Anti-Inflammatory Drugs
Anti-Inflammatory Medications
o Aspirin
o Nonsteroidal anti-inflammatory drugs
o Corticosteroids
o Used when inflammatory response is appropriate, abnormal, or persistent or in the presence
of tissue destruction
o Inflammation resulting from infectious processes treated with antimicrobial drugs (which
help treat infections caused by pathogens)
Types of Inflammation
o Acute inflammation
o Immediate response to injury of local tissues
▪ Three stages:
• Vascular stage:
o Vasoconstriction of small blood vessels at site of injury
o Vasodilation of capillaries and venules to increase
capillary blood flow, increasing temperature and redness
at the site (Stays very local)
o Increased protein exudates into extravascular spaces
• Cellular stage:
o Influx of leukocytes to injury site
o Slowing of flood flow and adhesion of leukocytes to wall
of blood vessels
o Migrate from vascular space to extravascular tissue
• Opsonization:
o Phagocytosis
o Inflammation occurs that makes antigens more susceptible
to macrophages and leukocytes -> increases phagocytic
activity
o Clinical manifestations:
▪ Pain, redness, swelling, breaks in skin – drainage, viral or bacterial infection
– fever and general malaise (aches and pains)
Page 1 of 16
, o Chronic Inflammation:
o Nonspecific – diffuse accumulation of macrophages and lymphocytes in area of
tissue destruction -> fibroblast proliferation and scarring
▪ May result in decreased mobility of function
o Granulomatous chronic inflammation – granulomas composed of macrophages
surrounded by lymphocytes
▪ Develop foreign bodies that have not been controlled by acute
inflammatory process
Infection
o Occurs when microorganisms invade a host, attach to cell receptors, and multiple -> injury
o Stimulates immune response
o Microorganisms that cause infectious disease include bacteria, viruses, fungi, and parasites.
o Antimicrobial drugs treat infections that might cause significant injury and harm to
the host
▪ Antibiotics treat bacterial infections
Normal Flora
o Colonization is the presence and growth of microorganisms
o Sterile areas that do not communicate directly with outside include organs like the heart,
liver, musculoskeletal system, and bodily fluids (urine)
o Normal flora populates skin, upper respiratory tract, and colon
o Protects host through various mechanisms
o Can become pathogenic, particularly if go outside normal environment
Host Defense Mechanisms
o Factors that
impair:
o Breaks in skin and mucous membranes
o Impaired blood supply
o Neutropenia and other blood disorders
o Malnutrition
o Poor personal hygiene
Page 2 of 16
, o Suppression of normal bacteria flora by antimicrobial drugs
o Suppression of immune system and inflammatory response
o Diabetes mellitus and other chronic diseases
o Advanced age
Acquired Infections
o Community-acquired: originate in community setting outside a health care facility
o Hospital-acquired: originate from microorganisms in hospitals and other health care facilities
o Health care-associated pneumonia: acquired from other facilities, such as nursing homes
o Higher risk of developing multi-drug resistant organisms
Antibiotic-Resistant Organisms
o Ability of certain bacteria to survive and multiple despite antibiotic therapy
o Higher rates in lower respiratory tract infections and those infections associated
with cystic fibrosis or osteomyelitis
o Antibiotic overuse can contribute to resistance
o Infectious disease specialists and laboratory personnel are helpful resources to
identify resistance patterns and trends
Drug Therapy
o Anti-infective: agents with antibacterial, antiviral, and antifungal properties
o Antibacterial: agents that kill bacteria (bactericidal) or inhibit growth and
replication (bacteriostatic)
▪ Broad-spectrum: effective against a wide-range of bacteria
• More likely to kill normal flora, putting patient at higher risk
for opportunistic infection
▪ Narrow-spectrum: effective against limited range or specific type of bacteria
• Preferred when possible
o Guidelines to promote more appropriate use of antimicrobial drugs:
o Avoid use in viral infections
o Give only when significant bacterial infection
o Use narrow-spectrum drug whenever possible
o Collect culture and sensitivity before 1st dose of antibiotic
o Minimize for fever unless other indications of infections
o Follow CDC recommendations for prevention and treatment of infections
o Consult infectious disease healthcare providers about local patterns of drug-
resistant organisms and treatment of complicated infections
C&S Studies
o Culture: identifies causative microorganisms
o Sensitivity: determines which drugs are more likely to be effective against an organism
o Since takes 48-72 hours: often initiates treatment with antimicrobial drug that is likely to
be effective
o Empiric therapy: informed estimate of the most likely pathogens given the
patient’s signs and symptoms and site of infection along with knowledge of
communicable diseases currently infecting other people in community
Page 3 of 16
Anti-Inflammatory Medications
o Aspirin
o Nonsteroidal anti-inflammatory drugs
o Corticosteroids
o Used when inflammatory response is appropriate, abnormal, or persistent or in the presence
of tissue destruction
o Inflammation resulting from infectious processes treated with antimicrobial drugs (which
help treat infections caused by pathogens)
Types of Inflammation
o Acute inflammation
o Immediate response to injury of local tissues
▪ Three stages:
• Vascular stage:
o Vasoconstriction of small blood vessels at site of injury
o Vasodilation of capillaries and venules to increase
capillary blood flow, increasing temperature and redness
at the site (Stays very local)
o Increased protein exudates into extravascular spaces
• Cellular stage:
o Influx of leukocytes to injury site
o Slowing of flood flow and adhesion of leukocytes to wall
of blood vessels
o Migrate from vascular space to extravascular tissue
• Opsonization:
o Phagocytosis
o Inflammation occurs that makes antigens more susceptible
to macrophages and leukocytes -> increases phagocytic
activity
o Clinical manifestations:
▪ Pain, redness, swelling, breaks in skin – drainage, viral or bacterial infection
– fever and general malaise (aches and pains)
Page 1 of 16
, o Chronic Inflammation:
o Nonspecific – diffuse accumulation of macrophages and lymphocytes in area of
tissue destruction -> fibroblast proliferation and scarring
▪ May result in decreased mobility of function
o Granulomatous chronic inflammation – granulomas composed of macrophages
surrounded by lymphocytes
▪ Develop foreign bodies that have not been controlled by acute
inflammatory process
Infection
o Occurs when microorganisms invade a host, attach to cell receptors, and multiple -> injury
o Stimulates immune response
o Microorganisms that cause infectious disease include bacteria, viruses, fungi, and parasites.
o Antimicrobial drugs treat infections that might cause significant injury and harm to
the host
▪ Antibiotics treat bacterial infections
Normal Flora
o Colonization is the presence and growth of microorganisms
o Sterile areas that do not communicate directly with outside include organs like the heart,
liver, musculoskeletal system, and bodily fluids (urine)
o Normal flora populates skin, upper respiratory tract, and colon
o Protects host through various mechanisms
o Can become pathogenic, particularly if go outside normal environment
Host Defense Mechanisms
o Factors that
impair:
o Breaks in skin and mucous membranes
o Impaired blood supply
o Neutropenia and other blood disorders
o Malnutrition
o Poor personal hygiene
Page 2 of 16
, o Suppression of normal bacteria flora by antimicrobial drugs
o Suppression of immune system and inflammatory response
o Diabetes mellitus and other chronic diseases
o Advanced age
Acquired Infections
o Community-acquired: originate in community setting outside a health care facility
o Hospital-acquired: originate from microorganisms in hospitals and other health care facilities
o Health care-associated pneumonia: acquired from other facilities, such as nursing homes
o Higher risk of developing multi-drug resistant organisms
Antibiotic-Resistant Organisms
o Ability of certain bacteria to survive and multiple despite antibiotic therapy
o Higher rates in lower respiratory tract infections and those infections associated
with cystic fibrosis or osteomyelitis
o Antibiotic overuse can contribute to resistance
o Infectious disease specialists and laboratory personnel are helpful resources to
identify resistance patterns and trends
Drug Therapy
o Anti-infective: agents with antibacterial, antiviral, and antifungal properties
o Antibacterial: agents that kill bacteria (bactericidal) or inhibit growth and
replication (bacteriostatic)
▪ Broad-spectrum: effective against a wide-range of bacteria
• More likely to kill normal flora, putting patient at higher risk
for opportunistic infection
▪ Narrow-spectrum: effective against limited range or specific type of bacteria
• Preferred when possible
o Guidelines to promote more appropriate use of antimicrobial drugs:
o Avoid use in viral infections
o Give only when significant bacterial infection
o Use narrow-spectrum drug whenever possible
o Collect culture and sensitivity before 1st dose of antibiotic
o Minimize for fever unless other indications of infections
o Follow CDC recommendations for prevention and treatment of infections
o Consult infectious disease healthcare providers about local patterns of drug-
resistant organisms and treatment of complicated infections
C&S Studies
o Culture: identifies causative microorganisms
o Sensitivity: determines which drugs are more likely to be effective against an organism
o Since takes 48-72 hours: often initiates treatment with antimicrobial drug that is likely to
be effective
o Empiric therapy: informed estimate of the most likely pathogens given the
patient’s signs and symptoms and site of infection along with knowledge of
communicable diseases currently infecting other people in community
Page 3 of 16
