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Pharma- Antimicrobial drugs > desinfectives and antispetics > Flashcards

desinfectives and antispetics Flashcards

1
Q

Disinfection

A

thermal or chemical destruction of pathogenic and other types of microorganisms

less lethal than sterilization because it destroys most recognized pathogenic microorganisms but not necessarily all microbial forms (e.g., bacterial spores)

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2
Q

Disinfectant

A

usually a chemical agent (but sometimes a physical agent) that destroys disease-causing pathogens or other harmful microorganisms but might not kill bacterial spores

Refers to substances applied to inanimate objects (surfaces)

Use on inanimate objects

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3
Q

Sterilants

A

kill both vegetative cells and spores

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4
Q

Disinfection can be accomplished by

A

chemical agents

physical agents

  • as ionizing radiation
  • dry or moist heat
  • superheated steam (autoclave, 120°C)

combination

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5
Q

Antiseptic and asepsis

A

substance that prevents or arrests the growth or action of microorganisms by inhibiting their activity or by destroying them

the term is used especially for preparations applied topically to living tissue (skin, mucous membranes, or wounds)

Asepsis: prevention of contact with microorganisms

Use on skin

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6
Q

Bacteriostatic

A

capable of inhibiting the growth or reproduction of bacteria

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7
Q

Bactericide

A

agent that kills bacteria

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8
Q

Sterile or Sterility

A

state of being free from all living microorganisms

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9
Q

Prevention of infection also can be achieved by

A

Washing
-dilutes the potentially infectious organism

establishing a barrier
-gloves

Hand hygiene is the most important means of preventing transmission of infectious agents!!!!

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10
Q

Properties of an ideal disinfectant

A

Broad spectrum: wide antimicrobial spectrum

Fast acting: rapid kill

Not affected by environmental factors:
active in the presence of organic matter (e.g., blood, sputum, feces)
compatible with soaps, detergents, and other chemicals encountered in use

Nontoxic: should not be harmful to the user or patient

Surface compatibility:
should not corrode instruments and metallic surfaces
should not cause the deterioration of cloth, rubber, plastics, and other materials

Residual effect on treated surfaces: should leave an antimicrobial film on the treated surface

Odorless: pleasant odor or no odor

Economical: low cost

Solubility: should be soluble in water

Stability: should be stable in concentrate and use-dilution

Cleaner: should have good cleaning properties

Environmentally friendly: should not damage the environment on disposal

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11
Q

Antiseptic and disinfectant

A 
alcohols
chlorhexidine
halogens: iodine, iodophors
peroxygencompounds
heavy metals
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12
Q

just disinfectant

A

halogens: chlorine
Phenolics
quaternary ammonium compouns
aldehydes

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13
Q

Alcohols

A

most frequently used for antisepsis and disinfection are ethanol and isopropyl alcohol (isopropanol)

Mechanism: they act by denaturation of proteins

optimum bactericidal concentration is 60–90% by volume in water

Use of alcohol-based hand rubs has been shown to reduce transmission of health care-associated bacterial pathogens

Pro:
No instrument impairment (no corrosive effects on metal instruments)

Con:

  • flammable and explosive
  • not sporicidal (not used as sterilants), no effect on parasites and spores
  • skin-drying effect
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14
Q

Chlorhexidine

A

Mechanism:kills by disrupting the cell membrane

against vegetative bacteria and mycobacteria and has moderate activity against fungi and viruses

mouthwash

The combination of chlorhexidine gluconate in 70% alcohol is the preferred agent for skin antisepsis in many surgical and percutaneous procedures

The advantage of this combination over povidone-iodine

  • more rapid action after application
  • retained activity after exposure to body fluids
  • persistent activity on the skin

Pro:

  • very low skin-sensitizing or irritating capacity (component of creams, soaps, mouthwashs)
  • resistant to inhibition by blood and organic materials

Con

  • neural toxicity
  • Elongated application may alter the oral flora
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15
Q

Iodine

A

bactericidal in 1 minute and kills spores in 15 minutes

Tincture of iodine (2% iodine and 2.4% sodium iodide in alcohol)

not commonly used

  • serious hypersensitivity reactions
  • staining of clothing and dressings
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16
Q

Iodophores

A

complexes of iodine with a surface-active agent such as polyvinyl pyrrolidone (PVP; povidone-iodine)

kill vegetative bacteria, mycobacteria, fungi, and lipid-containing viruses

may be sporicidal upon prolonged exposure

can be used as antiseptics or disinfectants

(Betadine)

surgical antiseptic

less irritating and less likely to produce skin hypersensitivity than tincture of iodine

Pro:
a somewhat broader spectrum of activity than chlorhexidine- including sporicidal action

Con

  • lack its persistent activity on skin
  • require time on skin before becoming active
17
Q

Chlorine

A

strong oxidizing agent and universal disinfectant

most commonly provided as a 5.25% sodium hypochlorite solution (household bleach )

disinfection of blood spills

Alternative chlorine-releasing compounds include chlorine dioxide and chloramine T
-These agents retain chlorine longer and have a prolonged bactericidal action

Pro:
strong disinfectant effect

Con

  • Frequent opening and closing of the container reduces the activity markedly
  • inactivated by blood, serum, feces, and protein-containing materials - surfaces should be cleaned before use
  • Corrosive to aluminum, silver, and stainless steel

autooxidized in contact with air

18
Q

Phenolics

A

oldest surgical antiseptics

bactericidal (including mycobacteria), fungicidal viricidal, NOT sporicidal

no longer used

  • corrosive effect on tissues
  • toxicity when absorbed
  • carcinogenic effect

These adverse actions are diminished by forming derivatives (o-phenylphenol, o-benzyl-p-chlorophenol, and p-tertiary amylphenol)

used for hard surface decontamination in hospitals and laboratories (floors, beds, and counter or bench top)

Con:
Skin absorption and skin irritation still occur with derivatives

19
Q

Quaternary ammonium compounds (“quats”)

A

surface-active detergents

widely used as disinfectants

Mechanism: to inactivation of energy-producing enzymes, denaturation of proteins, and disruption of the cell membrane

used for sanitation of noncritical surfaces (floors, bench tops, furniture, and walls, equipment that contacts intact skin (blood pressure cuffs))

20
Q

Spaulding classification

not important

A

The system classifies a medical device as critical, semicritical, or noncritical on the basis of:

  • risk to patient safety from contamination on a device
  • strategy for reprocessing contaminated medical devices
21
Q

Critical Items

not important

A

confer a high risk for infection if they are contaminated with any microorganism

  • objects that enter sterile tissue or the vascular system
  • must be sterile
  • surgical instruments, cardiac and urinary catheters, implants, and ultrasound probes used in sterile body cavities
22
Q

Semicritical Items

not important

A

contact mucous membranes or nonintact skin

  • respiratory therapy and anesthesia equipment, some endoscopes, laryngoscope blades, cystoscopes…
  • small numbers of bacterial spores are permissible
  • Glutaraldehyde, hydrogen peroxide, ortho-phthalaldehyde, and peracetic acid with hydrogen peroxide
23
Q

Noncritical Items

not important

A

come in contact with intact skin but not mucous membranes

bedpans, blood pressure cuffs, crutches and computers

24
Q

Aldehydes

A

Formaldehyde, glutaraldehyde, Ortho-phthalaldehyde

used for disinfection or sterilization of instruments such as fiberoptic endoscopes, respiratory therapy equipment, hemodialyzers, and dental handpieces that cannot withstand exposure to the high temperatures of steam sterilization

Pro:

  • not corrosive for metal, plastic, or rubber
  • broad spectrum of activity (bactericidal, sporicidal, fungicidal)

Con:

  • Failure of disinfection due to presence of organic material
  • formaldehyde is a potential carcinogen, highly irritating to respiratory mucous membranes and eyes
  • Protection of health care workers is needed (Ortho-phthalaldehyde is safe)

disrupt proteins?

25
Q

Peroxygen compounds

A

hydrogen peroxide and peracetic acid

high killing activity and a broad spectrum against bacteria, spores, viruses, and fungi

their decomposition products are not toxic and do not injure the environment

26
Q

Peroxygen compounds - hydrogen peroxide

A
  • disinfection of respirators, soft contact lenses…
  • 10–25% hydrogen peroxide are sporicidal
  • Automated equipment using vaporized hydrogen peroxide or hydrogen peroxide mixed with formic acid is available for sterilizing endoscopes
  • 3% solution of hydrogen peroxide is commonly used as a wound antiseptic
27
Q

Peroxygen compounds Peracetic acid (CH3COOOH)

A
  • hydrogen peroxide + acetic acid + sulfuric acid as a catalyst
  • more active than hydrogen peroxide as a bactericidal and sporicidal agent
  • An automated machine - developed for sterilization of medical, surgical, and dental instruments.
  • hemodialyzers
  • potent tumor promoter
28
Q

Heavy metals

A

principally mercury and silver

rarely used as disinfectants

29
Q

Heavy metals - mercury

A

Pro:
thimerosal (organomercury compound) 0.001–0.004% is still used safely as a preservative of vaccines, antitoxins, and immune sera

Con:

  • environmental hazard
  • some pathogenic bacteria have developed plasmid-mediated resistance
  • Hypersensitivity (in up to 40% of the population)
30
Q

Heavy metals - silver

A

Inorganic silver salts are strongly bactericidal

Silver nitrate 1:1000, has been most commonly used - gonococcal ophthalmitis in newborns (Credé’sprophylaxis)

Silver sulfadiazine used to suppress bacterial growth in burn wounds

31
Q

*Octenidine

A

cationic antiseptic

It is bactericidal against Gram-positive and Gram-negative bacteria as well as fungicide.

Octenidine may have a larger antibacterial activity spectrum than chlorhexidine, in particular towards Gram-negative bacteria.

A development of resistance to octenidine has not been reported.

No side effects of octenidine have been described.

32
Q

Sterilisation

A

validated process used to render a product free of all forms of viable microorganisms.

33
Q

Sterilants

A

Autoclaving for many year: pressurized steam at 120°C for 30 minutes

When autoclaving is not possible (lensed instruments, plastic and rubber) - ethylene oxide - 440–1200 mg/L at 45–60°C with 30–60% relative humidity
-Con: classified as a mutagen and carcinogen

34
Q

Alternative sterilants now being used increasingly

A
  1. vapor phase hydrogen peroxide
  2. peracetic acid
  3. Ozone !
  4. gas plasma
  5. chlorine dioxide
  6. Formaldehyde
  7. propylene oxide
  8. UV-light

Pharma- Antimicrobial drugs (12 decks)

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