Anti-infectives and Pharmacological Monitoring Lecture Notes

This set of vocabulary flashcards covers anti-infective classifications, specific drug classes (antibacterials, antivirals, antifungals), their mechanisms of action, major adverse effects, and nursing considerations.

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.

Bactericidal

A classification of antimicrobial action that causes the death of bacteria.

Bacteriostatic

A classification of antimicrobial action that inhibits the growth of bacteria.

Broad spectrum

Antibiotics that are active against a wide variety/number of bacterial types.

Narrow spectrum

Antibiotics that are active against a specific/few group of bacterial types.

Superinfections

A new infection that occurs because of antibiotic use and the destruction of normal flora, such as Thrush or Vaginal yeast infections.

Pseudomembranous colitis

An infection caused by $Clostridium\,difficile$ characterized by persistent or bloody diarrhea, fever, and abdominal pain, which may be fatal.

Empiric therapy

The administration of antibiotics to treat a likely cause of an infection before the specific bacteria is identified via culture.

Definitive therapy

The 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.

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.

Vancomycin

A glycopeptide antibiotic that binds to the bacterial cell wall resulting in death; used for serious gram-positive infections like MRSA (IV) and severe $C.\,difficile$ (PO).

Trough level

The lowest concentration of a drug in the blood, measured within $30\,min$ before the next dose; for Vancomycin, the optimal level is $10\text{ to }20\,\mu g/mL$.

Red Man Syndrome

A rate-dependent infusion reaction to Vancomycin caused by histamine release, resulting in flushing, erythema, pruritus of the upper body, hypotension, and tachycardia.

Metronidazole (Flagyl)

An antibiotic used for intraabdominal infections, trichomoniasis, and $C.\,difficile$ that interferes with bacterial DNA synthesis; must avoid alcohol 24 hours before and 36 hours after due to disulfiram-like reactions.

Macrolides

A class of antibiotics including Azithromycin, Clarithromycin, and Erythromycin that inhibit protein synthesis and may cause QT prolongation or hepatotoxicity.

Tetracyclines

Antibiotics that inhibit protein synthesis and bind to $Ca^{2+}$, $Mg^{2+}$, and $Al^{3+}$ ions; contraindicated in children under 8 and pregnancy due to tooth discoloration.

Aminoglycosides

Potent bactericidal antibiotics (e.g., Gentamicin, Tobramycin) used for serious gram-negative infections; known for serious toxicities including ototoxicity and nephrotoxicity.

Fluoroquinolones

Bactericidal antibiotics ending in "-floxacin" that alter bacterial DNA; carry an FDA black box warning for tendinitis and tendon rupture.

Sulfonamides

Bacteriostatic agents that prevent bacterial synthesis of folic acid; may cause Stevens-Johnson Syndrome, a rare but life-threatening skin reaction.

Penicillins

A class of $\beta$-lactam antibiotics that inhibit bacterial cell wall synthesis; the most common adverse effect is an allergic reaction or rash.

Cephalosporins

Bactericidal antibiotics chemically similar to penicillins, divided into five generations where gram-negative coverage increases with each generation.

Nitrofurantoin (Macrobid)

An antibiotic used for UTIs that can cause harmless dark yellow or brown urine and carries risks of pulmonary and liver toxicity.

Phenazopyridine

A urinary tract analgesic (not an antibiotic) used for pain relief from cystitis; it will turn urine red or orange.

Linezolid (Zyvox)

Used for multidrug-resistant gram-positive bacteria (VRE, MRSA); can cause serotonin syndrome if taken with SSRIs.

Acyclovir

The drug of choice for treating initial and recurrent episodes of Herpes simplex virus (HSV-1, 2) and Varicella-zoster virus (VZV).

HAART (Highly Active Antiretroviral Therapy)

An HIV treatment regimen including at least three medications to decrease drug resistance and reduce viral load to undetectable levels ($< 50\text{ copies/mL}$).

Amphotericin B

An IV polyene antifungal for life-threatening systemic infections; highly toxic, causing nephrotoxicity, hypokalemia ($K^+ < 3.5\,mEq/L$), and severe infusion reactions.

Cyclosporine

An immunosuppressant that inhibits T-cell activity to prevent organ transplant rejection; causes nephrotoxicity and its levels are significantly increased by grapefruit juice.