Lecture 10: Infection 7

Lecture 10: Infection 7 Synergy · synergy: the interaction of two or more drugs when their combined effect is greater than the sum of the effects seen when each drug is given alone ↳ higher efficacy · synergy can lead to lower individual drug dosing (within recommended range) ↳ decreased risk or severity of side effects · analgesia: opioids & NSAIDS/Tylenol · inflammation: antihistamines & glucocorticoids · infection: bactericidal & bacteriostatic (eg. cefazolin & gentamicin) Ebola · viral infection · cytokine storm, DIC, hypoperfusion, organ failure ↳ so much inflammation (cytokine storm) it destroys the patient · pathogenicity: virus enters body through infected bodily fluids, attacks WBC throughout the body, forms blood clots that lower platelets and lead to DIC, crazy inflammation cytokine storm, vascular and organ damage can lead to death from organ failure HIV (human immunodeficiency virus) · a retrovirus, contagious, spread by bodily fluids · destroys T-lymphocytes: helper T-cells (CD4 specific) · seroconversion: infected patient test positive (serum antibodies present in high enough numbers to test positive) up to 6 months post exposure ↳ "window" period: infectious period prior to the original infected person knowing (6 months) · HIV binds to CD4 receptor (docking), fusion, transcription, integration, replication, and then HIV is secreted by CD4 helper T cell · Signs & symptoms: initially asymptomatic, then pharyngitis, lymphadenopathy, headache, rash, declining T cells · AIDS (acquired immunodeficiency syndrome) ↳ extremely low T-cells ↳ high risk for other opportunistic infections · treatment: focuses on interrupting replication steps (transcriptase inhibitors or integration inhibitors) ↳ decreases disease progression NOT curative ↳ ART (antiretroviral therapy) → post exposure prophylaxis Antifungals · MOA: increase cell membrane permeability · polyene antifungals: ↳ drugs: Nystatin (PO, cream); Amphotericin (IV) · azole antifungals ↳ drugs: fluconazole, Ketonazole, bifonazole (canesten) · allylamine antifungals ↳ drugs: Lamisil (terbinafine) Syphillis · STI spread by sexual contact · bacteria: Treponema pallidum · stages: ① Primary - painless chancre at area of contact (highly infectious) ② Secondary - rash on palms and soles + other symptoms ③ Tertiary (untreated disease) - multi & variable organ lesions + organ failure · diagnosis: serum antibody test · treatment: bugs and drugs UTI (urinary tract infection) · signs & symptoms: frequent urination, burning/pain on urination (dysuria), cloudy urine ↳ risk of upper UTI is glomerulonephritis · treatment: based on pathogen · diagnosis: urine culture Cranberry Juice · cranberries are composed of water (88%), organic acids like salicylate, fructose, and antioxidants · cranberry juice can act as a preventative treatment for UTI's if taken in high amounts daily ↳ inhibits the adhesion of E. coli to host cells by binding to the fimbrial tips * Glomerulonephritis · caused by untreated UTI · the glomerulus is what makes urine, so inflammation of the glomerulus can lead to the inability to make urine (acute renal failure) · glomerulonephritis is not always caused by UTI's * Traveller's Diarrhea /E. coli Infection · can cause glomerulonephritis · can also cause complete failure of the Kidneys (hemolytic uremic syndrome) · G- pathogens → GI symptomology ↳ 50% are bacterial: e. coli, Klebsiella, Salmonella, Shigella + carbapenems + lincosamides Sulfonamides · inhibits nucleic acid synthesis/decreases metabolite synthesis · sulfa- prefix · drugs: Sulfamethoxazole; T-sulfamethoxazole (aka co-trimoxazole, TMP, SMX (Bactrim, Septra) · Efficacy: UTI's (common allergy tho) Fluoroquinolones · -xacin suffix · drugs: Ciprofloxacin, levofloxacin, norfloxacin · efficacy: UTI, GI infections * + fluoroquinolones + nitroimidazoles * + sulfonamides Nitroimidazoles · drug: metronidazole (Flagyl) · efficacy: C. difficile, H. pylori, Prophylaxis (eg. dental)