Anti-infectives: An Introduction Flashcards

Comprehensive vocabulary flashcards covering anti-infective medications including penicillins, cephalosporins, fluoroquinolones, antivirals, and antimycobacterials.

Penicillins Pharmacodynamics

Bactericidal; these drugs inhibit the biosynthesis of peptidoglycan in the bacterial cell wall.

Aminopenicillins

Antibiotics with greater activity against Gram-negative bacteria due to an enhanced ability to penetrate the outer-membrane organisms; used for $E.\text{ coli}$, $P.\text{ mirabilis}$, and $H.\text{ influenzae}$.

Beta-lactamase inhibitors

Compounds such as clavulanate, sulbactam, and tazobactam that are combined with penicillins to broaden their spectrum.

Probenecid

A medication that prolongs the half-life of penicillins and increases the risk for toxicity.

Immediate Allergic Reactions (Penicillins)

Serious reactions that occur within $2-30\text{ minutes}$ of administration.

Penicillin Rash

A non-allergic maculopapular rash that occurs 9\text{%} of the time, appearing $7-10\text{ days}$ into treatment.

Amoxicillin Clinical Use

First-line therapy for acute otitis media (AOM) and sinusitis.

Amoxicillin/Clavulanate Clinical Use

First-line therapy for infections following bites, including human bites.

Cephalosporins Pharmacodynamics

Bactericidal; these structurally and chemically similar drugs to penicillins inhibit mucopeptide synthesis in the bacterial cell wall.

First-Generation Cephalosporins

Include cephalexin (Keflex) and cefazolin (Ancef); primarily active against Gram-positive bacteria like $S.\text{ aureus}$ and $S.\text{ epidermidis}$.

Fifth-Generation Cephalosporins

Example includes ceftaroline (Teflaro); similar to third-generation but active against methicillin-resistant $S.\text{ aureus}$ (MRSA).

Fluoroquinolones Pharmacodynamics

Bactericidal; interfere with bacterial enzymes required for the synthesis of bacterial DNA.

Fluoroquinolones U.S. Boxed Warning

Warning regarding tendonitis and tendon rupture, with higher risk for the elderly (over $60$ years) and those on corticosteroids.

Lincosamides: Clindamycin (Cleocin)

Inhibits bacterial protein synthesis; carries a U.S. boxed warning for severe colitis.

Macrolides Pharmacodynamics

Bacteriostatic; inhibit RNA-dependent protein synthesis; activity increases in alkaline media.

Macrolide Enterohepatic Recycling

A process that can lead to drug buildup in the system and cause nausea or vomiting.

Linezolid

An oxazolidinone that inhibits bacterial ribosomal protein synthesis; includes a U.S. boxed warning for serotonin syndrome.

Sulfonamides Pharmacodynamics

Bacteriostatic; these drugs block folic acid synthesis in both Gram-positive and Gram-negative bacteria.

Nitrofurantoin ADRs

Can cause brown-colored urine and pulmonary fibrosis; should be monitored with a chest x-ray if a cough develops.

Tetracyclines Pharmacodynamics

Bacteriostatic; these drugs bind reversibly to the $30\text{S}$ subunit of the bacterial ribosome.

Vancomycin

A bactericidal glycopeptide used for severe Gram-positive infections like MRSA; ADRs include ototoxicity, nephrotoxicity, and "red man" syndrome.

Nucleoside Analogues

Antiviral drugs like acyclovir and valacyclovir that block cell entry or act inside host cells to treat viruses like HSV, shingles, and chickenpox.

Harvoni

A fixed-dose combination of ledipasvir and sofosbuvir used for treatment of Hepatitis C.

Neuraminidase Inhibitors

Antivirals like oseltamivir (Tamiflu) and zanamivir (Relenza) that inhibit the enzyme used to cleave budding viral progeny from cellular attachments.

Remdesivir

An antiviral for COVID-19 that inhibits the virus’ RNA polymerase essential for viral replication.

Griseofulvin

Antifungal that inhibits fungal cell mitosis at metaphase and binds to human keratin to resist fungal invasion.

Mazzotti reaction

An adverse reaction that may occur with the administration of ivermectin.

Metronidazole (Flagyl)

An antiprotozoal that treats parasitic and bacterial infections; requires avoiding alcohol due to a disulfiram-like (Antabuse) reaction.

Isoniazid (INH)

An antimycobacterial that inhibits mycolic acid synthesis; may cause peripheral neuropathy, treated with Vitamin $B_6$ (pyridoxine).

Rifampin

An antimycobacterial that inhibits RNA synthesis and commonly causes orange-colored body fluids.

Ethambutol ADR

An antimycobacterial that may cause optic neuritis, requiring a baseline ophthalmology examination.

Directly Observed Therapy (DOT)

A monitoring practice where every dose of medication is directly observed by a provider to ensure patient compliance.

Antibiotic Stewardship Core Elements

Four pillars: Commitment, Action for policy and practice, Tracking and reporting, and Education and expertise.