treatment of respiratory tract infections
DESCRIPTION
Treatment of Respiratory Tract infections. Prof. Azza EL-Medany. Objectives of the lecture. At the end of lecture , the students should be able to understand the following: Types of respiratory tract infections Antibiotics commonly used to treat respiratory tract infections and their - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/1.jpg)
Treatment of Respiratory Tract
infections
![Page 2: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/2.jpg)
Prof.
Azza EL-Medany
![Page 3: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/3.jpg)
Objectives of the lectureAt the end of lecture , the students
should be able to understand the following:
Types of respiratory tract infectionsAntibiotics commonly used to treat respiratory tract infections and their side effects. Understand the mechanism of action,
pharmacokinetics of individual drugs.
![Page 4: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/4.jpg)
Classification of respiratory tract
infectionsUpper respiratory tract
infections (URTI’s)
Lower respiratory tract infections (LRTI’s)
![Page 5: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/5.jpg)
![Page 6: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/6.jpg)
LRTI’s URTI’s•Bronchitis Acute, Chronic, Acute exacerbation of chronic bronchitis •Pneumonia Community -acquired Hospital-acquired
RhinitisSinus infectionPharyngitis/tonsilitisLaryngitis
Bacteria mainly:S. pneumoniaH. influenzaM. catarrhalis
VirusesBacteria , mainly Group A streptococcus & H. influenzae
Causes
Broad- spectrum penicillins Amoxicillin, AmpicillinCephalosporinsMacrolidesFlouroquinolones
Antibiotics ( Bacteria)Decongestants,eg:pseudoephedrineAlternative medicine,eg:Vit c, Plenty of fluids, analgesics
Treatment
![Page 7: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/7.jpg)
Penicillins
![Page 8: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/8.jpg)
Mechanism of action of penicillins
Inhibits bacterial cell wall synthesis
Bactericidal
![Page 9: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/9.jpg)
Broad spectrum penicillinsAmoxicillinAmpicillin Acts on both gram –positive & gram-
negative microorganisms
Sensitive to β-lactamase enzyme
![Page 10: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/10.jpg)
PharmacokineticsGiven orally or parentrallyNot metabolized in human.Relatively lipid insoluble.Excreted mostly unchanged in urine.Half-life 30-60 min ( increased in renal failure).
![Page 11: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/11.jpg)
![Page 12: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/12.jpg)
Therapeutic usesUpper respiratory tract infections,
especially those produced by Group A gram positive beta-hemolytic streptococci.
Lower respiratory tract infections
![Page 13: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/13.jpg)
β-Lactamase inhibitors Clavulanic acid Sulbactam
Themselves have no antibacterial activity.
They inactivate β-lactamase enzyme
e.g. Amoxicillin/clavulanic acid (augmentin)
Ampicillin/ sulbactam
![Page 14: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/14.jpg)
Cephalosprins
![Page 15: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/15.jpg)
Mechanism of action of Cephalosporins
Inhibit bacterial cell wall synthesis
Bactericidal
![Page 16: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/16.jpg)
2nd Generation Cephalosporins
Cefuroxime axetil, cefaclorEffective mainly against Gram-
negative bacteria.Well absorbed orallyActive against β-lactamase –
producing bacteria
![Page 17: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/17.jpg)
3rd Generation Cephalosporins
Ceftriaxone / Cefotaxime
Have enhanced activity against gram-negative bacilli
Given by intravenous routeEffective treatment in
pneumonia produced by β-lactamase producing bacteria
![Page 18: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/18.jpg)
Pharmacokinetics of cephalosporins
Given parenterally or orally
Relatively lipid insoluble
Excreted Mostly unchanged in the urine. Half-life 30-90 min (increased in renal failure)
![Page 19: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/19.jpg)
Adverse effects of cephalosporins
![Page 20: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/20.jpg)
![Page 21: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/21.jpg)
![Page 22: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/22.jpg)
Mechanism of actionInhibit protein synthesis by binding to 50 S subunit of the bacterial ribosomes
Bacteriostatic Bacteriocidal at high concentration
![Page 23: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/23.jpg)
ClarithromycinMore effective on G+ bacteria. Stable at gastric acidity Inhibits cytochrome P450 system Metabolized to active metabolite Excreted in urine 20-40% unchanged or
metabolite Bile approx. 60% Half-life 4-5 hours
![Page 24: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/24.jpg)
Azithromycin
More effective on G- bacteria.
Stable at gastric acidity Undergo some hepatic metabolism
( inactive metabolite ) Biliary route is the major route of
elimination Only 10-15% excreted unchanged in the
urine Half- life ( 3 days) Once daily dosing
No effect on cytochrome P- 450
![Page 25: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/25.jpg)
Adverse effects
![Page 26: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/26.jpg)
![Page 27: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/27.jpg)
![Page 28: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/28.jpg)
Mechanism of action
Inhibit DNA synthesis by inhibiting DNA Gyrase enzyme
![Page 29: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/29.jpg)
CIPROFLOXACIN Antibacterial spectrum
Mainly effective against G – bacteria
![Page 30: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/30.jpg)
Pharmacokinetics
Well absorbed orally ( available i.v ) Di & tri- valent cations interfere with its
absorption Concentrates in many tissues, esp. kidney,
prostate, lung & bones/ joints Does not cross BBB Excreted mainly through the kidney Half-life 3.3 hrs
![Page 31: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/31.jpg)
Adverse effects of fluoroquinolones
Nausea , vomiting & diarrheaCNS effects ( confusion, insomnia, headache, dizziness & anxiety).Damage growing cartilage (arthropathy)Phototoxicity
![Page 32: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/32.jpg)
Contraindications
Is preferably avoided in adolescents (under 18 years because of arthropathy)
Pregnancy/lactation
![Page 33: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/33.jpg)
Clinical Uses
![Page 34: Treatment of Respiratory Tract infections](https://reader033.vdocument.in/reader033/viewer/2022051020/5681660b550346895dd945b3/html5/thumbnails/34.jpg)
THANK YOU