Osman Yousuf – Unit 12
Infectious Diseases
Treatment Types
Type 1 - Antibiotics
Antibiotics are treatments given for a variety of bacterial infections such as strep throat,
caused by the bacteria streptococcus pyogenes. Antibiotics can be given orally or by
injections, intravenously or intramuscularly. Oral drugs are administered and prescribed to
patients by pharmacists, and general practitioners (GPs) and injections can only be given by
healthcare professionals such as GP’s and Doctors. Antibiotics are decently available by
many healthcare professionals or other authorised prescribers but may not be as accessible
due to doctor’s prescription and permission needed. Antibiotics need specific conditions to
be effective, such as being stored at room temperature or below 25 degrees. Permitting
individuals are not eligible for free prescriptions; Prescription charges make antibiotics cost
£9.65 per item. For individuals of low-income households, or from underprivileged
backgrounds this can cause a barrier to receiving treatment. Limited healthcare
infrastructure can also cause individuals to not receive correct and appropriate treatment.
However, as this is a prescription drug, it can be delivered to a patient’s home, or to a local
pharmacy for collection to improve ease of access and availability.
The first line of treatment for strep throat is Amoxicillin or Penicillin. The course duration to
treat strep throat usually lasts for 10 days. They work by destroying bacteria and disrupting
processes bacterial cells undergo which slows down growth rate and can kill bacteria. Their
mode of action includes, disruption of selective membrane permeability, degradation of the
structure and function of the cell wall, inhibition and blockage of protein synthesis, and
some drugs inhibit DNA synthesis, thus disrupting replication. Amoxicillin mechanism of
action is it inhibits the biosynthesis and repair of the bacterial cell wall, it does this by
inhibiting penicillin-binding proteins. Many bacterial infections are fought by the immune
system. In some cases, the infection can overwhelm the immune system, in which antibiotics
are needed to assist in fighting the infection. Sometimes, specific bacteria such as MRSA are
resistant to antibiotics and therefore the infection remains and antibiotics will not work on
those individuals. Therefore, antibiotics in this case are not appropriate for patients.
Antibiotics are contraindicated for certain people to include pregnant or breastfeeding
women, as some are considered teratogenic therefore affecting the foetus, or health.
However, it is safe to take amoxicillin during pregnancy and whist breastfeeding.
Contraindication for amoxicillin and derivatives includes individuals with any previous history
of an allergy to use of medication.
Amoxicillin and other antibiotics are accepted in most religions due to no ingredients
deriving from animals, and no component of alcohol within the formula. However, in
Jainism, harm against any form of life and microorganisms are prohibited against, as
antibiotics kill bacteria, it goes against Jainism. Therefore, Jains may not prefer to accept this
treatment, for diseases, which could result in worsening of progression of disease. In cases
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where treatment is vital for survival, Jains may accept it as necessary (even though
regretted).
Some antibiotics may contain gelatine for the capsule, as this derives from animals it affects
Followers of Islam, in which Gelatine is forbidden. However, this is solved by obtaining
medication without capsule form, in other forms such as suspension, or ingesting without
the capsule.
Some cultures may carry out their own traditional ways to ‘cure’ diseases, this could also
contribute to worsening progression of the disease when treatment is not immediate once
disease has been diagnosed. Another cultural barrier to treatment is misunderstandings of
diseases and how it affects the body, and how treatment could control the disease.
Antibiotics such as Amoxicillin has many side effects such as allergic reactions (rare) in the
form of skin rashes urticaria or hives, swelling of the face, tightness of the throat, redness of
the skin, diarrhoea, and an upset stomach. In rare cases where allergic reactions do occur,
antihistamines are given. Receiving antibiotics for the treatment of infectious diseases such
as strep throat overweighs the side effects. This is due to the symptoms of the disease
alleviated when on a course. Additionally, the common side effects are not extreme to
severely affect health, whereas step throat could deteriorate quality of life and general
health. In very rare side effects such as allergies occur there are other medications to end
the side effect. Overall treatment improves infectious diseases, to eliminate it from the body,
and improve quality of life.
Type 2 – Antivirals
Antivirals are treatments given for viral infections caused by viruses such as Influenza A.
Influenza A is caused by the Influenza A virus (IAV). Antivirals are more specific to one virus
rather than a variety. Most antivirals are drugs that are taken orally but other medications
can be given by injections, intravenous drips/therapy, topical creams, and in powdered form.
GP’s, doctors, and other healthcare providers can prescribe and administer this treatment to
patients. Antivirals are decently available but may not be when contagious diseases
circulates and spreads in areas. They also are not easily accessible as there must be a
prescription or permission required from authorised prescribers. Reduced healthcare
infrastructure further contributes to antivirals being less accessible. Some antiviral
medications such as HIV treatment is free in England, making it more accessible to the
public. However, as Influenza A is a prescribed medication, and unless individuals have
exemptions or eligible for free treatment, it costs £9.65 per item. This can hinder particular
individuals from underprivileged backgrounds to accessing this treatment. Antivirals must be
stored as directed in a cool, dry place unless directed otherwise. As antivirals are part of a
prescription, it can be transported and delivered to a patient’s home, or at a specific
pharmacy for collection for improved ease of access and availability.
The first line of treatment for Influenza A is medications such as Oseltamivir or Zanamivir.
The recommended course duration for taking Oseltamivir is for 5 days for adolescents and
adults. However, for immunocompromised patients, it is extended to 10 days. They are
usually produced when a disease has no vaccine such as hepatitis viruses. Oseltamivir’s
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mechanism of action is that it disrupts the ability for viruses to enter host cells by blocking
receptors, and to exit host cells by targeting the enzyme neuraminidase. Adaptations and
mutations can cause viruses to change within the body and can respond less to antivirals,
leading to antiviral resistance in which the drugs will no longer work and is not appropriate
as a treatment. Oseltamivir is contraindicated to patients with known allergies or
hypersensitivity to the components of the drug.
Oseltamivir and other antivirals contain a gelatine capsule. In religions such as Islam,
gelatine is forbidden. However, it is simply resolved by obtaining a different form of antivirals
or taking it without ingesting the capsule.
Some cultures may carry out their own traditional ways to ‘cure’ diseases, this could
contribute to worsening progression of the disease when treatment is not immediate once
disease has been diagnosed. Another cultural barrier to treatment is misunderstandings of
diseases and how it affects the body, and how treatment could control the disease.
Antivirals such as Oseltamivir can cause side effects such as cough, dry mouth, diarrhoea,
fatigue, or headaches. In more uncommon or rare cases it can cause joint or muscle pain,
skin rashes, urticaria and hives from allergic reactions. The common side effects are not
severe, therefore receiving treatment overweighs the side effects. For severe side effects, it
can be reversed with other drugs such as antihistamines for allergic reactions. Overall, with
treatment, the virus can be reduced or completely treated to improve quality of life.
Type 3 – Antiretrovirals
Antiretrovirals are a combination of medications given to work against retroviral diseases.
This is most used to treat HIV. HIV is caused by the exposure to the human
immunodeficiency virus. This may weaken the immune system and result in
immunocompromised patients. Drugs are prescribed which are taken orally. They are
administered by healthcare professionals such as GP’s, doctors, and other authorised
prescribers in HIV pharmacies. As treatment must be prescribed, this makes the drug less
accessible, reduced healthcare infrastructure (such as HIV pharmacies) can lead to
insufficient availability of the drugs in specific areas, as well as reducing ease of access. All
HIV treatment and care in England is free. HIV clinics are mostly ‘open access’ which requires
no referral from a GP, they can provide a prescription for HIV treatment at Pharmacies. This
greatly improves availability and access to the public. Individuals from all backgrounds can
access this treatment provided by the NHS. After a certain time on being on antiretrovirals,
the drugs are available to be delivered to a specific place of choice, or for collection at
pharmacies. This also makes treatment easier, accessible, and available.
The first line of treatment for HIV is an integrase inhibitor such as dolutegravir, alongside
medications of tenofovir and emtricitabine which are called the ‘backbone’ of the multiple
drug combinations. Tenofovir and emtricitabine are inhibitors, their mechanism of action is
inhibiting HIV reverse transcriptase, it assists in preventing HIV transcription from RNA to
DNA. This treatment is taken from 1-6 months to achieve an ‘undetectable’ load, and
possibly extended for another 6 months to maintain an undetectable load, in which HIV has
been supressed. From then on HIV medication is to be taken daily for the rest of the
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