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CHAPTER 7 Immunizations and Antimicrobials

CHAPTER 7 Immunizations and Antimicrobials. 7-2. Introduction. This chapter covers Disease terminology/concepts Immunizations Antimicrobials Active and passive immunity Proper use of anti-infective agents. 7-3. Disease Not (dis) at ease Body fails to function properly Numerous causes

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CHAPTER 7 Immunizations and Antimicrobials

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  1. CHAPTER 7 Immunizations and Antimicrobials 7-2

  2. Introduction This chapter covers Disease terminology/concepts Immunizations Antimicrobials Active and passive immunity Proper use of anti-infective agents 7-3

  3. Disease Not (dis) at ease Body fails to function properly Numerous causes Many due to infections Sign Objective Measurable Definitive (Continues) General Disease Terminology 7-4

  4. Symptom Subjective Based on perception Cannot be measured consistently Syndrome Specific grouping of signs/symptoms (S/S) Diagnosis Identification of disease (Continues) General Disease Terminology 7-5

  5. Prognosis Prediction of outcome of disease process Chief complaint Concern that caused patient to seek medical help Etiology Cause of disease (Continues) General Disease Terminology 7-6

  6. Chronic condition Long term Acute condition Short term Remission S/S of chronic disease may subside Relapse Recurrence of S/S (Continues) General Disease Terminology 7-7

  7. Exacerbation Acute return of S/S Mortality Measure of deaths attributed to specific disease Morbidity Measure of disability/problems related to illness (Continues) General Disease Terminology 7-8

  8. Epidemiology Study of patterns, causes, spread, and effects of disease conditions (as determined by CDC) Endemic Disease continually present within a specific population/region Epidemic Disease occurs suddenly over specific geographic region (Continues) General Disease Terminology 7-9

  9. General Disease Terminology Pandemic Disease spreads throughout country or world-wide Reminder It is better to prevent infections (such as with the use of vaccinations) than it is to treat them 7-10

  10. Immunity Immune response produces antibodies against foreign microbes; inherited, acquired, induced Two broad types Active: produced artificially (vaccination), or naturally (by contracting illness); long-lasting Passive: administration of immunoglobulins; short-lived 7-11

  11. Resistance occurrence may be due to Antibiotic being destroyed by bacterial enzymes Alteration in protein binding Bacteria pumping antibiotic out, preventing it from destroying bacteria Use of antibiotics when not needed Microbial Resistance Mechanisms 7-12

  12. Antibacterial Drug Classification Bacteriostatic (inhibits replications) versus bactericidal (actively destroys bacteria) Broad-spectrum (effective against wide range of bacteria) versus narrow spectrum (used after specific organism is identified) Mechanism of action (commonly used to classify HIV medications) 7-13

  13. Antibacterial Agents • Refer to text for in-depth information concerning these agents • Beta-lactams • Chemically related drugs • Inhibit materials needed for bacterial cell wall synthesis • For example, penicillins, cephalosporins, monobactams, carbacephems, carbapenems (Continues) 7-14

  14. Antibacterial Agents • Quinolones • Block two enzymes responsible for DNA growth, leading to breakage of DNA, which results in bactericidal activity • Prolonged use may cause superinfection • May cause tendon inflammation with rupture, even after medication is discontinued • Example of fluoroquinolones: ciprofloxacin (Continues) 7-15

  15. Antibacterial Agents • Aminoglycosides • Gram-negative coverage • Bactericidal • Dosage based on patient weight, renal function, and serum blood levels • May cause hearing loss and kidney failure • For example, amikacin, gentamicin, tobramycin (Continues) 7-16

  16. Antibacterial Agents • Glycopeptides • Bactericidal • Bind to portion of cell wall of microorganism, preventing cell wall development • Effective against gram-positive cocci • For example, vancomycin (monitor serum blood levels), telavancin (has long duration; given once daily) (Continues) 7-17

  17. Antibacterial Agents • Macrolides • Inhibit bacterial protein synthesis • Commonly used for pulmonary infections • Tetracyclines • Broad spectrum • Bacteriostatic • Can cause permanent tooth discoloration (Continues) 7-18

  18. Antibacterial Agents • Folate inhibitors • Bacteriostatic • Primary use: treatment of UTIs • Sulfonamides • Quinupristin-Dalfopristin • Inhibit bacterial protein synthesis • Bacteriostatic against gram-positive bacteria • Administered IV (Continues) 7-19

  19. Antibacterial Agents • Daptomycin • Bactericidal against gram-positive bacteria • Interferes with electrical activity of cell membrane • Useful in treatment of MRSA • Clindamycin • Oral or IV • Active against gram-positive cocci, anaerobes (Continues) 7-20

  20. Antibacterial Agents • Metronidazole • Synthetic drug • Anaerobic spectrum of activity • Inhibits bacterial protein synthesis resulting in cell death • Part of cocktail drug to treat peptic ulcer disease (PUD) due to H. pylori 7-21

  21. Antituberculosis Drugs • TB • May affect lungs, kidneys, spine, and brain; air-borne transmission; chronic • MDR TB • Due to suboptimal treatment (inappropriate drug doses/noncompliance) • Treatment • For example, rifampin, isoniazid 7-22

  22. Antivirals • Vaccinations as prevention are preferred over treatment of viruses • HSV • Treatment interferes with viral DNA synthesis, thus inhibiting viral replication • For example, valacyclovir • Influenza • Prevention available through oral administration, inhalation, or vaccination (Continues) 7-23

  23. Antivirals • RSV • Major cause of lung disease in children • Treatment includes: ribavirin (inhibits RNA and DNA viruses) • HCV • Most common blood-borne infection in the United States • Treatment examples: simeprevir, peginterferon (Continues) 7-24

  24. Antivirals • HIV • Infects cells of immune system • May progress to AIDS • Treatment: antiretrovirals that include several drug classes • NRTIs (e.g., abacavir) • NNRTIs (e.g., efavirenz) • PIs (e.g., ritonavir) 7-25

  25. Antifungal Agents • Two basic forms of fungi in humans • Yeasts • Molds • Fungi may be local or systemic • Treatments prevent production of ergosterol • Example: nystatin (oral or topical cream), miconazole (topical) 7-26

  26. Summary • Learn and understand general disease terminology to lay the foundation for discussions on infectious diseases • Immunity • Passive • Active 7-27

  27. Summary • Microbial resistance mechanisms • Anti-infective agents • Antibacterial agents • Antituberculosis drugs • Antivirals • Antifungals 7-28

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