Chapter 7

Introduction to Cell Physiology

Copyright 2008 Lippincott Williams & Wilkins.

Chemotherapeutic Agents
Alter cellular function or disrupt cellular
integrity, causing cell death
Prevent cellular reproduction, eventually
leading to cell death

Copyright 2008 Lippincott Williams & Wilkins.

Chemotherapeutic Drugs
Destroy organisms that invade the body
Bacteria, viruses, parasites, protozoa, fungi
Destroy abnormal cells within the body
Neoplasms and cancers

Copyright 2008 Lippincott Williams & Wilkins.

Parts of a Human Cell

Nucleus
Cell membrane
Cytoplasm

Copyright 2008 Lippincott Williams & Wilkins.

Structure of a Cell

Copyright 2008 Lippincott Williams & Wilkins.

Cell Nucleus
Contains genetic material
Necessary for cell reproduction
Regulates cellular production of proteins
Each cell is programmed by the genes for the
production of specific proteins
Allows the cell to carry out its function
Maintains cell homeostasis or stability
Promotes cell division
Copyright 2008 Lippincott Williams & Wilkins.

Cell Membrane
Surrounds the cell
Separates the intracellular fluid from the
extracellular fluid
Essential for cellular integrity

Copyright 2008 Lippincott Williams & Wilkins.

Structure of a Lipid Cell Membrane

Copyright 2008 Lippincott Williams & Wilkins.

Organelles of the Cytoplasm

Mitochondria
Endoplasmic reticulum
Free ribosomes
Golgi apparatus
Lysosomes

Copyright 2008 Lippincott Williams & Wilkins.

Components of Cell Membrane

Cell membrane is made up of lipids and proteins
Several lipids make up the cell membrane
Phospholipids
Glycolipids
Cholesterol
Lipid layer provides a barrier for the cell and
maintains homeostasis of the cell
Copyright 2008 Lippincott Williams & Wilkins.

Receptor Sites
Found on the cell membrane
Specific receptor sites allow interaction with
various chemicals

Copyright 2008 Lippincott Williams & Wilkins.

Identifying Markers
Surface antigens
Important in the role of cellular immunity
Histocompatibility proteins allow for selfidentification
The bodys immune system recognizes these
proteins and acts to protect self-cells and to
destroy nonself-cells
Copyright 2008 Lippincott Williams & Wilkins.

Channels
Channels or pores allow for the passage of
substances into and out of the cell
Some drugs are designed to affect certain
channels within the cell

Copyright 2008 Lippincott Williams & Wilkins.

Cell Properties
Endocytosis
Involves incorporation of material into the cell
Pinocytosis and phagocytosis occur
Exocytosis
Allows a cell to move a substance to the cell
membrane and secrete the substance outside the
cell
Hormones, neurotransmitters, and enzymes are
excreted into the body by this process
Copyright 2008 Lippincott Williams & Wilkins.

Homeostasis of the Cell

Passive transport
Happens without the expenditure of energy and can
occur across any semipermeable membrane
Occurs by diffusion, osmosis, and facilitated diffusion
Active transport
Energy-requiring process
Movement of particular substances against a
concentration gradient
Important in maintaining cell homeostasis
Copyright 2008 Lippincott Williams & Wilkins.

Passive Transport
Diffusion
Does not require energy
The movement of solutes from a region of high
concentration to a region of lower concentration
across a concentration gradient
Osmosis
Does not require energy
Movement of water from an area low in solutes
to an area high in solutes
Copyright 2008 Lippincott Williams & Wilkins.

Phases of the Cell Cycle

G0 phase
Resting phase
G1 phase
Gathering phase
S phase
Synthesizing phase
G2 phase
Last substances needed for division are collected
and produced
M phase
Actual cell division occurs, producing two identical
daughter cells
Copyright 2008 Lippincott Williams & Wilkins.

Cell Cycle

Copyright 2008 Lippincott Williams & Wilkins.

Cell Physiology
May alter the cell membrane, causing the cell to
rupture and die
May deprive the cell of certain nutrients,
altering the proteins that the cell produces and
interfering with normal cell functioning and cell
division
May affect the normal cells of patients to some
extent
Copyright 2008 Lippincott Williams & Wilkins.

Chapter 8
Anti-infective Agents

Copyright 2008 Lippincott Williams & Wilkins.

Drug Therapy Across the Lifespan

Copyright 2008 Lippincott Williams & Wilkins.

Development of Anti-infective Therapy

1920s
Paul Ehrlich worked on developing a
synthetic chemical effective against
infection-causing cells only
Scientists discovered penicillin in a mold
sample
1935
The sulfonamides were introduced
Copyright 2008 Lippincott Williams & Wilkins.

Mechanisms of Action
Interfere with biosynthesis of the bacterial cell
wall
Prevent the cells of the invading organism from
using substances essential to their growth and
development
Interfere with steps involved in protein synthesis

Copyright 2008 Lippincott Williams & Wilkins.

Mechanisms of Action (cont.)

Interfere with DNA synthesis
Alter the permeability of the cell membrane to
allow essential cellular components to leak out

Copyright 2008 Lippincott Williams & Wilkins.

Mechanism of Anti-infective Agents

Copyright 2008 Lippincott Williams & Wilkins.

Anti-infective Activity
Anti-infectives vary in their effectiveness against
invading organisms
Some are selective: they are effective only for a
small number of organisms
Bactericidal: kill the cell
Bacteriostatic: prevent reproduction of the cell

Copyright 2008 Lippincott Williams & Wilkins.

Narrow Spectrum vs Broad Spectrum

Narrow spectrum of activity
Effective against only a few microorganisms
with a very specific metabolic pathway or
enzyme
Broad spectrum of activity
Useful in treating a wide variety of infections
Copyright 2008 Lippincott Williams & Wilkins.

Human Immune Response

Goal of anti-infective therapy is reduction of the
population of the invading organism
Drugs that eliminate all traces of any invading
pathogen might be toxic to the host as well
Immune response is a complex process involving
chemical mediators, leukocytes, lymphocytes,
antibodies, and locally released enzymes and
chemicals
Copyright 2008 Lippincott Williams & Wilkins.

Problems With Treating Infections in

Immunosuppressed Patients
Anti-infective drugs cannot totally eliminate the
pathogen without causing severe toxicity in the
host
These patients do not have the immune response
in place to deal with even a few invading
organisms

Copyright 2008 Lippincott Williams & Wilkins.

Resistance
Anti-infectives act on a specific enzyme system
or biological process; many microorganisms that
do not act on a specific system are not affected
by the particular drug
This is considered natural or intrinsic resistance
to that drug

Copyright 2008 Lippincott Williams & Wilkins.

Acquired Resistance
Microorganisms that were once sensitive to the
particular drug have begun to develop acquired
resistance
This results in serious clinical problems

Copyright 2008 Lippincott Williams & Wilkins.

Ways Resistance Develops

Producing an enzyme that deactivates the
antimicrobial drug
Changing cellular permeability to prevent the drug
from entering the cell
Altering transport systems to exclude the drug
from active transport into the cell
Altering binding sites on the membranes or
ribosomes, which then no longer accept the drug
Producing a chemical that acts as an antagonist to
the drug
Copyright 2008 Lippincott Williams & Wilkins.

Preventing Resistance
Limit the use of antimicrobial agents to the
treatment of specific pathogens sensitive to the
drug being used
Make sure doses are high enough, and the
duration of drug therapy long enough
Be cautious about the indiscriminate use of antiinfectives
Copyright 2008 Lippincott Williams & Wilkins.

Identification of the Pathogen

Identification of the infecting pathogen is done
by culture
A culture of a tissue sample from the infected
area is done
A swab of infected tissue is allowed to grow
on an agar plate
Staining techniques and microscopic
examination identify the bacterium
Stool can be examined for ova and parasites
Copyright 2008 Lippincott Williams & Wilkins.

Sensitivity of Pathogen
Shows which drugs are capable of controlling the
particular microorganism
Important to be done for microorganisms that
have known resistant strains
Along with a culture, identifies the pathogen and
appropriate drug for treatment

Copyright 2008 Lippincott Williams & Wilkins.

Factors Affecting Prescribing

Anti-infective Agents
Identification of the correct pathogen
Selection of the right drug
One that causes the least complications
for that particular patient
One that is most effective against the
pathogen involved
Copyright 2008 Lippincott Williams & Wilkins.

Combination Therapy
Use of a smaller dosage of each drug
Some drugs are synergistic
In infections caused by more than one organism,
each pathogen may react to a different antiinfective agent
Sometimes, the combined effects of the different
drugs delay the emergence of resistant strains
Copyright 2008 Lippincott Williams & Wilkins.

Adverse Reactions to
Anti-infective Therapy
Kidney damage
Gastrointestinal (GI) tract toxicity
Neurotoxicity
Hypersensitivity reactions
Superinfections
Copyright 2008 Lippincott Williams & Wilkins.

Prophylaxis of Anti-infective Agents

People traveling to areas where malaria is
endemic
Patients who are undergoing gastrointestinal or
genitourinary surgery
Patients with known cardiac valve disease, valve
replacements, and other conditions requiring
invasive procedures
Copyright 2008 Lippincott Williams & Wilkins.