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PHPG 2093 > ANTIBACTERIAL DRUGS 3 > Flashcards

ANTIBACTERIAL DRUGS 3 Flashcards

1
Q

Nyatakan kelas & ubat bagi moa menghalang sintesis protein (jejas scr langsung fungsi ribosom)

A

(1) 50s - macrolide,clindamycin,chloramphenicol,
oxazolidinones
(2) 30s - aminoglycosides,tetracycline
(3) Miscellaneous antibiotic - fusidic acid

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2
Q

Nyatakan cth ubat bagi Macrolide & MOA

A
  • cth ubat : erythromycin , azithromycin, clarithromycin , roxithromycin
    MOA : Macrolide bertindak pd subunit ribosom ke 50s pd bact.
  • Kemudian, akan menghlg translocation iaitu perpindahan peptidyl tRNA dari tapak A ke tapak P
  • Menghlg proses pemanjgn rantaian polipeptida
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3
Q

Macrolide Indication

A
  • Rawatan dan pencegahan jangkitan disebabkan oleh staphlococci and pneumococco dan kalangan individu yang
    hypersensitive kepada penicillin.
  • Intracellular dan atypical bacteria (Azithromycin)
  • H. pylori dalam ulser ppetic (Clarithromycin)
  • 2nd line untuk rawatan Gonnorhea dan Syphilis.
  • Rawatan jangkitan middle ear dan sinus (H. influenza danStrep. Pneumonia)
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4
Q

Macrolide Side Effects , Adverse Effects & Drug Interactions

A 
Side Effects :
 Nausea
 Vomiting
 Tinnitus
 Cholestasis hepatitis

Adverse effects :
 Epigastric distress (Erytromycin)  Bacterial resistance (used more than 1 week)
 Hypersensitivity

Drug Interactions :
 Epigastric distress (Erytromycin)  Bacterial resistance (used more than 1 week)
 Hypersensitivity

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5
Q

Macrolide Warning & Precaution

A
  • Patients with known QT prolongation ora history of ventricular dysrhythmia.
  • Patients on medications that prolong the QT interval: antipsychotic medication including atypical antipsychotics, amiodarone & other antiarrhythmics, some antidepressants.
  • Pregnancy, heart disease and electrolyte
    disturbances
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6
Q

Terangkan Lincosamides

A
  • Lincomycin

- Clindamycin : semisynthetic of Lincomycin & lebih potent

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7
Q

Terangkan Clindamycin dri segi MOA

A

MOA : bertindak pd subunit ribosom ke 50s pd bakteria

  • menghalang translocation iaitu perpindahan peptidyl tRNA dari tapak A ke tapak P
  • halang proses pemanjgn rantaian polipeptida
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8
Q

Clindamycin Indication, Side Effects, Adverse Effects & Drug Interaction

A 
Indication :
 Digunakan sebagai rawatan alternatif 
untuk jangkitan akibat anaerobic 
bakteria.
 Digunakan secara topikal bagi rawatan
jerawat. 
 Digunakan dalam jangkitan tulang dan sendi.

Side Effects :
 Diarrhea, Pseudomembranous colitis, Unpleasant/ metallic taste in mouth, Joint pain, Nausea, Vomiting

Adverse Effects :
- Superinfection by resistant clostridia

Drug Interaction :
- Vaccine BCG, Cholera, Tyhpoid
 Disease interaction: Colitis, Prematurity,
Liver disease, Renal dysfunction

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9
Q

Clindamycin Warning & Precaution

A

 May cause overgrowth of dangerous bacteria in the large intestine. This may cause mild diarrhea or may cause a life-threatening condition called colitis (inflammation of the large intestine)
 diarrhea, myasthenia gravis,Crohn’s disease, ulcerative colitis,severe liver disease, blood in the bowel movement, severe renal impairment, atopic dermatitis

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10
Q

Terangkan Chloramphenicol dri segi MOA & spectrum activity

A

MOA : - merencat sintesis protein dgn mengikat pd ribosom 50s
- halang pemanjangan rantai protein dgn merencat peptidyl transferase
- peptidyl transferase berfungsi mengikat 2 asid amino dgn ikatan peptide utk hasilkan protein
SPECTRUM ACTIVITY : - broad spectrum
- limited use due to severe toxicity

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11
Q

Chloramphenicol Indication

A

 Digunakan sebagai alternatif kepada Macrolide dan Tetracycline untuk jangkitan disebabkan oleh atypical
bacteria (Mycoplasma, Legionella, Ricketssia, Coxiella)
 Digunakan sebagai alternatif kepada Penicliin dan Cephalosporin untuk rawatan meningitis (H. Influenza), Typhoid fever dan jangkitan anaerobic bakteria.
 Digunakan sebagai eye drop dan oinment untuk jangkitan pada mata.

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12
Q

Chloramphenicol Adverse Effects & Drug Interaction

A

Adverse Effects :
 Bone marrow suppression
 Aplastic anemia
 Grey baby syndrome

Drug Interactions :
 Merupakan enzim inhibitor kepada CYP450

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13
Q

Chloramphenicol Warning & Precaution

A

 Very bad and sometimes deadly blood problems have happened with chloramphenicol.
 This may cause more chance of getting an infection, bleeding problems, or slow healing.
 Aplastic anemia that happened with
chloramphenicol has led to a certain kind of cancer (leukemia)

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14
Q

Terangkan Oxazolidinones

A
  • cth ubat : Linezolid (bacteriostatic)
    MOA : - mengikat pd bacteriak 23s ribosomal RNA of the 50s subunit
  • halang pembentukan 70s ribosomal unit lalu merencat sintesis protein
    SPECTRUM ACTIVITY :
  • efektif pd drug resistant gram (+) : vancomycin & MRSA
  • limited to serious bacteria infection when other antibiotic fail
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15
Q

Linezolid Indication, Adverse Effects & Drug Interaction

A

Indication :
-Limited to serious bacteria infection
when other antibiotic fail.

Adverse Effects :
- Thrombocytopenia

Drug Interactions :
 Makanan tinggi tyramine kerana boleh menyebabkan hypertensive crisis.
 Alkohol

Disease interaction:
 Collitis
 Bone marrow suppression

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16
Q

Linezolid Warning & Precaution

A
  • Diarrhea from an infection with Clostridium difficile bacteria.
  • Pheochromocytoma, Thyrotoxicosis, Carcinoid syndrome, pancytopenia
  • Increased blood acidity due to high levels of lactic acid.
17
Q

Nyatakan cth ubat bg 30s ribosome inhibitor

A

(1) Aminoglycosides : amikacin , gentamicin , neomycin , kanamycin , streptomycin
(2) Tetracycline : tetracycline , chlortetracycline , oxytetracycline , minocycline

18
Q

Terangkan MOA Aminoglycosides

A
  • bertindak pd subunit ribosom yg ke 30s pd RNA bakteria
  • menganggu translation hingga menyebbkn pentafsiran genetik kod yg salah pd rantaian ribosom bact & menghasilkan sintesis protein yg abnormal
  • ganggu translocation tRNA dari tapak A ke tapak P dan menyebabkan pemanjgn rantai polipeptida terhlg & tiada pembentukan rantai polipeptida yg lengkap
19
Q

Terangkan Aminoglycosides dri segi spectrum activity & lain2

A

SPECTRUM ACTIVITY :
- narrow spectum , efektfi pd gram (-) bacilli & sedikit gram (+) cocci & mycobacteria TB
LAIN2 :
- concentration dependent : keupayaan membunuh bact meningkat sbaik shj kepekatan antibiotik meningkat
- post antibiotic effect : masih berupaya membunuh bakteria walaupun kepekatan antibiotik dibawah MIC

20
Q

Aminoglycoside Indication

A

 Plaque, brucellosis dan 1st line untuk
tuberculosis.(Streptomycin)
 Jangkitan disebabkan gram negative
(Gentamicin, Tobramycin)
 Dalam gram negative septicemia secara
kombinasi dengan Penicillin dan
metronidazole.
 Pseudomonas infections secara kombinasi dengan antipseudomonal penicillin.
 Enterococcal endocarditis secara kombinasi
dengan Vancomycin dan Gentamicin.
 Hepatic encephalopathy (Neomycin)
 Sterilization of intestine before surgery and bacillary dysentery (Neomycin)
 Secara topical untuk kulit dan mata secara kombinasi dengan Polymixin B atau Bacitracin

21
Q

Aminoglycosides Adverse Effects & Drug Interaction

A

Adverse Effects :
- Nephrotoxicity, Ototoxicity, Neuromuscular block, Malabsorption

Drug Interactions :
- Antibiotics, Skeletal muscle relaxants, Anticoagulants, Diuretics

22
Q

Aminoglycosides Warning & Precaution

A
  • Avoid aminoglycosides if you’re allergic to them or any inactive ingredients these drugs may contain.
  • Are allergic to sulfites (often found in
    certain wines and dried fruits)
  • Have kidney or hearing problems, including problems with balance and uncontrollable eye movements
  • Have a disorder affecting the nerves and
    muscles, like multiple sclerosis or
    myasthenia gravis.
  • Are 65 years of age or older
  • You have a newborn or very young baby
    who might be treated for a serious infection using aminoglycosides
23
Q

Terangkan Tetracycline dri segi MOA & Spectrum Activity

A

Cth : Tetracycline, Chlortetracycline, Oxytetracycline, Minocycline, Demeclocycline (not in FUKKM)

MOA : - tetracycline bertindk pd subunit ribosom ke 30s bacteria
- halang kemasukan amino acyl-tRNA ke mRNA ribosom complex di tapak penerima (A)
- menyebabkan sintesis protein bacteria terencat
SPECTRUM ACTIVITY : broad spectrum

24
Q

Tetracycline Indication & Adverse Effects

A

Indication :

  • Sebagai alternatif pada Macrolide dalam jangkitan disebabkan Chlamydia, Mycoplasma dan Legionella. (Doxycycline)
  • Lyme disease, Typhus dan Rocky Moutain spotted fever, Acne vulgaris, Cholera

Adverse Effects :
- Epigastric distress, Yellow staining, Cholestatic hepatitis, Phototoxicity, Superinfection

25
Q

Tetracyline Drug Interaction & Warning & Precaution

A 
Drug Interaction :
- Calcium channel blockers is of clinical 
significance because when these agents 
are given concurrently during the 
perioperative period they may lead to 
respiratory depression or prolonged 
apnoea.

Warning & Precaution
- Severe hepatic disease and renal disease, Peptic ulser, Kanak kanak bawah 8 tahun, Pregnancy and lactation

26
Q

Terangkan Miscellaneous Antibiotik (Fusidic Acid) dari segi MOA & Spectrum Activity

A

MOA : - merencat sintesis protein dgn halang pengikatan tRNA pd ribosom
SPECTRUM ACTIVITY : narrow spectrum
- efektif pd gram (+) bacteria

27
Q

Fusidic Acid Indication , Side Effects & Adverse Effects

A 
Indication :
 Digunakan secara kombinasi dengan
agen antistaphylococcal dalam
staphylococcal sepsis.
 Digunakan secara topical dalam eye 
infection

Side Effects :
- Skin rashes, Skin itching, Pain, stinging, burning sensation or redness of skin on application, Contact dermatitis

Adverse Effects :
- Jaundice, Skin eruption

28
Q

Fusidic Acid Drug Interaction, Warning & Precaution

A

Interactions :
 Ritonavir and Saquinavir: inhibition of
metabolism and increased fusidic acid
levels.
 Cholestyramine: binds fusidic acid and
decreases bioavailability.

Warning & Precaution
- Use caution in patients with jaundice/
hepatic dysfunction.

PHPG 2093 (14 decks)

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