Anti-infectives Lecture Review

A set of 75 practice flashcards covering anti-infective medications, nursing implications, and general principles from medical lecture notes.

Antibacterials

Medications used to treat infections caused specifically by bacteria.

Antivirals

Medications used to treat infections caused specifically by viruses.

Antifungals

Medications used to treat infections caused specifically by fungi.

Hypersensitivity Reactions

Immune responses that can present as skin rash, urticaria (hives), pruritus (itching), and swelling.

Anaphylactic Reactions

Systemic medical emergencies characterized by throat or chest tightness, wheezing, dyspnea, and a swollen tongue.

Superinfections

New infections that occur during or after antibiotic therapy because the body's normal flora has been destroyed.

Thrush (Oral Candidiasis)

A superinfection characterized by creamy white lesions on the tongue or mouth and a sore mouth.

Vaginal Yeast Infection

A superinfection characterized by perineal itching and a thick, white, curd-like vaginal discharge.

Pseudomembranous Colitis

A potentially fatal overgrowth of Clostridium difficile causing persistent or bloody diarrhea, fever, and abdominal pain.

Culture and Sensitivity (C&S) Timing

Samples must be obtained BEFORE the first dose of antibiotic is given to avoid altering the growth of bacteria in the lab.

Empiric Therapy

Treating a likely cause of infection before the specific causative bacteria is identified by laboratory work.

Definitive Therapy

Targeted antibiotic administration based on confirmed laboratory results of culture and sensitivity testing.

Prophylactic Therapy

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

Narrow Spectrum Antibiotics

Antibiotics that are active against only a specific group or a few types of bacteria.

Low/Narrow Therapeutic Index

A narrow margin of safety where the difference between the average effective dose and the toxic dose is very small.

Bacterial Resistance

The ability of bacteria to become less sensitive or totally insensitive to an antibiotic, often through genetic mutation.

Vancomycin (Intravenous)

A glycopeptide antibiotic used intravenously to treat Methicillin-resistant Staphylococcus aureus (MRSA).

Vancomycin (Oral)

Form of the drug used specifically for treating severe Clostridium difficile (C. diff) infections because it remains in the GI tract.

Vancomycin Peak Level

The highest concentration of the drug in the blood, measured after the complete infusion is finished.

Vancomycin Trough Level

The lowest concentration of the drug in the blood, measured right before (within 30 minutes) the next dose.

Target Vancomycin Trough Range

The desired optimal blood level for Vancomycin is between $10$ and $20\,mcg/mL$.

Ototoxicity Symptoms

Adverse effects including tinnitus (ringing in the ears), dizziness, balance issues, and hearing loss.

Nephrotoxicity Indicators

Signs of kidney damage including decreased urine output ($< 30\,mL/hr$), hematuria, edema, and Serum Creatinine levels $> 1.2\,mg/dL$.

Red Man Syndrome

A rate-dependent infusion reaction caused by rapid histamine release; signs include flushing, erythema of the face/neck, and hypotension.

Metronidazole (Flagyl)

A drug that interferes with bacterial DNA synthesis used for intraabdominal infections, mild C. diff, and trichomoniasis.

Metronidazole Alcohol Warning

Strictly avoid alcohol for 24 hours before and 36 hours after therapy to prevent a severe disulfiram-like reaction.

Trichomoniasis Teaching

Instruction that all sexual partners must be treated simultaneously and sexual intercourse avoided until the infection is resolved.

Macrolide "ACE" Mnemonic

The names of the drugs in this class: Azithromycin, Clarithromycin, and Erythromycin.

QT Prolongation

A dangerous cardiac arrhythmia/dysrhythmia that can be caused by Macrolides or Fluoroquinolones.

Macrolide Hepatotoxicity Signs

Symptoms to report include fatigue, jaundice, abdominal pain, dark urine, and clay-colored or pale stools.

Tetracyclines

A class of drugs including Doxycycline and Minocycline used for acne, Chlamydia, Lyme disease, and H. pylori.

Tetracycline Contraindications

Should not be given to pregnant or nursing women or children under 8 years old due to effects on teeth and bones.

Tetracycline Calcium Interaction

These drugs bind to calcium ions, forming insoluble complexes that cause permanent tooth discoloration and enamel hypoplasia.

Tetracycline Dietary Restrictions

Do NOT take with dairy products, antacids, iron preparations, or calcium/magnesium/aluminum supplements.

Aminoglycosides "GNATS" Mnemonic

The names of the drugs in this class: Gentamicin, Neomycin, Amikacin, Tobramycin, and Streptomycin.

Aminoglycoside Monitoring

Because of narrow safety margins, high trough levels indicate drug accumulation and an elevated risk for toxicity.

Fluoroquinolones

A class of drugs ending in "-floxacin" used for various infections; includes Ciprofloxacin and Levofloxacin.

Fluoroquinolone Black Box Warning

An FDA warning regarding the increased risk of tendinitis and tendon rupture.

Fluoroquinolone Fluid Intake

Patients should take these with at least $2,000\,mL$ of fluid per day to avoid crystalluria.

Sulfonamides

Drugs such as Sulfamethoxazole-trimethoprim (Bactrim) primarily used for UTIs and Staphylococcus infections.

Sulfonamide Synergism

The concept where two drugs like SMX and TMP work together ($1+1=3$) to achieve high concentrations in the kidneys.

Stevens-Johnson Syndrome (SJS)

A rare life-threatening reaction to sulfonamides involving flu-like symptoms followed by blisters and widespread peeling of the skin.

Hematologic Toxicity

Adverse effects on the blood including agranulocytosis, hemolytic anemia, and thrombocytopenia, requiring CBC monitoring.

Sulfa Cross-Sensitivity

Patients with a sulfa allergy may have a reaction to Celecoxib, which contains a sulfonamide component.

Sulfonamide Hypoglycemia Risk

Increased risk of low blood sugar when taking these drugs concurrently with sulfonylureas for diabetes.

Beta-Lactamase Inhibitors

Chemicals like clavulanate, sulbactam, and tazobactam that block enzymes from destroying penicillin molecules.

Epinephrine (Anaphylaxis Treatment)

A single-use injection administered into the middle of the outer thigh for 3 seconds to treat severe allergic reactions.

Penicillin Cross-Sensitivity

A history of severe or anaphylactic reaction to penicillin often precludes the use of cephalosporins or carbapenems.

Penicillin Fluid Restrictions

Take doses with water only; avoid citrus juices and caffeine-containing beverages which can interfere with the drug.

Cephalosporins

Drugs beginning with the prefix "Cef-" or "Ceph-"; they are chemically similar to penicillins.

Ceftaroline (Teflaro)

The only cephalosporin (5th generation) that is effective against MRSA.

Meningitis Cephalosporins

Third and fourth-generation cephalosporins like Ceftriaxone and Cefepime that can cross the blood-brain barrier.

Cephalosporin Disulfiram-like Reaction

Occurs when drugs like cefazolin or cefotetan are taken with alcohol, causing stomach cramps, vomiting, and hypotension.

Clindamycin Serious Risk

Carries a severe risk for inducing pseudomembranous colitis (C. diff infection).

Nitrofurantoin (Macrobid)

A first-line drug for UTIs that may cause a harmless dark yellow or brown discoloration of the urine.

Phenazopyridine (Pyridium)

A urinary tract analgesic used for pain and burning; it does NOT treat the underlying infection.

Phenazopyridine Urine Effect

This medication turns urine a bright red or orange color, which is a harmless side effect.

Linezolid (Zyvox)

A drug reserved for multidrug-resistant bacteria like Vancomycin-resistant enterococci (VRE) and MRSA.

Linezolid Tyramine Interaction

Eating aged cheese, pepperoni, or wine while on this drug can trigger a severe hypertensive reaction.

Oseltamivir (Tamiflu) Timing

Must be initiated within $2$ days of the onset of influenza symptoms to be effective.

Vitamin C (Ascorbic Acid) Benefit

A supplement essential for tissue repair that enhances the absorption of iron (ferrous sulfate).

Echinacea

An herbal supplement used topically for wounds or orally to stimulate the immune system against common colds.

Acyclovir

The drug of choice to suppress the replication of Herpes Simplex Virus Type I & II and Varicella-Zoster Virus.

Interferon Adverse Effects

Can cause severe depression, suicidal ideation, hepatotoxicity, and myelosuppression.

Ribavirin

A drug used in combination therapy for Hepatitis C that is classified as Pregnancy Category X.

HAART Goal

The primary goal of Highly Active Antiretroviral Therapy is to reduce HIV viral load to undetectable levels ($< 50\,copies/mL$).

Onychomycosis

A fungal infection of the nails that causes them to become thick and yellow.

-Azole Antifungals

Highly hepatotoxic drugs like Fluconazole that inhibit Cytochrome P450 enzymes, increasing the levels of other medications.

Vaginal Cream Teaching

Instruct patients to abstain from sexual intercourse and continue treatment even during menstruation.

Terbinafine (Lamisil) Oral Use

Used to treat onychomycosis; involves 3 to 6 months of treatment and carries a risk of liver failure.

Nystatin Oral suspension

Must be swished thoroughly around the mouth for several minutes to coat lesions before swallowing.

Amphotericin B

A drug reserved for life-threatening systemic fungal infections; it requires a test dose and slow IV infusion over 2 to 6 hours.

Amphotericin B Toxicities

Monitor for severe nephrotoxicity and hypokalemia ($< 3.5\,mEq/L$) which can cause cardiac dysrhythmias.

Cyclosporine

An immunosuppressant used to prevent organ transplant rejection by suppressing T-cells; it carries a risk of prominent tremors.

Cyclosporine Grapefruit Interaction

Grapefruit juice inhibits metabolism, increasing drug levels by $50\%$ to $200\%$ and raising toxicity risk.