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Pharmacology Chapters 20 and 21
Terms in this set (78)
The macrolide antibiotic drug azithromycin (Zithromax) has a half life of 68 hours. That means it takes 68 hours for the body to excrete one half of a single dose of Zithromax. This extended therapeutic effect is good because it makes it possible to take Zithromax just once a day for five days to complete treatment, while most other antibiotic drugs have a shorter half life and have to be taken two or three times a day for seven days or more. Also, the patient is less likely to forget to take a dose of once-a-day Zithromax. However, if the patient has an allergic reaction to Zithromax, that reaction will last longer and could be more severe.
____-______ drugs are used to treat systemic (not topical) infections in all parts of the body. These include bacterial infections, viral infections, fungal infections, and yeast infections.
____-_____ drugs include antibiotic drugs (sulfonamides, anti-infectives, penicillins, cephalosporins, aminoglycosides, tetracyclines, and others), antiviral drugs, antifungal drugs, and antiyeast drugs.
a group of drugs that inhibit the growth of bacteria.
Sulfonamide Anti-Infective Drugs
Sulfonamide drugs are effective against many gram-negative and gram-positive bacteria. They are commonly used to treat otitis media infections in the ____, _____ ____ infections, and meningitis.
ear, urinary tract infections, and meningitis
Sulfonamide drugs are also known as
_______ antibiotic drugs are a group of drugs that kill bacteria.
Penicillin antibiotic drugs are a group of drugs that kill bacteria. These drugs share the common ________structure of a beta-lactam ring
_________ drugs, such as the penicillin drug amoxicillin, that are able to kill a variety of different types of bacteria are known as broad spectrum antibiotic drugs.
__________ antibiotic drugs are a group of drugs that kill bacteria.
They interfere with the cell wall that surrounds each bacterium, causing disruption of the intracellular contents and cell death. This group of antibiotic drugs is further divided into first-generation, second-generation, and third-generation ______ _______.
First-generation ________ drugs have a fairly broad spectrum of effectiveness against various bacteria, but are not very effective against bacteria that produce penicillinase.
Second-generation cephalosporin drugs are more _______ than first-generation cephalosporin drugs against bacteria that produce penicillinase. They are also effective against more gram-positive bacteria.
Third-generation cephalosporin drugs are the ____ ______ of all the cephalosporin drugs against bacteria that produce penicillinase.
Third-generation cephalosporin drugs also show the greatest effectiveness against _____-____ and gram-______ bacteria
gram-negative and gram-positive bacteria
The cost of third-generation cephalosporin drugs is ______ than that of other cephalosporin drugs.
Generic __________ antibiotic drugs begin with cef-, cefa-, cefe-, cefi-, cefo-, or cepha-.
__________ antibiotic drugs are a group of drugs that kill bacteria. They interfere with the synthesis of protein in the bacterial wall.
Some _________ drugs (kanamycin, neomycin) are not absorbed from the intestine into the blood, and so they are given orally as a _____ ______ to inhibit intestinal bacteria prior to abdominal surgery.
Some aminoglycoside drugs (______, _________) are not absorbed from the intestine into the blood, and so they are given orally as a bowel prep to inhibit intestinal bacteria prior to abdominal surgery.
All aminoglycoside antibiotic drugs have the potential to cause _____ ______ to the auditory nerve (ototoxicity) or to the kidneys (nephrotoxicity). Patients receiving aminoglycoside antibiotic drugs are carefully monitored with hearing tests (audiograms) and blood tests (BUN and creatinine) for kidney function.
_________ antibiotic drugs inhibit the growth of bacteria by inhibiting protein synthesis in the cell wall of the bacterium.
_________ drugs are used to treat a wide variety of gram-negative and gram-positive bacterial infections, as well as other bacterial infections, and are used to treat the sexually transmitted diseases of gonorrhea and syphilis.
Tetracycline antibiotic drugs
________ antibiotic drugs are a group of drugs that either inhibit or kill bacteria by interfering with RNA and protein synthesis within the bacteria.
__________ is used in combination with other drugs to treat gastric ulcers caused by H. pylori infection
Azithromycin and clarithromycin are used to prevent Mycobacterium avium-intracellulare infection in _____ ______.
The macrolide antibiotic drug azithromycin (_______) has a half life of 68 hours. That means it takes 68 hours for the body to excrete one half of a single dose of ________.
This extended therapeutic effect is good because it makes it possible to take ______ just once a day for _____ days to complete treatment, while most other antibiotic drugs have a shorter half life and have to be taken two or three times a day for seven days or more.
Also, the patient is less likely to forget to take a dose of once-a-day Zithromax. However, if the patient has an allergic reaction to Zithromax, that reaction will last _____ and could be more _______.
This combination drug contains two different ________drugs.
These combination drugs contain an antibiotic drug (erythromycin, trimethoprim) and a sulfonamide anti-infective drug (sulfamethoxazole, sulfisoxazole).
Bactrim (trimethoprim, sulfamethoxazole)
Septra (trimethoprim, sulfamethoxazole)
Historical Notes Azidothymidine (AZT, zidovudine, Retrovir) pg 359 *
Azidothymidine (AZT, zidovudine, Retrovir) was originally synthesized in 1974. It was tested as a treatment for cancer but was not effective. Other uses for it were not investigated and it was simply shelved. The word retrovirus was coined in 1977 and is a shortened form of the phrase reverse transcriptase plus the word virus. The human immunodeficiency virus (HIV) is a retrovirus because it contains reverse transcriptase, an enzyme that transcribes or encodes RNA (instead of the usual DNA) for its genetic information.
Drug therapy for AIDS focuses on drugs to suppress the virus, as well as drugs to treat any _________ opportunistic infections that develop.
Drugs used to treat HIV inhibit the growth of the ________ but are unable to kill it. They are, however, able to decrease the viral load (total number of viruses in the blood and lymphocytes) and delay the onset of AIDS and clinical complications from opportunistic infections. The goal of drug therapy is to suppress HIV replication as much as possible for as long as possible.
These combination drugs contain a _______ inhibitor drug (lopinavir, ritonavir), a nonnucleoside reverse transcriptase inhibitor drug (efavirenz), a nucleoside reverse transcriptase inhibitor drug (abacavir, emtricitabine, lamivudine, zidovudine), and/or a nucleotide analog reverse transcriptase inhibitor drug (tenofovir).
The protease inhibitor drug ________ is not available as an individual drug.
Originally, HIV-positive patients were not begun on drug therapy until they began to exhibit _______. Later, the standard treatment was to treat patients with one antiviral drug as soon as a diagnosis of HIV was made. The first study of combined therapy showed that using two or more antiviral drugs increased the CD4 cell count so significantly that combination therapy (the so-called "AIDS cocktail") became the standard treatment in 1996
The first study of combined therapy showed that using two or more antiviral drugs increased the CD4 cell count so significantly that combination therapy (the so-called "____ _______") became the standard treatment in 1996
Current drug therapy uses _____ or _______ antiviral drugs in combination; this is more effective than one drug and also decreases the risk of developing resistant strains of HIV. Several individual antiviral drugs are given at the same time, or the physician can prescribe a single tablet that contains two different antiviral drugs. In 2006, the FDA approved the first combination drug to contain three different AIDS drugs: Atripla.
two or three
Topical fungal infections of the skin include ringworm, athlete's foot, and jock itch, all of which are caused by the fungus Tinea. A fungal infection of the nails (onychomycosis) can be treated ______ if the infection has not reached the _______.
When a fungal infection becomes embedded in the nailbed and the nail becomes misshapen, thickened, and discolored, then it must be treated with ___ _______ drugs that act systemically through the blood to reach the tissues around the nail.
________ is a new growth of cells that may be benign or malignant. All malignant neoplasms are classified as cancer, a Latin word meaning crab, because cancer metastasizes or spreads outward from the original site like the legs of a crab
To properly treat any type of cancer, the physician must determine two things: the _____ of ____ and the _____ of the cancer.
type of cancer
To determine the type of cancer, a ______ is taken from the tumor site or a blood specimen is drawn to examine blood cells.
The extent of cancer progression is referred to as the _____.
The stage indicates whether or not the cancer has spread beyond the original or primary site and _______ to secondary sites, such as regional lymph nodes or other parts of the body.
The selection of appropriate _________ drugs is based on the type of cancer and the stage of the cancer. A treatment that is appropriate for one type of cancer is usually not appropriate for a different type of cancer and may not even be appropriate for the same cancer that has progressed to a more advanced stage.
Only when the type of ______ and its ______ has been determined can the physician select an appropriate chemotherapy drug treatment regimen.
Drugs used to treat cancers or malignant neoplasms are known as chemotherapy drugs or ________ drugs.
_________ therapy refers to chemotherapy (or radiation therapy) that is given to cancer patients after they have had surgery to remove a tumor. The purpose of _________ therapy is to aid in eradicating any remaining tumor cells. The word __________ is taken from a Latin word meaning aiding.
A ______ occurs when cancerous cells stop actively reproducing. Some cancer patients experience a complete ______ following chemotherapy, others have a partial _______, but some patients actually experience tumor growth while being treated with chemotherapy.
When the tumor size increases or new metastatic lesions appear despite chemotherapy, the patient is said to have ________ chemotherapy. A new combination of chemotherapy drugs may then be tried.
____________ chemotherapy drugs act against metabolites, important byproducts produced from other substances in the cell during the process of metabolism.
Antimetabolite chemotherapy drugs target rapidly dividing cells, such as cancer cells, that have a high rate of ________. The category of antimetabolite chemotherapy drugs includes purine analog chemotherapy drugs, pyrimidine analog chemotherapy drugs, and folic acid blocker chemotherapy drugs.
________ is a molecule that forms the base upon which adenine and guanine are built. These two substances are important components of the DNA molecule in each cell.
An ________ is a drug that is created by slightly modifying the molecular structure of another substance (in this case, a purine). Purine analog chemotherapy drugs take the place of the purine base structure, and so the normal metabolites (adenine, guanine) cannot be built, DNA cannot be produced, and the cancer cell cannot divide. These drugs are used to treat different types of leukemia.
_________ is a molecule that forms the base upon which cytosine, thymine, and uracil are built. These three substances are important components of the DNA molecule. ____________ analog chemotherapy drugs take the place of the _______ base structure, and so the normal metabolites (cytosine, thymine, uracil) cannot be built, DNA cannot be produced, and the cancer cell cannot divide.
_____ ______ is a B vitamin whose metabolite is important in DNA production in the cell. _____ ______ blocker chemotherapy drugs act as antagonists in that they compete with folic acid for the same enzyme.
In the early 1900s, the only treatments available for cancer were surgical _____ and _________ therapy.
excision and radiation
The discovery of the first chemotherapy drug, ____ _____, came about serendipitously. During the 1940s, researchers who were reviewing medical records from World War I noticed that Allied soldiers who were exposed to the chemical weapon _____ ______ gas had a decreased level of WBCs. It was thought that this adverse effect could be used as a therapeutic effect in patients with leukemia whose WBC counts were abnormally elevated.
Nitrogen mustard (the drug mechlorethamine) and its derivative drugs are still used to treat ______ today.
Certain cancers need ________ to grow, particularly cancers that arise from tissues that are influenced by the male sex _____ testosterone or by the female sex _______ estradiol and progesterone.
_________ drugs used to treat these cancers block the effect of those hormones or surround the cancer cells with a hormone that has the opposite hormonal effect.
Some examples of hormonal chemotherapy drugs includes
androgen hormonal chemotherapy drugs,
antiandrogen hormonal chemotherapy drugs,
________ hormonal chemotherapy drugs,
Estrogen hormonal chemotherapy drugs act in a similar way to that of the main female hormone ________, which is produced by follicles of the ovary.
Estrogen hormonal chemotherapy drugs are used to provide _______ treatment for advanced breast cancer and/or advanced prostate cancer.
_______ treatment provides relief from symptoms but is not intended to cure.
Estrogen Hormonal Chemotherapy Drugs
Chemotherapy enzymes drugs are enzymes that break down the amino acid ______. Human cells can synthesize their own supply of ______, and so ________ is not one of the eight essential amino acids that the body needs to produce protein.
_______ cells, however, cannot synthesize their own asparagine. By breaking down asparagine, the chemotheraphy drug deprives the cancer cell of asparagine, and the cell cannot build protein or divide.
These chemotherapy drugs are used to treat leukemia.
Asparaginase is derived from the common _____ _____Escherichia coli (E. coli) that causes most urinary tract infections. Cancer patients who are hypersensitive to asparaginase can be treated with pegaspargase, a modified form of asparaginase that contains polyethylene glycol (PEG).
Chemotherapy ______ were introduced in the late 1960s in order to combine the effectiveness of several chemotherapy drugs and direct them against one specific type of cancer. Prior to this, only single-agent chemotherapy drugs were used.
In selecting drugs for a ______ _________, the success of each drug in treating that type of cancer is compared with that of other drugs. The most successful drugs are combined into one protocol. The different therapeutic effects of the various chemotherapy drugs maximize the effectiveness of therapy, while minimizing the side effects that would be caused by a large dose of just one drug.
Today, chemotherapy protocols are used to treat nearly every type of ______. Protocols are designated by acronyms that combine the first letters of the generic name drug or trade name drug or an abbreviation of that drug name in the name of the protocol.
Because cancer is a life-threatening disease, ____ as well as _____ chemotherapy drugs are constantly being evaluated for their effectiveness against specific types of cancer.
Chemotherapy drugs target rapidly dividing cancer cells. However, their effects are also felt in other areas where cells normally divide rapidly, such as in the mucous membranes lining the ____ and _______ and in the bone marrow.
mouth and intestines
Chemotherapy drugs kill rapidly dividing cancer cells, but they also affect the rapidly dividing cells in the mucous membrane of the GI tract, causing irritation. These drugs also directly stimulate the vomiting center in the brain. In addition, some chemotherapy drugs cause the release of serotonin in the small intestine, which stimulates the vomiting reflex. The nausea and vomiting that occur as a result of chemotherapy can be so severe and prolonged that, without ________ drugs, the patient might elect to discontinue life-saving chemotherapy.
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