ANTIBACTERIAL DRUGS 4

Question 1

Nyatakn pengkelasn inhibitors of bacterial nucleic acid synthesis

Answer 1

(1) DNA inhibitor : fluoroquinolones , metronidazole

(2) RNA inhibitor : rifampicin , mupirocin

Question 2

Terangkan ubat bagi Fluoroquinolones beserta MOA

Answer 2

• cth ubat : ofloxacin , ciprofloxacin , levofloxacin , moxifloxacin
  MOA : - merencat sintesis DNA bakteria
• merencat type II DNA topoisomerase (DNA gyrase)
• DNA gyrase catalyzes the conversion of relaxed closed circular DNA into negatively super twisted form, thereby promoting replication & transcription

Extra info :
•Bactericidal
•Concentration dependent killing
•Post antibiotic effect

Question 3

Fluoroquinolones Indication & Adverse Effects

Answer 3

Indication :
• Resistant infections.
• Severe systemic infection seperti GIT infection,
UTI, prostatitis, respiratory infection, osteomyelitis
• Pseudomonas infection
• Enteric fever caused by Salmonella (Ciprofloxacin)

Adverse Effects :
• Tendinitis and tendon rupture
• Seizures
• Prolongation of QT interval

Question 4

Fluoroquinolones Drug Interaction , Warning & Precaution

Answer 4

Drug Interaction :
- Merupakan enzyme inhibitor bagi
cytochrome P-450 isozymes

Warning & Precaution
• Who have an aortic aneurysm or are at risk of an aortic aneurysm (such as patients with peripheral
atherosclerotic vascular diseases, hypertension.

Question 5

Terangkan Metronidazole dri segi MOA & Spectrum Activity

Answer 5

MOA : halang sintesis protein dgn berinteraksi dgn DNA
- menyebabkn kehilangan struktur double heliks DNA & double strand heliks terbuka (breakage)
- menyebabkan kematian sel bakteria
SPECTRUM ACTIVITY :
- aktif pd anaerobic bacteria

Question 6

Metronidazole Indication & Adverse Effects

Answer 6

Indication :
• Pseudomembranous colitis
• Serious anaerobic infections (sepsis secondary to bowel disease)

Adverse Effects :
- Metronidazole-induced central nervous system toxicity is uncommon but can present
as cerebellar dysfunction, altered mental status, or seizures

Question 7

Metronidazole Drug Interaction , Warning & Precaution

Answer 7

Drug Interaction :
- Alcohol, Anticoagulants, such as warfarin, Astemizole, Busulfan, Cimetidine

Warning & Precaution :
- Crohn’s disease, Kidney disease, Liver disease, Cancer, Effects on the nervous system, Allergy reactions

Question 8

Terangkan Mupirocin dri segi MOA & Spectrum Activity

Answer 8

MOA : - merencat scr reversible…
- akan merencat sintesis RNA
SPECTRUM ACTIVITY :
- has excellent in vitro activity against staphylococci & most streptococci
- less activity against other gram (+) & gram (-) bact

Question 9

Mupirocin Indication & Side Effects

Answer 9

Indication :
- Skin infection.

Side Effects :
• Blistering, crusting, irritation, itching, or reddening of the skin.
• canker sores.
• cracked, dry, scaly skin.
• pain, swelling, tenderness, warmth on the skin.
• sores, ulcers, or white spots on the lips or tongue or inside the mouth.

Question 10

Mupirocin Adverse Effect, Warning & Precaution

Answer 10

Adverse Effects :
- Burning, Stinging

Warning & Precaution :
• Do not use it on skin areas that have cuts, scrapes, or burns. If it does get on these areas, rinse it off right away with water.

Question 11

Terangkan inhibitors of bacterial metabolism

Answer 11

• cth : Trimethoprim + Sulfamethoxazole , Sulfonamides
• asid folik diperlukan utk sintesis purine & pyrimidine
• bacteria menggunaka PABA utk sintesis asid nukleik
• kekurangn asid folik mybbkn sel bakteria tdk membesar & membahagi

Question 12

Terangkan MOA bg Trimethoprim & Sulfamethoxazole

Answer 12

• MOA Trimethoprim : halang sintesis tetrahydrofolic acid dgn merencat enzim dihydrofolate reductase
• MOA Sulfamethoxazole : halang sintesis bakteria asid dihidrofolik dgn bersaing dgn asid PABA

Question 13

Trimethoprim & Sulfamethoxazole Indication & Side Effects

Answer 13

Indication :
• Middle ear, urine, respiratory, and intestinal infections.
• Merawat dan mencegah pneumonia (pneumocystistype).

Side Effects :
- Dizziness, Headache, Lethargy, Diarrhea, Anorexia, Nausea, Vomiting, Rash

Question 14

Trimethoprim & Sulfamethoxazole Adverse Effects, Drug Interaction, Warning & Precaution

Answer 14

Adverse Effects :
- Rash, Photosensitivity

Drug Interaction :
- Warfarin, Dofetilide, Methenamine, Methotrexate

Warning & Precaution :
• Severe liver disease
• Kidney disease

Question 15

Nyatakan cth inhibitors of membrane cell

Answer 15

• Polymycin B

- Polymycin E

Question 16

Terangkan MOA & Spectrum Activity bg inhibitors of membrane cell

Answer 16

• mengikat pd tapak yg bercas negatif di lapisan lipopolysaccharide gram (-) bakteria
• akn menggantikan calcium & magnesium , menyebabkan lapisan lipoposaccharide mnjadi tdk stabil
• integriti membran sel bact meningkat
• meningkatkan kebolehtelapan membran sel bakteria
• kebocoran kandungan sitoplasma dan sel bakteria mati
  SPECTRUM ACTIVITY :
• limited to gram (-) organisms

Question 17

Polymyxin B & E Indication & Side Effects

Answer 17

Indication :
- Susceptible infections due to P. aeruginosa including UTIs, meninges, bloodstream, and
eye infections.

Side Effects :
- Pain, Redness, Swelling at the injection site, Temporary eye stinging/ burning/ redness/ itchiness, Temporary blurred vision if used as eye drops.

Question 18

Polymyxin B & E Adverse Effects, Warning & Precaution

Answer 18

Adverse Effects :
•Nephrotoxicity
•Neurotoxicity

Warning & Precaution :
• Avoid concurrent use of a curariform muscle relaxant and
other neurotoxic drugs (ether, tubocurarine, succinylcholine, gallamine, decamethonium and sodium citrate) which may precipitate respiratory depression. If signs of respiratory paralysis appear, respiration should
be assisted as required, and the drug discontinued.