Scribd Logo
Upload

Welcome to Scribd!

  • Antibiotic - Blood Brain Barrier

    Uploaded by

    zaky
    22 views26 pages
    The document discusses the blood-brain barrier (BBB) and its role in limiting the entry of drugs into the central nervous system. Key points include: - The BBB is formed by tight junctions between endothelial cells of brain capillaries and surrounding glial cells, which restrict the passage of hydrophilic drugs. - Lipophilic drugs and negatively charged substances can more easily pass through the BBB compared to positively charged ones. Conditions like trauma, inflammation, and ischemia can also temporarily reduce the BBB's function. - Several areas of the brain are not protected by the BBB, allowing greater drug penetration in places like the hypothalamus and neurohypophysis. The selectivity of the BBB influences

    Original Description:

    Antibiotik

    Original Title

    Antibiotic_Blood Brain Barrier

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    The document discusses the blood-brain barrier (BBB) and its role in limiting the entry of drugs into the central nervous system. Key points include: - The BBB is formed by tight junctions between endothelial cells of brain capillaries and surrounding glial cells, which restrict the passage of hydrophilic drugs. - Lipophilic drugs and negatively charged substances can more easily pass through the BBB compared to positively charged ones. Conditions like trauma, inflammation, and ischemia can also temporarily reduce the BBB's function. - Several areas of the brain are not protected by the BBB, allowing greater drug penetration in places like the hypothalamus and neurohypophysis. The selectivity of the BBB influences

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    22 views26 pages

    Antibiotic - Blood Brain Barrier

    Uploaded by

    zaky
    The document discusses the blood-brain barrier (BBB) and its role in limiting the entry of drugs into the central nervous system. Key points include: - The BBB is formed by tight junctions between endothelial cells of brain capillaries and surrounding glial cells, which restrict the passage of hydrophilic drugs. - Lipophilic drugs and negatively charged substances can more easily pass through the BBB compared to positively charged ones. Conditions like trauma, inflammation, and ischemia can also temporarily reduce the BBB's function. - Several areas of the brain are not protected by the BBB, allowing greater drug penetration in places like the hypothalamus and neurohypophysis. The selectivity of the BBB influences

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 26

    ANTIBIOTIK

    BLOOD BRAIN BARRIER


    Noor Wijayahadi
    The “blood-brain barrier (BBB)”
    • Kapiler pembuluh darah di SSP mempunyai
    tight junctions yang menyusun BBB.

    • Kapiler pembuluh darah di SSP terbungkus


    sel glia pericapillar yang menyusun BBB.

    • Sel endotel kapiler pembuluh darah di SSP


    mempunyai P-glycoprotein yang memompa
    obat keluar endotel
    The “blood-brain barrier (BBB)”

    • BBB hambat masuknya obat yang hidrofilik


    (larut air) ke dalam SSP

    • BBB tidak berfungsi pada ischemia dan


    inflamasi.

    • BBB menyebabkan berkurangnya efek obat


    ke SSP
    Blood-Brain Barrier

    1. Lipofilik (larut lemak) lebih mudah


    menembus BBB
    2. Bermuatan negatif lebih mudah menembus
    BBB daripada bermuatan positif
    3. Kadar CO2 tinggi / O2 rendah sebabkan
    vasodilatasi  menurunkan BBB
    4. Trauma & inflamasi menurunkan BBB

    4
    4
    Blood-Brain Barrier
    5. Beberapa area SSP tidak terlindungi BBB – the
    circumventricular organs (CVO) sekitar ventrikel 3
    dan 4:
    • parts of the hypothalamus - median eminence
    • Neurohypophysis
    • pineal gland
    • area postrema
    • subfornical organ
    • subcommissural organ

    5
    5
    Selectivity of the Blood Brain Barrier

    Peripheral Capillary Brain Capillary

    Protein permeability restricted to:


    • small molecules (<600D)
    Glucose
    • lipophilic substances
    (hydroxyl group)

    (amine group)
    Fungsi BBB menurun pada:
    1. Hipertensi
    2. Bayi  belum terbentuk sempurna
    3. Hiper Osmolalitas
    4. Paparan mikrowave
    5. Paparan radiasi
    6. Infeksi  inflamasi
    7. Trauma, iskemia, inflamasi, tekanan tinggi
    ANTIBIOTIK
    KUMAN GRAM (+)
    Penisilin
    • Narrow-spectrum
    – Penicillin G (IV)
    – Penicillin VK (PO)
    • Penicillinase-resistant  Antistaphylococcal
    – Cloxacillin, dicloxacillin (PO)
    – Nafcillin (IV)
    – Oxacillin (IV)
    • Extended-spectrum
    – Ampicillin/.Amoxicillin (PO)
    – Amoxicillin + clavulanate (PO)
    – Piperacillin (IV)
    – Ticarcillin (IV)
    Cephalosporins

    1st  Gram (+)


    2nd  spektrum lebih luas  Gr (-) Gr (+)
    3rd  spektrum Gr (-) Gr (+)
     Serious Gram negative infections
    – CeftriAXone and cefotAXime  menembus BBB
    – Ceftazidime  anti-Pseudomonal
    4th cefepime  Anti-Pseudomonal coverage
    Spektrum Gr (-)/Gr (+) baik
    5th Ceftaroline
     MRSA
    Pola 1 Pola 2 Pola 3
    Karakter - concentration - time dependent - time
    P-Dinamik dependent - PAE minimal dependent
    - PAE sedang sampai sedang - PAE lama
    sampai lama
    Jenis Antibiotik Aminoglikosida Beta laktam Tetrasilkin
    Fluorokuinolon Makrolid Azitromisin
    Metronidasol Klindamisin Glikopeptid
    Amfoterisin B Oksazolidin Kuinopristin
    Ketolid Flusitosin Flukonasol
    Daptomisin
    Dosing Maksimumkan Maksimumkan Optimalkan
    Regimen dosis / duration of jumlah obat
    konsentrasi obat exposure keseluruhan

    Parameter Peak Level dan Time above MIC AUC


    P-Kinetik AUC
    DAYA PENETRASI ANTIBIOTIK
    BBB

    You might also like