ANTI-INFECTIVES Flashcards
father of ANTISEPTIC surgery
Joseph Lister
father of MODERN chemotherapy
Paul Ehrlich
what did Joseph Lister use in sugery and post-traumatic infections or “ward fever”
phenol / carbolic acid
worked on antibacterial dyes, organo-arsenicals (tx for syphilis, and the so-called “magic bullets”
Paul Ehrlich
major tenet or principle of MODERN ANTIMICROBIAL THERAPY
selective toxicity
a property of a certain medicinal agent to kill one type of pathogenic microorganisms without harming the host’s cell
selective toxicity
HISTORICAL DEVELOPMENT
- most successful anti-infective agents were based on Group IIB and Group VA elements
1920
HISTORICAL DEVELOPMENT
most successful anti-infective agents were based on ____ and ____ elements
Group IIB (mercury) and Group VA (arsenic, antimony)
HISTORICAL DEVELOPMENT
used for sleeping sickness
Atoxyl
(Sodium arsanilate and arsphenamine)
substances that destroys or kill microorganisms that causes infection
ANTI-INFECTIVES
- compounds that is used locally to kill microorganism
- aka local anti-infective agents
GERMICIDES
-cidal
kill
-static
prevent growth
agents that prevents the transmission of infection by the destruction of pathogenic microorganisms when applied to INANIMATE OBJECTS
DISINFECTANT
the ratio of a dilution of a given test disinfectant to the dilution of phenol required to kill a given strain of SALMONELLA TYPHI
PHENOL COEFFICIENT
Phenol coefficient the ratio of a dilution of a given test disinfectant to the dilution of phenol required to kill a given strain of ____
Salmonella typhi
the antibacterial activity of alcohol increases with increasing molecular weight until the ____ carbon only
8th
SARs of ALCOHOLS
____ decreases solubility
branching
SARs of ALCOHOLS
organism used to test the antibacterial property
Staphylococcus aureus
SARs of ALCOHOLS
the ability of alcohols against MO is the result of their ability to ____ and CHO by destroying the primary structure of proteins
denature important proteins
ALCOHOLS
- pertains to ETHANOL
- clear, colorless, volatile liquid with a burning taste and a characteristic odor
- fermentation product of grain and other carbohydrate containing sources
- most widely used RECREATIONAL drug
- undergoes a series of oxidation-reduction reactions in vivo
ALCOHOL 95%
ALCOHOLS
synonyms
Ethyl alcohol
Ethanol
Wine spirit
ALCOHOLS
responsible for the “HANGOVER”
acetaldehyde
ALCOHOLS
inihibits aldehyde dehydrogenase
DISULFIRAM
ALCOHOLS
effects of acetaldehyde
N&V, vasodilatory flushing
ALCOHOLS
catalyst in the hydration of ethylene
H2SO4
ALCOHOLS
ethanol that has been rendered “UNFIT FOR USE” in intoxicating beverages by the addition of other substances
DENATURED ALCOHOL
ALCOHOLS
a denatured alcohol that contains methanol and bnezene that is UNSUITABLE for external and internal use
COMPLETELY DENATURED ALCOHOL
ALCOHOLS
ethanol that is treated with one or more substances to be used in tinctures, MW, lotions and extraction purposes
SPECIALLY DENATURED ALCOHOL
ALCOHOLS
- absolute ethanol
- contains NLT 99% of w/w, prepared by azeotropic distillation of ethanol-benzene mixture
- used in pain in carcinoma, neuralgias, and as chemical reagent or solvent
DEHYDRATED ETHANOL
ALCOHOLS
- 2-propanol or propan-2-ol
- slightly bitter tase
- 91% v/v of isopropanol
- use to cleanse the skin and disinfect surgical apparatus/instruments
- rapidly bactericidal in concentration range of 50%-95% at 40% give equal antiseptic property to 60% alcohol
- prepared by hydration of propylene with H2SO4 as catalyst
ISOPROPYL ALCOHOL
ALCOHOLS
synonyms for isopropyl alcohol
2-propanol
propan-2-ol
ALCOHOLS
used in gauze pads
AZEOTROPIC ISORPROPYL ALCOHOL, USP
ALCOHOLS
susbtitute for ethanol
isopropyl
mercury needs ____ to be eliminated
chelating agent
antidote for arsenic poisoning
British anti-Lewisite (BAL)
limitations of heavy metals
neurotoxicity
it measures the antiseptic property
phenol coefficient
common targets of drugs
nucleus
cell wall, murein/peptidoglycan
cytoplasmic membrane
cytoplasm
targets genetic make up
pancidal
most effective type of ALCOHOLS
primary
which is more effective between ethyl and propyl
ethyl
which is more effective between isopropyl and ethyl
isopropyl
can cause disulfiram-like reaction
metronidazole
USES OF ALCOHOL
EXternal use
antiseptic
preservative
mild counterirritant
solvent
USES OF ALCOHOL
RUBBING alcohol
astringent
rubefacient
mild local anesthetic
USES OF ALCOHOL
INternal use
mild sedative
weak vasodilator
carminative
ALCOHOLS
100mL
13% alc/vol
sparkling wine
wine
ALCOHOLS
425mL
2.7% alc/vol
light beer
ALCOHOLS
285mL
4.9% alc/vol
regular beer
ALCOHOLS
60mL
20% alc/vol
fortified wine
ALCOHOLS
30mL
40% alc/vol
spirits
ALCOHOLS
- used in sterilizing plastic, effectively destroy all forms of life
- carcinogenic and extremely toxic
- non-selective alkylating agent
- colorless, flammable gas, used to sterilize temperature sensitive medical equipmnet and certain pharmaceuticals that cannot be autoclaved
- commercial product: Oxirane, Carboxide
- MOA: alkylation of functional groups in nucleic acids and proteins by nucleophilic opening of the oxide
ETHYLENE OXIDE
C2H4O
ethylene oxide is a ____ agent
non-selective alkylating agent
ETHYLEEN OXIDE
- gas sterilant
- long term use can cause cancer
OXIRANE
- contains NLT 37% w/v HCHO with methanol
- miscible in water and alcohol
- cloudy at RT
- embalming agent, deodorant, antiseptic
- gas preparation - disinfectant for rooms, clothes and instruments
- direct and non-specific alkylation of the nucleophilic functional groups of proteins and nucleic acids forming carbinols
FORMALDEHYDE
(Formol , formalin)
ALDEHYDE
why is methanol added to formaldehyde
to retard polymerization
MOA of formaldehyde
direct and non-specific alkylation of nucleophilic functional groups of proteins & nucleic acids
ALDEHYDE
Formaldehyde should be stored in what temperature to avoid cloudiness
15C
- aka Glutarol
- used as sterilizing solution for equipment and instruments that cannot be autoclaved
GLUTARALDEHYDE DISINFECTANT SOLUTION
PHENOLS
substitution with aklyl, aryl, and halogen in ____ increases bactericidal properties
PARA position
PHENOLS
presence of ____ enhances bactericidal activity more than branched groups
straight chain alkyl groups
PHENOLS
____ and ____ are LESS TOXIC than parent compounds while retaining bactericidal properties
alkylated phenols and resorcinol
PHENOLS
immediate antidote
glycerin
- a general protoplasmic poison
- acts on cell membrance and inactivates INTRACYTOPLASMIC ENZYMES forming unstable complexes
- the lipophilic part of the molecule is trapped by the membrane phospholipids
- denature bacterial proteins (cidal effect) at low concentrations
- lysis of bacterial cell membrane occurs at higher concentrations
PHENOLS
PHENOLS
acts on ____
cell membrane
PHENOLS
inactivates ____
intracytoplasmic enzymes
PHENOLS
____ at LOW concentrations
denature bacterial proteins
PHENOLS
____ at HIGHER concentrations
lysis of bacterial cell membrane
substances that if a healthy living cell is exposeed to in significant amounts, the cell will be adversely affected, damaged, or killed
PROTOPLASMIC POISONS
- introduced by Joseph Lister (1867) as surgical alcoholic antiseptic
- used as the standard to which most germicides are compared
- it is a colorless to pale-pink crystalline with characteristic medicinal odor
- a general protoplasmic poison
PHENOL
PHENOLS
used to treat ** mild itchiness (pruritus)**
Phenolated calamine lotion
PHENOLS
used as general antiseptic
phenol-glycerin
PHENOLS
- phenol with 10% water
- pharmaceutical aid
LIQUEFIED phenol
PHENOLS
- phenol coefficient of 4
- used in combination with camphor in liquid petrolatum
- used externally as antiseptic and anti-irritant
p-chlorophenol
PHENOLS
- nonirritating antiseptic with broad spectrum antibacterial and anti-fungal properties
- available as shampoo which is used for the treatment of fungal infection
p-chloro-m-xylenol
PHENOLS
- a white to light tan crystalline powder
- a bisphenolic, more potent than monophenolic
- easily absorbed onto skin and even sebaceous glands
- uses 2%-3% in soaps, detergent creams, lotions, and shampoo
- effective against GRAM POSITIVE but RESISTANT to GRAM NEGATIVE
- can cause neurologic toxicity in infants and in burn patients
HEXACHLOROPHENE
PHENOLS | HEXACHLOROPHENE
how many % in soaps, detergent creams, lotions, and shampo
2%-3%
PHENOLS | HEXACHLOROPHENE
effective against ____
gram POSITIVE
PHENOLS | HEXACHLOROPHENE
resistant to ____
gram NEGATIVE
PHENOLS | HEXACHLOROPHENE
side effect
neurologic toxicity to infants & burn patients
PHENOLS
- aka methylphenol
- phenol coefficient: 2.5
- yellow to brownish-yellow liquid that has a characteristic creosote odor
- obtained from coal tar or petroleum by alkaline extraction into aqueous medium, acidification, and fractional distillation
- antiseptic and disinfectant
- unpleasant odor
CRESOL, NF
PHENOLS
- 4-chloro-3-methyl-phenol
- colorless crystal and used as a preservative
CHLOROCRESOL
PHENOLS
- 4-allyl-2-methylphenol
- obtained from CLOVE, a pale yellow liquid with strong aroma and pungent taste used as local anesthetic and antiseptic
EUGENOL
PHENOLS
- isopropyl m-cresol
- antifungal for the treatment of Tinea capitis, Tinea corpus
THYMOL
PHENOLS
- m-dihydroxybenzene
- white needle-like crystals or amorphous powder
- less stable in alkaline pH
- weak antiseptic (PC of 0.4), keratolytic agent
RESORCINOL
good and effective against ANAEROBIC microorganism and in cleaning CONTAMINATED WOUNDS
oxidizing agents
MOA:
* depend upon liberation of oxygen (peroxide) in the tissues and their ability to denature proteins (permanganates)
OXIDIZING AGENTS
PHENOLS
- 4-allyl-2-methylphenol
- white crystals with faint phenolic odor and has astringent taste (numbness); PC of 98
- antiseptic, local anesthetic, surfactant
HEXYLRESORCINOL
OXIDIZING AGENTS
% of peroxide that is common in markets
3%
OXIDIZING AGENTS
higher % of peroxides is used as
bleach
OXIDIZING AGENTS
what breaks down peroxidase
catalase (peroxidases)
OXIDIZING AGENTS
- Gly-Oxide
- stable complex of UREA (from proteins) and hydrogen peroxide (12.6%) in anhydrous glycerin
- releases hydrogen peroxide when mixxed with water
- effective in treating oral ulcerations
CARBAMIDE PEROXIDE TOPICAL SOLUTION
OXIDIZING AGENTS
- white granular powder, explosive (pure); addition of 30% water to make it safer
- 5-10%: keratolytic, keratogenic, tx of acne caused by propionic bacterium
- induce proliferation of epithelial cells leading to sloughing and repair
HYDROUS BENZOYL PEROXIDE
OXIDIZING AGENTS
cannot be used in pure form, must be in low concentrations only
HYDROUS BENZOYL PEROXIDE
OXIDIZING AGENTS
HYDROUS BENZOYL PEROXIDE:
% concentration used as keratolytic, keratogenic, and tx of acne
5-10%
HALOGEN COMPOUNDS
OLDEST and one of the most effective and useful germicide
(Egyptian era)
ELEMENTAL IODINE
HALOGEN COMPOUNDS
- complexes of iodine with non-ionic and cationic surfactants while retaining the germicidal property and reducing the volatility and irritant property of iodine
IODOPHORS
HALOGEN COMPOUNDS
poorly soluble in water
IODINE
HALOGEN COMPOUNDS
what should be added to IODINE to increase solubility in water
Sodium iodide
Potassium iodide
SOLUBILIZING AGENTS
HALOGEN COMPOUNDS
composition of LUGOL’S solution
< 5% iodine
HALOGEN COMPOUNDS
composition of IODINE solution
2% iodine in water
HALOGEN COMPOUNDS
composition of iodine TINCTURE
2% iodine in 50% alcohol
HALOGEN COMPOUNDS
MOA:
* PROTEIN INACTIVATION by iodination of phenylalanyl anf tyrosyl residues; oxidation of -SH groups
IODINE
HALOGEN COMPOUNDS
- an iodophor
- complex of iodine with PVP
- the complex is extremely water souluble and release iodine SLOWLY, non-toxic, non-volatile, and non-staining to the skin or wounds
POVIDONE-IODINE
HALOGEN COMPOUNDS
Betadine is ____% of iodine
10%
HALOGEN COMPOUNDS
hypochlorite and chloramine + water
water disinfectant
potable water
HALOGEN COMPOUNDS
MOA:
* chlorination (oxidation) of amide nitrogen (peptide bond) atoms in protein and oxidation of sulfyhydryl
CHLORINE
HALOGEN COMPOUNDS
- p-dichlorosulfamoylbenozoic acid
- white crystalline, photosensitive withfaint chlorine odor
- in pellet form
HALAZONE
HALOGEN COMPOUNDS
use of sodium salt
HALAZONE
water disinfectant
HALOGEN COMPOUNDS
- N,N-dichlorodicarbonamidine
- bright yellow crytsalline solid with a faint chlorine odor
- insoluble in water and in organic solvents
- unstable to light and heat
CHLOROAZODIN
HALOGEN COMPOUNDS
used for wound dressing
CHLOROAZODIN
glyceryltriacetate
HALOGEN COMPOUNDS
- complex of sodium salt of dodecylbenzenesulfonic acid and HClO
- white powder with a faint chlorine odor
- combines germicidal properties of HOCl with the mulsifying, wetting and keratolytic actions of anionic detergent
- USES: broad spectrum (G+ & G-), removal of necrotic tissue, counteract odorous discharges, irritant and disinfect cysts and fistulas
OXYCHLOROSENE SODIUM
- quaternary ammonium compounds taht ionize in water and exhibit surface active properties
- ends on “-onium” or “-inium”, water-soluble, non-staining, non-corrosive, manifest low toxicity
- has a polar head and lipophilic tail
- has bactericidal action against a broad spectrum bacteria, fungi, and protozoa
CATIONIC SURFACTANTS
MOA:
* lower down the interfacial tension
CATIONIC SURFACTANTS
CATIONIC SURFACTANTS
- occurs as white gel, soluble in water, alcohol, and organic solvents
- aqueous solution are colorless, slightly alkaline and very foamy
- modern day gamot na pula
BENZALKONIUM CHLORIDE
CATIONIC SURFACTANTS
BENZALKONIUM CHLORIDE:
antiseptic
1:750 to 1:2000
CATIONIC SURFACTANTS
BENZALKONIUM CHLORIDE:
irrigation
1:2000 to 1:40000
CATIONIC SURFACTANTS
- detergent
- emulsifying agent
- wetting agentgiven with NaNO3 for preservative action
BENZALKONIUM CHLORIDE
CATIONIC SURFACTANTS
BENZALKONIUM CHLORIDE:
with sodium nitrate as PRESERVAATIVE
1:1750 TO 1:5000
CATIONIC SURFACTANTS
- 1-hexadecylpyridinium chloride
- white powder that is very soluble in water and alcohol
- USES: general antiseptic for skin, laceration, irrigation, and available as throat lozenges and MW
CETYLPYRIDINIUM CHLORIDE
CATIONIC SURFACTANTS
- mixture of methylated derivatives of methylbenzothonium chloride
- used to control DIAPER RASH caused by bacterium ammoniagenes which liberates ammonia in decomposed urine
METHYLBENZETHONIUM CHLORIDE
CATIONIC SURFACTANTS
- a colorless crystalline powder that is soluble in water, alcohol, and most organic solvents
- similar to Benzaolkonium chloride
BENZETHONIUM CHLORIDE
CATIONIC SURFACTANTS
- most effective of a series of antibacterial biguanides
- broad spectrum antibacterial activity (inactive agains acid fast bacteria, spores, and viruses)
CHLORHEXIDINE GLUCONATE
- active against gram + microorganisms and inactivating fungi
- G- are resistant
- forms colorless leucobase under alkaline condition
CATIONIC DYES
noncolored substances that gives off color under specific conditions
leucobase
DYES
used in mumps
Gentian violet
DYES
combined w/ phenol
basic fuchsin
DYES
used in replacing water in aquarium
methylene blue
DYES
Gentian violet
Basic fuchsin
triphenylmethane dye
DYES
methylene blue
thiazine dye
DYES
- hexamethyl-p-rosaniline chloride
- aka crystal violet, methyl violet, methylrosaniline chloride
- available as green powder or green flakes with metallic sheen
- USE: vaginal suppository or pessaries, tx of ringworm and yeast infection, anthelmintic for threadworm and pinworm
GENTIAN VIOLET
DYES
GENTIAN VIOLET:
% concentration for the tx of ringworm and yeast infection
1-3%
DYES
- mixture of chlorides of rasniline and p-rosaniline
- green crystalline powder with a metallic appearance
- component of Carbol-fuchsin solution (Castellani’s paint)
BASIC FUCHSIN
DYES
Castellani’s paint
Carbol-fuchsin soln
DYES
synonyms for GENTIAN VIOLET
crystal violet
methyl violet
methylrosaniline chloride
DYES
- dark green powder with metallic appearance
- can cause methemoglobinemia; can tint the urine and stool bluegreen
- ANTIDOTE for CYANIDE and NITRATE poisoning
METHYLENE BLUE
DYES
Methylene blue can cause
methemoglobinemia
DYES
antidote for CYANIDE nad NITRATE poisoning
methylene blue
- local anti-infective and tx of SYHPHILIS
- SAR: organic moieties increase lipid solubility, render the compound bacteriostatic
- MOA: reacts with the -SH of enzymes and other proteins by forming R-S-Hg-R
MERCURIALS
elemental mercury
MERCURIALS
- yellow powder, insoluble in water, non-irritating and non-staining
- MOA: formation of covalent compounds
NITROMERSOL
MERCURIALS
- previous active composition of merthiolate or “gamot na pula”
- cream colored, water-soluble powder, non-staining and non-irritating to tissues
- weakly bacteriostatic agent
THIMEROSAL
MERCURIALS
- contains mercurochrom, which is responsible for its red-orange color
MERBROMIN
MERCURIALS
what gives off the red-orange color of MERBROMIN
mercurochrom
- prevents contamination
- effective at low concentration against possible microorganisms (<1% concentrations)
- non toxic
- compatible with other ingredients
- stable for the shelf life of the products
- must be potent
PRESERVATIVES
PRESERVATIVES
- useful antifungal preservative for liquid dosage forms
- has low toxicity
- SAR: increase activity as MW increases
PARABENS
PRESERVATIVES
esters of p-hydrobenzoic acid
PARABENS
PRESERVATIVES
- methyl-p-hydroxybenzoate
- white crystalline powders
- for MOLDS
methylparaben
PRESERVATIVES
- propyl-p-hydroxybenzoate
- white crystalline powder
- for YEAST
propYlparaben
PRESERVATIVES
n-buty-p-hydroxybenzoate
butyparaben
PRESERVATIVES
ethyl-p-hydroxybenzoate
ethylparaben
PRESERVATIVES
product of hydrolysis of PABA
p-aminobenzoic acid
PARABENS
PRESERVATIVES
- 0.1-0.5%: bacteriostatic agent for injections, opthalmic use, and intranasal administration
- white crystalline solid with a camphor-like aroma
- unstable when heated
CHLOROBUTANOL
PRESERVATIVES
CHLOROBUTANOL:
% concentration as bacteriostatic agent in injections, ophthalmic use, and intranasal administration
0.1-0.5%
PRESERVATIVES
- clear liquid with an aromatic odor
- commonly used for vials for injectable drugs in 1-4% water or saline solution
BENZYLALCOHOL
PRESERVATIVES
- Orange oil, Rose oil
- used in PERFUMERY
PHENYLETHYL ALCOHOL
PRESERVATIVES
- ____ are naturally occuring in GUM BENZOIN and in PERU and TOLU balsams
- white crystalline solid that slowly sublimes at RT
Benzoic acid and its esters
PRESERVATIVES
- preservative of choice for FRESH FRUIT JUICES
- white crystalline solid
- preservative in acidic liquid preparation
SODIUM BENZOATE
PRESERVATIVES
- transparent colorless crystals
- antifungal preservative
SODIUM PROPIONATE
PRESERVATIVES
- effective antifungal preservative especially in preparations containing SUGAR
SORBIC ACID
PRESERVATIVES
- preservative in injectable drugs, bacteriostatic efficacy is reduced in the presence of SERUM
Phenylmercuric NITRATE
PRESERVATIVES
short chain acids must be in what FORM to be able to use as preservatives
salt form
PRESERVATIVES
- occurs as WHITE PRISMS
Phenylmercuric ACETATE
HALOGEN COMPOUNDS
____ and its products are used mainly as WATER DISINFECTANT
CHLORINE
HALOGEN COMPOUNDS
CHLORINE is dissolved in water releasing ____
HCl + HOCl
MERCURIALS
TWO CLASSES OF ORGANOMERCURIALS:
* does not IONIZE READILY
compounds with ATLEAST one carbon-mercury
MERCURIALS
TWO CLASSES OF ORGANOMERCURIALS:
* compounds with MERCURY bonded to ____
heteroatoms
