Dims cute

BSN-2F

NCM 106 – Anti-infective agent 4. Interfere with the DNA

synthesis in the cell.
- Are drugs designed to target foreign
5. Alter permeability of the cell
organisms that have invaded and
membrane to allow essential
infected the body of a human host.
cellular components to leak.
- Use of drugs to treat systemic
 Anti-infective Activity:
infection is an actively new concept,
- Vary in their spectrum of activity;
beginning with Paul Ehrlich in the
that is, they vary in their
1920s
effectiveness against invading
- His research to develop a synthetic
organisms.
chemical that would be effective only
- 2 types of Spectrum:
against infection-causing cells, not
1. Narrow spectrum – selective
human cells, led the way to for the
in their action that they are
scientific investigation of anti-
only effective against only a
infective agent.
few microorganisms.
- In 1920s penicillin was discovered
2. Broad spectrum – interfere
- 1935 the sulfonamides were
with their biochemical
introduced.
reaction in many kinds of
- Although it targets foreign
microorganism, making them
substance, it does not possess total
useful in treatment of a wide
selective toxicity, which is the ability
variety of infection.
certain protein and enzymes
- Several drugs are “cidal” and
systems used only by the infecting
“static”, depending on the
organism, but not by human cells.
concentration on the drug present.
 Therapeutic action
 Bactericidal – so active
- An act of attacking the invading
against invading
organism.
microorganism that they
- Goal: is to interfere with the normal
cause death of the cell they
functioning of the invading organism
affect.
to prevent from reproducing and to
 Bacteriostatic – not
cause death cell without affecting
aggressive, and they
the host.
interfere the ability of the cell
- Specific mechanism:
to reproduce.
1. Interfere with biosynthesis of
 Human Immune Response:
the pathogen wall. Since
- The goal of anti-infectives is to
bacterial cell has different
reduce the amount of foreign
composition from the human
substance in the body where the
cell
immune response can work on its
2. Prevent the invading cells
own.
using substance essential to
- If drug is aggressive enough, it might
their growth and
be toxic to the body.
development, leading to the
- It involves complex interaction
inability to divide and cause
among:
cell death.
1. Chemical mediators
3. Interfere with the protein
2. Leukocytes
synthesis
3. Lymphocytes
4. Antibodies
Dims cute
BSN-2F
5. Locally released enzymes
- When this response is completely
functional, and all necessary
materials can be produced then it
can isolate and eliminate the foreign
bodies.
- Person who is immunocompromised
– the immune system may be
incapable of eliminating the foreign
substance.
- It is difficult to treat patient with such
immune system because:
1. Anti-infective agent cannot
eliminate the pathogen
without causing severe
toxicity in the host.
2. This patient does not have
the inflammatory or immune
response in place to deal
with few invading organisms.
 Resistance
- Can be natural or acquired and
refers to the ability over time to
adapt to an anti-infective drug and
produce cells that are no longer
affected by a drug.
- This is because anti-infective drug
acts on a specific enzymes system
or biological processes and many
microorganisms that do not use this
system are not affected by anti-
infective drug and have some
natural resistance.
- Some microorganisms that was
sensitive to the drug would acquire
resistance to the agents. This can
result to serious problem.
 Acquiring resistance:
- Developed resistance in several
ways:
1. Producing an enzyme – that
deactivates the antimicrobial
drug.
2. Changing cellular
permeability – to prevent
drug from entering the cell or
altering the transport system
to exclude the drug.
3. Altering binding site on the
membrane – no longer
accept the drug.
4. Producing chemical – that
acts as an antagonist to the
drug.
- Other microbes may develop
resistance through genetic mutation.
 Preventing resistance
- Drug dosage – is important in
preventing the development of
resistance. Doses should be high
enough and duration of drug therapy
should be long enough to eradicate
even slightly of microorganism.
- Duration of drug use – is critical to
ensure that the microbes are
eliminated and no chance of
growing. And develop resistance
strain.
 Using of anti-infective agent:
- Anti-infective agent is used to treat
systemic infection and sometimes as
means of prophylaxis.
 Treatment of system infection:
1. Identification of the
pathogen:
- Is an important first step in
determining which anti-infective drug
should be used.
- Is done by culturing a tissue sample
from the infected area.
- Cultures – are performed in a
laboratory, in which a swab of
infected tissue can grow on an agar
plate.
- Staining technique and microscopic
examination are used to identify the
offending bacterium.
2. Sensitivity to the pathogen
- Sensitivity testing – it is important to
perform this test to evaluate bacteria
and determine which drugs can
control the microorganism.
Dims cute
BSN-2F
- Important with microorganism with
resistance strain.
- Culture and sensitivity testing – both
identify the causal pathogens and
the most appropriate drug for
treating the infection.
3. Combination therapy
- Combination of two or more types of
drug effectively treats the infection.
- Combination drugs – maybe
effective in interfering with its cellular
structure in different areas of
developmental phase.
- Several reasons that combination
therapy can be used:
 Health care provider may be
encouraged to use a smaller
dose of each drug, leading to
fewer adverse effects but still
having a therapeutic impact
 Some drugs are synergistic –
which means they are more
powerful when given in
combination.
 Many microbial infections are
caused by more than one
organism, and each
pathogen may react to a
different anti-infective agent.
 Sometimes, combined
effects of the different drugs
delay the emergence of
resistant strains.
 Prophylaxis
- Prevention of specific disease before
they occur.
 Adverse reactions to anti-infective
therapy
- There are no anti-infective drugs that
do not have adverse effect, it will
always have an effect on the body
once taken.
- Commonly adverse effect:
1. Kidney damage – occurs
most frequently with drugs
that are metabolized by the
kidney and then eliminated in
the urine.
- Such drug as direct toxic effect on
the fragile cells in the kidney, can
cause conditions ranging from renal
dysfunction to full-blown renal
failure.
2. GI tract – are very common
with many anti-infective,
many of these agents have
direct toxic effect on the cell
lining of GI tract.
- It causes:
 Nausea
 Vomiting
 Stomach upset
 Diarrhea
3. Nervous
system/neurotoxicity –
some anti-infectives can
damage or interfere with the
function of nerve tissue,
usually in areas where drugs
tend to accumulate in high
concentration
- Example: Aminoglycoside – collect
in the eight cranial nerve and can
cause:
 Dizziness
 Vertigo
 Loss of hearing
4. Hypersensitivity –
reportedly occur with many
antimicrobial agents.
- Most of these agents, which are
protein bound for transfer through
the cardiovascular system, can
induce antibody formulation in
susceptible people.
5. Superinfection – are
infections that occur when
opportunistic pathogens that
were kept in check by the
“normal” floral bacteria can
invade tissues.
- Common superinfections include:
1. Vaginal
Dims cute
BSN-2F

2. GI yeast infection
- Caused by proteus and
pseudomonas throughout the body.