(MIDTERM) Anti-Infectives Flashcards
1
Q
Standards for Removing Microorganisms
A
- ANTISEPSIS
- DISINFECTION
- DECONTAMINATION
- SANITATION
- STERILIZATION
- PASTEURIZATION
2
Q
The combination of processes that removes or destroys contamination to prevent an infectious agent or contaminant from reaching a susceptible site
A
DECONTAMINATION
3
Q
A set of practices or procedures to ensure that good hygiene is being maintained to prevent disease due to waste
A
SANITATION
3
Q
Processes that will result in a surface/object being free from any microorganisms or viruses
A
STERILIZATION
4
Q
ANTISEPTIC - Compounds that either kill (___________) or prevent the growth (______________) of microorganisms when applied to
________________________
A
CIDAL
STATIC
LIVING TISSUES
4
Q
Processes of food preservation that eliminate pathogens by using gentle heat in order to extend
shelf life
A
PASTEURIZATION
5
Q
Ideal Antiseptics:
A
- Low toxicity
- Sustained and rapid lethal action against microorganisms
- Low surface tension
- Non-irritating and non-allergenic
6
Q
DISENFECTANT - Prevents the transmission of infection by what means?
Applied to ____________________
A
INANIMATE OBJECTS /NON LIVING OBJECTS
7
Q
Ideal Disinfectants:
A
- Exerts rapid lethal action against microorganisms including the
spores (inactive form). - Good penetrating properties in organic matter
- Not inactivated by living tissues
- Non-corrosive
7
Q
Exerts rapid lethal action against microorganisms including the
__________________
A
SPORES (inactive form)
8
Q
Susceptibility Testing:
* Against Staphylococcus aureus
- Studies determine the concentration of alcohol that shows
effectiveness in killing the bacteria
A
ALCOHOLS (R-OH)
9
Q
Effectivity of Alcohol
* Up to 8 carbons
* Antibacterial Property DECREASES with BRANCHING:
- 1 > 2 > 3 Alcohols
A
ALCOHOLS (R-OH)
10
Q
Against Staphylococcus aureus
A
Susceptibility Testing
11
Q
Studies determine the concentration of alcohol that shows effectiveness in killing the bacteria
A
Susceptibility Testing
12
Q
Up to 8 carbons
A
Effectivity of Alcohol
13
Q
Antibacterial Property DECREASES with BRANCHING:
A
1 > 2 > 3 Alcohols
14
Q
ETHANOL, USP
Primary Use:
A
_ External Application
- Antiseptic
- Mild astringent
- Anesthetic properties
14
Q
Antibacterial Property DECREASES with BRANCHING:
1 > 2 > 3 Alcohols
A
Effectivity of Alcohol
14
Q
ALCOHOLS:
A
1.) ETHANOL, USP
2.) ISOPROPYL ALCOHOL
15
Q
Composed of Benzene + Methanol (AKA Wood Alcohol)
A
Denatured Alcohol
15
Q
AKA: Wine spirit, Ethyl alcohol
A
1.) ETHANOL, USP
16
Q
ETHANOL, USP
Available Concentrations:
A
95% = Absolute Alcohol
70% = Accepted BACTERICIDAL Concentration
49-50% = Diluted Alcohol
17
Q
Absolute Alcohol
A
95%
18
Q
Accepted BACTERICIDAL Concentration
A
70%
19
Diluted Alcohol
49-50%
20
99% Ethanol, obtained via absolute
azeotropic distillation of ethanol and benzene
Dehydrated Alcohol
21
* Series of OXIDATION
* Primary Enzymes Involved:
- Alcohol dehydrogenase
- Aldehyde dehydrogenase
Metabolism of Ethanol
21
ETHANOL, USP
Primary Enzymes Involved:
* Alcohol dehydrogenase
* Aldehyde dehydrogenase
21
A Carcinogen
Acetaldehyde
21
Metabolism of Ethanol
Ethanol ----------ALCOHOL
DEHYDROGENASE-----------> Acetaldehyde --------ALDEHYDE DEHYDROGENASE-----------> Acetic Acid
21
Accumulates and
Causes Flushing
Syndrome in Ethanol
Intoxication
Acetaldehyde
22
Component of
Vinegar
Acetic Acid
23
Excreted via Urine
Acetic Acid
24
AKA Rubbing Alcohol
ISOPROPYL ALCOHOL
25
Substitute for ethanol
ISOPROPYL ALCOHOL
26
ISOPROPYL ALCOHOL
Concentrations Available:
* 91% v/v solution
* 70% = Concentration of Commercial RUBBING ALCOHOL
27
ISOPROPYL ALCOHOL
Preparation:
Sulfuric acid-catalyzed hydration of propylene
28
ISOPROPYL ALCOHOL
Bactericidal Concentration Range:
60% - 90% v/v
29
v/v solution
91%
30
Concentration of Commercial RUBBING ALCOHOL
70%
31
An EPOXIDE
Ethylene Oxide
32
Refers to CYCLIC ETHERS (R-O-R) or Ethers in Ring Form
EPOXIDE
33
A colorless, flammable gas
EPOXIDE
34
Employed in Gas Sterilization of HEAT-SENSITIVE MATERIALS such as plastic
EPOXIDE
35
* ALKYLATION of proteins, DNA, and RNA
* Resulting in cell disruption, inactivation, and ultimately death
Mechanism of Germicidal Action:
36
Ethylene Oxide
Advantage:
Readily diffuses to porous materials
37
Ethylene Oxide
Disadvantages:
* A carcinogen
* Extremely toxic, especially in repeated exposures
* Flammable and may cause spontaneous combustion
38
Measurement of a disinfectant‘s effectiveness compared to Phenol
Phenol coefficient
39
Determine the Dilution of a Disinfectant to kill Salmonella typhi then, compares it to the Dilution of Phenol that kills the same bacteria
Phenol coefficient
40
Phenol coefficient
If value is <1 =
Lower Efficacy
41
Phenol coefficient
If value is >1 =
Greater Efficacy
42
Activity of Phenols Based on Concentration:
* Low Concentration = Achieves Protein Denaturation
* High Concentration = Achieves Lysis
43
Achieves Protein Denaturation
Low Concentration
44
Achieves Lysis
High Concentration
45
STRUCTURE-ACTIVITY RELATIONSHIP OF PHENOLS
* 2 Activities of Phenols are increased if:
1. Substitution at the PARA (p) POSITION
(2) R-Group is Substituted with Halogens
46
Activity is further increased if substituted with a LARGER ELECTRON SHELL OR RADIUS
(2) R-Group is Substituted with Halogens
47
PHENOLICS
1.) PHENOL
2.) p-CHLOROPHENOL
3.) HEXACHLOROPHENE
4.) CRESOL
5.) CHLOROCRESOL
6.) THYMOL
7.) EUGENOL
8.) RESORCINOL
9.) HEXYLRESORCINOL
48
AKA “Carbolic acid”
PHENOL
49
Described as a Pale pink crystalline material
PHENOL
50
Proponent for Use of Phenol as _______________
Disinfectant
50
Surgical antiseptic in 1867
Joseph Lister - PHENOL
50
0.1 – 1% Phenol
Phenolated calamine lotion
50
PHENOL
Preparations and Concentrations:
* Phenolated calamine lotion (0.1 – 1% Phenol)
* 4% Phenol Solution – Used to Cauterize small wounds
50
Used in combination with camphor in liquid petrolatum
p-CHLOROPHENOL
50
p-CHLOROPHENOL
Primary Use =
External antiseptic and anti-irritant
51
Used to Cauterize small wounds
4% Phenol Solution
51
PHENOLICS
Phenol Coefficient:
4
51
HEXACHLOROPHENE
Structure:
Biphenol Ring
51
* Insoluble in water
* Soluble in alcohol and other organic solvents
HEXACHLOROPHENE
51
Structure: Biphenol Ring
Increased Potency
52
HEXACHLOROPHENE
Use:
Topical applications
53
HEXACHLOROPHENE
Gram (+)
Gram (–) = Resistant
54
Obtained from coal tar in
petroleum via alkaline
extraction or distillation
CRESOL
55
CRESOL
Phenol Coefficient:
2.5
56
* Preservative, disinfectant, antiseptic, and preservative in pharmaceutical products
- Highly potent
* Slightly soluble in water
CHLOROCRESOL
57
Slightly soluble in water
- Highly potent
CHLOROCRESOL
57
Preservative, disinfectant, antiseptic, and preservative in pharmaceutical products
CHLOROCRESOL
58
Thyme sn
Thymus vulgaris
58
A volatile oil from Thyme (Thymus vulgaris)
THYMOL
59
THYMOL
Use:
* Mild fungicidal
* Ringworm infection
59
* A volatile oil from Thyme (Thymus vulgaris)
* Slightly soluble in water
* Soluble in alcohol
* Use:
- Mild fungicidal
- Ringworm infection
THYMOL
60
Local anesthetic and antiseptic property
EUGENOL
61
Component in Toothache Drops and Mouthwashes
EUGENOL
62
* Weak antiseptic
* Use:
- Keratolytic agent
* Soluble in water and alcohol
* Light sensitive and readily oxidizes
* Phenol coefficient:
- 0.4
RESORCINOL
62
EUGENOL
Phenol coefficient:
14.4
63
Weak antiseptic
RESORCINOL
63
RESORCINOL
Use:
Keratolytic agent
64
RESORCINOL
Phenol coefficient:
0.4
65
AKA 4-hexylresorcinol
HEXYLRESORCINOL
66
HEXYLRESORCINOL
Effect:
Produces numbness when applied to tongue
67
HEXYLRESORCINOL
Use:
Surfactant, Anesthetizing activity
68
HEXYLRESORCINOL
Phenol coefficient against S. aureus:
98
69
OXIDIZING AGENTS
Mechanism of Action:
Liberation of Nascent Oxygen
69
AKA Agua Oxigenada
HYDROGEN PEROXIDE
69
A short-lived, highly reactive form of oxygen
Liberation of Nascent Oxygen
69
AKA Monoatomic Oxygen
Liberation of Nascent Oxygen
69
Produced by the __________________________ to form its individual atomic components [O]
decomposition (breakdown) of Diatomic Oxygen [O2]
69
* AKA Monoatomic Oxygen
* A short-lived, highly reactive form of oxygen
* Produced by the decomposition (breakdown) of Diatomic Oxygen [O2] to form its individual atomic components [O]
* Considered a free radical due to its unpaired electron, making it highly reactive
Liberation of Nascent Oxygen
69
Considered a ______________ due to its unpaired electron, making it
highly reactive
free radical
69
OXIDIZING AGENTS
Examples:
Hydrogen Peroxide
Carbamide Peroxide
Benzoyl Peroxide
70
Has POOR TISSUE PENETRABILITY
HYDROGEN PEROXIDE
70
HYDROGEN PEROXIDE
Efficacy:
Active against ANAEROBIC MICROORGANISMS
70
A common group of bacteria that harbors the skin
ANAEROBIC MICROORGANISMS
70
Use limited as TOPICAL AGENT, especially for WOUND CLEANING
HYDROGEN PEROXIDE
70
* AKA Agua Oxigenada
* Use limited as TOPICAL AGENT, especially for WOUND CLEANING
* Efficacy:
- Active against ANAEROBIC MICROORGANISMS
- A common group of bacteria that harbors the skin
* Has POOR TISSUE PENETRABILITY
HYDROGEN PEROXIDE
71
A complex that contains UREA and HYDROGEN PEROXIDE
CARBAMIDE PEROXIDE
72
CARBAMIDE PEROXIDE
3 Uses:
- Antiseptic and Disinfectant
- Treatment of Oral Ulceration
- Aid in earwax removal
72
BENZOYL PEROXIDE
2 Uses:
- Keratolytic
- Antibacterial agent against Cutibacterium acnes
72
Antibacterial agent against Cutibacterium acnes:
A causative agent for acne
72
* Induces cell proliferation (epithelial), leading to sloughing and repair
- Results in loosening and removal of dead skin cells
BENZOYL PEROXIDE
Mechanism of Action (Keratolytic):
73
Component of PanOxyl
BENZOYL PEROXIDE
74
2 HALOGEN- CONTAINING COMPOUNDS
1.) CHLORINE
2.) IODINE AND IODOPHORS
75
All Preparations containing Iodine are _______________
BACTERICIDAL
75
CHLORINE
Uses:
- Water disinfectant
- Bleaching agent
75
Bleaching agent
Example:
Sodium Hypochlorite (Zonrox)
75
* Readily penetrates the bacterial cell membrane, leading to its disruption due to the formation of holes.
* Resulting to leakage of intracellular contents
CHLORINE
Mechanism of Action
75
IODINE AND IODOPHORS
Action:
All Preparations containing Iodine are BACTERICIDAL
76
IODINE AND IODOPHORS
Preparations:
- Iodine Tincture
- Iodine Solution
- Lugol’s Solution
76
2% Elemental Iodine in 50% Alcohol
Iodine Tincture
76
2% Elemental Iodine
Iodine Solution
76
Utilizes non-ionic surfactant
Iodophors
76
5% Elemental Iodine
Lugol’s Solution
76
AKA Strong Iodine Solution
Lugol’s Solution
76
AKA Iodine in Potassium Iodide (I2-KI)
Lugol’s Solution
76
_____________ of nucleotides (DNA/RNA Components) and fatty/amino acids (Fats/Proteins)
OXIDATION
77
* Rapid penetration of bacterial cell wall
* OXIDATION of nucleotides (DNA/RNA Components) and fatty/amino acids (Fats/Proteins)
* Resulting in the disruption of vital cellular mechanisms and the
deactivation of proteins and bacterial DNA/RNA
* Ultimately leading to CELL DEATH
Mechanism of Action of Iodine Preparations
77
Rapid penetration of bacterial cell wall
Mechanism of Action of Iodine Preparations
77
Ultimately leading to CELL DEATH
Mechanism of Action of Iodine Preparations
77
Preparation that releases iodine
Iodophors
77
Utilizes non-ionic surfactant
Example:
Polyvinylpyrrolidone (PVP)
78
Added to Iodine to produce a Water-Soluble Complex
Polyvinylpyrrolidone (PVP)
79
Slowly releases iodine
Polyvinylpyrrolidone (PVP)
80
REDUCES STAINING and irritation as compared when using Iodine alone
Polyvinylpyrrolidone (PVP)
81
Iodophors
Iodophors
82
Contains Polyvinylpyrrolidone (PVP)
POVIDONE-IODINE
83
Active component in Betadine
POVIDONE-IODINE
84
POVIDONE-IODINE
Use:
Antiseptic and disinfectant
85
POVIDONE-IODINE
Advantage as Compared to Using Iodine Alone:
- Less staining
- More washable
86
* Contains a POSITIVELY CHARGED HEAD, which interacts with the
Negatively Charged Surfaces of the Cell Membrane
* Penetrates the membrane, disrupts cellular proteins and nucleic
acid
* Leads to INCREASED MEMBRANE PERMEABILITY
- Resulting in leakage of cellular contents
CATIONIC SURFACTANTS
Mechanism of Action
87
Leads to INCREASED MEMBRANE PERMEABILITY:
Resulting in leakage of cellular contents
88
BENZALKONIUM CHLORIDE
Other uses:
- Detergent
- Treatment of Nail infections
- Nail antiseptic, current component of Merthiolate
88
CATIONIC SURFACTANTS:
1.) BENZALKONIUM CHLORIDE
2.) METHYLBENZETHONIUM CHLORIDE
3.) CETYLPYRIDINIUM CHLORIDE
4.) CHLORHEXEDINE
88
BENZALKONIUM CHLORIDE
Pharmaceutical Application:
Emulsifying agent
88
Former: Thimerosal (Mercury-Compound)
88
BENZALKONIUM CHLORIDE
Precaution:
Inactivated by soaps, anionic and non-ionic surfactants
88
Treatment of DIAPER RASH in infants
METHYLBENZETHONIUM CHLORIDE
88
Caused by Candida
Treatment of DIAPER RASH in infants
88
Component of Diaparene
Treatment of DIAPER RASH in infants
88
General antiseptic in concentrations of:
1:100
1:1,000
1:10,000 solution
CETYLPYRIDINIUM CHLORIDE
88
General antiseptic in concentrations of:
1:100
1:1,000
1:10,000 solution
89
Component of THROAT LOZENGES and MOUTHWASHES at a 1:20,000 dilution
CETYLPYRIDINIUM CHLORIDE
89
CETYLPYRIDINIUM CHLORIDE
Example:
Difflam Lozenges
89
CHLORHEXEDINE
Use:
* Wound Irrigation
* Component of Mouthwashes
- Example: Orahex Mouthwash
89
CHLORHEXEDINE
Example:
Orahex Mouthwash
89
DYES
Effectiveness:
Exists in a Cationic Form
89
Active against BACTERIA
Exists in a Cationic Form
89
DYES
Mechanism of Action: VARIES
* Membrane disruption
* Reactive oxygen species (Free radicals) generation
89
Membrane disruption:
Similar to Cationic surfactants and Halogens
89
Reactive oxygen species (Free radicals) generation:
Similar to Oxidizing agents
89
3 EXAMPLES OF DYES
1.) GENTIAN VIOLET
2.) BASIC FUCHSIN, USP
3.) METHYLENE BLUE
90
Chemically:
* Hexamethyl-prosaniline chloride
GENTIAN VIOLET
91
Also known as:
- CRYSTAL VIOLET
- Methyl Violet
GENTIAN VIOLET
91
Use:
- Vaginal suppositories
- Treatment of Ringworm (Candida) and Yeast Infection
GENTIAN VIOLET
91
Component of Castellani’s paint
Antifungal product used to treat Tinea cruris
BASIC FUCHSIN, USP
92
Treatment of fungal infections:
- Ringworm
- Athlete’s foot (Tinea pedis)
BASIC FUCHSIN, USP
92
Treatment of fungal infections:
- Ringworm
- Athlete’s foot (Tinea pedis)
93
METHYLENE BLUE
Properties;
Weak Antiseptic
93
Treatment of:
- Cystitis
- Urethritis
METHYLENE BLUE
94
Infection of the Bladder caused by Urinary Tract Infection
Cystitis
94
Inflammation of the Urethra caused by infection
Urethritis
94
Mercury BINDS to microbial enzymes, particularly those containing
Sulfhydryl Group (-SH) and reacts to form a COVALENT BOND
(irreversible) R-S-HG-R Group
Mechanism of Action of Mercury-Containing Compounds
94
* Historically, Elemental mercury was once used in the treatment of
Syphilis (Treponema pallidum) = Calomel (Mercurous chloride)
* Mercury salts were formerly used as anti-inflammatory
Uses of Mercury-Containing Compounds
94
Historically, _______________ was once used in the treatment of
Syphilis (Treponema pallidum) = Calomel (Mercurous chloride)
Elemental mercury
94
Syphilis sn
Treponema pallidum
95
Mercurous chloride
Calomel
95
____________ were formerly used as anti-inflammatory
Mercury salts
96
Mercury-Containing Compounds
Disadvantage:
Mercury Toxicity
96
2 EXAMPLES OF Mercury-Containing Compounds
1. Thimerosal
2. Nitromersol
96
* Antiseptic
- Former component of the Nail Antiseptic Merthiolate
THIMEROSAL
97
* Preservative in Multi-Dose Vaccines
- Example: Bacillus-Calmette-Guerin (BCG) Vaccine used against Tuberculosis
- Replaced due to potential mercury toxicity
THIMEROSAL
98
Preservative in Multi-Dose Vaccines
Example:
Bacillus-Calmette-Guerin (BCG) Vaccine used against Tuberculosis
99
______________________ Vaccine used against Tuberculosis
Bacillus-Calmette-Guerin (BCG)
100
Effective in LOW CONCENTRATIONS against ALL POSSIBLE MICROORGANISMS
Preservatives
Effectivity
100
NITROMERSOL
Use:
* Antiseptic
- Skin infection
- Other Ocular infections
100
Replaced due to potential mercury toxicity
Preservative in Multi-Dose Vaccines
100
Preservatives
Advantages:
* Non-Toxic
* Compatible
* Stable
100
Active against YEAST
ETHYLPARABEN
100
Preservative in many cosmetic and food products
PARABENS
100
* Para-Substituted Ester Group in Phenol Ring
* R-Group is Substituted by Alkyl Groups:
- Methyl
- Ethyl
- Butyl
PARABENS;
General Sturcture & Structure-Activity Relationship
100
2 EXAMPLES OF Preservatives
1. PARABENS
2. BENZOIC ACID
100
R-Group is Substituted by Alkyl Groups:
- Methyl
- Ethyl
- Butyl
100
4 EXAMPLES OF PARABENS
(1) METHYLPARABEN
(2) ETHYLPARABEN
(3) PROPYLPARABEN
(4) BUTYLPARABEN
100
Active against BOTH MOLD
PROPYLPARABEN
100
Active against MOLDS
METHYLPARABEN
100
Active against BOTH MOLDS & YEAST
BUTYLPARABEN
100
Its sodium salt SODIUM BENZOATE
is commonly used:
More soluble in Water
100
Its sodium salt SODIUM BENZOATE
is commonly used
BENZOIC ACID
100
Inhibits growth of BACTERIA,
MOLDS, & YEAST in acidic
environments
BENZOIC ACID
100
__________________ in Phenol Ring
Para-Substituted Ester Group
100
Its sodium salt _____________
is commonly used
SODIUM BENZOATE
