Antiinfective-Agents课件.ppt

《Antiinfective-Agents课件.ppt》由会员分享，可在线阅读，更多相关《Antiinfective-Agents课件.ppt（36页珍藏版）》请在淘文阁 - 分享文档赚钱的网站上搜索。

1、Antiinfective AgentsBy Jim ClarkeAerosolized Anti-infectivesn n2 occasionally used agentsPentamidine(NebuPent)Pentamidine(NebuPent)Ribavirin(Virazole)Ribavirin(Virazole)Indications for Pentamidinen nHistory of one or more episodes of PCPn nA low CD4 lymphocyte countRationale for Administrationn nAer

2、osol administration delivers drug to area of lung most likely to be affectedn nParenteral administration has numerous side effectsn nAerosol administration produces higher blood levels than parenteralDosing Issuesn nUse nebulizer designed for Pentam useShould produce particles in 1-2 micron Should p

3、roduce particles in 1-2 micron rangerangeShould have one-way valves directing Should have one-way valves directing exhalation through filterexhalation through filtern nGive tx in negative pressure booth or roomDosing Issuesn nPregnant or nursing mothers should avoid contactn nUse gloves,mask&eyewear

4、Ribavirinn nClassificationClassification Anti-viral agent that works against RSV Anti-viral agent that works against RSV(Respiratory Syncytial Virus),influenza&herpes(Respiratory Syncytial Virus),influenza&herpes simplexsimplexn nIndicationsIndications Given via inhalation to children suffering from

5、 RSVGiven via inhalation to children suffering from RSV Only given if patient has severe bronchiolitis with Only given if patient has severe bronchiolitis with moderate to severe hypoxemiamoderate to severe hypoxemiaDosing Issuesn nVirazole must be given with SPAG nebulizern nGenerally given via hea

6、d-hoodn nCan be given via ventilatorAerosolized Antibiotic Usen nIn Cystic FibrosisHas become a popular method for Has become a popular method for prevention of pneumonia prevention of pneumonia Prevents outbreaks of Prevents outbreaks of Pseudomnas Pseudomnas aeruginosa,Hemophilus influenzae&aerugi

7、nosa,Hemophilus influenzae&Staphylococcus aureusStaphylococcus aureusn nGentamicinGentamicinDefinitionsn nAntibiotic is a substance produced by microorganisms that is capable of inhibiting or killing bacteria and other microorganismsn n“Mode of Action”-how the antibiotic actually kills the targeted

8、microorganismsHow Antibiotics WorkInhibition of Cell Wall Synthesisn nThese antibiotics prevent normal cell wall formationn nExamples of these antibiotics;PenicillansPenicillansBacitracinBacitracinCephalosporinsCephalosporinsVancomycinVancomycinInhibition of Protein Synthesisn nPrevention of the rib

9、osomes ability to make necessary proteinsn nExamplesGentamicinGentamicinErthromycinErthromycinStreptomycinStreptomycinTetracyclinesTetracyclinesInhibition of Nucleic Acid Synthesisn nPrevents DNA replication or formation of messenger RNAn nExamplesCiproCiproTrimethoprimTrimethoprimSulfonamidesSulfon

10、amidesRifampinRifampinAntibiotic Sensitivity&Resistancen nSensitivity-measures how well the antibiotic inhibits or kills n nResistance-describes an organisms ability to inactivate the antibioticPenicillinsn nInhibit cell wall formationInhibit cell wall formationn nNumerous forms available-generic ag

11、ents Numerous forms available-generic agents always end with“cillin”always end with“cillin”n nNumerous strains of SNumerous strains of Staph.Aureus,E.coli,taph.Aureus,E.coli,Proteus and pseudomonas species are Proteus and pseudomonas species are resistant to penicillansresistant to penicillansn nNaf

12、cillan is now the only agent that generally Nafcillan is now the only agent that generally works on works on Staph.AureusStaph.Aureusn nPenicillans used to treat Penicillans used to treat Strep.,Strep.,some some Staph Staph and Haemophilus influenzae infectionsand Haemophilus influenzae infectionsCe

13、phalosporinsn nBroken into 3 categoriesFirst generation-active on gram+First generation-active on gram+organismsorganismsSecond generation-more active on gram-Second generation-more active on gram-organismorganismThird generation-variable against Third generation-variable against gram+;more active a

14、gainst gram-gram+;more active against gram-Aminoglycosidesn nAct by prevention of normal protein synthesisn nUsed to treat many gram-pneumoniasn nExamplesGentamicin,Tobramycin&AmikacinGentamicin,Tobramycin&Amikacinn nInhalation used in tx of Pseudomonas pneumonias in Cystic Fibrosisn nThese agents c

15、an be extremely nephrotoxicTetracyclinesn nAct by interfering with protein synthesisn nBroad spectrumn nUsed to treat atypical pneumoniasMycoplasma pneumoniaeMycoplasma pneumoniaen nCause GI irritation;nausea,diarrhean nShould not be used with children except for short periods-(tooth discoloration)F

16、luoroquinolonesn nBroad Spectrumn nInhibition of DNA synthesisn nUsed widely in COPD&Cystic FibrosisPseudomonas AeruginosaPseudomonas Aeruginosan nExamples;Cipro(Ciprofloxacin)Cipro(Ciprofloxacin)Noroxin(Norfloxacin_Noroxin(Norfloxacin_Sulfonamidesn nInhibit nucleic acid synthesisNot really an antib

17、iotic!Not really an antibiotic!n nUsed mainly to treat urinary&some intestinal infectionsn nTrimethoprim-Sulfamethoxazole combination used to treat Pneumocystis carinii pneumoniaMiscellaneous AntibioticsChloramphenicoln nVery rarely used due to chances of causing“aplastic anemia”n nOnly used in case

18、s of life-threatening infections resistant to other antibioticsFlagyln nUsed as an antiprotozoal agent to treat GI infections&most anaerobesNitrofurantoin(Furadantin)n nSynthetic agent(not a true antibiotic)n nBroad Spectrum agentn nUsed mainly in tx of urinary tract infectionsn nCan cause pulmonary

19、 side effectspleural effusions and infiltratespleural effusions and infiltratesAntifungal Agentsn nAmphotericin BHas Has severesevere toxic side effects-toxic side effects-nephrotoxicity;fever;decreased BPnephrotoxicity;fever;decreased BPCan cause metabolic acidosis!Can cause metabolic acidosis!n nNystatinTopical treatment for Topical treatment for Candida albicansCandida albicans infectionsinfectionsAnti-Tuberculosis DrugsEnd of this session