NURS 6521N Advanced Pharmacology – IBD and IBS Differences

NURS 6521N Advanced Pharmacology – IBD and IBS Differences

NURS 6521N Advanced Pharmacology – IBD and IBS Differences

Although both ulcerative colitis and Crohn disease have distinct pathologic findings, approximately 10%-15% of patients cannot be classified definitively into either type; in such patients, the disease is labeled as indeterminate colitis. Systemic symptoms are common in IBD and include fever, sweats, malaise, and arthralgias.

The rectum is always involved in ulcerative colitis, and the disease primarily involves continuous lesions of the mucosa and the submucosa. Both ulcerative colitis and Crohn disease usually have waxing and waning intensity and severity. When the patient is symptomatic due to active inflammation, the disease is considered to be in an active stage (the patient is having a flare of the IBD). (See Presentation.)

In many cases, symptoms correspond well to the degree of inflammation present for either disease, although this is not universally true. NURS 6521N Advanced Pharmacology – IBD and IBS Differences. In some patients, objective evidence linking active disease to ongoing inflammation should be sought before administering medications with significant adverse effects (see Medication), because patients with IBD can have other reasons for their gastrointestinal symptoms unrelated to their IBD, including coexisting irritable bowel syndrome (IBS), celiac disease, or other confounding diagnoses, such as nonsteroidal anti-inflammatory drug (NSAID) effects and ischemic or infectious colitis.

Although ulcerative colitis and Crohn disease have significant differences, many, but not all, of the treatments available for one condition are also effective for the other. Surgical intervention for ulcerative colitis is curative for colonic disease and potential colonic malignancy, but it is not curative for Crohn disease.

NURS 6521N Advanced Pharmacology – IBD and IBS Differences

References:

Chumpitazi, BP, Shulman RJ. Underlying molecular and cellular mechanisms in childhood irritable bowel syndrome. Moi Cell Pediatri. 2016 Dec 3 (1):11.

Lacy BE. The science, evidence, and practice of dietary interventions in irritable bowel syndrome. Clinic Gastroenterology. 2015 Nov. 13(11):1899-906

Lashner B. Inflammatory bowel disease. Carey WD. Ed. Cleveland Clinic: Current Clinical Medicine- 2009. Philadelphia, PA: Saunders; 2009

Lehrer, J. (2018). Irritable Bowel Syndrome. Medscape. Retrieved October 15, 2018.

Thoreson R, Cullen JJ. Pathophysiology of inflammatory bowel disease; an overview. Surgical Clinic North America 2007 Jun 87(3):575-85

Tslanos EV, Katesanos KH, Tslanos VE. Role of genetics in the diagnosis and prognosis of Crohn’s disease.  World J Gastroenterology 2012 Jan 14. 18(2): 105-18

Quigley, EMM. The gut-brain axis and the microbiome: clues to pathophysiology and opportunities for novel management strategies in irritable bowel syndrome (IBS). J Cin Med. 2018 Jan 3. 7(1)

Schirbel A, Fiocchi C. Inflammatory bowel disease: Established and evolving considerations on its etiopathogenesis and therapy. J Dig Dis. 2010;11(5):266–276.

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NURS 6521 Advanced Pharmacology Week8 Assignment – Antimicrobial Agents

Antimicrobial Agents
Antimicrobials are the most widely used agents in the healthcare system. Antimicrobial agents are prescribed to kill or inhibit the growth of specific microorganisms. Therapies that kill microorganisms are called microbiocidal therapies and therapies that only inhibit the growth of microorganisms are called microbiostatic therapies.
Antimicrobial agents are categorized as antifungal, antibacterial, antiparasitic or antiviral
agents [Ani18].
They are categorized according to the specific organism they are aimed at the inhibition or kill.
Many times therapy is initiated before identifying the source of infection
[Arc17].
Antibacterial Agents
Antibacterial agents are classified as any medication that inhibits the growth and reproduction of bacteria. These agents attack the bacteria to kill or prevent replication.
Antibacterials are divided into two groups that are by their speed of action and residue production
[Antnd].
Classification of antibacterial agents is categorized according to the inhibition of cell wall synthesis, inhibition of protein synthesis, and inhibition of bacterial nucleic acid synthesis [Antnd].
Classifications of antibiotics are:

Penicillins
o
Also known as beta-lactam antibiotics
o
Discovered and the and most widely used
o
Inhibits cell wall synthesis by disrupting the synthesis of the peptidoglycan layer of bacterial cell walls; binds to and inactivates the penicillin-binding proteins
o
Most are unstable in the acidity of the stomach and must be given intravenously.
o
Renal impairment necessitates dosage adjustment
o
Potential side effects:
abdominal pain, headache, rash, diarrhea, and taste perversion
o
Common uses:
dental abscesses, pneumonia, gonorrhea, respiratory infections, skin infections, and urinary infections
Common antibiotics: amoxicillin, ampicillin, nafcillin, penicillin G,
penicillin V, piperacillin,
[And16]

Beta-lactam/Beta-lactamase inhibitor combinations
o
Prevent the breakdown of the beta-lactam by organisms that produce the enzyme and increasing antibacterial activity.
o
Alternative treatment for organisms such as S. aureus, Haemophilus influenzae, and Bacteroides fragilis
o