1. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 0 Chapter 7 Measurement Systems and Their Equivalents

2. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 1  Old measurement system  1 drop (gtt) = 1 minim ( ɱ )  60 minims = 1 fluid dram ( ʒ )  1 grain = 1 grain of wheat or rice  60 grains (gr) = 1 dram ( ʒ )  8 drams ( ʒ ) = 1 ounce ( ℥ ) Apothecary System

3. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 2  gr ss = 1/2 grain  gr v = 5 grains  ʒ v = 5 drams  ℥ iiss = 2 1/2 ounces  ɱ x = 10 minims Apothecary System Symbolic Notation

4. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 3  United States Customary System of Measurement  drop— gtt  teaspoon— t, tsp = 5 mL  tablespoon— T, tbs = 3 tsp  cup—c = 8 ounces Household Measurement System

5. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 4 Household Measurement System

6. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 5Units  International Units (IU)  United States Pharmacopoeia (USP) units  Measured according to strength and desired effect  heparin  insulin  penicillin G  vitamins A, D, E

7. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 6 Milliequivalents  mEq/L—liquid  mEq/ml—liquid  mEq/tab—solid  mEq/hr—semisolid

8. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 7 Chapter 18 Antimicrobials, Antifungals, and Antivirals

9. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 8 Clostridium perfringens. From Cotran RS, Kumar V, and Collins T (1999): Robbins’ pathologic basis of disease (6 th ed). Philadelphia: Saunders. Common Indications  Infections  Disinfectants, germicides, antiseptics

10. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 9 Common Side Effects  Anorexia, changes in taste sensation  Nausea, vomiting, diarrhea  Photosensitivity  Dizziness, headache, insomnia  Skin rashes and eruptions

11. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 10 Microorganisms  Microbiology: study of microscopic organisms  bacteria  viruses  parasites  fungi  protozoa

12. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 11 Microorganisms  Pathogenic  Normal flora  Shape  Cocci  Spirilla  Gram staining  Positive  Negative  Need for oxygen  aerobic  anaerobic  facultative

13. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 12 Antimicrobials  Destroy microorganisms or inhibit microorganism growth  Include:  antibiotics  bacteriostatics  bactericidal agents

14. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 13 Antibiotic Therapy  Choose carefully  Rarely given preventatively or prophylactically  Narrow-spectrum  Broad-spectrum

15. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 14 3 rd Generation  Suprax  Cefzil  Rocephin 4 th Generation  Maxipine Common Cephalosporins 1 st Generation  Ancef  Kefzol  Duricef  Keflex  Anspor 2 nd Generation  Ceclor  Cefotan  Ceftin  Vantin

16. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 15 Common Macrolides  Erythromycin  EES  Zithromax  Biaxin  Dynabac  TAO

17. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 16 Discoloration of the teeth caused by tetracycline. From Christensen GJ (1994): A consumer’s guide to dentistry. St. Louis: Mosby. Common Tetracyclines Short-acting tetracyclines  Aureomycin  Panmycin  Sumycin  Terramycin Intermediate-actingtetracyclines  Declomycin Long-acting tetracyclines  Vibramycin  Minocin

18. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 17 Common Aminoglycosides  Amikacin  Gentamicin  Kanamycin  Neomycin  Streptomycin  Tobramycin

19. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 18 Common Quinolone Antimicrobials  Cipro  Penetrex  Maxaquin  Levaquin  Noroxin  Floxin  Tequin  Avelox

20. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 19 Miscellaneous Antibiotics  Vancomycin  Chloramphenicol  Metronidazole (Flagyl)  Topical antibiotic preparations

21. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 20 Common Sulfonamides (Sulfa Drugs)  Gantrisin  Gantanol  Azulfidine  Triple Sulfa  Bactrim  Septra  Sulamyd  Silvadene cream

22. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 21 Urinary Tract Antiseptics  Nitrofurantoin  Methenamine  Nalidixic acid  Cinoxacin

23. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 22 Mycobacterium tuberculosis colonies. From Forbes BA, Sahm DF, Weissfeld AS (2002): Bailey & Scott’s diagnostic microbiology (11 th ed). St. Louis: Mosby. Tuberculosis  Drug Therapy  Isoniazid (INAH)  Rifampin  Pyrazinamide (PZA)  Ethambutol  Streptomycin

24. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 23 Tinea corporis. From Zitelli BJ and Davis HW (2002): Atlas of pediatric physical diagnosis (4 th ed). St. Louis: Mosby. Fungal Infections  Spore-forming yeasts and molds  Prefer moist, warm, dark environment  Feet  Groin  Underarms  Most common Fungal infections  Ringworm  Athletes Foot  Candida Albicans – mouth and vagina

25. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 24 Common Antifungal Drugs  Fungizone  Diflucan  Nizoral  Mycostatin  Lamisil  Lotrimin  Monistat  Terazol  Desenex

26. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 25 Common Non-HIV Antiviral Drugs  Symmetrel and Flumadine—Influenza A  acyclovir (Zovirax)— herpes simplex, genital herpes, varicella zoster infections  ganciclovir— cytomegalovirus

27. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 26 HIV Antivirals  No cure for HIV  Health preserved, life prolonged  Multiple drug interactions and side effects  High cost, toxicity  Drug cocktail used  New drugs

28. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 27 Drugs to Treat Malaria  Insect vector (usually mosquito)  High fever, chills, sweating, jaundice  May give drugs prophylactically Chloroquine (drug of choice), quinine, primaquine

29. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 28 Antiseptic vs Disinfectant  Antiseptic: inhibiting growth of microbial flora  Disinfectant (germicide): agent decreasing number of microorganisms  Sanitization: cleaning and removing dirt

30. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 29 Antiseptics  Iodine preparations  Betadine, tincture of iodine  rapid-acting, potent germicides  Alcohol  antiseptic  70% isopropyl is bactericidal  area should be air-dried

31. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 30 Antiseptics  Hexachlorophene  Hydrogen peroxide  does not penetrate skin  damaging to new tissue  Silver preparations  used in eye, on burns  Mercury preparations  thimerosal

32. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 31Disinfectants  Use on inanimate objects only  Sterilize or destroy all microorganisms and spores  Dilute sodium hypochlorite (1:10)  Make fresh every 24 to 36 hours  Boric acid as eyewash or irrigant  Gentian violet