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鹂 Gastric discomfort: Nausea, vomiting, and diarrhea
Bony structures and Teeth :discoloration and hypoplasia of the teeth and a temporary stunting of growth
Fatal hepatotoxicity: in pregnant women
Phototoxicity: severe sunburn b 5 & f f & 3 & f f " ! & f f > b
7
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P 0 師 藿h ? TTr 棗 f f 乔 晻 垐 _ _ _ P P T 1 0 i . 兦0J + D= ' =
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穑 4. Vestibular problems: dizziness, nausea, vomiting
5. Pseudotumor cerebri: Benign intracranial
hypertension , headache , blurred vision
6. Superinfections: pseudomembranous enterocolitis B & f f & 3 & f f b 8 K
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p p t _ x < * T D ' = +襻 4 8 ?馾 C B 1 + # p p t _ h / 2 B C B # p p t _ y B *馳 3 > B
p p t _ y < * T +8 +0 + T 0 + T 0 { 餾 囗 X (
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饀 Section 2 Chloramphenicol & $ `
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饌 Chloramphenicol is either bacteriosestatic or bactericidal
It is active against both aerobic and anaerobic gram-positive and gram-negative organisms
It has effective against rickettsiae, helicoids, Chlamydia and mycoplasma. & f f H
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`
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饀 Chloramphenicol may be administered either intravenously or orally
It penetrate blood-brain barrier, placental barrier, blood-ocular barrier
It is inactivated by conjugation with glucuronic acid in liver, secreted by the renal tubule . & f f " $
- @` 餒
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稹
Bacterial meningitis: meningococcal meningitis
Rickettsial infections: typhus or Rocky Mountain spotted fever
Eye infection: outer eye infection, intraocular infection, eyeball infection
Anaerobic infection: peritoneal abscess, pelvic inflammation and peritonitis @ . & f f " & f f 0 @` 餒
d 0 師 藿h ? 33 洙 33 y _ _ _ P P T 1 0 Y + D= ' =
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h 鹦
h
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饞 " 0A d v e r s e e f f e c t 0 T & $ 3 & $ 3 & $ 3 & $ f3 饊
h
餤 T ? ? ? " I1
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餒 Bone marrow depression
Aplastic anemia
Gray baby syndrome:
poor feeding, depressed breathing,
cardiovascular collapse, cyanosis and death \ = \ ; & f f " " V & f f z @` 餒
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l 痄
l
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饸 & 0D r u g r e s i s t a n c e 0 X ' $ f3 & $ f3 & $ f3 ' $ f3 鹑
l
餤 % ? ? ? " m
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皎 P r o d u c e i n a c t i v a t o r a c e t y l c o e n z y m e A t r a n s f e r a s e
M e m b r a n e p e r m e a b i l i t y i s d e c r e a s e d , c h l o r a m p h e n i c o l p e n e t r a t e t h e o r g a n i s m l e s s " & f f H % @` 餒
l 0 師 藿h ? TTr 棗 f f 乔 晻 垐 _ _ _ P P T 1 0 i . 訋惔? + D= ' =
@B + 0 `
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餤 0+ ? ? ? " B 饉 v 0 _ _ _ P P T 1 0 6 _ _ _ P P T 9
饠 @ Artificial Synthetic
antibacterial drugs A A & $ `
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饜 Section I Quinolones : & $ ` & $ `
餒
0 師 藿h ? f 觋 f f 櫶 y _ _ _ P P T 1 0 Y + D= ' =
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餶
餞 ; ? ? " 9% 饉 v 0 _ _ _ P P T 1 0 6 _ _ _ P P T 9
餝 The first generation :
nalidixic acid, pipemidic acid
The second generation:
norfloxacin, ofloxacin, ciprofloxacin
The third generation:
sparfloxacin, levofloxacin, grepafloxacin
The fourth generation:
clinafloxacin, gatifloxacin. x & ` & f3 & `& & f3 & `* & f3 & ` & f3 &
餒
0 師 藿h ? TTr 棗 f f 乔 晻 垐 8 0 _ _ _ P P T 1 0 . 箖衪Q| 0 瘐 饙 (
餟
餱 郕 ? ? " Y
鸨 S Fluorequionlones:
The second generation
The third generation
The fourth generation
T T & ` C 餒
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餷 . 0a n t i b a c t e r i a l a c t i o n 0 " 0 & $ 3
餒 $a ? " M % 饊 x 0 _ _ _ P P T 1 0 8 _ _ _ P P T 9
^ All of the quinolones are bactericidal
First generation only has active against some gram-negative bacteria
Second generation expend gram-negative bacteria spectrum
Third generation have active against gram-positive organisms, chlamydia, mycoplasma, Legionella and Bacillus tuberculosis
The fourth generation have active against anaerobic bacterium & _ 1 x _ & f f P
[ @` 餒
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饃 interfering with the action of DNA gyrase:
gram-negative bacteria
interfering with the action of topoisomerase IV:
gram-positive bacteria , v v 2 v v & f3 ' $ f f 6 # ?
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餭 ) Inhibit the replication of bacterial DNA * * & f f
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餤 0C l i n i c a l u s e s 0 & $ f3
餪 瑧 ? ? " 饉 v 0 _ _ _ P P T 1 0 6 _ _ _ P P T 9
瘅 + 1. Genitourinary tract infections :
Urinary tract infections, prostatitis, cervicitis
2. Intestinal infection:
gastroenteritis, bacillary dysentery, diarrhea
3. Respiratory infection:
bronchitis, nasosinusitis ,pneumonia
4. Skeletal system infection:
medullitis and arthrosis 0 , & f3 ) & f f b C
z
1
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餦 " 0a d v e r s e e f f e c t 0 & $ f3 饇
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餔 | G a s t r o i n t e s t i n a l d i s c o m f o r t :
p o o r a p p e t i t e , n a u s e a , v o m i t i n g , d i a r r h e a
2 . C N S p r o b l e m s :
d i z z i n e s s , h e a d a c h e , i n s o m n i a , c o n v u l s i o n
3 . A l l e r g i e s
a n g i o n e u r o t i c e d e m a s k i n r a s h J / q N & f f & f f J
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饑 ; Contraindications:
pregnancy, nursing mothers and children 0 < & f3 ( & f f 餒
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餞 <丽 ? ? " v 饉 v 0 _ _ _ P P T 1 0 6 _ _ _ P P T 9
4 1. Altered target:
modifications in the bacterial DNA gyrase
2. Decreased accumulation:
decreased number of porin proteins
increased energy-dependent efflux system 0 & f3 & f f , ; 6 9 餒
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餩 norfloxacin & $ ` 6
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This agent is effective against both gram-negative and gram-positive organisms in treating urinary tract infections and prostatitis, but not in systemic infections 0 & f3 & f f " x " 餒
0 師 藿h ? f 觋 f f 櫶 y _ _ _ P P T 1 0 Y + D= ' =
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v
餑
ciprofloxacin & $ ` 穑
餪 劎 ? ? " /?
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Ciprofloxacin is the most potent, used to treat many systemic infections with the exception of serious infections caused by MRSA, the enterococci and pneumococci. It is particularly useful in treating infections caused by gram-negative bacilli. 0 & f3 & f f 4 U 餒
0 師 藿h ? f 觋 f f 櫶 y _ _ _ P P T 1 0 Y + D= ' =
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餱 年 ? ? ? " j
餧 Ofloxacin
& $ ` 餻
餞 茱 ? ? " I 饉 v 0 _ _ _ P P T 1 0 6 _ _ _ P P T 9
餢 Ofloxacin is primarily used in the treatment of prostatitis. It may be used as alternative therapy in patients with gonorrhea. It has some benefit in the treatment of skin and lower respiratory tract infections. 0 & f3 & f f , ' 餒
0 師 藿h ? f 觋 f f 櫶 y _ _ _ P P T 1 0 Y + D= ' =
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餻 Section II Sulfonamides : & $ ` & $ ` 馉
餪 ? ? Q
饉 v 0 _ _ _ P P T 1 0 6 _ _ _ P P T 9
饖 , oral, absorbable
oral, nonabsorbable
topical - - & $ f3
館
餪 ? ? 饉 v 0 _ _ _ P P T 1 0 6 _ _ _ P P T 9
餒 classification & $ f3 餒
0 師 藿h ? 33 洙 33 0 E = 衑 鹫 (
鹦
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餱 x
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饘 . 0A n t i b a c t e r i a l a c t i o n 0 B & $ f3 & $ f3 & $ f3 痃
餞 ! ? ? " 饊 x 0 _ _ _ P P T 1 0 8 _ _ _ P P T 9
鹜 The sulfonamides are bacteriosestatic;
These drugs inhibit both gram-positive and gram negative bacteria;
They have active against nocardia, Chlamydia trachomatis, and some protozoa;
They have no effective against mycoplasma, Rickett's organism, helicoid & f f t _ 4
@` 餒
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synthase $ $ 鹜
p
< 6 pm
餫
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p
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p
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p
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@B A ? %, ( < + O %, (
< + D駈 ' = % ( D ' = % ( D窬 ' =4 @B B B B % ( D聒 ' = 1駹 : B v i s i b l e *駉 3 >+ B# s t y l e . v i s i b i l i t y < * p % ( D ' = +襻 4 8 ?馾 C B 0 - # p p t _ w / 2 B C B # p p t _ x B *馳 3 > B
p p t _ x < * p D ' = +褓 4 8 ?馶 C B # p p t _ y B C B # p p t _ y B *馳 3 > B
p p t _ y < * p + ` 0 鹑 帻 t 餪 (
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& $ f3 ' $ f3 疝
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* Systemic infections:
oral and absorbable sulfonamides
2. Intestinal infection:
oral and nonabsorbable sulfonamides
3. Wound infection:
topical sulfonamides , & f f b
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O 1. Crystalluria:
crystallura, hematuria, obstruction
adequate hydration and alkalinization of urine
2. Kernicterus:
sulfonamides displace bilirubin from binding sites on serum albumin
3. Hypersensitivity:
rashes, angioedema
4. Hemopoietic disturbances:
Hemolytic anemia, Granulocytopenia thrombocytopenia L P x & f3 & f f & f f * H
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饒 Increased PABA synthesis:
overcome the inhibition of the dihydropteroate synthetase by the sulfas
2. Altered enzyme:
decreased affinity for the sulfonamides
3. Decreased uptake:
decreased permeability of membrane > & f f & f f , >
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饠 . Sulfisoxazole
Sulfamethoxazole
Sulfadiazine / / & ` $
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饉 Sulfisoxazole and sulfamethoxazole are used almost exclusively to treat urinary tract infections.
Sulfadiazine achieves high concentrations in cerebrospinal fluid, therefore it has preventative and therapeutic effective against Epidemic meningitis ( & f f .
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鹱 i Sulfasalazine is widely used in ulcerative colitis, enteritis, and other inflammatory bowel disease. 0 j & f3 & f f
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饠 ( Sodium sulfacetamide Mafenide acetate ) ) & ` ,
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饏 Sodium sulfacetamide ophthalmic solution or ointment is effective treatment for bacterial conjunctivitis and as adjunctive therapy for trachoma.
Mafenide acetate is used topically to prevent bacterial colonization and infection of burn wounds. 0 & f3 & f f 4
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饖 V 1. The antibacterial spectrum is similar to that of
sulfamethoxazole
It inhibited dihydrofolate reductase
It is used alone in acute urinary tract infections and in the treatment of bacterial prostatitis
It induce megaloblastic anemia, leukopenia, and granulocytopenia
It altered dihydrofolate reductase, resulting in drug resistance P N x x & f3 﨣 & f f & f f <
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鹇 Co-trimoxazole is combination of trimethoprim-
sulfamethoxazole
It shows greater antimicrobial activity than equivalent quantities of either drug used alone
It inhibits two sequential steps in the synthesis of tetrahydrofolic acid L / F & f f & f f P @` 餒
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