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Antihypertensive & Lipid Lowering Agents > Anti-Infectives > Flashcards

Anti-Infectives Flashcards

1
Q

Goal of antiinfectives

A

reduce population of foreign organisms in host

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2
Q

Types of antiinfectives

A
  • antibiotics (bacteria)
  • antifungals
  • antivirals
  • antiprotozoals
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3
Q

how do antiinfectives work

A
  • cell wall synthesis and permeability
  • (we don’t have cell walls)
  • interrupt protein synthesis
  • interrupt DNA replication
  • resource limitation
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4
Q

selective toxicity/

A

ability to affect certain proteins or enzyme systems that are used by infecting organsim but not by human cells

ability to target specific organisms

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5
Q

resistance

A

ability of pathogens over time to adapt to an antiinfective to produce cells that are no longer affected by a particular drug

ability of organism to evade effects of antiinfective

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6
Q

bactericidal

A

-substances that causes death of bacteria
-usually by interfering with cell membrane stability or with proteins/ enzymes that maintain cellular integrity of bacteria

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7
Q

bacteriostatic

A
  • substance that prevents replication of bacteria
  • usually by interfering with proteins/ enzyme systems necessary for reproduction of bacteria
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8
Q

superinfection

A

infections that occur when opportunistic pathogens that were kept in check by “normal” bacteria have opportunity to invade tissues and cause infections b/c normal flora bacteria have been destroyed by antibiotic therapy

treatment for initial infection led to 2nd infection

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9
Q

broad-spectrum antibiotics

A

effective against wide range of bacteria

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10
Q

narrow-spectrum antibiotics

A

effective only against very selective bacteria

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11
Q

combination therapy

A
  • synergistic
  • lower dose (fewer reactions)
  • less resistance
  • fewer superinfections
  • one protects the other, - Unasyn (ampicillin and sulbactum), Augmentin (amoxicillin and clavulanic acid)

less neg effects on liver, kidneys

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12
Q

downsides to combination therapy

A
  • increases risk of toxicity
  • more side effects
  • increased cost
  • complicates compatibility issues via IV route

both hard on kidneys, both metabolized by liver

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13
Q

cultures

A
  • optimally, ID organism first
  • “match drug to bug”, 2-3 days though…
  • often not feasible
  • at least get cultures
  • still not always feasible
  • broad spectrum out the gate

get culture before you start antibiotics

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14
Q

types of cultures

A

gram stain - retains or loses stain after alcohol exposure
PCR - polymerase chain reaction - copies DNA to amount that are detectable

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15
Q

prophylaxis

A
  • surgery
  • valvular disease
  • neutropenia
  • recurrent infections
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16
Q

misuse of antibiotics

A
  • treating viral infections
  • treating “fever of unknown origin”
  • wrong dose
  • treating w/o knowing the bug
17
Q

resistance

A
  • reduction of drug at site of action
  • alter the receptor site
  • make their own weapons
  • inactivate the drug
18
Q

MRSA

A
  • S. aureus
  • colonizes our skin
  • penicillin used widely starting 1940s
  • resistance developed with penicillinase
  • Methicillin - resistance developed as well - obsolete
  • most common isolation indication
  • requires stronger, more dangerous antibiotics to treat now - costs more
  • increase LOS and morbities
19
Q

proper antibiotic use

A
  • complete full course
  • allergies more likely when incomplete
  • more likely to share or take later when incomplete
  • resistant strains of bacteria
20
Q

timely administration

A
  • timeliness is important w/ antibiotic admin
  • most require admin at specific frequencies
  • some must reach certain concentration
  • other more reliant on length of exposure
21
Q

Vancomycin

A
  • powerful antibiotic, used for C. diff and PCN resistnat S. aureus
  • most common IV abx used in US hospitals
  • risk of toxicity via IV route
  • Kidneys (1 in 20) and ears
  • reputation element may exist
  • Trough level goal 5-20 mcg/mL
  • admin’d over specific period of time
22
Q

Red Man Syndrome

A
  • peculiar to Vancomycin
  • usually preceded by rapid administration
  • flushing, rash, pruritis, tachycardia, hypotension
  • infuse over at least 60 minutes
  • supportive care antihistamines, steroids, fluids for hypotn
23
Q

Clostridium difficile

A
  • found in feces
  • usually caused by antibiotic administration
  • soap and water
  • mild - metronidazole
  • severe - vancomycin
  • really severe - both
24
Q

bad reactions

A
  • range from mild to deadly
  • N/V
  • diarrhea
  • itching, rash, anaphylaxis
25
Q

Steven Johnson Syndrome

A
  • autoimmune reaction to certain drugs, including some antibiotics
  • skin and mucus membrane infammation and sloughing
  • rare but serious
  • starts with fever, burning pain in skin and eyes
  • d/c with offending drug
  • no specific treatment
  • supportive care
26
Q

tuberculosis

A
  • replicates very slowly
  • cough, low grade fever, night sweats, hemoptysis
  • lengthens abx course
  • multiple drugs
  • compliance issues due to length of treatment and population

Antihypertensive & Lipid Lowering Agents (2 decks)

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