Identify the major pharmacological classes of anti-infective agents.

Assignment Overview
This discussion is based on the required textbook reading and ALL unit material. Please review these, before contributing to the discussion.

Alignment to Unit Student Learning Outcomes [USLOs]
Upon completing this assignment, you will be able to:

Recognize variables contributing to various infections.
Identify the major pharmacological classes of anti-infective agents.
Summarize mechanisms of action of the pharmacological classes and major prototypes of anti-infective agents.
Classify the major pharmacological indications of anti-infective agents.
Identify the side effects of each major prototype of anti-infective agents.
Explain adverse (toxic) reactions of each major prototype of anti-infective agents as applicable.
Recognize contraindications of each major prototype of anti-infective agents.
Recognize therapeutic considerations of each major prototype of anti-infective agents as applicable.
Drug Prototypes
Antibacterial Antiviral
Cell wall synthesis inhibitors:
Penicillin (pen-i-sill-in) (G, V, amoxicillin/clavulanic acid – penicillin/beta lactamase inhibitor), cephalosporin, vancomycin (van-koe-mye-sin)
Disruption of cell membrane:
Polymyxin B (pol-i-miks-in-bee)
Protein synthesis inhibitors:
Azithromycin (aye-zith-roe-mye-sin), doxycycline (dox-i-sye-kleen), gentamicin (jen-ta-mye-sin), clindamycin (klin-da-mye-sin)
Anti-metabolites:
Trimethoprim-sulfamethoxazole (trye-meth-oh-prim/sul-fa-meth-ox-a-zole)
Nucleic acid inhibitors
Ciprofloxacin (sip-roe-flox-a-sin), rifampin (rif-am-pin)
TB
Rifampin (rif-am-pin)
Isoniazid (eye-soe-nye-a-zid)
Oseltamivir (Tamiflu) (o-sel-tam-i-vir): viral release inhibitor/neuraminidase inhibitor
Acyclovir (ay-sye-kloe-veer): nucleoside (purine) analog
HAART therapy 3 drug cocktail (NRTI, integrase inhibitor)
Efavirenz (e-fav-e-renz): reverse transcriptase inhibitor
Raltegravir (ral-teg-ra-veer): integrase inhibitor
Miscellaneous Antifungal
Metronidazole (me-troe-ni-da-zole)
Membrane stability Inhibitors: amphotericin B (am-foe-ter-i-sin bee), nystatin (nye-stat-in)
Ergosterol inhibitors: fluconazole (floo-kon-a-zole)

Assignment Choose ONE of the following scenarios to discuss in paragraph form with no fewer than six sentences.

Scenario 1

You are assigned to care for a patient who was recently admitted to your unit with pneumonia and is ordered antibiotics. The physician starts with vancomycin to attack the bacteria.

What is the mechanism of action of this antibiotic? (USLO 9.2, 9.3)
What side effects and adverse reactions will you be monitoring for a while the patient is taking this medication? (USLO 9.5, 9.6)
What are the contraindications? (USLO 9.7)
Your patient is being discharged home on this medication. What is included in the patient teaching? (USLO 9.8)
Patients taking antibiotics are also at risk for superinfection. Describe what this is, how it is manifested, and preventative measures. (USLO 9.1, 9.3, 9.6, 9.8)
Scenario 2

M.H is readmitted to the hospital after five days at home with no improvement of his infection. The physician decides to order an aminoglycoside (gentamicin).

Explain why aminoglycosides are administered for serious infection, not as a first choice for treating infection. (USLO 9.3, 9.4)
When completing your initial assessment and patient history what would be concerning to you? (USLO 9.4, 9.8)
What side effects and adverse reactions will you be monitoring while the patient is taking an aminoglycoside? (USLO 9.5, 9.6)
What are the contraindications of aminoglycosides? (USLO 9.7)
What patient population would be administered aminoglycosides with extreme caution? Explain your answer. (USLO 9.6, 9.7, 9.8)
Scenario 3

You are assigned a patient who is complaining of painful urination, frequency, and urgency. The physician orders a sulfonamide, trimethoprim-sulfamethoxazole.

What is the mechanism of action of this antibiotic? (USLO 9.2, 9.3)
What are the side effects and adverse reactions of sulfonamides? (USLO 9.5, 9.6)
What are the contraindications? (USLO 9.7)
What teaching must be included when the patient is taking sulfonamides? (USLO 9.2,9.3,9.4)
Scenario 4

M.R has been prescribed Amphotericin B for a systemic fungal infection.

How are systemic fungal infections different from cutaneous infections? What are common examples of each? (USLO 9.1)
What is the mechanism of action of Amphotericin B? Why aren’t antibiotics prescribed? (USLO 9.3, 9.4)
What are the side effects/adverse reactions/contraindications of Amphotericin B? (USLO 9.5, 9.6, 9.7)
What are opportunistic infections and how are they pertinent here? (USLO 9.1, 9.6)