N3540 Anti-infectives Lecture Notes

Comprehensive vocabulary flashcards covering anti-infective categories, specific antibiotic classes, antivirals, antifungals, and immunosuppressants as presented in the lecture transcript.

Anti-infectives

Substances that work to prevent or treat infections.

Antimicrobials

Natural or synthetic agents that have the ability to either kill or slow the growth of microorganisms.

Gram-negative bacteria

Bacteria with an additional outer membrane that makes them harder to penetrate by medications.

Bactericidal

A property of antimicrobials that causes the death of bacteria.

Bacteriostatic

A property of antimicrobials that inhibits the growth of bacteria, allowing the immune system to take over.

Broad spectrum antibiotics

Antibiotics that are active against a wide variety of bacterial types, though they may also kill good normal flora.

Superinfection

A new infection that occurs during antibiotic therapy due to the destruction of normal flora, such as thrush, vaginal yeast infections, or pseudomembranous colitis.

Empiric therapy

Administration of an antibiotic to treat a likely cause of an infection before the specific bacteria is known.

Definitive therapy

Administration of antibiotics based on known results of culture and sensitivity testing.

Prophylactic therapy

Antibiotics taken before anticipated exposure to an infectious organism to prevent an infection, such as before surgery.

Therapeutic index

A measure of a drug's safety defined as the ratio of a drug's average lethal dose to its average effective dose.

Peak level

The highest concentration of a drug in the blood, measured after completion of the infusion.

Trough level

The lowest concentration of a drug in the blood, measured right (within $30\,min$) before the next dose.

Vancomycin

A glycopeptide antibiotic used for serious Gram-positive infections like MRSA (IV) and severe C. difficile (PO) that requires trough levels between $10$ and $20\,mcg/mL$.

Red Man Syndrome

A rate-dependent infusion reaction to Vancomycin characterized by flushing, pruritus, and an erythematous rash on the face, neck, and upper torso.

Metronidazole (Flagyl)

An antimicrobial used for Giardia, Trichomoniasis, and C. difficile that requires patients to avoid alcohol for $48\,hours$ after treatment to prevent a disulfiram-like reaction.

Macrolides

A class of antibiotics including Azithromycin and Erythromycin that inhibits protein synthesis and may cause QT prolongation and hepatotoxicity.

Tetracyclines

Antibiotics that end in "-cycline" and bind to $Ca^{2+}$, $Mg^{2+}$, and $Al^{3+}$; they are contraindicated in children under $8$ and pregnant women due to tooth discoloration.

Aminoglycosides

A class of antibiotics (e.g., Gentamicin, Amikacin) that carries a high risk for irreversible ototoxicity and nephrotoxicity.

Fluoroquinolones

Antibiotics ending in "-floxacin" that carry an FDA black box warning for tendinitis and tendon rupture.

Sulfonamides

Also known as "sulfa drugs," these can cause crystalluria (requiring $2,000\,mL$ of fluid daily) and life-threatening Stevens-Johnson Syndrome.

Stevens-Johnson Syndrome (SJS)

A rare but life-threatening adverse effect of sulfonamides characterized by flu-like symptoms followed by a widespread peeling rash and blisters.

Beta-lactamases

Enzymes produced by some bacteria capable of destroying the beta-lactam ring in penicillins, making the medication ineffective.

Cephalosporins

Bactericidal antibiotics chemically similar to penicillins, categorized into five generations with increasing Gram-negative coverage.

Ceftaroline (Teflaro)

A 5th generation cephalosporin and the only one effective against MRSA.

Nitrofurantoin

An antimicrobial used specifically for UTIs that may cause harmless dark yellow or brown urine and requires monitoring of liver and pulmonary function.

Phenazopyridine (Pyridium)

A urinary tract analgesic used for relief of bladder pain and frequency that will turn urine red or orange.

Linezolid (Zyvox)

An antimicrobial used for MRSA and VRE that may cause serotonin syndrome if taken with SSRIs.

Oseltamivir (Tamiflu)

An antiviral used for the prophylaxis and treatment of influenza that should be administered within $2\,days$ of symptom onset.

Ascorbic Acid (Vitamin C)

A vitamin important for wound healing and tissue repair that enhances the absorption of iron.

Fluconazole (Diflucan)

An azole antifungal that inhibits cytochrome P-450 enzymes and can increase levels of drugs like warfarin, leading to an increased risk of bleeding.

Nystatin

An antifungal used to treat intestinal, oral (thrush), or cutaneous candidiasis, often administered as an oral suspension using a "swish and swallow" method.

Cyclosporine

An immunosuppressant drug used to prevent organ rejection that interacts significantly with grapefruit juice and St. John's Wort.