patients should be warned against driving or operatingmachinery while taking this type of medication. (Seeappendix IV, page 2.)HISTAMINE H2 RECEPTOR ANTAGO-NISTS.— Histamine H2receptor antagonists blockhistamines that cause an increase of gastric acidsecretion in the stomach. Histamine H2 receptorantagonists are effective in preventing complicationsof peptic ulcer disease and alleviating symptoms ofthis disease. (See appendix IV, page 2.)ANTACIDS.—Antacids are drugs used tocounteract hyperacidity in the stomach. Normally,there is a certain degree of acidity in the stomach. Anexcess of acid can irritate the mucous membranes andis commonly known as indigestion, heartburn, ordyspepsia. In some disease states, the gastrointestinaltract may become excessively acidic (very low pH),causing diarrhea or leading to peptic ulcer formation.Antacids may interfere with the body’s ability to usemany drugs. For this reason, oral drugs normallyshould not be taken within 2 hours of taking an antacid.(See appendix IV, page 3.)NOTE: It is important for you to be aware ofthe significance of the sodium content of mostantacids, particularly for cardiac patients orpatients on a low-sodium diet.ANTISEPTICS, DISINFECTANTS, ANDGERMICIDES.—These agents are primarilyintended for the prevention of infections by destroyingbacteria or preventing their growth. The differencesamong them are based primarily on degree of activityand how they are used.Antiseptics suppress thegrowth of microorganisms.Germicides killsusceptible organisms. Disinfectantsare agents usedto disinfect inanimate objects and are primarilygermicidal in their action. All of these agents are forexternal use only, unless otherwise indicated. (Seeappendix IV, pages 3 and 4.)SULFONAMIDES.—Sulfonamides were thefirst effective chemotherapeutic agents to be availablein safe therapeutic dosage ranges. They were themainstay of therapy of bacterial infections in humansbefore the introduction of the penicillins in 1941.Sulfonamides are synthetically produced and areeffective against both g r a m - p o s i t i v e a n dgram-negative organisms. (See appendix IV, page 5.)PENICILLINS.—Penicillin is one of the mostimportant antibiotics. It is derived from a number ofPenicillium molds commonly found on breads andfruits. The mechanisms of action for the penicillins isthe inhibition of cell wall synthesis during thereproductive phase of bacterial growth. It is one of themost effective and least toxic of the antimicrobialagents. (See appendix IV, page 5.)CEPHALOSPORINS.—The cephalosporins area group of semisynthetic derivatives of cephalosporinC, an antimicrobial agent of fungal origin. They arestructurally and pharmacologically related to thepenicillins. Because the cephalosporins arestructurally similar to the penicillins, some patientsallergic to penicillin may also be allergic to cephalo-sporin drugs. The incidence of cross-sensitivity isestimated to be 5 to 16 percent.This family of antibiotics is generally divided intogenerations:First generation — cefazolin sodium (Ancef®,Kefzol®)Second generation — cefoxitin sodium(Mefoxin®)Third generation — cefotaxime sodium(Claforan®)The main differences among the groups is thechange in the antibacterial spectrum. The thirdgeneration agents have a much broader gram-negativespectrum than the earlier generations.Examples of various cephalosporins are listed inappendix IV, page 6.T E T R A C Y C L I N E S . — Te t r a c y c l i n e s ,introduced in 1948, were the first truly broad-spectrumantibiotics. They include a large group of drugs with acommon basic structure and chemical activity. Themost important mechanism of action of thetetracyclines is the blocking of the formation ofpolypeptides used in protein synthesis. Because oftheir broad spectrum of activity, tetracyclines are mostvaluable to treat mixed infection, such as chronicbronchitis and peritonitis; however, they are drugs ofchoice for only a few bacterial infections. Tetracyclineis also used as a topical preparation to treat acne.The tetracyclines are relatively nontoxic, the mostcommon side effects being mild gastrointestinaldisturbances. Allergic reactions and anaphylaxis arerare. Administration to children and pregnant womenis not indicated because it may produce discolorationof the teeth and depress bone marrow growth. Themajor hazard of tetracycline therapy is the overgrowthof resistant organisms, especially Candida andstaphylococci.6-5
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