Beta lactam_end 1

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Contains a beta lactam nucleus in its molecular structure. • Works by inhibiting cell wall synthesis by the bacterial organism. • Classification: - Penam - Cephem - Penem - Monobactam

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Nội dung Text: Beta lactam_end 1

Group 1 Beta-lactam antibiotic
1. Intruduction: • Contains a beta lactam nucleus in its molecular structure. • Works by inhibiting cell wall synthesis by the bacterial organism. • Classification: - Penam - Cephem - Penem - Monobactam
2. Clinical use • Prophylaxis and treatment of bacterial infections. • Manly active against Gram (+), some Gram (-).
3. Mode of action - Peptidoglycan - Cross link
- Cấu trúc 3D của vách tế bào
- D-alanyl-D-alanyl - Sự tổng hợp vách tế bào (giai đoạn 3) - Tranpeptidase
- Vòng Beta Lactam Peniciline Cephalosporin
- PBPs Các PBPs tổng hợp liên kết ngang bình thường (1,2) Các PBPs đã liên kết Peniciline và bị bất hoạt (4,5)
- Spheroplast hay Protoplast - Sự ly giải tế bào
4. The antibotic resistance of the bacteria Produce β-lactamase or penicillinase Breaking open the β-lactam ring Gram-negative Alterations in the beta-lactam targets (PBPs) Gram-positive Notable examples: methicillin-resistant Staphylococcus aureus and penicillin- resistant Streptococcus pneumoniae
5. Empric therapy • Spectrum of antibiotic ► Wide-spectrum ► Narrow-spectrum
Diabetic Foot Ulcer 1. Bacteria: • Staphylococcus aureus: Gram (+) • Streptoccoci: Gram (+) 2. Antibiotic: • Dicloxacillin • First-generation cephalosporin • Amoxicillin/clavulanate
Community-acquired pneumonia 1. Bacteria: • Streptococcus pneumonia: Gram(+) • Haemophilus influenza: Gram (-) • Legionella spp.: Gram (-) • Clamdophila pneumonia: Gram (-) 2. Antibiotic: • Amoxicillin • Penicillin G • Cefuroxime • Ceftriaxone • Cefotaxime
Spontaneous Bacterial Peritonitis 1. Bacteria • E.Coli: Gram (-) 2. Antibiotic • Cefotaxime
6. Adverse effects: 1. Hypersensitivity reactions: – Type I: less frequent, cross reactive with penicillin (5- 10%). Patient with a H/O anaphylaxis to penicillins should not receive cephalosporins – Type II: thrombocytopenia, hemolytic anemia, neutropenia, interstitial nephritis or abnormal liver functions- reversible. – Type III: serum sickness- cefaclor.
6. Adverse effects: 2. Nephrotoxicity with cephalothin. 3. GIT disturbances. 4. Biliary pseudolithiasis (ceftriaxone) 5. Hypoprothombinemia, bleeding tendency (responds to vitamin K), disulfiram like reaction with alcohol- cefoperazone, cefotetan. 6. Superinfection with 2ndand 3rdgeneration – fungi and staph.
References • “Dược lý học lâm sàng” – Trường ĐH Y Hà Nội. • http://en.wikipedia.org/wiki/Peptidoglycan • http://en.wikipedia.org/wiki/Cell_wall • http://vietsciences.free.fr/khaocuu/nguyenlandung/cautructebaovk.htm • Goodman & Gilman's The Pharmacological Basis of Therapeutics 11 th • http://www.ncbi.nlm.nih.gov/pubmed/15338052 • http://en.wikipedia.org/wiki/Beta-lactam_antibiotic • http://en.wikipedia.org/wiki/Beta-lactamase#Extended-spectrum_beta