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Aminoglycosides

Aminoglycosides

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Published by Hassan.shehri

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Published by: Hassan.shehri on Feb 01, 2008
Copyright:Attribution Non-commercial

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06/15/2013

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Urinary antiseptics
Urinary antiseptics
:
Produce effective bactericidal concentration in urine
, nosystemic antibacterial effect but may be toxic.Often administered with acidifying agents (low pH in itself isinhibitor of bacterial growth in urine).Used for recurrent or chronic UTI -sustain sterility.
Drugs:1.Nitrofurantoin2.Methenamine
1
 
Nitrofurantoin
Mechanism of action.
Undergoes reduction: 5 nitro
nitro anion, superoxideandother oxygen radicals
bacterial toxicity. Affectbiochemical processes (RNA and DNA and proteinsynthesis).Antimicrobial activity.
Is bactericidal for most urinary pathogens.
Effective against many strains of E. coli and Enterococci-resistance develops slowly.
Not effective against proteusand pseudomonas andmany of enterobacterand klebsiella.
Antibacterial activity high at pH <5.5.Therapeutic uses
Used for the treatment and prevention of UTI.
Long term prophylaxis of lower UTI
caused by susceptiblebacteria.Used prophylacticallypost intercourse in women with
 
chronic
2
 
Nitrofurantoin-contd.
Adverse effects
Nausea, vomiting, diarrhea.
Hemolytic anemia (in patients deficient in G6PD)
Pulmonary hypersensitivity reactions
 –
Acute pneumonitis.
 –
Subacutereactions-acute respiratory distress syndrome
( pulmonaryinfiltration, effusion-fever and eosinophiliamay occur-resolution may occur. –
Chronic reactions-
more than 6 months therapy-chronic desquamative
interstitialpneumonitiswith fibrosis (resolution does not occur).
Intrahepaticcholestasis,
hepatocellulardamage-
fatal.Neurological disorders -headache, vertigo, drowsiness, muscular aches andnystagmus,
neuropathies.Contraindications
-Pregnant women at term, nursing mothers.-Infants less than 1 month and nursing infants-cellular damage and anemia.-Impaired renal function (creatinineclearance <40 ml/min).
3

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