Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
NEW
GENERATION

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalac...
INTRODUCTION





“against life”.
Produced by
microorganisms.
BUT

www.indiandentalacademy.com










Beta Lactams
Penicillins
(PCN)
Cephalosporins
Carbapenems
Monobactams
Vancomycin
Bacitracin
Polymyxin
ww...






Macrolides
Aminoglycosides
Sulfonamides
Flouroquinolones
Other” antibiotics

www.indiandentalacademy.com
www.indiandentalacademy.com
GLYCYLCYCLINE

www.indiandentalacademy.com
TIGECYCLINE








Glycylcline
FDA – 2005,june17.
Similar – Tc & minocycline.(D-9).
Action
: inhibits 30 s ribosome...





NOT – children , HS
Pregnancy, lactating mother, geriatrics ?
No oral forms
Ad – effects: GIT,
TEETH & BONE

Tgc;...
KETOLIDE

www.indiandentalacademy.com
TELITHROMYCIN









Ketolide (macro)
Semi-synthetic erythromycin.
FDA -2004 April
Action
: 50 s ribosome & 30 s –...
OXAZOLIDINONES

www.indiandentalacademy.com
LINEZOLID









Oxazolidinones
FDA - 2001
Action: 30 s & 50 s – initiation .
Indication: MR strep, MRSA
SSSI, Na...





Ad – eff : GIT, platelets.
Interaction : MAO,SSRI - seratonin syn.
Dose : 600 mg BD.(100 Rs)
Light sensitive.
Ran...
LIPOPEPITIDE

www.indiandentalacademy.com









DAPTOMYCIN

Sep-2003
Sapaotroph streptomyces reseosporus.
Action – rapid depolarization.
- inhibition of pr...
LINCOSAMIDE

www.indiandentalacademy.com
STREPTOGRAMINS








Lincosamide
FDA – 1999
Pristinamycin – quinupristin/dalfopristin (30:70).
Action : early ste...
www.indiandentalacademy.com
.
www.indiandentalacademy.com
GLYCOPEPTIDE
(MACROLIDE)

www.indiandentalacademy.com
vancomycin




1956
Workhorse .
VRE, VISSA, VRSA

www.indiandentalacademy.com
www.indiandentalacademy.com
FOSFOMYCIN











Phosphonic acid - glycopeptides
Action – enolpyruvyltransferase – cell wall
- attachment
Ind...
TEICOPLANIN










Glycopeptide
Actinoplanes teicomyceticus .
More lipophilic ( vancomycin)
Lesser toxicity.
A...
RAMOPLANIN





Glycolipodepeptide – macrocyclic
10 time > vanco.
Broad spectrum.
Clinical trial.

www.indiandentalaca...
SPECTINOMYCIN






Structurally different from aminoglycosides.
Indication : penicillin HS, gonorrhoea.
Ad – Eff : GI...








ROKITAMYCIN – borrelia
RU 28965 – sterp. Pneu.
TE – 0381 – legionnaires.
EVEROLIMUS -rapamycin –psoriasis.
...
AMINOGLYCOSIDES

www.indiandentalacademy.com
DIBEKACIN







Analog – kanamycin
Broad spectrum.
E-Coli, pseudomonas .
Dose : 100 mg im or iv.
Indication : RTI, ...
NEW use of OLDER ones

www.indiandentalacademy.com
www.indiandentalacademy.com
CARBAPENEMS

www.indiandentalacademy.com
www.indiandentalacademy.com
ERTAPENEM







Similar to meropenem
Indication : GN & anaerobic
CA infection – 1st line (FDA)
HA infection – NOT – ...
Faropenem








Effective – GP & GN.
PBPS 2&1A.
Indication : L & U RTI, ENT, UTI.
AD-Eff : GIT.
Dose : 150 – 300 ...
CEPHALOSPORINS

www.indiandentalacademy.com
CEFTOBIPROLE





FDA – 2003 – clinical trial.
Indicated : MRSA, SSSI, Nasocomial
Injectable.

www.indiandentalacademy....
CEFEPINE HCL







Semisynthetic 4th gen.
Indication : pneumonia, UTI, SSSI.
Caution : Child, pregnancy, geriatrics...
QUINOLONES

www.indiandentalacademy.com
TROVAFLOXACIN










1997
4 – gen.
Broadest spectrum.
Action : DNA gyrus, ty 4 topoisomerase (dormant)
Indicati...
GEMIFLOXACIN-MESYLATE









4 gen.
Action : similar.
GP & GN .
Indication : MRSA, MDR, H.inf, klebsella
pneu.
Ad...
MOXIFLOXCIN








3rd gen.
2000 – FDA.
Indication : penicillin resistant pneu,
sinusitis, bronchitis & CAP.
Cont-i...
www.indiandentalacademy.com
 PRULIFLOXACIN
 RUFLOXACIN
 TEMOFLOXACIN
 SITAFLOXACIN
 GREPAFLOXACIN

(1999torsedes de pointes)

www.indiandentalaca...
SULFONAMIDES



No new (drotrecogin – alfa)
Upjohn – presence of sulfo with
antiviral drug .

www.indiandentalacademy.co...
TEMOCILLIN








MR – GN (klebsella , H.Inf, e-coli)
Action : same pen
Narrow spectrum BLRP.
Indication : renal i...
 PIPERACILLIN

& TAZOBACTAM

 SULBACTAM

www.indiandentalacademy.com
ANTIFUNGAL

www.indiandentalacademy.com
VORICONAZOLE






Triazole
Indication : Serious fungal infection.
1st & only drug – FDA (ampo – B).
Ad – Eff : visio...
POSACONAZOLE










Triazole .(NOXAFI)
FDA – july- 13- 2004
Action : cytochrome p450 14a –
demethylase (sterol)...
TERCONAZOLE :
-Vaginal
 ISAVUCONAZOLE :
-Clinical phase.
-resistant – fluconazole
 RAVUCONAZOLE :
-Clinical trial.
-rela...
CASPOFUNGINS








FDA & EU
Action : cell wall .
Indicated : invasive aspergillosis, refractory
to ampo – B, oesop...
MICAFUNGIN






Glucan synthesis.
Action : cell wall 1-3 beta- D- glucan.
Broad spectrum.( no –zygo)
Dose : 150mg/da...
SERATOCONAZOLE





Imidazole
Action : cell wall.
Indicated : Athletes foot .
Ad – Eff : burning, dermatitis

www.indi...
ANTIVIRAL

www.indiandentalacademy.com
ATAZANAVIR
Protease inhibitor.
 Anti-retro viral.
 FDA-2003
 1st - OD.(2006) -300mg
 Ad – Eff : bilirubin, torsades de...
TENOFOVIR:



Blocks reverse transcriptase.
FDA – 2001

FOSAMPRENAVIR:




FDA – 2003
Active – amprenavir.
Protease i...


ADEFOVIR DIPIVOXIL :
- Inhibits HBV DNA polymerase.
- indication : HBV
- Ad – Eff : GIT, Nepro.
- dose : 10mg OD.



E...
NOVEL MODES



Focus – virulence
Molecular biology & genomics – NOT

Nancy khardori -2006 med clin. N Am 90
www.indiande...
www.indiandentalacademy.com


ANTI-QUORUM SENSING MECHANISM:
- Protective biofilm.



ENZYMES:
- Damage to DNA .

.



PATHOGENICITY ISLAND:
- Viru...


CHEMICAL MODIFICATION
– Beta – lactamas inhibitors – saturated by
ext.spectrum Beta-lactamas .
– LY333328 – vancosamine...


ANTIBIOTICS HYBRIDE

– Two in One

Hamilton-miller JM .Dual – action antibiotic hybrid. J antimicro
chemotherapy 1994;3...
AMP


NATURAL ANTIBIOTICS:
– Innate immunity.
– Lipid – peptide interaction.
– Defensins.

MERD 2007 AMP – SMART BOMBS (f...


Designed AMP:
– Laboratory synthesized
– Anti pneumococcal – peptide
analogue

www.indiandentalacademy.com


BACTERIAL ATTACHMENT INHIBITORS:
– Bacterial receptors Vs oligosaccharide –
mucosa
– Non cellular oligosaccharides.

ww...
BACTERIOPHAGES (1917)
– Intravenous phage –
stap.aureus.
– Alernative antibiotics.

www.indiandentalacademy.com
METAGENOMICS:
-

Removal of Plasmid DNA

CISRO GENE TECHNOLOGY:
- cytokine & interferon
- adenovirus - vector

www.indiand...
PROTIEN INHIBITORS:


Hemocidins



Staphostatins

www.indiandentalacademy.com
NANOTECNOLOGY





Nanopills
- carbon
- amino acid
- semiconductors
- plastic
Quantum dot
Target antibiotics – bucky ba...
www.indiandentalacademy.com
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com
Upcoming SlideShare
Loading in …5
×

Antibiotics pre3 /certified fixed orthodontic courses by Indian dental academy

933 views

Published on


The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

Published in: Health & Medicine, Technology
  • Be the first to comment

  • Be the first to like this

Antibiotics pre3 /certified fixed orthodontic courses by Indian dental academy

  1. 1. NEW GENERATION INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. INTRODUCTION    “against life”. Produced by microorganisms. BUT www.indiandentalacademy.com
  3. 3.         Beta Lactams Penicillins (PCN) Cephalosporins Carbapenems Monobactams Vancomycin Bacitracin Polymyxin www.indiandentalacademy.com
  4. 4.      Macrolides Aminoglycosides Sulfonamides Flouroquinolones Other” antibiotics www.indiandentalacademy.com
  5. 5. www.indiandentalacademy.com
  6. 6. GLYCYLCYCLINE www.indiandentalacademy.com
  7. 7. TIGECYCLINE       Glycylcline FDA – 2005,june17. Similar – Tc & minocycline.(D-9). Action : inhibits 30 s ribosome Indication : GPV & GNV & anaerobes. MRSA,VRE,ESBL-Klebsiella & E-coli SST infection, Intra-abdominal NOT – pseudomonas or proteus Dose : 100 mg than 50 mg BD liver –lower kidney-not www.indiandentalacademy.com
  8. 8.     NOT – children , HS Pregnancy, lactating mother, geriatrics ? No oral forms Ad – effects: GIT, TEETH & BONE Tgc;first of a new class of antimicrobial agent:eugene Applebaun, USA: pharmacotherapy -2006 aug 26 (18) . Tgc; a new glycylcycline antibiotics :kasbekan,pennsylvania,usa:Amj health syst pharm 2006 1;63 www.indiandentalacademy.com
  9. 9. KETOLIDE www.indiandentalacademy.com
  10. 10. TELITHROMYCIN       Ketolide (macro) Semi-synthetic erythromycin. FDA -2004 April Action : 50 s ribosome & 30 s – propagation. carried - phagocytes . Indication : RTI( pneumonia.strep), H.Inf . Dose : 800 mg OD. 7 days. Ad – eff : GIT, Blurring of vision, Jaundice. FDA – WARNING – NOT – acute bacterial sinusitis and bronchitis. - myasthenia www.indiandentalacademy.com
  11. 11. OXAZOLIDINONES www.indiandentalacademy.com
  12. 12. LINEZOLID        Oxazolidinones FDA - 2001 Action: 30 s & 50 s – initiation . Indication: MR strep, MRSA SSSI, Nasocomial pneu. No action on GN . Cont-ind; HS, Platelet Disorders . Pregnancy , child , lactating mother & geriatrics ? www.indiandentalacademy.com
  13. 13.     Ad – eff : GIT, platelets. Interaction : MAO,SSRI - seratonin syn. Dose : 600 mg BD.(100 Rs) Light sensitive. Ranbezolid. Tsiodras s.gold HS – Linezolid resistance in a clinical isolate of stap..aureus. Lancet.2006 jul (21). Vonder lipper: efficacy & safety of Linezolid in MDR – TB 2006: J infection. www.indiandentalacademy.com
  14. 14. LIPOPEPITIDE www.indiandentalacademy.com
  15. 15.       DAPTOMYCIN Sep-2003 Sapaotroph streptomyces reseosporus. Action – rapid depolarization. - inhibition of protein, DNA, RNA Indication – SSSI, Stap.aureus bacterimia , Not in pneumonia – surfactants Dose – 4 mg/kg iv OD Ad – eff – myopathy & rhabdomyolysis Lin, dap, tig – supplement for vancomycin resistant MRSA & VRE update on antibiotic resistance in hospital – June 2006 - Medline www.indiandentalacademy.com
  16. 16. LINCOSAMIDE www.indiandentalacademy.com
  17. 17. STREPTOGRAMINS        Lincosamide FDA – 1999 Pristinamycin – quinupristin/dalfopristin (30:70). Action : early step protein & bond formation. Dual mechanism Indicated : MRSA, VRE- faecum, SSSI. AD – Eff : myalgia , arthralgia – 30% Quinupristin/Dalfopristin : med lett drugs ther 1999: 41 Nadler et al . quinupristin/dalfopristin: a novel selective spectrum antibiotic for MRSA & GP. Clin. Microbial news 1999;130 www.indiandentalacademy.com
  18. 18. www.indiandentalacademy.com
  19. 19. . www.indiandentalacademy.com
  20. 20. GLYCOPEPTIDE (MACROLIDE) www.indiandentalacademy.com
  21. 21. vancomycin    1956 Workhorse . VRE, VISSA, VRSA www.indiandentalacademy.com
  22. 22. www.indiandentalacademy.com
  23. 23. FOSFOMYCIN         Phosphonic acid - glycopeptides Action – enolpyruvyltransferase – cell wall - attachment Indicated – UTI E-coli, entero- faecalis. Dose – 1 sachet – 4 ou. No cross reaction with beta lactam. Child, geriatrics, nursing mother - ? pregnancy – Not Fosfomycin- 70% Vs Cipro % www.indiandentalacademy.com
  24. 24. TEICOPLANIN          Glycopeptide Actinoplanes teicomyceticus . More lipophilic ( vancomycin) Lesser toxicity. Action : inhibits peptidoglycan syn. Indication : MRSA, PRS, Entero. AD-Eff : Granulocytopenia Dose : 400 mg – 1 st then 200 mg iv or im Other s under investigation www.indiandentalacademy.com
  25. 25. RAMOPLANIN     Glycolipodepeptide – macrocyclic 10 time > vanco. Broad spectrum. Clinical trial. www.indiandentalacademy.com
  26. 26. SPECTINOMYCIN     Structurally different from aminoglycosides. Indication : penicillin HS, gonorrhoea. Ad – Eff : GIT. Dose : 2 g deep im www.indiandentalacademy.com
  27. 27.        ROKITAMYCIN – borrelia RU 28965 – sterp. Pneu. TE – 0381 – legionnaires. EVEROLIMUS -rapamycin –psoriasis. ORITAVANCIN. TELAVANCIN. ALBAVANCIN. Severe psoriasis Tx with new macrolid –everolimus: BJD ; 2007 vol 156 www.indiandentalacademy.com
  28. 28. AMINOGLYCOSIDES www.indiandentalacademy.com
  29. 29. DIBEKACIN       Analog – kanamycin Broad spectrum. E-Coli, pseudomonas . Dose : 100 mg im or iv. Indication : RTI, UTI, Burns Ad – Eff : Nepro, Oto toxicity . ISEPAMICIN – diaminocyclitol derivatives www.indiandentalacademy.com
  30. 30. NEW use of OLDER ones www.indiandentalacademy.com
  31. 31. www.indiandentalacademy.com
  32. 32. CARBAPENEMS www.indiandentalacademy.com
  33. 33. www.indiandentalacademy.com
  34. 34. ERTAPENEM      Similar to meropenem Indication : GN & anaerobic CA infection – 1st line (FDA) HA infection – NOT – ESBL Dose : 1gm iv – 30 min. Highly protein bound Ad – Eff : no clinical study( child, pregnant, lactating mother) www.indiandentalacademy.com
  35. 35. Faropenem        Effective – GP & GN. PBPS 2&1A. Indication : L & U RTI, ENT, UTI. AD-Eff : GIT. Dose : 150 – 300 mg – TID. Caution : pregnant. No study – child, geriatrics . www.indiandentalacademy.com
  36. 36. CEPHALOSPORINS www.indiandentalacademy.com
  37. 37. CEFTOBIPROLE    FDA – 2003 – clinical trial. Indicated : MRSA, SSSI, Nasocomial Injectable. www.indiandentalacademy.com
  38. 38. CEFEPINE HCL       Semisynthetic 4th gen. Indication : pneumonia, UTI, SSSI. Caution : Child, pregnancy, geriatrics. Dose : 0.5 to 1gm. BD. AD – Eff : GIT, Injectable site, C-Ind : pseudomembranous colitis. www.indiandentalacademy.com
  39. 39. QUINOLONES www.indiandentalacademy.com
  40. 40. TROVAFLOXACIN         1997 4 – gen. Broadest spectrum. Action : DNA gyrus, ty 4 topoisomerase (dormant) Indication :CAP, nosocomial, pneumonia, bronchitis NOT – UTI, pyelonephrites Meningitis Dose : 100mg to 200 mg/day ; oral or iv Ad – Eff : hepatic FDA – WARNING 1999,JUNE-LIVER TOXICITY.RESERVED FOR LIFE THREATING . www.indiandentalacademy.com
  41. 41. GEMIFLOXACIN-MESYLATE        4 gen. Action : similar. GP & GN . Indication : MRSA, MDR, H.inf, klebsella pneu. Ad –Eff : GIT. Dose : 320 mg OD – po or iv. Only FQ – therapeutic level. www.indiandentalacademy.com
  42. 42. MOXIFLOXCIN       3rd gen. 2000 – FDA. Indication : penicillin resistant pneu, sinusitis, bronchitis & CAP. Cont-ind : QT interval, HS. Ad – Eff : GIT,QT prolonged. Dose : 400mg /day. www.indiandentalacademy.com
  43. 43. www.indiandentalacademy.com
  44. 44.  PRULIFLOXACIN  RUFLOXACIN  TEMOFLOXACIN  SITAFLOXACIN  GREPAFLOXACIN (1999torsedes de pointes) www.indiandentalacademy.com
  45. 45. SULFONAMIDES   No new (drotrecogin – alfa) Upjohn – presence of sulfo with antiviral drug . www.indiandentalacademy.com
  46. 46. TEMOCILLIN        MR – GN (klebsella , H.Inf, e-coli) Action : same pen Narrow spectrum BLRP. Indication : renal impaired pt . Dose : 1gm iv or im 12 hrs. Ad – Eff : angioedema, HS. Pregnancy, child, geriatrics ? Liver more et al : 2005 activity of temocilline Vs prevalent ESBL enterobacterecia : SE England FIS medline nov 2005. www.indiandentalacademy.com
  47. 47.  PIPERACILLIN & TAZOBACTAM  SULBACTAM www.indiandentalacademy.com
  48. 48. ANTIFUNGAL www.indiandentalacademy.com
  49. 49. VORICONAZOLE      Triazole Indication : Serious fungal infection. 1st & only drug – FDA (ampo – B). Ad – Eff : vision, Dose : 3mg/kg iv or 200mg. Walsh T – National institute A & I :Mycosis study group jan2002 /;compared voriconazole Vs ampo-B. www.indiandentalacademy.com
  50. 50. POSACONAZOLE         Triazole .(NOXAFI) FDA – july- 13- 2004 Action : cytochrome p450 14a – demethylase (sterol) Invasive infection. Dose : oral 600 to 800mg / day. More potent than varico. Zygomycetes. Ad – Eff : GIT, taste. www.indiandentalacademy.com
  51. 51. TERCONAZOLE : -Vaginal  ISAVUCONAZOLE : -Clinical phase. -resistant – fluconazole  RAVUCONAZOLE : -Clinical trial. -related to vari & flu.  www.indiandentalacademy.com
  52. 52. CASPOFUNGINS       FDA & EU Action : cell wall . Indicated : invasive aspergillosis, refractory to ampo – B, oesophagities . Dose : 70 mg iv Ad – Eff ; GIT , skin Caution : hepatic, preg, lactating, www.indiandentalacademy.com
  53. 53. MICAFUNGIN      Glucan synthesis. Action : cell wall 1-3 beta- D- glucan. Broad spectrum.( no –zygo) Dose : 150mg/day Indication : stem cell transplant pt. oesophageal candida. ANIDULA – similar aspergilluse nidulans. www.indiandentalacademy.com
  54. 54. SERATOCONAZOLE     Imidazole Action : cell wall. Indicated : Athletes foot . Ad – Eff : burning, dermatitis www.indiandentalacademy.com
  55. 55. ANTIVIRAL www.indiandentalacademy.com
  56. 56. ATAZANAVIR Protease inhibitor.  Anti-retro viral.  FDA-2003  1st - OD.(2006) -300mg  Ad – Eff : bilirubin, torsades de points,  www.indiandentalacademy.com
  57. 57. TENOFOVIR:   Blocks reverse transcriptase. FDA – 2001 FOSAMPRENAVIR:    FDA – 2003 Active – amprenavir. Protease inhibitor. FOMIVIRSEN:   Blocks viral mRNA - coding CMV – retinitis ; HIV www.indiandentalacademy.com
  58. 58.  ADEFOVIR DIPIVOXIL : - Inhibits HBV DNA polymerase. - indication : HBV - Ad – Eff : GIT, Nepro. - dose : 10mg OD.  ENTECAVIR : - Inhibits DNA reverse transcriptase. - Dose : 0.5mg OD. www.indiandentalacademy.com
  59. 59. NOVEL MODES   Focus – virulence Molecular biology & genomics – NOT Nancy khardori -2006 med clin. N Am 90 www.indiandentalacademy.com
  60. 60. www.indiandentalacademy.com
  61. 61.  ANTI-QUORUM SENSING MECHANISM: - Protective biofilm.  ENZYMES: - Damage to DNA . .  PATHOGENICITY ISLAND: - Virulence encoded genes. - VREF. - Virstatin - Cholera toxin gene. Hung DT . Small-molecule inhibitor of vibrio cholerae. science 2005;310 Goldsmith. Plasmid-encoded MucB protein is a DNA polymerase:Natl AcadSci USA www.indiandentalacademy.com 2000;97
  62. 62.  CHEMICAL MODIFICATION – Beta – lactamas inhibitors – saturated by ext.spectrum Beta-lactamas . – LY333328 – vancosamine sugar. – L786392 – carbapenem – PBP2a - PBP 5 Waldor MK.a new approch for antibiotics development .N Engl j Med 2006 :354 www.indiandentalacademy.com
  63. 63.  ANTIBIOTICS HYBRIDE – Two in One Hamilton-miller JM .Dual – action antibiotic hybrid. J antimicro chemotherapy 1994;33 www.indiandentalacademy.com
  64. 64. AMP  NATURAL ANTIBIOTICS: – Innate immunity. – Lipid – peptide interaction. – Defensins. MERD 2007 AMP – SMART BOMBS (frog skin & human lung) www.indiandentalacademy.com
  65. 65.  Designed AMP: – Laboratory synthesized – Anti pneumococcal – peptide analogue www.indiandentalacademy.com
  66. 66.  BACTERIAL ATTACHMENT INHIBITORS: – Bacterial receptors Vs oligosaccharide – mucosa – Non cellular oligosaccharides. www.indiandentalacademy.com
  67. 67. BACTERIOPHAGES (1917) – Intravenous phage – stap.aureus. – Alernative antibiotics. www.indiandentalacademy.com
  68. 68. METAGENOMICS: - Removal of Plasmid DNA CISRO GENE TECHNOLOGY: - cytokine & interferon - adenovirus - vector www.indiandentalacademy.com
  69. 69. PROTIEN INHIBITORS:  Hemocidins  Staphostatins www.indiandentalacademy.com
  70. 70. NANOTECNOLOGY    Nanopills - carbon - amino acid - semiconductors - plastic Quantum dot Target antibiotics – bucky ball www.indiandentalacademy.com
  71. 71. www.indiandentalacademy.com
  72. 72. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

×