Download - ANTIMICROBIAL THERAPY
![Page 1: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/1.jpg)
1
ANTIMICROBIAL THERAPYCHAPTER 13
![Page 2: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/2.jpg)
2
Chemotherapeutic Agents
Antibiotics: bacteriocidal vs bacteriostatic
Synthetic Drugs vs natural product
![Page 3: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/3.jpg)
3
History
Ancient remedies
Ehrlich
Domagk
Fleming
![Page 4: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/4.jpg)
4
Properties of Antimicrobial Agents
Selective Toxicity
Spectrum of Activity– Narrow
– Broad
![Page 5: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/5.jpg)
5
Spectrum of Activity
![Page 6: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/6.jpg)
6
Drug Mechanisms of Action
Inhibition of Cell Wall Synthesis
Disruption of Cell Membrane Function
![Page 7: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/7.jpg)
7
Drug Mechanisms of Action
Inhibition of Protein Synthesis
Inhibition of Nucleic Acid Synthesis
Antimetabolites
![Page 8: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/8.jpg)
8
Summary of Targets
![Page 9: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/9.jpg)
9
Side Effects
Toxicity
Allergy
Disruption of Microflora
![Page 10: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/10.jpg)
10
Classes of antibiotics Aminoglycosides Tetracyclines Sulfonamides Quinolones Polypeptides B-lactams Macrolides Glycopeptides Cephalosporins
![Page 11: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/11.jpg)
11
aminoglycosides
kanamycin, neomycin, amikacin
Binds 30 S ribosome
![Page 12: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/12.jpg)
12
tetracyclines
Tetracycline, Doxycycline
Binds 30 S ribosome
![Page 13: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/13.jpg)
13
sulfanamides
Sulfacetamide
Trimethoprim
Sulfamethizole
Folate synthesis inhibition. They are competitive inhibitors of the enzyme
![Page 14: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/14.jpg)
14
B-lactams
AmoxicillinCarbenicillinPenicillinAmpicillin
disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
![Page 15: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/15.jpg)
15
quinolones
inhibit the bacterial DNA gyrase or the topoisomerase IV enzyme
![Page 16: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/16.jpg)
16
polypeptides
bacitracin
Polymyxin B
Inhibits isoprenyl pyrophosphate
Interacts with the bacterial cytoplasmic membrane, changing its permeability.
![Page 17: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/17.jpg)
17
macrolides
Azithromycin
Clarithromycin
Spectinomycin
Erythromycin
Binds to 50s ribosome
![Page 18: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/18.jpg)
18
Glycopeptides
Vancomycin- last resort drug
inhibiting peptidoglycan synthesis
![Page 19: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/19.jpg)
19
cephalosporins
CefaclorCefalexinCeftobiproleCefotaxime
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
![Page 20: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/20.jpg)
20
Resistance to Drugs
Chromosomal - Klebsiella B lactamases
Plasmid borne - ribosomal protein mutations
![Page 21: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/21.jpg)
21
Mechanisms of Drug Resistance
Mutations in Target molecules
Alterations in membrane permeability
Enzyme development
![Page 22: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/22.jpg)
22
Fig. 27-27
PhosphorylationAdenylation
Streptomycin
Chloramphenicol
-Lactamase
Penicillin
Acetylation
![Page 23: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/23.jpg)
23
Table 27-7
![Page 24: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/24.jpg)
24
Mechanisms of Drug Resistance
Enzyme Activity Changes
Alterations in Anabolic Pathways
![Page 25: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/25.jpg)
25
Generations of Drugs
First/Second/Third Line Drugs
Cross Resistance
![Page 26: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/26.jpg)
26
![Page 27: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/27.jpg)
27
Limiting Drug Resistance
Effective Drug Concentrations
Simultaneous Drug Administration• Synergism - clavulanic acid• Antagonism -
Restricting Drug Prescriptions
![Page 28: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/28.jpg)
28
Determining Microbial Sensitivities
Disk Diffusion Method
Dilution Method
Serum Killing Power
Automated Methods
![Page 29: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/29.jpg)
29
Ideal Antimicrobial Attributes
Solubility
Selective toxicity
Stable toxicity level
Allergenicity
Tissue stability
Resistance Acquisition
Shelf Life
Cost
![Page 30: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/30.jpg)
30
Antibacterials — Cell Wall Target Penicillins
![Page 31: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/31.jpg)
31
Antibacterials — Cell Wall Target
Cephalosporins
Carbapenems
![Page 32: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/32.jpg)
32
Antibacterials — Cell Membrane Target
Polymyxins
![Page 33: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/33.jpg)
33
Antibacterials — Protein Synthesis Inhibition
Aminoglycosides
Tetracyclines
Chloramphenicol
Macrolides
Insert Fig. 13.13
![Page 34: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/34.jpg)
34
Antibacterials — Nucleic Acid Synthesis Inhibition
Rifampin
Quinolones
![Page 35: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/35.jpg)
35
Antibacterials — Antimetabolites
Sulfonamides
Isoniazid
Ethambutol
Nitrofurans
![Page 36: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/36.jpg)
36
Antifungals
Imidazoles
Polyenes
Griseofulvin
![Page 37: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/37.jpg)
37
Antifungals
Flucytosine
Tolnaftate
Terbinafine
![Page 38: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/38.jpg)
38
Antivirals
Nucleotide analogs
![Page 39: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/39.jpg)
39
Antivirals
Amantidine/Rimantidine
Interferons/Immunoenhancers
![Page 40: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/40.jpg)
40
Antiprotozoan Drugs
Quinine/derivatives
Metronidazole
Pyrimethamine
Suramin
![Page 41: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/41.jpg)
41
Antihelminthic Drugs
Niclosamide
Mebendazole
Ivermectin
![Page 42: ANTIMICROBIAL THERAPY](https://reader034.vdocument.in/reader034/viewer/2022051219/56816341550346895dd3d25b/html5/thumbnails/42.jpg)
42
Special Drug Resistance Problems