MIDTERM 01 - Local Anti-infectives Flashcards by Juan Carlos Cornelio

He discovered carbolic acid (phenol) in 1867; he is considered as the “father of antiseptic surgery”

Joseph Lister

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He created antibacterial dyes and antiparasitic organic arsenicals; he also created salvarsan, which is used to treat syphilis; he is considered as the “father of chemotherapy”

Paul Ehrlich

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Paul Ehrlich proposed the principle of __________, which refers to the property of certain chemicals to kill one type of organism while not harming another

Selective toxicity

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Year when antimicrobial agents were first used

1920s

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Anti-infective agents were based on the group-IIB element __________ and group-VA elements __________ and __________ (MAA)

Mercury, Arsenic, Antimony

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Year when sulfonamides and sulfones were first used

1950s

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Are anti-infective agents that are used locally

Germicides

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Are compounds that kill or prevent the growth of microorganisms when applied to living tissue (Subtypes of germicides)

Antiseptics

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Are agents that prevent transmission of infection by the destruction of pathogenic microorganisms when applied to inanimate objects (Subtypes of germicides)

Disinfectants

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The most important means of preventing transmission

Handwashing

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Application of an agent to living tissue for the purpose of preventing infection (Standards for removing microorganisms)

Antisepsis

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Destruction or marked reduction in the number or activity of microorganisms (Standards for removing microorganisms)

Decontamination

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Chemical or physical treatment that destroys most vegetative microbes or viruses, but not spores, in or on inanimate surfaces (Standards for removing microorganisms)

Disinfection

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Reduction of microbial load on an inanimate surface to a level considered acceptable for public health purposes (Standards for removing microorganisms)

Sanitization

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A process intended to kill or remove all types of microorganisms, including spores, and usually including viruses with an acceptably low probability of survival (Standards for removing microorganisms)

Sterilization

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A process that kill nonsporulating microorganisms by hot water or steam at 65°C-100°C (Standards for removing microorganisms)

Pasteurization

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Activity __________ with molecular weight (SAR of primary alcohols against S. aureus)

Increases

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As chain length __________, van der Waals interactions increase, and the ability to penetrate microbial membranes increases (SAR of primary alcohols against S. aureus)

Increases

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As water solubility __________, the apparent antimicrobial potency diminishes (SAR of primary alcohols against S. aureus)

Decreases

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Branching of the alcohol chain __________ antibacterial property (SAR of primary alcohols against S. aureus)

Decreases

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Mechanism of action for primary alcohols

Protein and carbohydrate denaturation

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Ranking of alcohols according to activity

Primary > Secondary > Tertiary

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A product of fermentation from grains and many other carbohydrates; by hydration of ethylene (Alcohol and related compounds)

Ethanol (Ethyl alcohol, Wine spirit)

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Is ethanol that has been rendered unfit for use in intoxicating beverages by the addition of other substances (Alcohol and related compounds)

Denatured alcohol (Methylated spirits, Denatured rectified spirit)

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Contains added wood alcohol (methanol) and benzene and is unsuitable for either internal or external use (Alcohol and related compounds - denatured alcohol)

Completely denatured alcohol

Is ethanol treated with one or more substances so that its use may be permitted for a specialized purpose (Alcohol and related compounds - denatured alcohol)

Specially denatured alcohol

__________ is externally used as an antiseptic, preservative, and mild counterirritant

Alcohol

__________ is used as an astringent, rubefacient, and mild local anesthetic

Rubbing alcohol

__________ is injected near nerves and ganglia to alleviate pain; has a low narcotic potency and is used internally in diluted form as a mild sedative

Ethanol

Uses ethanol as sole solvent (Examples of alcohol preparations)

Spirits

Uses water and ethanol as solvent (Examples of alcohol preparations)

Tinctures

Uses ethanol as cosolvent (Examples of alcohol preparations)

Fluidextracts

Drug that inhibits aldehyde dehydrogenase; used to treat alcoholism

Disulfiram (Antabuse)

Contains NLT 99% w/w C2H5OH; used as a chemical reagent or solvent; is not ingested (Alcohol and related compounds)

Dehydrated alcohol (Absolute ethanol)

Considered as a suitable substitute for ethanol; used as antiseptic for the skin and disinfectant for surgical instruments (Alcohol and related compounds)

Isopropyl alcohol

_________% concentration is considered equal in antiseptic efficacy to a 60% ethanol in water solution

40%

Used to sterilize medical equipment and certain pharmaceuticals that cannot be heat-sterilized in an autoclave (Alcohol and related compounds)

Ethylene oxide (C2H4O)

Ethylene oxide forms explosive mixtures in air at concentrations ranging from __________ to __________ by volume

3%-80%

A commercial sterilant containing 10% ethylene oxide and 90% carbon dioxide by volume

Carboxide

Is irritating to mucous membranes, causes hardening of the skin, and is carcinogenic (Aldehyde compounds)

Formaldehyde (Formalin)

Formalin contains NLT __________% w/v of formaldehyde

37%

Is used as a dilute solution for sterilization of equipment and instruments that cannot be autoclaved; is stabilized in alkaline solution (Aldehyde compounds)

Glutaraldehyde

Remains the standard to which the activity of most germicidal substances is compared

Phenol, USP

The ratio of a dilution of a given test disinfectant to the dilution of phenol that is required to kill a strain of Salmonella typhi under carefully controlled time and temperature conditions

Phenolic coefficient

Substitution of alkyl, aryl, and halogen (especially in the __________ position) increases bactericidal activity (SAR of phenol)

Para

Substitution with alkyl, aryl, and halogen (especially in the para position) groups __________ bactericidal activity (SAR of phenol)

Increases

Straight-chain alkyl groups __________ bactericidal activity more than branched groups (SAR of phenol)

Enhance

Alkylated phenols and resorcinols are __________ toxic than the parent compounds while retaining bactericidal properties (SAR of phenol)

Less

Phenols denature bacterial proteins at __________ concentrations (SAR of phenol)

Low

Lysis of bacterial cell membranes with phenols occur at __________ concentrations (SAR of phenol)

Higher

Considered as a protoplasmic poison (caustic to the skin); is used occasionally as an antipruritic in phenolated calamine lotion (Phenols and their derivatives)

Phenol/Carbolic acid

Is simply phenol containing 10% water; the liquid form is convenient because it can be measured and transferred easily (Phenols and their derivatives)

Liquefied phenol

Used in combination with camphor in liquid petrolatum as an external antiseptic and anti-irritant (Phenols and their derivatives)

p-Chlorophenol

Phenol coefficient of p-chlorophenol

A nonirritating antiseptic agent; marketed in a 2% conc. as a shampoo; used topically for the treatment of Tinea (ringworm) infections such as athlete's foot (Tinea pedis) and jock itch (Tinea cruris) (Phenols and their derivatives)

p-Chloro-m-xylenol (PC-MX; Metasep)

A biphenol that generally possesses greater potency than a monophenol; increased degree of chlorination increases its antiseptic potency further; banned by the FDA as an OTC (Phenols and their derivatives)

Hexachlorophene

A mixture of isomeric methylphenols; has an unpleasant odor (Phenols and their derivatives)

Cresol

Phenol coefficient of cresol

2.5

A component of Strepsils that is an example of cresol derivative

Amylmetacresol

Is only slightly soluble in water; at the low concentration that can be achieved in aqueous media, the compound is only useful as a preservative (Phenols and their derivatives)

Chlorocresol (4-chloro-3-methylphenol)

Is extracted from the oil of thyme (Thymus vulgaris); has mild fungicidal properties and is used in alcohol solutions and dusting powders to treat Tinea (ringworm) infections (Phenols and their derivatives)

Thymol

Is obtained primarily from clove oil; has both anesthetic and antiseptic activity and can be directly applied on a piece of cotton to relieve toothaches; also used in mouthwashes (Phenols and their derivatives)

Eugenol

Phenol coefficient of eugenol

4.4

A weak antiseptic; a keratolytic agent; used in 1-3% concentrations in solutions, ointments, and pastes, and in 10-20% concentrations for the treatment of skin conditions (Phenols and their derivatives)

Resorcinol (m-Dihydroxybenzene; Resorcin)

Phenol coefficient of resorcinol

0.4

An effective antiseptic (both bactericidal and fungicidal); it possesses surfactant properties; has local anesthetic activity (Phenols and their derivatives)

Hexylresorcinol (4-Hexylresorcinol)

Phenol coefficient of hexylresorcinol

The germicidal activity of __________ depend on their ability to liberate oxygen in the tissues

Oxidizing agents

Is a stable complex of urea and hydrogen peroxide; used as an antiseptic and disinfectant; effective in the treatment of oral ulcerations and in dental care (Oxidizing agents)

Carbamide peroxide topical solution

In its pure powder form, it is explosive; in 5% & 10% concentrations, it is used as a keratolytic and keratogenic; it is used in the treatment of acne (Oxidizing agents)

Hydrous benzoyl peroxide

Used in iodine tincture, strong iodine solution, and iodine solution; one of the most effective and useful of the germicides

Elemental iodine (I2)

Probably acts to inactivate proteins by iodination of aromatic residues and oxidation; used as a bactericidal and fungicidal (Halogen containing agents)

Iodophors

Used in presurgical disinfection of the incision site; used to treat infected wounds and damage to the skin; effective for both bacterial and fungal infections (Halogen containing agents - iodophors)

Povidone-iodine (Betadine; Isodine; Polymer polyvinylpyrrolidone [PVP] - iodine)

2% iodine in 50% alcohol with sodium iodide (Examples of iodine preparations)

Iodine tincture

5% iodine in water with potassium iodide (Examples of iodine preparations)

Strong iodine solution (Lugol's solution)

2% iodine in water with sodium iodide (Examples of iodine preparations)

Iodine solution

Optimal antiseptic effect of chlorine-containing compounds is at around pH __________

HClO (Organic or inorganic chlorine-containing compound)

Inorganic

NaOCl (Organic or inorganic chlorine-containing compound)

Inorganic

Ca(OCl)2 (Organic or inorganic chlorine-containing compound)

Inorganic

N-chloro compounds (Organic or inorganic chlorine-containing compound)

Organic

A photosensitive compound; is used to disinfect drinking water (Halogen containing agents - chlorine containing compounds)

Halazone (p-Dichlorosulfamoylbenzoic acid)

Unstable to light or heat; used in very dilute solutions to disinfect wounds, as packing for dental caries, and for lavage and irrigation (Halogen containing agents - chlorine containing compounds)

Chloroazodin (N,N-Dichlorodicarbonamidine; Azochloramid)

Chloroazodin explodes above __________°C

155°C

The antiseptic action of __________ is long lasting because of its extremely slow reaction with water (Halogen containing agents - chlorine containing compounds)

Chloroazodin

Is the complex of the sodium salt of dodecylbenzenesulfonic acid and hypochlorous acid; has rapid-cidal action against most microorganisms (Halogen containing agents - chlorine containing compounds)

Oxychlorosene sodium (Oxychlorosene; Clorpactin)

Compounds that are ionized in water and exhibit surface-active properties (Cationic surfactants)

Quaternary ammonium compounds

2 structural moieties of quaternary ammonium compounds

Cationic head group (hydrophilic); Long hydrocarbon tail (lipophilic)

Benzalkonium chloride, methylbenzethonium chloride, benzethonium chloride, cetylpyridinium chloride, and chlorhexidine gluconate are all examples of __________

Quaternary ammonium compounds (Cationic surfactants)

Cationic dyes are active against __________ bacteria and many fungi

Gram-positive

__________ bacteria are generally resistant against cationic dyes

Gram-negative

Used as vaginal suppository for treatment of yeast infection and anthelmintic for strongyloides and oxyuriasis (Dyes)

Gentian violet (Crystal violet; Methyl violet)

Used as an ingredient of carbolfuchsin (Castellani's paint); treatment of fungal infection, ringworm, and athlete's foot (Dyes)

Basic Fuchsin

Used as treatment for methemoglobinemia (low conc.) and is a cause of methemoglobinemia (high conc.); used as an antidote for cyanide poisoning (Dyes)

Methylene blue

Used for syphilis (Mercurials - inorganic mercury compounds)

Elemental mercury

Used as an antiseptic (Mercurials - inorganic mercury compounds)

Mercuric chloride, Mercurous chloride (Calomel)

Used for skin infections such as impetigo, psoriasis, and ringworm (Mercurials - inorganic mercury compounds)

Ammoniated mercury [Hg(NH2)Cl]

Used for eye infection (Mercurials - inorganic mercury compounds)

Mercuric oxide

Its use is not recommended (Types of mercurials)

Inorganic mercury compounds

2 types of mercurials (IO)

Inorganic mercury compounds, Organic mercury compounds

Usually employed as antiseptics, preservatives, or diuretics (Types of mercurials)

Organic mercury compounds

Compounds with at least one carbon-mercury bond _________ ionize readily

Does not

Compounds with mercury bonded to heteroatoms (e.g., oxygen, nitrogen, sulfur) ionize __________ or __________ (PC)

Partially, Completely

Organic mercury compounds react with sulfhydryl (-SH) groups in enzymes and other proteins to form covalent compounds of the type __________

R-S-Hg-R

Are used to prevent microbial contamination and maintain sterility

Preservatives

Have antifungal properties; activity generally increases with molecular weight (Preservatives)

p-Hydroxybenzoic acid derivatives

__________ is most effective against molds (Preservatives - p-hydroxybenzoic acid derivatives)

Methyl ester

__________ is most effective against yeasts (Preservatives - p-hydroxybenzoic acid derivatives)

Propyl ester

The more lipid-soluble __________ is the preferred preservative for drugs in oil or lipophilic base (Preservatives - p-hydroxybenzoic acid derivatives)

Propyl ester

4 examples of p-Hydroxybenzoic acid derivatives (MEPB)

Methylparaben, Ethylparaben, Propylparaben, Butylparaben

A p-Hydroxybenzoic acid derivative that is not used in products anymore

Butylparaben