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Title

Pharmacology for Radiologic Technologists, Part 5: Antimicrobials and Endocrine Agents (0.5 credit hours)

Abstract

This course pairs a consideration of antimicrobial/antibiotic agents with an examination of pancreatic and ovarian hormones. Description of antimicrobial agents includes an overview of mechanisms and an analysis of beta lactam derivatives (penicillins, cephalosporins), macrolides, tetracycline, fluoroquinolones and aminoglycosides. The hormonal portion addresses the endocrine pancreas including the actions and indications for insulin, oral antidiabetic agents, and glucagon. Overview of the female sex hormones includes the general metabolic functions of estrogen and progesterone; adverse effects associated with estrogen and progestins; current opinions regarding estrogen replacement; and contraceptive mechanisms for combination and estrogen-only products.

Course Approval Expiration/End Date: July 1, 2011 Category A Credit.

This activity may be available in multiple formats or from different sponsors. The ARRT does not allow CE activities such as internet courses, home study programs or directed readings to be repeated for CE credit in the same or any subsequent biennium.

Author

Dan Becker, DDS

Dr. Becker received his bachelor of science in zoology from Ohio University in 1968 and his doctor of dental surgery from Ohio State University in 1972. Although Dr. Becker is a dentist, his interest always centered on academia and he began teaching biology at Sinclair Community College (Dayton, OH) as a part-time instructor in the autumn of 1972. He accepted a full-time faculty position in the Dental Hygiene department in 1976, but continued his teaching within the Biology department as well.

Dr. Becker's interest in pharmacology and anesthesia attracted him to Miami Valley Hospital where he became involved with their dental residency instructing dental residents and learning from mentors during rotations within departments of anesthesia and emergency medicine. During this time, he developed and taught courses in pharmacology and pathophysiology for nursing and other allied health programs until his teaching at Sinclair became entirely devoted to these subject areas. Currently he is a full professor at Sinclair Community College and Associate Director of Education at Miami Valley Hospital. He has published in numerous scientific journals and textbooks, and lectures extensively throughout the United States and Canada.

Objectives

After completion of the module the learner should be able to:

Describe four general mechanisms by which antimicrobial agents act and offer example agents using each mechanism.
Compare and contrast the penicillins and cephalosporins.
State the principal indications and side effects for macrolides, tetracycline fluoroquinolones and aminoglycosides.
Distinguish the actions of insulin, oral hypoglycemics and antihyperglycemics in the regulation of blood glucose concentrations.
Describe the general metabolic functions of estrogen and progesterone.
Discuss the adverse effects associated with estrogens and progestins, and current opinions regarding postmenopausal hormone replacement.
Distinguish the proposed contraceptive mechanisms for combination products, progestin only products and postcoital regimens..

Resources

Bibliography
Part A

Abramowicz M, Ed. Choice of antibacterial drugs. The Medical Letter on Drugs and Therapeutics. 2002;44:34-54.

Chambers HF. General Considerations of Antimicrobial Therapy. In: Brunton LL, Lazo JS, Parker KL, Eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2006.

Olin BR, Hebel SK, Dombek CE, eds. Drug Facts and Comparisons. 2006 ed. St Louis, Mo: Facts and Comparisons, Inc; 2006.>

Salkind AR CPFJW. The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy . JAMA 2001; 285(19):2498-505.

Shepherd GM. Allergy to beta-lactam antibiotics. Immunol Allergy Clin N Amer 1991;11(3):611-633.

Part B
Abramowicz M, ed. Oral contraceptives. The Medical Letter on Drugs and Therapeutics. 2000;42:42-44.

Bailar J. Retrospective: Hormone �replacement therapy and cardiovascular diseases. N Engl J Med 2003;349(6):521-522.

Davis SN. Insulin, Oral Hypoglycemic Agents, and the Pharmacology of the Endocrine Pancreas. In: Brunton LL, Lazo JS, Parker KL, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2006.

Fletcher SW, Colditz GA. Failure of estrogen plus progestin therapy for prevention. JAMA. 2002;288(3):366-68

Glasier A. Emergency postcoital contraception. N Engl J Med 1997;337(15):1058-64. (Editorial: pages 1078-9)

Herrington DM, Howard TD. From presumed benefit to potential harm: Hormone therapy and heart disease. N Engl J Med 2003;349(6):519-521.

Loose-Mitchell DS, Stancel GM. Estrogens and Progestins. In: Brunton LL, Lazo JS, Parker KL, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2006.

Manson JE, Martin KA. Postmenopausal hormone-replacement therapy. N Engl J Med 2001;345:34-40.

Olin BR, Hebel SK, Dombek CE, editors. Drug Facts and Comparisons. 2006 ed. St Louis, Mo: Facts and Comparisons, Inc; 2003.

Vandenbroucke JP, Rosing J, et al. Oral contraceptives and the risk of venous thrombosis. N Engl J Med 2001;344:1527-35.

Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the women's health initiative randomized controlled trial. JAMA. 2002;288(3):321-333

Webliography
Overview of Antimicrobial Therapy

American Medical Association. AMA (Infectious Disease) Antibiotics and Antimicrobials. 1995 - 2005. Available at: http://www.ama-assn.org/ama/pub/category/1863.html. Accessed April 4, 2007.

ThinkQuest.org. Cellupedia. Cell Anatomy. Available at: http://library.thinkquest.org/C004535/cell_anatomy.html. Accessed April 4, 2007.

United States Deaprtment of Health and Human Services. 2001:01:18HHS Releases Action Plan to Combat Antimicrobial Resistance. Available at: http://www.hhs.gov/news/press/2001pres/20010118b.html. Accessed April 4, 2007.

University of Edinburgh (Scotland), School of Biological Sciences. Penicillin and other antibiotics. Available at: http://helios.bto.ed.ac.uk/bto/microbes/penicill.htm. Accessed April 4, 2007.

University of Wisconsin - Madison, Department of Bacteriology. Microbiology Textbook. The Microbial World: They Rule! The Cell Wall. Available at: http://www.microbiologytext.com/index.php?module=Book&func=displayarticlesinchapter&chap_id=35. Accessed April 4, 2007.

Pancreatic and Ovarian Hormones
Bowen R. The Endocrine Pancreas: Introduction and Index. December 8, 2002. Available at: http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/pancreas/. Accessed April 4, 2007.

Brody S, Florida Atlantic University Libraries. Jewish Heroes in America. Dr. Gregory Goodwin Pincus: Father of "The Pill." October 18, 2006. Available at: http://www.fau.edu/library/br138.htm. Accessed April 4, 2007.

Greep RO, National Academy of Sciences. Min Chueh Chang, October 10, 1908 - June 5, 1991. By Roy O. greep. Biographical Memoirs. Available at: http://www.nap.edu/html/biomems/mchang.html. Accessed April 4, 2007.