CLINICAL PHARMACOLOGY 2 (SPH 0122)

MUHAMMAD AMIRUL BIN HAMID (012011050002)

NOR AISYAH BT ABDULLAH ZAWAWI (012011050108)

DMA GROUP 9

16 APRIL 2012

SIR WAN AZMAN

ANTI-MICROB

OBJECTIVE TO IDENTIFY THE DEFINATION OF ANTIMICROB AND

SYNTHETIC AGENT

TO IDENTIFY INDICATIONS OF THE DRUG

TO IDENTIFY MECHANISM OF ACTION

TO IDENTIFY CONTRAINDICATION OF DRUG

TO IDENTIFY SIDE EFFECT

TO IDENTIFY SPECIAL PERCAUTION

TO IDENTIFY OVERDOSE MANAGEMENT

WHAT IS ANTIMICROB Antimicrobial is a substance that kills or inhibits the growth

of microorganisms such as bacteria, fungi, or protozoans.

There are mainly two classes of antimicrobial drugs:

Those obtained from natural sources:

1. Beta-lactam antibiotic (such as penicillins)

2. Protein synthesis inhibitors(such as aminoglycosides)

Synthetic agents:

1. Anti-helminthes

2. Anti-fungal

3. Anti-viral

ANTI-HELMINTHES

INDICATION OF DRUG Anti helmintics or antihelminthics are drugs that

expel parasitic worms (helminths) from the body, by either stunning or killing them.

This includes both flat worms, flukes and tapeworms and round worms.

such as nematodes, cestodes, trematodes, infectious protozoa, and amoebae.

TYPE OF ANTI HELMINTHES

DRUG Type

-Albendazole

-Mebandazole

-Thiabendazole

-Fenbendazole

-Triclabendazole

-Flubendazole

Albendazole Albendazole is used to treat infections caused by

worms. Albendazole works by keeping the worm from absorbing sugar (glucose), so that the worm loses energy and dies.

Albendazole is used to treat:

-Hydatid disease (echinococcosis);

-Infection of the nervous system caused by pork tapeworms (neurocysticercosis).

ALBEN TabletsAlbendazole 200mg

Box of 30 strips of 2 tablets each

Mebandazole Mebendazole belongs to the family of medicines

called anthelmintics. Anthelmintics are medicines used in the treatment of worm infections.

Mebendazole is used to treat:

-Common roundworms (ascariasis);

-Hookworm infections (uncinariasis);

-Pinworms (enterobiasis; oxyuriasis);

-Whipworms (trichuriasis); and

-More than one worm infection at a time.

Mebendazole Tablets USP 500 mg

Thiabendazole This medication is used to treat roundworm infections

such as threadworm, hookworm/creeping eruption (cutaneous larva migrans), and visceral larva migrans(toxocariasis). This medication is also used for other types of roundworm infections such as pinworm, whipworm, large roundworm (ascariasis), and trichinosis when other therapies have failed or are unavailable.

Triclabendazole Triclabendazole is a member of the

benzimidazole family of anthelmintics. The benzimidazole drugs share a common molecular structure, triclabendazole being the exception in having a chlorinated benzene ring but no carbamate group.

MECHANISM OF ACTION An anti helmintic may interfere with the parasites'

carbohydrate metabolism, inhibit their respiratory enzymes, block their neuromuscular action, or render them susceptible to destruction by the host's macrophages.

SIDE EFFECT Anthelmintics usually do not cause side effects.

However, sometimes the drugs produce diarrhoea, headaches, and dizziness.

SPECIAL PERCAUTIONS wash your bedding every 2-3 days in non chlorine

oxygen bleach

DO NOT eat any raw or uncooked foods such as carpaccio or sushi.

avoiding sources of infection like untreated or fresh water

CONTRAINDICATIONS Presence of known allergy to any of these drugs

Lactation

Pregnancy (in most cases)

Caution should be used in the presence of renal or hepatic disease or severe diarrhea and malnourishment

OVERDOSE MANAGEMENT Giving medicines in very small doses will not affect the

parasitic host.

It should be noted, though, that overdose of anti-parasitics can be exceptionally dangerous to the person taking them.

Dosage must be properly controlled to avoid this

ANTI-FUNGAL

INDICATION OF DRUG An antifungal drug is medication used to

treat fungal infections such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as cryptococcal meningitis, and others

There are also many different types of antifungal medicines, including:

- clotrimazole

- econazole nitrate

- miconazole

TYPE OF ANTI FUNGAL DRUGa. Antifungal antibiotics

-Polyene antibiotics (AmphotericanB/Nystatin/hamycin/Natamcin)-Others (Griseofluvin)

b. Antimetabolites-Flucytosine

c. Azole-Clotrimazole-Econazole-miconazole

d. Miscellaneous-Terbinafine-Pneumocandins

Antifungal antibiotics

Polyene antibiotics

• Polyene antibiotics, are a class of antimicrobial polyene compounds that target fungi.

• These polyene antimycotics are typically obtained from some species of Streptomyces bacteria.

• The polyenes bind to ergosterol in the fungal cell membrane and promote leakiness which may contribute to fungal cell death

• Amphotericin B, nystatin, and natamycin are examples of polyene antimycotics.

Cont..Amphotericin B

Amphotericin B is used to kill fungus that can cause serious or life-threatening infections.

Amphotericin B is not effective against bacterial infections or viruses.

Nystatin

Nystatin is used to treat fungal infections of the skin, mouth, vagina, and intestinal tract.

Nystatin works by stopping the growth of the fungus

ContHamycin It is similar to nystatin but more water soluble. This medication is a polyene antimycotic organic

compound, prescribed for oral thrush, and vaginal infections.

Natamcin Natamycin (INN), also known as pimaricin, is a naturally

occurring antifungal agent produced during fermentation by the bacterium Streptomyces natalensis, commonly found in soil.

Natamycin is classified as a macrolide polyene antifungal and, as a drug, is used to treat fungal keratitis.

Amphotericin B for Injection, USP

Antimetabolite

An antimetabolite is a chemical that inhibits the use of a metabolite, which is another chemical that is part of normal metabolism.

Flucytosine

-belongs to the group of medicines called antifungals. It is used to treat certain fungus infections.

Azole

Clotrimazole

Clotrimazole is used to treat yeast infections of the vagina, mouth, and skin such as athlete's foot, jock itch, and body ringworm. It can also be used to prevent oral thrush in certain patients.

Cont..Econazole

Econazole nitrate is an antifungal medication of the imidazole class.

used to treat infections caused by a fungus.

They work by killing the fungus or preventing its growth.

Miconazole

Miconazole, an antifungal agent, is used for skin infections such as athlete's foot and jock itch and for vaginal yeast infections.

Miconazole comes as a cream, lotion, powder, spray liquid, and spray powder to be applied to the skin.

Econazole nitrate 1% cream - 30 gm

Miscellaneous

Terbinafine

Terbinafine is used to treat certain types of fungal infections (e.g., fingernail or toenail). It works by stopping the growth of fungus. This medication belongs to a class of drugs known as antifungals.

Terbinafine 1%

MECHANISM OF ACTION Antifungals work by exploiting differences between

mammalian and fungal cells to kill the fungal organism without dangerous effects on the host.

Unlike bacteria, both fungi and humans are eukaryotes.

SIDE EFFECTDepending on which type of antifungal medicine you are

using. Topical antifungals

- irritation- a mild burning sensation- itching- redness

Oral antifungals- feeling sick- diarrhoea- headache

Intravenous antifungals

- loss of appetite

- feeling sick

- vomiting

- diarrhoea

- chills

- headache

- muscle and joint pain

SPECIAL PRECAUTIONS Keep your skin clean and dry. Shampoo your hair and

scrub your skin regularly, then dry them thoroughly.

If symptoms do not improve within a few weeks, the prescribing physician should be informed.

While taking this medicine, regular medical visits should be scheduled. The physician needs to keep checking for side effects throughout the antifungal therapy.

CONTRAINDICATIONS Anyone with a known allergy

Pregnant or lactating women (with the exception of terbinafine for life-threatening infections)

Patients with renal or liver disease

-Drug metabolism or excretion may be altered, or condition may worsen as a result of the actions of the drug

OVERDOSE MANAGEMENT The recommended dosage depends on the type of

antifungal drug and the nature and extent of fungal infection being treated.

Doses may also be different for different patients.

The prescribing physician or the pharmacist can provide dosage information.

ANTI-VIRAL

INDICATION OF DRUG Antiviral drugs are a class of medication used

specifically for treating viral infections.

Like antibiotics, specific antivirals are used for specific viruses.

TYPE OF ANTI VIRAL DRUGa. Anti-herpes virus agent

-Acyclovir

-Valaciclovir

b. Anti-influenza

-Amantadine

-Zanamir

c. Anti-retroviral

-Nucleoside Reverse Transcriptase Inhibitors (Lamivudine/Zadovudine)

-non- Nucleoside Reverse Transcriptase Inhibitors (Nevirapine/Efavirenz)

Anti-herpes virus agent

Acyclovir

Acyclovir is an antiviral drug. It slows the growth and spread of the herpes virus so that the body can fight off the infection.

Acyclovir is used to treat infections caused by herpes viruses. Illnesses caused by herpes viruses include genital herpes, cold sores, shingles, and chicken pox.

Cont..Valaciclovir

Valaciclovir or valacyclovir (brand names Valtrex, Zelitrex) is an antiviral drug used in the management of herpes simplex and herpes zoster (shingles).

It slows the growth and spread of the herpes virus so that the body can fight off the infection.

Valacyclovir will not cure herpes, but it can lessen the symptoms of the infection.

Acyclovir (generic ZOVIRAX) 400mg x30s

Tablets

Anti-influenza

Amantadine

Amantadine is an antiviral medicine. It is used to prevent or treat certain influenza (flu) infections (type A).

Amantadine will not work for colds, other types of flu, or other virus infections.

Cont..Zanamir

Zanamivir is a prescription medication used to treat and prevent the flu(influenza).

Zanamivir may also be given to prevent influenza in people who may be exposed but do not yet have symptoms.

Amantadine 100mg

Anti-retroviral

Nucleoside Reverse Transcriptase Inhibitors

Reverse-transcriptase inhibitors (RTIs) are a class of antiretroviral drug used to treat HIV infection, tumors, and cancer. RTIs inhibit activity of reverse transcriptase, a viral DNA polymerase enzyme that retroviruses need to reproduce.

Cont..Lamivudine

Lamivudine is an oral medication that is used for the treatment of infections with the human immunodeficiency (HIV) and hepatitis B viruses.

Zadovudine

Zidovudine is used alone or with other medications to treat human immunodeficiency virus (HIV) infection in patients with or without acquired immunodeficiency syndrome (AIDS).

It will slow the spread of HIV infection in the body.

Lamivudine Tablets 100mg

Cont..Non- Nucleoside Reverse Transcriptase Inhibitors

Non-nucleoside reverse-transcriptase inhibitors (NNRTIs) are the third class of antiretroviral drugs that were developed.

attach themselves to reverse transcriptase and prevent the enzyme from converting RNA to DNA.

Cont..Nevirapine

Nevirapine is used in combination with other medications to treat human immunodeficiency virus (HIV) infection in patients with or without acquired immunodeficiency syndrome (AIDS).

It works by decreasing the amount of HIV in the blood.

Efavirenz

Efavirenz is used with other medications to treat human immunodeficiency virus (HIV) infection in patients with or without acquired immunodeficiency syndrome (AIDS).

It works by slowing the spread of HIV in the body

Efavirenz 200 mg

Capsules/Efavirenz 600 mg Tablets

MECHANISM OF ACTION Antiviral drugs work by inhibiting the virus before it

enters the cell, stopping it from reproducing, or, in some cases, preventing it from exiting the cell.

However, like antibiotics, viruses may evolve to resist the antiviral drug.

SIDE EFFECT Depending on what antiviral medication you are

taking and your reaction to it

However, some possible side effects that are common to many antiviral drugs include dizziness, fatigue, joint or muscle pain, headache, dry mouth, nausea, vomiting, loss of appetite, weight loss, insomnia, and mild anxiety or irritability.

SPECIAL PERCAUTIONS Get Enough Sleep

Wash Your Hands

Stay Away From Sick People

Each of the drugs listed has specific warnings. See specific drugs references or ask a pediatrician.

CONTRAINDICATION allergy to the drug

Pregnancy (in most cases)

OVERDOSE MANAGEMENT The recommended dosage depends on the type of

antiviral drug and the nature and extent of viral infection being treated.

Doses may also be different for different patients.

The prescribing physician or the pharmacist can provide dosage information.