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Voiceover Immunity and Antieverything

Maryn Moreni・52 minutes read

Module three covers immunity and anti-infective agents including vaccines, antibiotics, antifungals, and antiretrovirals, discussing dosages, side effects, and selective use. Various types of antibiotics, their mechanisms, and implications for patient care, as well as culture and sensitivity tests for antibiotic selection are highlighted.

Insights

Culture and sensitivity tests are essential for selecting the right antibiotic against a specific pathogen, preventing resistance development, and ensuring effective treatment.
Immunosuppressant medications are crucial for certain patients but can lead to anemia, infections, and bleeding due to bone marrow suppression, emphasizing the need for careful monitoring and management.
Different classes of antibiotics have varying mechanisms and risks, such as bacteriostatic versus bactericidal drugs, with considerations for side effects, interactions, and patient-specific factors to optimize treatment outcomes.

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Recent questions

What are some common side effects of metronidazole?
Nausea, metallic taste, headache, neurotoxicity, paresthesia, seizures.

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Summary

00:00

Module Three: Immunity and Anti-Infective Agents

Module three covers immunity and anti-infective agents like antibiotics, antivirals, antifungals, and antiretrovirals.
The module spans two weeks with five chapters, including two ATI modules, a Picmonic, and a module 3 quiz worth 20 points.
Discussion includes selected vaccines, their dosages, and the immune system's harmful effects when attacking the body.
Immunosuppressant medications are explained, highlighting their necessity and implications for patients.
Antibiotics, bacteriostatic versus bactericidal drugs, hypersensitivity reactions, and resistance are discussed.
Culture and sensitivity tests help select effective antibiotics, especially before starting broad-spectrum antibiotics.
Superinfections, classes of antibiotics causing them, and comparisons between superficial and systemic fungal infections are covered.
Live vaccines like nasal influenza vaccines can cause mild subclinical cases of the targeted disease and should be avoided for immunocompromised individuals.
Inactivated vaccines, such as IM injections for influenza or HPV, do not replicate or cause disease and may require boosters for prolonged immunity.
Recombinant vaccines like Hepatitis B and HPV are generated in labs, containing partial viral subunits or bacterial proteins to prevent diseases like cervical cancer.

17:04

Bone marrow produces blood cells; grapefruit drug interactions.

Platelets are produced by bone marrow, which also generates red and white blood cells.
Suppression of bone marrow can lead to anemia due to decreased red blood cells and infections from reduced white blood cells.
Platelet suppression can result in a risk of bleeding due to inadequate clotting.
Grapefruit juice can interact with certain drugs, causing increased drug levels and potential toxicity.
Topical antifungals like nystatin and fluconazole are used for superficial fungal infections.
Superficial fungal infections, such as nail and skin infections, may persist for months before treatment is sought.
Common superficial fungal infections include athlete's foot and jock itch.
Topical antifungals have limited systemic absorption, reducing adverse effects to the treated area.
Oral antifungal therapy may be necessary for deeper skin infections.
Nystatin, a polyene antifungal, is used for candida infections and can cause minor skin irritation or gastrointestinal issues.

34:33

Choosing Effective Antibiotics for Infections

Bacteriostatic antibiotics are used when the immune system can take over the work of holding foreign invaders at bay, while bactericidal antibiotics do the work themselves.
Immune-compromised individuals should not receive bacteriostatic antibiotics as their immune system cannot take over the work.
Culture and sensitivity tests are crucial for selecting an effective antibiotic against the specific pathogen causing the infection.
Selecting an inappropriate antibiotic can delay proper treatment and promote resistance development.
Lab tests like culture and sensitivity involve identifying pathogens from specimens and determining the most effective antibiotic against them.
Broad-spectrum antibiotics are initially used until culture and sensitivity results are obtained, then may be switched to narrow-spectrum antibiotics.
Peak levels of antibiotics in the body should be monitored to check for toxicity, while trough levels ensure the antibiotic is effective.
Super infections can occur when normal microorganisms are destroyed by antibiotics, leading to overgrowth of pathogenic microbes.
Penicillins kill bacteria by disrupting their cell walls and are specific to bacterial cells.
Macrolides inhibit bacterial protein synthesis and are safe for pregnancy, with newer versions having longer half-lives and causing less GI irritation.

52:14

Antibiotics: Risks and Monitoring Guidelines

Tetracyclines do not inhibit cell wall synthesis but bacterial protein synthesis, causing permanent teeth discoloration if given before age 8, and should not be taken with milk or iron supplements due to decreased absorption.
Direct sunlight exposure during tetracycline therapy can lead to severe photosensitivity, and the drug should be avoided in children under 8 years and during pregnancy due to potential effects on teeth and bone development.
Tetracyclines pose a high risk of superinfection, and patients should watch for signs like foul-smelling diarrhea, vaginal discharge, and painful urination, with prompt disposal of outdated prescriptions recommended.
Fluoroquinolones like ciprofloxacin inhibit bacterial DNA synthesis, are well absorbed orally, but carry risks of cartilage toxicity and tendonitis, especially in patients over 60 or receiving corticosteroids.
Fluoroquinolones should be discontinued if tendon pain occurs, and caution is advised in patients under 18 due to potential cartilage development effects, with immediate discontinuation if nerve or tendon pain arises.
Sulfonamides suppress bacterial growth by inhibiting folic acid synthesis, commonly used for UTIs, but may cause urinary crystals, hypersensitivity reactions, and should be avoided in pregnancy due to potential congenital malformations.
Aminoglycosides like gentamicin inhibit bacterial protein synthesis, are usually given parenterally, and can cause ototoxicity, nephrotoxicity, and neurotoxicity, requiring careful monitoring in patients with kidney impairment or hearing loss.
Vancomycin, a glycopeptide, binds to bacterial cell walls causing cell death, reserved for severe infections like MRSA, can be ototoxic and nephrotoxic, with frequent hearing evaluations necessary and potential for red man syndrome with rapid IV administration.
Aminoglycosides should be discontinued at the first sign of hearing impairment, with regular monitoring of kidney function and serum drug concentrations, adjusting doses as needed to prevent permanent damage.
Vancomycin, effective against MRSA, requires careful monitoring for ototoxicity and nephrotoxicity, with Peak and trough levels drawn after three doses and doses adjusted accordingly, with a risk of red man syndrome with rapid IV administration.

01:09:07

Managing Metronidazol: Side Effects and Precautions

When administering intravenous infusions of medications like gentamycin or aminoglycosides, if red man syndrome occurs, it is crucial to slow down the infusion to prevent adverse effects. Metronidazol, also known as Flagel, is a common treatment for non-malarial protozoan infections such as Giardia, disrupting nucleic acid synthesis and exhibiting antibacterial properties. Additionally, it is effective against Anor robes causing abscesses, Gang Green, diabetic skin ulcers, and h pylori infections associated with peptic ulcer disease.
Metronidazol, when taken orally, may lead to minor adverse effects like nausea, dry mouth, metallic taste, and headache. High doses can result in neurotoxicity, including paresthesia and seizures. Combining metronidazol with alcohol or alcohol-containing medications can trigger a severe reaction, emphasizing the importance of avoiding alcohol consumption while on this medication. Notably, metronidazol in oral and injectable forms carries a black box warning for being carcinogenic in lab animals, stressing the necessity of using it only for approved indications.

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