Date post: | 02-Jun-2018 |
Category: |
Documents |
Upload: | 2lipsandrowses |
View: | 228 times |
Download: | 0 times |
of 22
8/10/2019 Antibacterial- Folic Acid Inhibitors
1/22
8/10/2019 Antibacterial- Folic Acid Inhibitors
2/22
are necessary for the synthesis of Aminoacids, hence necessary for bacterialprotein synthesis
growth of micro-organisms
8/10/2019 Antibacterial- Folic Acid Inhibitors
3/22
SulfonamidesSulfadiazine
SulfamethoxazoleSulfisoxazoleSulfamethizole
DiaminopyrimidineTrimethoprim
8/10/2019 Antibacterial- Folic Acid Inhibitors
4/22
8/10/2019 Antibacterial- Folic Acid Inhibitors
5/22
Derivatives of sulfanilamidesFirst drug to prevent and cure human
bacterial infection successfullybacteriostatic(stops bacteria fromreproducing)
Structural analogs of para-aminobenzoic acid (PABA)
8/10/2019 Antibacterial- Folic Acid Inhibitors
6/22
8/10/2019 Antibacterial- Folic Acid Inhibitors
7/22
MOA: competitively inhibitdihydropteroate synthase
SOA: broad spectrum agents; againstmany gram positive organisms(Streptococcus pyogenes,Streptococcus pneumoniae ) and certaingram negative organism ( Haemophilus
influenzae, Escherichia coli, Proteusmirabilis ) and other strain Chlamydiatrachomatis, Nocardia, Actinomyces,Bacillus anthracis
8/10/2019 Antibacterial- Folic Acid Inhibitors
8/22
Inhibited bySULFONAMIDES Dihydropteroate
synthase
Dihydrofolate
reductase
8/10/2019 Antibacterial- Folic Acid Inhibitors
9/22
INDICATION: Often used to treat urinary tract
infections(E. coli) including acute andchronic cystitis, and chronic upper UTITx for nocardiosis, trachoma, inclusionconjunctivitis and dermatitis herpetiformis
8/10/2019 Antibacterial- Folic Acid Inhibitors
10/22
8/10/2019 Antibacterial- Folic Acid Inhibitors
11/22
Sulfadiazine + Pyrimethamine tx oftoxoplasmosis
Px should take 2liters fluid to avoid UTcomplicationPyrimethamine: Ldose=75mg; 25mg
daily& Sulfadiazine= 1g/every 6 hours; for3-6 wks
8/10/2019 Antibacterial- Folic Acid Inhibitors
12/22
Cotrimoxazole*=Sulfamethoxazole +Trimethoprim
Tx for Pneumocystis carinii pneumonia,Shigella enteritis, Serratia sepsis, UTI*,respiratory infections, gonococcalurethritisDOC for Stenotrophomonas maltophiliaIncreased frequency of Cutaneoushypersensitivity for AIDS Px
8/10/2019 Antibacterial- Folic Acid Inhibitors
13/22
Sulfisoxazole + Erythromycin = AcuteOtitis Media ( H. Influenzae)
Sulfisoxazole + Phenazopyridine =uncomplicated UTI (relief of Sx of pain,
burning, urgency)
8/10/2019 Antibacterial- Folic Acid Inhibitors
14/22
Prophylactic sulfonamide therapy toprevent Streptococcal infections andrheumatic fever recurrences
PRECAUTIONS:May cause blood dyscrasias (HemolyticAnemia)
For Px w/ G6PD deficiency, AplasticAnemia, Thrombocytopenia,Agranulocytosis, Eosinophilia
8/10/2019 Antibacterial- Folic Acid Inhibitors
15/22
Life Threatening Hepatitis Caused by drug toxicity (rare SE) Headache, nausea, vomiting, jaundice
Hypersensitivity (manifest in skin&mucous membranes)
skin rashexfoliative dermatitisphotosensitivity
8/10/2019 Antibacterial- Folic Acid Inhibitors
16/22
8/10/2019 Antibacterial- Folic Acid Inhibitors
17/22
Trimethoprim
8/10/2019 Antibacterial- Folic Acid Inhibitors
18/22
Substituted pyrimidineCommonly combined withsulfamethoxazole
MOA: Inhibits dihydrofolate reductasethus blocking bacterial folic acidsynthesis
SOA: most gram negative and grampositive microorganism
*If used alone may develop resistance
8/10/2019 Antibacterial- Folic Acid Inhibitors
19/22
SOA: Streptococcus pneumoniae,Neisseria meningitidis,
Corynebacterium diphtheriae ; somestrains of Staphylococcus aureus,Staphylococcus epidermidis, Proteusmirabilis, Enterobacter, Salmonella,Shigella, Serratia, Klebsiella andEscherichia coli
8/10/2019 Antibacterial- Folic Acid Inhibitors
20/22
Inhibited byTRIMETHOPRIM
Dihydropteroatesynthase
Dihydrofolate
reductase
8/10/2019 Antibacterial- Folic Acid Inhibitors
21/22
INDICATION:Tx for UTI caused by E. coli, P. mirabilis,Klebsiella and Enterobacter
Tx for acute gonococcal urethritis, acuteexacerbation of chronic bronchitis,shigellosis, and Salmonella infections
Prophylactic/Suppressive therapy for P.Carinii pneumoniaDOC for Stenotrophomonas maltophiliainfections
8/10/2019 Antibacterial- Folic Acid Inhibitors
22/22
PRECAUTIONSSkin sensitization (rash, pruritus,exfoliative dermatitis)Blood dyscrasia(rarely)Adverse GI effect(nausea, vomiting,epigastric distress glossitis)Neonate may develop kernicterusAIDs Px may suffer from fever, rash,malaise, pancytopenia