Class 3: Anti-infectives

What type of cells come from myeloid progenitor cells

eosinophils
basophils
monocytes/macrophages
neutrophils

What type of cells come from lymphoid progenitor cell

T cell
B cell
NK cell

Neutrophils

Up to 65% of WBC
1st to site of tissue damage
live up to 1 week

What is the name for immature neutrophils

Band cells

Lymphocytes

NK cells, B cells, T cells
Innate and memory

Monocytes

Mature into macrophages
Specific to tissues

Eosinophils

Allergy response
Release enzymes/chemical mediators
Destroy allergens and parasites

Basophils

Allergy response
Proinflammatory and anticoagulating

Causes of decreased WBC numbers

Autoimmune diseases
Chronic infections
Cancer
Immunodeficiency
Drug therapy

Autoimmune diseases and decreased WBC

Systemic inflammation decreases synthesis and proliferation
Depletion due to chronic requirements

Chronic infections and decreased WBC

Depletion d/t chronic requirements

Cancer and decrease WBC

Destruction of production organs
Interference with maturation of normal WBCs

Immunodeficiency and decreased WBC

Inborn errors
-DiGeorge syndrome: malformed thymus

Drug therapy and decreased WBC

Glucocorticoids
Cytotoxic agents (chemo drugs and immunosuppresants)

Body defences

Physical
Immune system
Pro-inflammatory chemical mediators
Fever

Pathogenicity

Organisms ability to evade or overcome body defences

Pathogen mechanisms

Strength in numbers
Toxin production

How to prevent an infection

WASH HANDS

Steps to ID infection

1) where is the illness
2)what is causing the illness
3) abx tx process

Viral infections

More contagious
E.g covid, influenza, common cold, laryngitis

Viral infection tx

Immunization

Bacterial infections

Less contagious
Strep throat, pneumonia
Common pathogens: TB, E coli, enterococci, s. aureus, acinetobacter

TX of bacterial infections

Abx
resistance is increasing

Botulism

G+ anaerobic neurotoxin
Blocks Ach

Tx of botulism

Antitoxin HBAT

Prevention of botulism

preservatives
-sodium = potassium nitrate salt
-nitrat/nitrates

Gram - infections

E coli
Klebsiella
Psuedomonas
Salmonella
Hib
Cholera
Syphillis
Gonorrhea
Nisseria M.

Gram + infections

Staphylococci
Streptococci
Enterococci
Listeria
C-Diff

Antibiotic empiric tx

Based on suspected bacteria
Start ASAO
drug must reach target

Antibiotic focal tx

C&S results = focused tx
Tx starts once results are known
Narrow spectrum abx
No abx if viral

Streptococcus pyogenes

Group a strep/pharyngitis (sore throat)
Incubation 2-4 days, highly infectious

S. pyogenes S&S

Fever
Sore throat
Headache
Malaise
Glomerulonephritis
Endocarditis

What other infections can s. pyogenes cause

Meningitis
Pneumonia
Cellulitis, Fasciitis
Septic arthritis
Bacteremia
Sepsis

What drugs inhibit cell wall synthesis

Penicillins
Cephalosporins
Bacitracin
Vancomycin

What drugs inhibit protein synthesis

Chloramphenicol
Erythromycin
Tetracyclines
Streptomycin

What drugs inhibit nucleic acid

Quinolones
Rifampin

What drugs inhibit antimetabolites

Sulfanilamide
Trimethoprim

Beta-lactam antibiotics

Penicillins
Cephalosporins
Carbapenems

Penicillins

illin suffix
Efficacy for G+ and G- bacteria
Narrow-broad spectrum
ALLERGY*

Treatment of pharyngitis with penicillin

Penicillin V, PO

TX of ottitis media with penicillin

Amoxicillin, PO

Clavulanic acid and tazobactam are what kind of drugs

B-lactamase inhibitors

Augmentin

Amoxicillin and clavulanic acid
co-amoxiclav

Timentin

Ticarcillin and clavulanic acid
co-ticarclav

Pip Taz

Pipercillin/Tazobactam
Tazosin, Zosyn
Broad spectrum

Cephalosporins

Cef prefix
Largest abx class

1st choice cephalosporins for skin infections

Cefazolin (Ancef), IV
Cephalexin (keflex), PO
Cefuroxime

Cephalosporins that cross BBB

3-5th generations
Ceftriaxone
Ceftazidime
Ceftaroline
Efficacy for bacterial meningitis and resistant bacterial infections

Carbapenems

Penem suffix
Potent, IV
Not 1st line meds

Carbapenem meds

Imipenem
Meropenem

What are carbapenems efficacious for

Broad spectrum
Serious and mixed infections
-meningitis
-aspiration pneumonia

Bacitracin med

Polysporin

Efficacy for bacitracin

Gram +
Broad spectrum
Topical, opthalmic, ear preparations

What does bacitracin treat?

Conjunctivitis
Skin/soft tissue topical infections
Prophylactic

Vancomycin drug class

Glycopeptides

What does vancomycin treat

1st choice: MRSA
2nd choice: c diff

Macrolides suffix

Mycin

Macrolide efficacy

Community acquired adult pneumonia
Gonorrhea combined w cephalosporin

Macrolide meds

Erythromycin
Azithromycin (zithromac)
Clarithromycin (biaxin)

Tetracyclines

ycline suffix
G+ and -T

Tetracycline meds

Tetracycline
Doxycycline
Monocycline

S/E of tetracyclines

Bone deformations
Teeth yellowing

Aminoglycoside meds

Gentamicin
Streptomycin
Neomycin
Tobramycin

Aminoglycosides

Potent
Narrow TI: Serum levels completedE

What do aminoglycosides treat

Higher risk infections
Tobramycin eye drops - bacterial conjunctivitis

S/E of aminoglycosides

Cytotoxic

Lincosamides

Clindamycin
Surgical prophylaxis

Fluoroquinolones

xacin suffix
gram - infections

Fluoroquinolone medications

Ciprofloxacin
Levofloxacin
Norfloxacin

What do fluoroquinolones treat

GI infections
UTIN

Nitromidazoles

Efficacy:
C diff (first choice)
H pylori
Prophylaxis

Nitroimidazole meds

Metronidazole (flagyl)

Sulfonamides

Sulfa prefix
Inhibit folic acid synthesis = inhibiting cellular fx

Sulfonamide meds

Sulfamethaoxazole
T-sulfamethozaxole (TMP/SMX, Bactrim, Septra)

What do sulfonamides treat

UTI

General ABX side effects

GI - diarrhea, abdominal pain, nausea
Superinfection w broader spectrums
Drug-drug interactions
Allergy !!

Polyene fungal abx

Fungal infections (cryptococcus and candida, aspergillus)
Increase cell membrane permeability

Polyene fungal abx

Amphotericin B - 1st choice of therapy, IV
Nystatin - Candida (skin, GI infections), PO

TB confirmation

Contagious!
- Sputum culture
- chest xray

TB Tx

6-12 mths
Synergy:
-rifampin (DNA inhibition)
-isoniazid (cell wall synthesis inhibition)
+ more anti-TB meds

Viruses

Non living
protein coated
parasitic nature
mutation is frequent
target is inside human cells

Key attributes of ebola

Cytokine storm
hemorrhage
organ failure

HIV tx

PEP - post exposure prophylaxis
Triple therapy x 28 days

Herpes virus simplex 2 tx

Acyclovir, PO/IV/cream

Herpes virus-5 (CMV) tx

Ganciclovir

Influenza tx

Tamiflu
Amantadine