THIS CLASS IS IN BRIEF FOR UNDERGRADUATE UNDERSTANDING AND EXAMINATION PURPOSE

1. Dr. RAGHU PRASADA M S
MBBS,MD
ASSISTANT PROFESSOR
DEPT. OF PHARMACOLOGY
SSIMS & RC.

4. Cause of disease
Means
Invasiveness
Toxigenesis
Stages
Colonization
Adherence
Nonspecific (dock)
Specific (anchor)
Invasion
Enzymes and Toxins

5. Natural Source-Fungal molds-Actinomycetes , Bacteria Bacillus,
Chemotherapeutic- Chemical
Semi-synthetic-Hybrid

8. Those that inhibit cell wall synthesis:
Isoniazid; pyrizinamide: Mycolic acid synthesis inhibitors
Ethambutol: Inhibits MA incorporation to cell wall
Those that affect nucleic acid metabolism:
Rifampin; rifabutin: DNA dependent RNA polymerase
inhibitors
Clofazimine: Binds to DNA and inhibits the template function
of DNA
Those that inhibits intermediary metabolism:
Dapsone; sulfoxone: The same as that of sulfonamides.

9. Aminoglycosides
β-lactams
-Penicillins
-Cephalosporins
-Carbapenams
-Monobactams
-Fluoroquinolones
-Glycopeptides
Ketolides
Lincosamides
Macrolides
Oxazolidinones
Streptogramins
Sulphonamides
Tetracyclines

10. Considerations
Identification of microbe
Drug sensitivity of microbe
Host factors
Site of infection
Immune status
Empirical therapy

11. Ability of an antibiotic to destroy target cells without
damaging host cells
Differences between microbes and host
Prokaryotic vs Eukaryotic
Cell wall
Inhibition of microbial enzymes
Disruption of bacterial protein synthesis

12. Host defense (immune system, skin)
Site of infection
BBB, vascularity, heart valves, abscess
Age
Pregnancy & Lactation
Previous Allergic Reaction
Genetic
Host defense mechanism: A chemotherapeutic regimen that
is perfectly adequate for immuno-competent patient
may be totally ineffective for immuno-incompetent
patient. Immuno-incompetence may be due to
deficiencies in Immunoglobulin, phagocytic cells and
cellular immune system.

13. Hepatic function: Erythromycin, clindamycin, rifampin,
Chloramphenicol depend on liver metabolisms for
the inactivation of antimicrobial mechanisms.
Patients with impaired liver function may accumulate
in the body active form of the drugs to a toxic level
if the dosage adjustment is not made.
Kidney function: Normal kidney function is essential for
disposal of -lactams, aminoglycosides, vancomycin,
Active form of these drugs may accumulate in the
patient with renal diseases.

14. Surgery
Bacterial endocarditis
Neutropenia
Other

15. MIC: Minimum inhibitory concentration if drug does not
get the concentration, then drug is ineffective
Mechanisms
Drug inactivating enzymes
Cease uptake of drug
Change in bacterial receptors
Synthesize drug antagonists
Acquisition
Spontaneous mutation – single resistance
Conjugation –multiple drug resistance

16. Natural (Inherent)
Lack target or transport
Acquired
Mutation
Horizontal transfer
Vertical
Horizontal
Transformation
Transduction
Conjugation

18. Prevent cross linking
Binds to transpeptidases
Add new monomers
Reseal wall
Osmotic Lysis
Bacterial Resistance
Penicillinase, MRSA
VRSA
Beta Lactamases
Cephalosporinases

20. Use of antibiotics to treat viral infections
Inadequate pathogen coverage
Excessive use of broad spectrum agents
Sub-optimal dosing
Retaining unfinished antibiotic for later use

21. Increased rate of treatment failure
Poor patient compliance
Increased mortality
Need for combination therapy
Increased cost of treatment

22. THANKYOU
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