ALBACIO

EDDIVA
DAPLI-AN
MAGWILANG
MASPIL
Chemotherapeutic agents are chemical substances used
within the body for therapeutic purposes. The term
generally implies a chemical that has been synthesized
by chemists or produced by a modification of a
preexisting chemical.
 5. ANTI-INFECTIVE AGENTS- DEFINITION

 Anti-infectives can work by altering the cell membrane of the pathogen,

by interfering with protein synthesis, or by interfering with the ability of
the pathogen to obtain needed nutrients.
 Anti-infectives also work to kill invading organisms or to prevent them
from reproducing, thus depleting the size of the invasion to one that can
be dealt with by the human immune system.
 Pathogens can develop resistance to the effects of anti-infectives over
time when (1) mutant organisms that do not respond to the anti-infective
become the majority of the pathogen population or (2) the pathogen
develops enzymes to block the anti-infectives or alternative routes to
obtain nutrients or maintain the cell membrane.
 5. ANTI-INFECTIVE AGENTS- DEFINITION

 An important aspect of clinical care involving anti-infective agents

is preventing or delaying the development of resistance. This can
be done by ensuring that the particular anti-infective agent is the
drug of choice for the specific pathogen involved and that it is
given in high enough doses for sufficiently long periods to rid the
body of the pathogen.
 Culture and sensitivity testing of a suspected infection ensures
that the correct drug is being used to treat the infection effectively.
Culture and sensitivity testing should be performed before an anti-
infective agent is prescribed.
 5. ANTI-INFECTIVE AGENTS

Anti-infectives can have several adverse

effects on the human host, including renal
toxicity, multiple GI effects, neurotoxicity,
hypersensitivity reactions, and
superinfections.
 5. ANTI-INFECTIVE AGENTS- ADVERSE EFFECTS

Kidney Damage
 Kidney damage occurs most frequently with drugs that are metabolized by the
kidney and then eliminated in the urine.
 When patients are taking these drugs (e.g., aminoglycosides), they should
be monitored closely for any sign of renal dysfunction.
 To prevent any accumulation of the drug in the kidney, patients should be
well hydrated throughout the course of the drug therapy
5. ANTI-INFECTIVE AGENTS- ADVERSE EFFECTS

Gastrointestinal Toxicity
GI toxicity is very common with many of the anti-infectives. Many of these
agents have direct toxic effects on the cells lining the GI tract, causing nausea,
vomiting, stomach upset, or diarrhea, and such effects are sometimes severe.
There is also some evidence that the death of the microorganisms releases
chemicals and toxins into the body, which can stimulate the chemoreceptor
trigger zone in the medulla and induce nausea and vomiting.
In addition, some anti-infectives are toxic to the liver. These drugs can cause
hepatitis and even liver failure. When patients are taking drugs known to be
toxic to the liver (e.g., many of the cephalosporins), they should be
monitored closely, and the drug should be stopped at any sign of liver
dysfunction.
5. ANTI-INFECTIVE AGENTS- ADVERSE EFFECTS
 Neurotoxicity
 Some anti-infectives can damage or interfere with the function of nerve
tissue, usually in areas where drugs tend to accumulate in high
concentrations.
 For example, the aminoglycoside antibiotics collect in the eighth
cranial nerve and can cause dizziness, vertigo, and loss of hearing.
 Chloroquine, which is used to treat malaria and some other rheumatoid
disorders, can accumulate in the retina and optic nerve and cause
blindness.
 Other anti-infectives can cause dizziness, drowsiness, lethargy, changes
in reflexes, and even hallucinations when they irritate specific nerve
tissues.
5. ANTI-INFECTIVE AGENTS- ADVERSE EFFECTS

Hypersensitivity Reactions
 Allergic or hypersensitivity reactions reportedly occur with many
antimicrobial agents.
 Most of these agents, which are protein bound for transfer through
the cardiovascular system, are able to induce antibody formation in
susceptible people. With the next exposure to the drug, immediate or
delayed allergic responses may occur.
 In severe cases, anaphylaxis can occur, which can be life-threatening.
Some of these drugs have demonstrated cross-sensitivity (e.g.,
penicillins, cephalosporins), and care must be taken to obtain a
complete patient history before administering one of these drugs.
 5. ANTI-INFECTIVE AGENTS- ADVERSE EFFECTS
 Superinfections
 One offshoot of the use of anti-infectives, especially broad-spectrum anti-infectives, is
destruction of the normal flora.
 Superinfections are infections that occur when opportunistic pathogens that were kept
in check by the “normal” flora bacteria have the opportunity to invade tissues.
 Common superinfections include vaginal or GI yeast infections, which are associated
with antibiotic therapy, and infections caused by Proteus and Pseudomonas throughout
the body, which are a result of broad-spectrum antibiotic use.
 If patients receive drugs that are known to induce superinfections, they should be
monitored closely for any signs of a new infection—sore patches in the mouth, vaginal
itching, diarrhea—and the appropriate treatment for any superinfection should be
started as soon as possible.
 5. ANTI-INFECTIVE AGENTS

 Some anti-infectives are used as a means of prophylaxis when patients

expect to be in situations that will expose them to a known pathogen,
such as travel to an area where malaria is endemic, or oral or invasive GI
surgery in a person who is susceptible to sub acute bacterial endocarditis.
1. ANTIBIOTICS