes
• Take with water and within forty-eight hours
of the onset of zoster rash
• Shortens duration of postherpetic neuralgia
• Commonly prescribed medication
• Side effects: nausea, vomiting, diarrhea,
constipation
54. zanamivir (Relenza)
• Treatment of influenza A and B
• Therapy initiated within 48 hr of symptom
onset
• 2 inhalations daily, at 12 hr intervals, for 5
days
• If using brochodilator, use it immediately
prior to admin of zanamivir
• Sometimes Rx as prophylactic
55. oseltamivir (Tamiflu)
• Prevents influenza A and B
• Initiated within forty-eight hours of
symptom onset
• Food improves tolerance
56. ganciclovir (Cytovene)
• Treating cytomegalovirus (CMV)
infections in immunocompromised
patients
• Follow chemotherapy preparations and
dispensing guidelines when mixing,
labeling, and packaging
• IV form not used for rapid or bolus
injection
58. foscarnet (Foscavir)
• Treatment of CMV infections in
immunocompromised patients
• IV infusion, not rapid or bolus
injection
• Patient must be hydrated, and Rx for
hydration should be included with
order for drug
59. Antiviral Dispensing Issues
• Patients who are given ganciclovir (Cytovene) or
foscarnet (Foscavir) IV must be well hydrated.
• Typically there are “standing orders” for hydration
when these drugs are prescribed.
Warning!
60. ribavirin (Virazole)
• Treating viral infections and pediatric
patients with RSV
• Absorbed systemically from the
respiratory tract following nasal and
oral inhalation
• Side effects: fatigue, headache,
insomnia, nausea, anorexia
62. Antiretrovirals
• Developed to limit the progression of
the retrovirus HIV, the cause of AIDS
• Five classes of antiretroviral drugs
63. Antiretrovirals
• Developed to limit the progression of
the retrovirus HIV, the cause of AIDS
• Five classes of antiretroviral drugs
– NRTIs
– NNRTIs
– NtRTIs
– PIs
– Fusion inhibitors
64. Nucleoside Reverse Transcriptase
Inhibitors (NRTIs)
• Inhibit the action of reverse
transcriptase to prevent the formation
of viral RNA from proviral DNA
• Cause a decrease in the amount of
virus in the body and subsequent
spread to other healthy cells
68. zidovudine (Retrovir)
• Previously called AZT
• One of first drugs developed specifically for
treatment of HIV
• Can be combined with all NRTIs except
stavudine
• Used in combination with lamivudine (with
or without PI) used for needlestick or sexual
exposure treatment
69. lamivudine (Epivir)
• Treatment
– HIV
– Chronic hepatitis B
• Must be taken exactly as prescribed
• Fewest side effects of any of the NRTIs
70. Non-Nucleoside Reverse
Transcriptase Inhibitors (NNRTIs)
• Inhibit the action of HIV reverse
transcriptase but at a different site on
the enzyme than the site targeted by
NRTIs
• Block RNA-dependent DNA
polymerase activities
72. efavirenz (Sustiva)
• Dosed once a day, preferably at
bedtime
• Patients should avoid high-fat meals
• Side effects
– Dizziness, headache
– Vivid dreams, nightmares, hallucinations
– Typically occur 1-3 hr after administration
– Typically subside after 2-4 weeks on drug
73. nevirapine (Viramune)
• Lower dose first 2 weeks and then
increased to appropriate therapeutic
level to avoid rash
• The antibiotic rifampin interferes with
this drug
• This drug decreases serum
concentration of PIs
• Must monitor liver functions
74. Nucleotide Reverse Transcriptase
Inhibitors (NtRTIs)
• Inhibit the activity of HIV-1 reverse
transcriptase by competing with natural
nucleic acid substrates
• Cause termination of chain formation
after incorporating in viral nucleic acid
76. Protease Inhibitors (PIs)
• Inhibit the protease enzyme, which
typically cleaves certain HIV protein
precursors that are necessary for the
replication of new infectious virons
• Results in production of immature,
noninfectious virons
• Combined with other antiretroviral
drugs
77. PI Side Effects
• Protease paunch
• Facial atrophy
• Breast enlargement
• Hyperglycemia
• Hyperlipidemia
• Increase in bleeding episodes in
hemophiliacs
78. PIs
• amprenavir (Agenerase)
• atazanavir (Reyataz)
• fosamprenavir (Lexiva)
• indinavir (Crixivan)
• lopinavir-ritonavir (Kaletra)
• nelfinavir (Viracept)
• ritonavir (Norvir)
• saquinavir (Fortovase, Invirase)
Drug List
79. indinavir (Crixivan)
• Do not take with
– St. John’s wort
– Grapefruit juice
– With food, especially high-fat
• Do take with a lot of water (48 oz/day)
to avoid kidney stones
• Package with a desiccant, and patient
to store in original container
80. lopinavir-ritonavir (Kaletra)
• Combination inhibits metabolism of
lopinavir, allowing increased plasma
levels of lopinavir
• Side effects
– Nausea and vomiting
– Diarrhea
– Pancreatitis
• Solution contains alcohol
81. nelfinavir (Viracept)
• Can cause diarrhea, but loperamide and
calcium carbonate can help control
• Take with food
82. ritonavir (Norvir)
• Causes increase in serum
concentrations and thus decreases
dosage frequency of other PIs, thus
decreasing side effects
• Given at a low dose
• Take with food
• Causes an altered sense of taste
• Store in the refrigerator
84. Fusion Inhibitors
How do fusion inhibitors represent an
advance in the treatment of HIV?
Answer: Prevents AIDS virus from
entering the immune cells.
86. Responding to HIV Exposure
• Centers for Disease Control guidelines
• Post-exposure prophylaxis (PEP)
• Begin within two hours
• Can decrease risk of infection by 80%
87. Combining Antiretrovirals
Regimen Type Recommendation
standard therapy NNRTI: efavirenz +
lamivudine + (zidovudine or
tenofovir or stavudine)
PI: lopinavir-ritonavir +
lamivudine + (zidovudine or
stavudine)
alternative therapy 3 × NRTI: abacavir +
lamivudine + (zidovudine or
stavudine)
post-exposure prophylaxis
(PEP)
zidovudine + lamivudine +
(indinavir or nelfinavir)
88. Antiretroviral Dispensing Issues
Avoid the following antiretroviral drug combinations:
– didanosine with zalcitabine
– zidovudine with stavudine
– lamivudine with zalcitabine
– stavudine with zalcitabine
Warning!
90. Discussion
What is one of the biggest problems when
treating HIV?
Answer: Noncompliance with
drug regimen due to problematic
side effects and complex dosing.