This document discusses various classes of antibiotics including their mechanisms of action, antimicrobial spectrum, therapeutic uses, and dosages. It covers penicillins, cephalosporins, macrolides, lincosamines, chloramphenicol, and aminoglycosides. For each class, it provides examples of specific antibiotics, the types of bacteria they are active against, common infections they are used to treat, and recommended dosages depending on the route of administration. Potential side effects are also outlined. The document provides a comprehensive overview of different antibiotic classes.
This document discusses guidelines for antibiotic treatment and management. It covers factors like selecting initial empiric therapy based on the infection type (mono vs polymicrobial), choosing agents based on likely pathogens, and tailoring therapy based on host factors. It recommends narrowing coverage once cultures identify pathogens. The optimal duration depends on the infection site but is typically 3-5 days for most infections. It advises converting IV therapy to oral when possible for safety and earlier discharge. Prolonged or excessive antibiotic use should be avoided to prevent resistance.
Antibiotics: classification and spectrum of actionBashar Mudallal
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This document provides an overview of different classes of antibiotics, including cell wall inhibitors, protein synthesis inhibitors, topoisomerase inhibitors, anti-metabolites, and anti-mycobacterials. It describes common antibiotics within each class, what types of bacteria they cover, and examples of specific antibiotics. It also briefly discusses empiric antimicrobial therapy and treatment for C. difficile infections.
Penicillin : Dr Rahul Kunkulol's Power point PresentationsRahul Kunkulol
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1. The document discusses different classes of beta-lactam antibiotics including penicillins, cephalosporins, carbapenems, and monobactams.
2. All beta-lactams work by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins. This prevents cross-linking of peptide chains in the cell wall causing the cell to burst.
3. Specific types of penicillins are discussed including natural penicillins, aminopenicillins, anti-staph penicillins, and anti-pseudomonal penicillins. Their spectrums of activity and uses are described.
This document provides information about antibiotics. It begins by defining antibiotics and their uses in treating bacterial infections. It then discusses bacterial cell structure, important medically relevant bacteria including gram-positive and gram-negative organisms. The document also covers antibiotic classification based on mechanism of action, new classes of antibiotics, dosing considerations, and common antibiotics including penicillins, their uses, mechanisms of action, and side effects. It concludes with a brief discussion of antibiotic resistance.
Cephalosporins & other β lactam antibioticsFarazaJaved
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The document summarizes cephalosporins and other β-lactam antibiotics. It discusses the classes of cephalosporins including their history, chemistry, mechanisms of action, uses, and resistance. It also briefly covers other β-lactam antibiotics such as β-lactamase inhibitors, monobactams, carbapenems, vancomycin, fosfomycin, polymyxins, and cycloserine. The five generations of cephalosporins are characterized by their spectra of activity against different bacteria. Adverse effects of cephalosporins include allergic reactions and nephrotoxicity.
This document summarizes tetracyclines and chloramphenicol, two broad-spectrum antibiotics. Tetracyclines are divided into three groups based on their structure and properties. They work by inhibiting bacterial protein synthesis. Chloramphenicol also inhibits bacterial protein synthesis. Both have broad antibacterial spectra, though chloramphenicol is more active against certain pathogens like Salmonella typhi and Haemophilus influenzae. Resistance to both can develop through various mechanisms such as efflux pumps or protective ribosomal proteins.
This document provides a classification and overview of various classes of antibiotics. It discusses beta-lactam antibiotics such as penicillins and cephalosporins, describing their mechanisms of action, spectra of activity, and common adverse effects. It also summarizes macrolides, fluoroquinolones, aminoglycosides, vancomycin, oxazolidinones, and lincosamides, outlining their gram-positive and gram-negative bacterial coverage and important pharmacological properties. The document is intended as an educational reference for antibiotics.
This document discusses tetracycline antibiotics. It notes that tetracyclines reversibly bind to the 30S ribosome and inhibit aminoacyl-tRNA binding. They are broad spectrum antibiotics active against most bacteria except Proteus and Pseudomonas. Resistance can develop through decreased cell permeability, increased drug efflux, ribosomal protection, or enzymatic inactivation. Common tetracyclines include doxycycline, minocycline and tetracycline itself. Adverse effects include gastrointestinal issues, renal impairment, hepatotoxicity and tooth discoloration in children. Drug interactions and contraindications are also discussed.
This document discusses guidelines for antibiotic treatment and management. It covers factors like selecting initial empiric therapy based on the infection type (mono vs polymicrobial), choosing agents based on likely pathogens, and tailoring therapy based on host factors. It recommends narrowing coverage once cultures identify pathogens. The optimal duration depends on the infection site but is typically 3-5 days for most infections. It advises converting IV therapy to oral when possible for safety and earlier discharge. Prolonged or excessive antibiotic use should be avoided to prevent resistance.
Antibiotics: classification and spectrum of actionBashar Mudallal
Â
This document provides an overview of different classes of antibiotics, including cell wall inhibitors, protein synthesis inhibitors, topoisomerase inhibitors, anti-metabolites, and anti-mycobacterials. It describes common antibiotics within each class, what types of bacteria they cover, and examples of specific antibiotics. It also briefly discusses empiric antimicrobial therapy and treatment for C. difficile infections.
Penicillin : Dr Rahul Kunkulol's Power point PresentationsRahul Kunkulol
Â
1. The document discusses different classes of beta-lactam antibiotics including penicillins, cephalosporins, carbapenems, and monobactams.
2. All beta-lactams work by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins. This prevents cross-linking of peptide chains in the cell wall causing the cell to burst.
3. Specific types of penicillins are discussed including natural penicillins, aminopenicillins, anti-staph penicillins, and anti-pseudomonal penicillins. Their spectrums of activity and uses are described.
This document provides information about antibiotics. It begins by defining antibiotics and their uses in treating bacterial infections. It then discusses bacterial cell structure, important medically relevant bacteria including gram-positive and gram-negative organisms. The document also covers antibiotic classification based on mechanism of action, new classes of antibiotics, dosing considerations, and common antibiotics including penicillins, their uses, mechanisms of action, and side effects. It concludes with a brief discussion of antibiotic resistance.
Cephalosporins & other β lactam antibioticsFarazaJaved
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The document summarizes cephalosporins and other β-lactam antibiotics. It discusses the classes of cephalosporins including their history, chemistry, mechanisms of action, uses, and resistance. It also briefly covers other β-lactam antibiotics such as β-lactamase inhibitors, monobactams, carbapenems, vancomycin, fosfomycin, polymyxins, and cycloserine. The five generations of cephalosporins are characterized by their spectra of activity against different bacteria. Adverse effects of cephalosporins include allergic reactions and nephrotoxicity.
This document summarizes tetracyclines and chloramphenicol, two broad-spectrum antibiotics. Tetracyclines are divided into three groups based on their structure and properties. They work by inhibiting bacterial protein synthesis. Chloramphenicol also inhibits bacterial protein synthesis. Both have broad antibacterial spectra, though chloramphenicol is more active against certain pathogens like Salmonella typhi and Haemophilus influenzae. Resistance to both can develop through various mechanisms such as efflux pumps or protective ribosomal proteins.
This document provides a classification and overview of various classes of antibiotics. It discusses beta-lactam antibiotics such as penicillins and cephalosporins, describing their mechanisms of action, spectra of activity, and common adverse effects. It also summarizes macrolides, fluoroquinolones, aminoglycosides, vancomycin, oxazolidinones, and lincosamides, outlining their gram-positive and gram-negative bacterial coverage and important pharmacological properties. The document is intended as an educational reference for antibiotics.
This document discusses tetracycline antibiotics. It notes that tetracyclines reversibly bind to the 30S ribosome and inhibit aminoacyl-tRNA binding. They are broad spectrum antibiotics active against most bacteria except Proteus and Pseudomonas. Resistance can develop through decreased cell permeability, increased drug efflux, ribosomal protection, or enzymatic inactivation. Common tetracyclines include doxycycline, minocycline and tetracycline itself. Adverse effects include gastrointestinal issues, renal impairment, hepatotoxicity and tooth discoloration in children. Drug interactions and contraindications are also discussed.
This document summarizes broad spectrum antibiotics tetracyclines and chloramphenicol. It describes the classification, mechanisms of action, antimicrobial spectrum, resistance, pharmacokinetics, adverse effects and therapeutic uses of tetracyclines. It also summarizes the mechanism of action, antimicrobial spectrum, resistance, pharmacokinetics, adverse effects and therapeutic uses of chloramphenicol. Both antibiotics are bacteriostatic, have broad spectra, can cause bone marrow toxicity and are enterohepatically circulated.
This document discusses several antibiotics, including their mechanisms of action, uses, and side effects. It covers penicillins, cephalosporins, quinolones, metronidazole, rifampicin and more. Key points include that quinolones inhibit bacterial DNA gyrase, metronidazole produces toxic radicals that disrupt DNA/proteins, and rifampicin inhibits bacterial RNA polymerase. Common uses and potential adverse effects are provided for each class. Pharmacokinetic properties such as absorption, distribution, metabolism and excretion are also summarized.
Recent advances in antibacterials include several newly approved drugs and those in development. Oxazolidinones like linezolid and newer glycopeptides like telavancin are effective against resistant strains. Lipopeptides like daptomycin and ketolides provide alternatives. Newer carbapenems like ertapenem and doripenem have improved properties. The development pipeline remains limited due to high costs and resistance. Future targets may include virulence factors, host pathways, and antimicrobial peptides. Antibiotic stewardship programs aim to optimize use and minimize unintended consequences of resistance development.
Antibiotics are obtained from fungi, bacteria, and actinomycetes. They are classified based on their chemical structure and mechanism of action. Penicillin was the first antibiotic used clinically in 1941 and is obtained from the fungus Penicillium notatum. It works by inhibiting cell wall synthesis in bacteria. While effective, bacteria can develop resistance through production of penicillinase enzymes or changes to cell wall transpeptidases. Semisynthetic penicillins were created to address limitations of penicillin like resistance and spectrum of activity.
This document summarizes the classes of β-lactam antibiotics, including their mechanisms of action, indications, and side effects. It discusses the four main classes: penicillins, cephalosporins, monobactams, and carbapenems. Each class is further broken down into generations or subtypes that have varying spectra of coverage and pharmacokinetic properties. Mnemonics are provided to help distinguish between the classes and generations.
The document discusses various classes of antibiotics including their mechanisms of action and clinical uses. It describes antibiotics that inhibit bacterial cell wall synthesis such as penicillins, cephalosporins, and carbapenems. It also discusses antibiotics that inhibit protein synthesis like macrolides, tetracyclines, and aminoglycosides. The document provides examples of narrow and broad-spectrum antibiotics and summarizes the clinical uses and important characteristics of selected antibiotics including penicillins, amoxicillin, ceftriaxone, and azithromycin. It also warns of potential adverse effects such as pseudomembranous colitis caused by antibiotics like clindamycin and lincomycin.
This document discusses different classes of beta-lactam antibiotics including cephalosporins, monobactams, and carbapenems. It describes the chemistry, mechanisms of action, spectra of activity, pharmacokinetics, uses, and adverse effects of various drugs within each class. First, second, third, fourth, and fifth generation cephalosporins are compared in terms of their antimicrobial spectra and examples are provided. Monobactams such as aztreonam are noted to have activity against aerobic gram-negative rods. Carbapenems like imipenem and meropenem have broad-spectrum gram-positive and gram-negative activity including anaerobes.
Colistin is a polymyxin antibiotic produced by Bacillus polymyxa that is effective against most gram-negative bacteria. It fell out of favor due to nephrotoxicity but remains a treatment of last resort for multidrug-resistant infections. There are two forms, colistin sulfate and colistimethate sodium, which are not interchangeable. Dosing is complicated due to lack of standardization. Colistin works by disrupting bacterial membranes. While resistance is still rare, its increased use has led to some resistant strains emerging.
Cephalosporins are a class of semisynthetic, β-lactam antibiotics derived from the fungus Cephalosporium. They are classified into 5 generations based on their year of development and spectrum of activity. Cephalosporins work by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins and preventing transpeptidation and cross-linking of peptidoglycan chains. This results in cell lysis and a bactericidal effect. Later generations have increased activity against Gram-negative bacteria and β-lactamase producers. Common uses include respiratory, urinary, skin/soft tissue infections as well as meningitis. Adverse effects are generally mild and include hyper
Piperacillin & tazobactam is effective against nosocomial infections caused by Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. It has shown success in treating lower respiratory tract infections, intra-abdominal infections, complicated urinary tract infections, and fever in neutropenic patients. Piperacillin is an extended spectrum penicillin while tazobactam is a beta-lactamase inhibitor that protects piperacillin from degradation, allowing it to be effective against beta-lactamase producing bacteria. Clinical trials demonstrate piperacillin-tazobactam is superior to other antibiotics for various infections and has a good
This document outlines antibiotic policy and guidelines for appropriate antibiotic use at a hospital. It discusses categorizing patients into different types based on risk factors and providing targeted therapy. It covers appropriate choices, dosages and durations of treatment for various infections including bloodstream, respiratory, urinary tract and intra-abdominal among others. Challenges around resistance and optimal use of antibiotics based on pharmacokinetic principles are also covered.
This document summarizes the salient features of β-lactam antibiotics and their mode of action, classification, spectrum of activity, and common adverse effects. It discusses penicillins, cephalosporins, and their subclasses. Penicillins inhibit bacterial cell wall synthesis by binding to penicillin binding proteins. They are more active against gram-positive bacteria. Cephalosporins have a similar mode of action but their activity spectrum varies between generations from gram-positive to broad-spectrum. Common adverse effects for both classes include hypersensitivity reactions and dysbiosis.
Cephalosporins are a class of beta-lactam antibiotics that inhibit bacterial cell wall synthesis. They include first, second, third, fourth, and fifth generation drugs with varying spectra of coverage. They have concentration-dependent bactericidal activity and are excreted renally. Common side effects include diarrhea, rash, and nephrotoxicity. Vancomycin and polymyxins have activity against gram-positive and highly resistant gram-negative bacteria, respectively. Tetracyclines have broad-spectrum coverage including MRSA and are bacteriostatic.
This document discusses various classes of newer antimicrobials that are used to treat resistant bacterial infections. It provides details on the mechanisms of action and modes of resistance for classes such as oxazolidinones, glycopeptides, lipopeptides, ketolides, glycylcyclines, carbapenems, cephalosporins, pleuromutilins, macrocyclic antibiotics, rifamycins, streptogramins, and quinolones. Newer drugs within these classes have improved properties compared to older drugs like having additional mechanisms of action, fewer drug interactions and side effects, and activity against drug-resistant bacteria.
The document discusses penicillins and cephalosporins, which are classes of beta-lactam antibiotics. It describes their discovery and mechanisms of action, inhibiting bacterial cell wall synthesis. It categorizes different generations and types of penicillins and cephalosporins based on their spectra of activity against gram-positive and gram-negative bacteria. It also addresses bacterial resistance, proper use, side effects, and alternatives like macrolides when patients exhibit penicillin allergies.
Ceftriaxone is a third-generation cephalosporin antibiotic used to treat a variety of bacterial infections. It works by inhibiting bacterial cell wall synthesis and has concentration-independent bactericidal activity. It is administered via intramuscular or intravenous injection, distributes well throughout the body including cerebrospinal fluid, and has a half-life of 7-8 hours. Common indications include lower respiratory, urinary tract, and abdominal infections caused by both gram-positive and gram-negative bacteria. Notable adverse effects include phlebitis, gastrointestinal upset, and skin reactions.
Penicillin and other beta-lactam antibiotics work by inhibiting the penicillin-binding proteins (PBPs) involved in bacterial cell wall synthesis. This disrupts cell wall formation and causes cell lysis and death. While effective against many gram-positive and some gram-negative bacteria, resistance can develop through beta-lactamase production or modifications of PBPs. Different penicillins have varying spectra of activity, pharmacokinetic properties, and resistance profiles that determine their clinical applications.
This document summarizes various antibiotics that inhibit cell wall synthesis, including glycopeptides like vancomycin, dalbavancin, telavancin, teicoplanin, and ramoplanin. It also discusses the lipopeptide daptomycin and other antibiotics such as bacitracin, fosfomycin, and cycloserine. The antibiotics covered are primarily effective against gram-positive cocci and are commonly used to treat methicillin-resistant Staphylococcus aureus (MRSA), skin and soft tissue infections, and pseudomembranous colitis.
This document discusses glycopeptides, lipoglycopeptides, and lipopeptides used to treat gram-positive bacterial infections. It begins with classifications of these drugs and mechanisms of action. Specifically, it focuses on vancomycin as the first glycopeptide antibiotic discovered from soil samples. It describes vancomycin's structure, mechanism of inhibiting cell wall synthesis, and pharmacokinetics. The document also covers the spectrum of activity and clinical uses of vancomycin and risks of resistance.
Chloramphenicol is a broad-spectrum antibiotic obtained from Streptomyces venezuelae that is active against both aerobic and anaerobic Gram-positive and Gram-negative bacteria. It works by reversibly binding to the 50S ribosomal subunit of bacteria and inhibiting protein synthesis. Resistance can develop through production of an acetyltransferase enzyme, decreased permeability, or lower bacterial ribosome affinity. Chloramphenicol has various clinical uses including treatment of serious rickettsial infections, meningococcal meningitis, and anaerobic infections. Adverse effects include bone marrow depression, hypersensitivity reactions, and gray baby syndrome in neonates.
Epilepsy is a chronic neurological condition characterized by recurrent seizures. The majority of childhood epilepsy is idiopathic or genetic in origin. Seizures can be generalized, arising from both hemispheres, or focal, arising from one hemisphere. Common generalized seizures include tonic-clonic, absence, and myoclonic seizures. Diagnosis involves a clinical history and may include EEG and imaging. Treatment primarily involves antiepileptic drug therapy to control seizures.
1. The document summarizes Malaysia's HIV/AIDS situation and recommendations for interventions. It reports that while HIV transmission is declining overall, sexual transmission now accounts for over 50% of new cases, especially among heterosexuals and men who have sex with men. 2. Key recommendations include expanding access to antiretroviral treatment, strengthening prevention services for at-risk groups, and implementing proven interventions like condom promotion and harm reduction programs. 3. Achieving the UNAIDS 90-90-90 targets of diagnosing 90% of HIV cases, treating 90% of those diagnosed, and virally suppressing 90% of those treated is an important goal.
This document summarizes broad spectrum antibiotics tetracyclines and chloramphenicol. It describes the classification, mechanisms of action, antimicrobial spectrum, resistance, pharmacokinetics, adverse effects and therapeutic uses of tetracyclines. It also summarizes the mechanism of action, antimicrobial spectrum, resistance, pharmacokinetics, adverse effects and therapeutic uses of chloramphenicol. Both antibiotics are bacteriostatic, have broad spectra, can cause bone marrow toxicity and are enterohepatically circulated.
This document discusses several antibiotics, including their mechanisms of action, uses, and side effects. It covers penicillins, cephalosporins, quinolones, metronidazole, rifampicin and more. Key points include that quinolones inhibit bacterial DNA gyrase, metronidazole produces toxic radicals that disrupt DNA/proteins, and rifampicin inhibits bacterial RNA polymerase. Common uses and potential adverse effects are provided for each class. Pharmacokinetic properties such as absorption, distribution, metabolism and excretion are also summarized.
Recent advances in antibacterials include several newly approved drugs and those in development. Oxazolidinones like linezolid and newer glycopeptides like telavancin are effective against resistant strains. Lipopeptides like daptomycin and ketolides provide alternatives. Newer carbapenems like ertapenem and doripenem have improved properties. The development pipeline remains limited due to high costs and resistance. Future targets may include virulence factors, host pathways, and antimicrobial peptides. Antibiotic stewardship programs aim to optimize use and minimize unintended consequences of resistance development.
Antibiotics are obtained from fungi, bacteria, and actinomycetes. They are classified based on their chemical structure and mechanism of action. Penicillin was the first antibiotic used clinically in 1941 and is obtained from the fungus Penicillium notatum. It works by inhibiting cell wall synthesis in bacteria. While effective, bacteria can develop resistance through production of penicillinase enzymes or changes to cell wall transpeptidases. Semisynthetic penicillins were created to address limitations of penicillin like resistance and spectrum of activity.
This document summarizes the classes of β-lactam antibiotics, including their mechanisms of action, indications, and side effects. It discusses the four main classes: penicillins, cephalosporins, monobactams, and carbapenems. Each class is further broken down into generations or subtypes that have varying spectra of coverage and pharmacokinetic properties. Mnemonics are provided to help distinguish between the classes and generations.
The document discusses various classes of antibiotics including their mechanisms of action and clinical uses. It describes antibiotics that inhibit bacterial cell wall synthesis such as penicillins, cephalosporins, and carbapenems. It also discusses antibiotics that inhibit protein synthesis like macrolides, tetracyclines, and aminoglycosides. The document provides examples of narrow and broad-spectrum antibiotics and summarizes the clinical uses and important characteristics of selected antibiotics including penicillins, amoxicillin, ceftriaxone, and azithromycin. It also warns of potential adverse effects such as pseudomembranous colitis caused by antibiotics like clindamycin and lincomycin.
This document discusses different classes of beta-lactam antibiotics including cephalosporins, monobactams, and carbapenems. It describes the chemistry, mechanisms of action, spectra of activity, pharmacokinetics, uses, and adverse effects of various drugs within each class. First, second, third, fourth, and fifth generation cephalosporins are compared in terms of their antimicrobial spectra and examples are provided. Monobactams such as aztreonam are noted to have activity against aerobic gram-negative rods. Carbapenems like imipenem and meropenem have broad-spectrum gram-positive and gram-negative activity including anaerobes.
Colistin is a polymyxin antibiotic produced by Bacillus polymyxa that is effective against most gram-negative bacteria. It fell out of favor due to nephrotoxicity but remains a treatment of last resort for multidrug-resistant infections. There are two forms, colistin sulfate and colistimethate sodium, which are not interchangeable. Dosing is complicated due to lack of standardization. Colistin works by disrupting bacterial membranes. While resistance is still rare, its increased use has led to some resistant strains emerging.
Cephalosporins are a class of semisynthetic, β-lactam antibiotics derived from the fungus Cephalosporium. They are classified into 5 generations based on their year of development and spectrum of activity. Cephalosporins work by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins and preventing transpeptidation and cross-linking of peptidoglycan chains. This results in cell lysis and a bactericidal effect. Later generations have increased activity against Gram-negative bacteria and β-lactamase producers. Common uses include respiratory, urinary, skin/soft tissue infections as well as meningitis. Adverse effects are generally mild and include hyper
Piperacillin & tazobactam is effective against nosocomial infections caused by Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. It has shown success in treating lower respiratory tract infections, intra-abdominal infections, complicated urinary tract infections, and fever in neutropenic patients. Piperacillin is an extended spectrum penicillin while tazobactam is a beta-lactamase inhibitor that protects piperacillin from degradation, allowing it to be effective against beta-lactamase producing bacteria. Clinical trials demonstrate piperacillin-tazobactam is superior to other antibiotics for various infections and has a good
This document outlines antibiotic policy and guidelines for appropriate antibiotic use at a hospital. It discusses categorizing patients into different types based on risk factors and providing targeted therapy. It covers appropriate choices, dosages and durations of treatment for various infections including bloodstream, respiratory, urinary tract and intra-abdominal among others. Challenges around resistance and optimal use of antibiotics based on pharmacokinetic principles are also covered.
This document summarizes the salient features of β-lactam antibiotics and their mode of action, classification, spectrum of activity, and common adverse effects. It discusses penicillins, cephalosporins, and their subclasses. Penicillins inhibit bacterial cell wall synthesis by binding to penicillin binding proteins. They are more active against gram-positive bacteria. Cephalosporins have a similar mode of action but their activity spectrum varies between generations from gram-positive to broad-spectrum. Common adverse effects for both classes include hypersensitivity reactions and dysbiosis.
Cephalosporins are a class of beta-lactam antibiotics that inhibit bacterial cell wall synthesis. They include first, second, third, fourth, and fifth generation drugs with varying spectra of coverage. They have concentration-dependent bactericidal activity and are excreted renally. Common side effects include diarrhea, rash, and nephrotoxicity. Vancomycin and polymyxins have activity against gram-positive and highly resistant gram-negative bacteria, respectively. Tetracyclines have broad-spectrum coverage including MRSA and are bacteriostatic.
This document discusses various classes of newer antimicrobials that are used to treat resistant bacterial infections. It provides details on the mechanisms of action and modes of resistance for classes such as oxazolidinones, glycopeptides, lipopeptides, ketolides, glycylcyclines, carbapenems, cephalosporins, pleuromutilins, macrocyclic antibiotics, rifamycins, streptogramins, and quinolones. Newer drugs within these classes have improved properties compared to older drugs like having additional mechanisms of action, fewer drug interactions and side effects, and activity against drug-resistant bacteria.
The document discusses penicillins and cephalosporins, which are classes of beta-lactam antibiotics. It describes their discovery and mechanisms of action, inhibiting bacterial cell wall synthesis. It categorizes different generations and types of penicillins and cephalosporins based on their spectra of activity against gram-positive and gram-negative bacteria. It also addresses bacterial resistance, proper use, side effects, and alternatives like macrolides when patients exhibit penicillin allergies.
Ceftriaxone is a third-generation cephalosporin antibiotic used to treat a variety of bacterial infections. It works by inhibiting bacterial cell wall synthesis and has concentration-independent bactericidal activity. It is administered via intramuscular or intravenous injection, distributes well throughout the body including cerebrospinal fluid, and has a half-life of 7-8 hours. Common indications include lower respiratory, urinary tract, and abdominal infections caused by both gram-positive and gram-negative bacteria. Notable adverse effects include phlebitis, gastrointestinal upset, and skin reactions.
Penicillin and other beta-lactam antibiotics work by inhibiting the penicillin-binding proteins (PBPs) involved in bacterial cell wall synthesis. This disrupts cell wall formation and causes cell lysis and death. While effective against many gram-positive and some gram-negative bacteria, resistance can develop through beta-lactamase production or modifications of PBPs. Different penicillins have varying spectra of activity, pharmacokinetic properties, and resistance profiles that determine their clinical applications.
This document summarizes various antibiotics that inhibit cell wall synthesis, including glycopeptides like vancomycin, dalbavancin, telavancin, teicoplanin, and ramoplanin. It also discusses the lipopeptide daptomycin and other antibiotics such as bacitracin, fosfomycin, and cycloserine. The antibiotics covered are primarily effective against gram-positive cocci and are commonly used to treat methicillin-resistant Staphylococcus aureus (MRSA), skin and soft tissue infections, and pseudomembranous colitis.
This document discusses glycopeptides, lipoglycopeptides, and lipopeptides used to treat gram-positive bacterial infections. It begins with classifications of these drugs and mechanisms of action. Specifically, it focuses on vancomycin as the first glycopeptide antibiotic discovered from soil samples. It describes vancomycin's structure, mechanism of inhibiting cell wall synthesis, and pharmacokinetics. The document also covers the spectrum of activity and clinical uses of vancomycin and risks of resistance.
Chloramphenicol is a broad-spectrum antibiotic obtained from Streptomyces venezuelae that is active against both aerobic and anaerobic Gram-positive and Gram-negative bacteria. It works by reversibly binding to the 50S ribosomal subunit of bacteria and inhibiting protein synthesis. Resistance can develop through production of an acetyltransferase enzyme, decreased permeability, or lower bacterial ribosome affinity. Chloramphenicol has various clinical uses including treatment of serious rickettsial infections, meningococcal meningitis, and anaerobic infections. Adverse effects include bone marrow depression, hypersensitivity reactions, and gray baby syndrome in neonates.
Epilepsy is a chronic neurological condition characterized by recurrent seizures. The majority of childhood epilepsy is idiopathic or genetic in origin. Seizures can be generalized, arising from both hemispheres, or focal, arising from one hemisphere. Common generalized seizures include tonic-clonic, absence, and myoclonic seizures. Diagnosis involves a clinical history and may include EEG and imaging. Treatment primarily involves antiepileptic drug therapy to control seizures.
1. The document summarizes Malaysia's HIV/AIDS situation and recommendations for interventions. It reports that while HIV transmission is declining overall, sexual transmission now accounts for over 50% of new cases, especially among heterosexuals and men who have sex with men. 2. Key recommendations include expanding access to antiretroviral treatment, strengthening prevention services for at-risk groups, and implementing proven interventions like condom promotion and harm reduction programs. 3. Achieving the UNAIDS 90-90-90 targets of diagnosing 90% of HIV cases, treating 90% of those diagnosed, and virally suppressing 90% of those treated is an important goal.
Rheumatoid arthritis is a chronic inflammatory joint disease that commonly affects the small joints of the hands and feet in a symmetrical pattern. It is characterized by persistent synovitis that can lead to joint damage and deformity over time if left untreated. Diagnosis is based on meeting at least 4 out of 7 criteria defined by the American Rheumatism Association, including morning stiffness, arthritis of 3 or more joints, arthritis of hand joints, symmetrical arthritis, rheumatoid nodules, positive rheumatoid factor, and radiographic changes. Treatment involves disease-modifying drugs such as methotrexate, sulfasalazine, hydroxychloroquine, and biologics to reduce inflammation and prevent further joint damage.
1) The document outlines several emergency procedures including rapid sequence intubation, chest tube insertion, femoral line insertion, CVP line insertion, and peritoneal tap.
2) It provides detailed steps for each procedure including necessary equipment, patient positioning, anesthesia, insertion technique, and post-procedure care.
3) The procedures are commonly assessed in OSCE exams and require careful preparation, sterile technique, knowledge of anatomy, and verification of correct placement.
Viral meningitis is usually self-limiting and caused by viruses like mumps and herpes. Bacterial meningitis has a higher risk of mortality and morbidity and is commonly caused by bacteria like pneumococcus, meningococcus, and H. influenzae depending on age. Diagnosis involves CT scan, lumbar puncture, and CSF analysis looking at cell count, glucose, protein and culture. Treatment for bacterial meningitis involves IV antibiotics targeting the suspected bacteria and supportive care. Complications can include hydrocephalus.
1) This document provides guidelines for the management of atrial fibrillation (AF), including evaluating the underlying causes, classifying the type of AF, assessing risk of complications, and approaches to rate control and rhythm control.
2) Rate control is recommended for most stable patients and involves pharmacological therapies like beta-blockers, calcium channel blockers, or digoxin, while assessing risk of thromboembolism and anticoagulating appropriately.
3) Rhythm control includes pharmacological or electrical cardioversion along with anticoagulation and maintenance medications to prevent AF recurrence, or non-pharmacological options like pacing or ablation for selected patients.
The document discusses various aspects of human sexuality including:
1) The normal sexual response cycle of desire, excitement and orgasm in men and women.
2) Several types of sexual dysfunctions that can occur including decreased libido, erectile dysfunction, delayed ejaculation and anorgasmia.
3) Paraphilias or abnormal sexual interests involving non-consenting partners or objects. Examples given include fetishism, voyeurism and pedophilia.
4) Gender identity disorders where one's identity does not match their biological sex.
The document discusses picornaviruses, a family of small RNA viruses that includes enteroviruses. It provides details on the structure, classification, and diseases caused by different genera of picornaviruses, with a focus on enteroviruses and polioviruses. Key points covered include the icosahedral structure of picornaviruses; classification of enteroviruses into different genera; diseases caused by different enteroviruses including poliomyelitis caused by polioviruses; laboratory diagnosis of enteroviral infections; and prevention of poliomyelitis through vaccines.
Tuberculosis is caused by infection with Mycobacterium tuberculosis. It typically affects the lungs but can spread to other organs. Primary TB occurs after initial exposure and may result in an asymptomatic Ghon focus or spread to lymph nodes and other sites. Secondary TB occurs from reactivation of a dormant lesion, usually in the apices of the lungs. Diagnosis involves testing sputum, blood, or other fluids for acid-fast bacilli on smear or culture. Chest x-ray may show consolidations, cavities or fibrosis. Treatment involves a multi-drug regimen over 6-9 months to prevent resistance, with monitoring of side effects like hepatitis and optic neuritis. Contact tracing and screening of household members is
Cardiac failure ( long case approach ) summaryDr. Rubz
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Cardiac failure, or heart failure, is defined as a state where the heart is unable to maintain an adequate cardiac output or can only do so at the expense of an elevated filling pressure. It is diagnosed when a patient with heart disease develops symptoms of low cardiac output, pulmonary congestion, or systemic venous congestion. Compensatory changes in heart failure include chamber enlargement, myocardial hypertrophy, increased heart rate, activation of the renin-angiotensin-aldosterone system and antidiuretic hormone release. Precipitating factors include myocardial infarction, arrhythmias, infections, noncompliance with medication or diet, and medical conditions like anemia, hyperthyroidism, or sepsis.
This document discusses various causes of thrombocytopenia including bone marrow disorders, increased platelet consumption, and hypersplenism. It specifically describes idiopathic thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP). ITP is characterized by autoantibodies against platelets that cause their premature destruction. It commonly presents with purpura and mucosal bleeding. Treatment involves corticosteroids, IVIG, or splenectomy. TTP is a thrombotic microangiopathy associated with a deficiency in a protease that breaks down fibrin. It presents with a pentad of thrombocytopenia, microangiopathic hemolytic an
This document summarizes scleroderma, a chronic disorder characterized by diffuse skin and internal organ fibrosis. It affects women more than men and usually appears between ages 20-40. There are three main forms: limited cutaneous systemic sclerosis, diffuse cutaneous systemic sclerosis which involves systemic organ involvement, and morphea which rarely progresses. Symptoms can include thickened skin, Raynaud's phenomenon, esophageal difficulties, lung and heart involvement. Investigations are used to confirm the diagnosis and check for complications. Management focuses on supportive care, symptomatic treatment, vasodilators, immunosuppressants, and educating the patient.
1. This document outlines the treatment plan and pathway for a patient presenting with chronic renal failure and fluid overload.
2. The plan involves diuresis with IV frusemide to reduce fluid, investigations to assess renal function and exclude other issues, and consideration of acute dialysis for severe cases.
3. Additional orders include monitoring for anemia, adjusting nutrition based on renal function, restricting fluid and protein intake, and making referrals to other services based on renal function and abilities.
Core competencies - Medical Development Division Dr Hirman Ismail
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The document outlines core competencies for officers in the Medical Development Division of the Malaysian Ministry of Health. It defines core competencies as a consensus set of essential skills and knowledge. It lists six domains of competencies and divides officers into three tiers based on their role and qualifications. The objectives are to ensure officers acquire critical management skills and prepare for future roles. Acquiring competencies is intended to improve performance, not burden officers, and will evolve over time.
1) Dengue fever is caused by the dengue virus and transmitted by Aedes mosquitoes. It presents with fever, rash, and thrombocytopenia.
2) Dengue hemorrhagic fever is a severe form characterized by bleeding, low platelets, and fluid leakage causing shock.
3) Diagnosis is based on fever, thrombocytopenia, bleeding, and fluid shifts seen on hematocrit levels. Severe cases are classified as dengue shock syndrome.
The document announces an e-mail auction to raise funds for the United Learning Centre, which provides education and meals to 140 refugee children in Malaysia. The auction includes donations of a Rado watch, porcelain vases, paintings, a lamp, and other items. Proceeds will help the learning center continue offering refugee children education, nutrition, and boarding for those whose parents work far away. The auction encourages supporting this charity auction to help children in need.
Prostate cancer for public awareness by DR RUBZDr. Rubz
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A presentation prepared for Charity Dinner with Fun Charity. All the profits of the event will go to FReHA (a NGO which supports women's and reproductive health.)
1) This document provides guidance on evaluating and diagnosing the cause of proteinuria. It outlines a three step approach to determine the amount, condition, and type of protein being excreted.
2) Transient proteinuria is usually benign, while persistent proteinuria over 1g/day requires further investigation including renal biopsy to diagnose underlying renal disorders like glomerulonephritis.
3) Management involves controlling blood pressure, reducing cardiovascular risk factors, and treating any identified underlying conditions like diabetes or renal disease.
This document summarizes different types of shock including hypovolemic, cardiogenic, neurogenic, septic, anaphylactic, and obstructive shock. It provides details on definitions, signs and symptoms, investigations, and management for each type of shock. General management includes maintaining the airway, providing oxygen, establishing intravenous access, monitoring vital signs, and administering fluids with or without vasopressors depending on the type and severity of shock. Specific investigations and treatments are outlined for each shock type.
The document discusses the second stage of labor and normal childbirth procedures. It describes:
1) The second stage of labor involves full dilation of the cervix over 1 hour followed by birth of the fetus. The fetus is born through a series of movements including extension, restitution, and external rotation of the head.
2) Proper techniques for assisting a normal vaginal delivery include encouraging the woman to push in her preferred position, suctioning the baby's mouth and nose after crowning, and gently guiding the shoulders and rest of the baby out one at a time to avoid tears.
3) Standard steps after birth include promptly placing the baby skin to skin on the mother, clamping and
The document discusses various classes of antibiotics including their spectrum of activity, mechanisms of action, and examples. It provides classifications of antibiotics such as narrow versus broad spectrum, bacteriostatic versus bactericidal. It describes common mechanisms of action such as inhibition of cell wall synthesis, protein synthesis, and nucleic acid synthesis. Examples of specific antibiotics are given for each class along with their dosages and availability in the Pakistani market.
The document discusses various classes of antibiotics including their spectrum of activity, mechanisms of action, and examples. It describes narrow and broad-spectrum antibiotics, and whether they are bacteriostatic or bactericidal. The main classes covered are beta-lactams like penicillins and cephalosporins, macrolides, quinolones, tetracyclines, aminoglycosides, chloramphenicol, and sulfonamides. It provides details on their mechanisms of inhibiting cell wall synthesis, protein synthesis, or nucleic acid synthesis. Examples of commonly used antibiotics in different species are given along with typical dosage ranges.
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Antibiotics lecture- 13- medical rev.pptAhmedKasem39
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This document provides an overview of antibiotics and antimicrobial agents presented by Prof Hanan Habib and Dr. Ali Somily. The objectives are to define key antibiotic concepts, recognize antibiotic classes and their mechanisms of action, spectrum of activity, and side effects. It discusses various classes of antibiotics that inhibit cell wall synthesis, alter cell membranes, inhibit protein synthesis, or act on nucleic acids. Ideal antibiotic criteria and principles of antimicrobial therapy are also reviewed. Mechanisms of antibiotic resistance and criteria for an ideal antimicrobial are presented. References for further information include the textbook Sherries Medical Microbiology.
This document discusses the pharmacology of antimicrobial agents. It begins by defining antimicrobials as chemical agents that destroy or inhibit the growth of infective agents. It then discusses the different classes of antimicrobials including antibacterials, antifungals, antivirals, and antineoplastics. The remainder of the document focuses on various classes of antibacterial agents including beta-lactams such as penicillins and cephalosporins, carbapenems, monobactams, and other cell wall synthesis inhibitors. It covers their mechanisms of action, spectra of activity, pharmacokinetics, uses, and adverse effects.
Antibacterial therapy in Otorhinolaryngology by Dr. Sudin KayasthaSudin Kayastha
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1. Sir Alexander Fleming discovered penicillin in 1928 when he noticed that a mold had developed on an accidentally contaminated staphylococcus culture plate and prevented the growth of staphylococci.
2. Antibiotics such as penicillins, cephalosporins, carbapenems, and others work by inhibiting bacterial cell wall synthesis or protein synthesis through various mechanisms of action.
3. Antibiotics have antibacterial spectra covering certain gram-positive and gram-negative bacteria but can also cause adverse effects like hypersensitivity reactions, and bacteria can develop resistance through various mechanisms such as producing beta-lactamases or altering binding sites.
A Power point presentation on Betalactam antibiotics suitable for undergraduate medical students. This Ppt is already presented in theory class lectures to the students of NEIGRIHMS, Shillong, Meghalaya
IX CHEMOTHERAPY OF INFECTIOUS DISEASES.pptTsegayeChebo
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This document discusses principles of antimicrobial chemotherapy and classification of antimicrobial drugs. It summarizes mechanisms of action, microbial resistance mechanisms, and therapeutic uses of various classes of antibacterial agents including beta-lactam antibiotics (penicillins, cephalosporins), aminoglycosides, tetracyclines, macrolides and other inhibitors of bacterial cell wall synthesis and protein synthesis. Adverse effects of these drug classes are also briefly outlined.
The document defines various terms related to antibiotics such as antimicrobials, bacteriostatic, bactericidal, and antibiotic resistance. It describes different types of antibiotics like narrow and broad spectrum and discusses minimum inhibitory concentration. It provides historical context on the discovery of penicillin and discusses the classification, mechanisms of action, uses, and development of resistance for penicillins and cephalosporins. [/SUMMARY]
The document discusses β-lactam antibiotics, which contain a β-lactam ring and include penicillins, cephalosporins, monobactams, and carbapenems. It notes that β-lactam antibiotics are active against both gram-positive and gram-negative bacteria but that bacteria have developed resistance through β-lactamase production and other mechanisms. Newer β-lactam antibiotics combined with β-lactamase inhibitors are effective against drug-resistant pathogens. Several newer combinations of β-lactam antibiotics and inhibitors approved or in development are described.
1. Antibiotics such as aminoglycosides and tetracyclines inhibit bacterial protein synthesis by binding to the 30S ribosomal subunit.
2. Aminoglycosides cause misreading of mRNA codons leading to improper protein production while tetracyclines block attachment of tRNA.
3. Other antibiotics like macrolides, chloramphenicol, and clindamycin bind to the 50S ribosomal subunit to inhibit protein synthesis and bacterial growth.
Penicillins are beta-lactam antibiotics derived from 6-aminopenicillanic acid. They act by inhibiting bacterial cell wall synthesis, exposing the osmotically unstable cell membrane and causing bacterial cell lysis. Penicillins are classified based on their spectrum of activity, resistance to penicillinase, and stability in acid environments. Common classes include penicillin G, broad-spectrum penicillins, and penicillinase-resistant penicillins. Penicillins are mostly excreted unchanged in urine, with some protein binding. Adverse effects include hypersensitivity reactions and superinfections.
This document discusses the antimicrobial therapy of neonates. It begins by defining antibiotics and classifying them based on their mode of action, spectrum of activity, and mechanism of action. Common bacterial diseases of neonates include neonatal diarrhea, joint ill, and pneumonia. For neonatal diarrhea, enrofloxacin is the drug of choice. For coccidiosis, sulfonamides are used. Metronidazole treats giardiasis. Penicillin and streptomycin are effective against joint ill. Macrolides like erythromycin and tylosin are useful to treat pneumonia. The document provides market drugs available in Pakistan for the different conditions.
This document provides an overview of antimicrobials (also known as antibiotics). It defines antimicrobials and discusses their classification as bactericidal or bacteriostatic. The document outlines the history of antimicrobial discovery and discusses their sources, selective toxicity, and modes of action. Key topics covered include the classification of antibiotics based on chemical structure and mechanism of action, as well as details on specific classes of antibiotics like penicillins, cephalosporins, carbapenems, and others.
Antimicrobial agents include antibiotics produced by microorganisms that inhibit other microorganisms. Antibiotics can be classified based on their mode of action and chemical structure. Major classes of antibiotics discussed include penicillins, cephalosporins, aminoglycosides, quinolones, and tetracyclines. Each class has distinct mechanisms of action, clinical uses, adverse drug reactions, and drug interactions that are important to consider when selecting antibiotic therapy.
This document discusses various types of beta-lactam antibiotics including penicillins and cephalosporins. It provides information on:
- Quinolones exhibit a long post-antibiotic effect while cefpirome is a 4th generation cephalosporin.
- All drugs listed are administered orally except gentamicin. Sulbactam is not a beta-lactamase inhibitor.
- Mechanisms of action, resistance, classifications, uses, pharmacokinetics and adverse effects of different beta-lactam antibiotics like penicillins, cephalosporins, carbapenems are explained in detail. Beta-lactamase inhibitors
HIV discrimination among health providers in Malaysia by Dr RubzDr. Rubz
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Although doctors took oath that they will treat everyone the best they can and without judging anyone but discrimination still exist especially in HIV affected people. Due to this issue, Pertubuhan Advokasi Masyarakat Terpinggir Malaysia has taken a step to engage with doctors at government sector and desensitize them and find the line to stand together.
HIV/AIDS data Hub Asia Pacific -Malaysia 2014Dr. Rubz
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This document provides a summary of HIV/AIDS data for Malaysia across multiple indicators:
- HIV prevalence is highest among key populations like people who inject drugs, female sex workers, and men who have sex with men. Condom use and safe injection practices have increased over time but remain below optimal levels.
- The number of reported HIV infections and AIDS-related deaths has declined in recent years. Most HIV transmissions are through heterosexual contact and injecting drug use.
- Vulnerability remains high as many key populations lack comprehensive HIV knowledge and access to prevention programs, testing, and treatment.
- Government spending on HIV has increased but more funding needs to be directed towards programs for key populations at higher
This document provides a regional overview of HIV/AIDS trends in Asia and the Pacific from 1990-2013. It summarizes that there are currently 4.8 million people living with HIV in the region, with new infections declining significantly since 2001 but remaining largely unchanged in the past 5 years. Treatment coverage has increased substantially, with 1.56 million people now on ART, however this is still only about one-third of those in need. The challenges ahead include addressing gaps in prevention for key populations and along the treatment cascade.
Testicular cancer for public awareness by Dr RubzDr. Rubz
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A presentation prepared for Charity Dinner with Fun Charity. All the profits of the event will go to FReHA (a NGO which supports women's and reproductive health.)
Breast Cancer for public awareness by Dr RubzDr. Rubz
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This document provides information from a presentation on breast cancer given by Dr. Ruby Bazeer. It discusses the anatomy of the breast and lymphatic system. Breast cancer is the most common cancer in women, with over 1.5 million new cases diagnosed annually. While breast cancer can be fatal if not detected early, it is curable when found early through methods like breast self-exams, clinical exams, ultrasound and mammography. The document outlines risk factors, signs and symptoms, screening recommendations, cancer stages and types of treatment for breast cancer. It aims to educate about this disease and the importance of early detection.
This is the first phase (qualitative) of the current project we are working on with the supervision of University Malaya and Yale School of Medicine.It will be publish as IBBS 2013 by end of the year. This slide is just a rough picture of what we are doing at the moment. This is copyright protected!
This document appears to be a set of slides for a lecture or teaching session on rapidly interpreting electrocardiograms (ECGs) given by Dr. James Smitt of Monash University on July 25, 2013 for third year medical students. The slides provide instruction on efficiently analyzing ECG readings to identify potential cardiac issues or abnormalities.
The document summarizes key details about the inguinal canal and inguinal hernias. It describes the anatomy of the inguinal canal including its entrance, exit, roof, floor, and walls. It then discusses direct and indirect inguinal hernias, their causes, signs and symptoms, examination findings, and surgical repair techniques like Lichtenstein and Shouldice repairs. Femoral hernias are also briefly covered.
The document describes the anatomy and physiology of the breast as well as common breast conditions. It discusses the structure of the breast including lobes, lobules, ducts, and surrounding tissues. It then covers common benign and malignant breast diseases like fibroadenomas, cysts, mastitis, and ductal carcinoma in situ. The document concludes with descriptions of clinical exam findings, imaging tests, biopsy procedures, and management of various breast abnormalities.
This document discusses techniques for breast examination and signs of breast cancer. It describes various types of lumps, skin changes, and nipple disorders that may indicate breast cancer, including hard or soft lumps, skin dimpling or redness, nipple inversion or discharge. It also summarizes ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, and how cancer can spread through lymph or blood vessels. Risk factors like genetics, lifestyle, and environment that may contribute to breast cancer development are outlined. Diagrams depict breast anatomy and different stages of cancer progression.
The document discusses various conditions that can affect the male genital tract including hydrocele, hematocele, spermatocele, varicocele, testicular tumors, testicular torsion, epididymo-orchitis, and undescended testis. It provides information on the presentation, risk factors, investigations, management, and complications of each condition. The document is a reference for doctors on evaluating and treating various scrotal and testicular issues.
This document discusses different types of hernias, including ventral, incisional, and Spigelian hernias. It defines a hernia as an abnormal protrusion of an organ outside its normal cavity. It classifies hernias based on their location, such as inguinal or femoral. Incisional hernias occur through a previous surgical wound. Signs and symptoms vary from a painless lump to a painful, swollen protrusion. Management typically involves surgical repair to excise the hernia sac and close the defect.
1. Orchitis and epididymo-orchitis are usually caused by blood-borne infections like Chlamydia, gonorrhea, or E. coli. They present with acute pain and swelling of the testes or epididymis.
2. Undescended testes occur in 1% of boys after 1 year of age and can lead to infertility if not treated. Risk factors include prematurity and family history. Treatment is orchidopexy to bring the testes into the scrotum.
3. Testicular torsion occurs when the spermatic cord twists, cutting off blood supply to the testes. It requires urgent surgery to untwist the cord or
Malaria is the most commonly imported tropical disease in the UK, with 1,500-2,000 cases reported annually. Three-quarters of cases are caused by Plasmodium falciparum, which can rapidly cause severe multi-organ disease if not treated promptly. Diagnosis relies on examination of blood films by an expert microscopist to detect parasites, though rapid diagnostic tests can also identify P. falciparum. Treatment depends on the Plasmodium species and severity of illness. Uncomplicated non-falciparum malaria is usually treated with chloroquine, while uncomplicated P. falciparum is treated with atovaquone-proguanil, quinine,
This document provides a summary of the physical findings associated with Acromegaly. It describes the characteristic features seen in the hands, face, neck, thorax, abdomen, skeletal system, and common lab abnormalities. The hands are large with broad palms and spatulate fingers, and may have hyperhidrosis, carpal tunnel syndrome, or osteoarthrosis. The face has prominent supraorbital ridges, large nose and lips, prognathism, interdental spacing, macroglossia, and possible optic atrophy or bitemporal hemianopia. Other findings include goiter in the neck, skin tags or acanthosis nigricans in the axilla, gynecomastia or cardiomegal
This document summarizes the physical exam findings that suggest Cushing's disease. When lying down, signs on the face include a moon face, hirsutism, acne, plethora from telangiectasia, and oral thrush. The shoulders may show supraclavicular fat pads and the abdomen may be obese with thin skin, purple striae, and bruising and wasting of the limbs. When standing up, the shoulders may have an interscapular buffalo hump and the spine may show kyphoscoliosis, vertebral fractures or osteoporosis. Long-term steroid use can cause similar findings and systemic exams include checking the urine for glucose, visual fields for pituitary tumors, and
Short case approach to parkinson's dz summaryDr. Rubz
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This document provides guidance on evaluating a patient for Parkinson's disease and related conditions. It describes key signs and symptoms to assess including mask-like facies, tremors, rigidity, bradykinesia, and postural instability. It also lists tests to help differentiate between Parkinson's disease and similar conditions like progressive supranuclear palsy or multiple system atrophy. Causes of true Parkinsonism are identified as well as differential diagnoses to consider.
Short case approach to speech analysis summaryDr. Rubz
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This document outlines a short case approach to analyzing speech through a series of tests of receptive and expressive language abilities, speech characteristics, repetition of sentences, and testing of other cognitive functions localized to different areas of the brain such as the frontal, temporal, parietal and occipital lobes. Tests include commands, writing, naming objects, line bisection, calculations, and motor skills to evaluate for conditions such as aphasia, dysarthria, apraxia, neglect and Gerstmann's syndrome resulting from lesions in specific brain regions. Physical exam of cardiovascular system is also recommended to investigate potential causes of stroke.
Stroke ( concise long case approach ) summaryDr. Rubz
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The document provides guidance on evaluating and managing patients presenting with suspected stroke. It outlines an approach to answering 6 key questions from the history, physical exam, and investigations to determine if the patient is having a stroke, identify the location and type of stroke, understand the mechanism, assess functional impairment, and identify risk factors. Principles of acute management include aspirin, thrombolysis if eligible, controlling blood pressure and blood glucose, and preventing hyperthermia. Secondary prevention involves antiplatelet therapy, anticoagulation if indicated, carotid endarterectomy for severe stenosis, controlling hypertension and lipids, smoking cessation, and managing diabetes risk factors.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
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Weâre talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
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The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 â 3649 E-mail : sales@trinexpharmacy.com
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Recomendaçþes da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS â Objetivos do Desenvolvimento SustentĂĄvel e a EstratĂŠgia Global para a SaĂşde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pĂłs-natais devem expandir-se para alĂŠm da cobertura e da simples sobrevivĂŞncia, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pĂłs-natais essenciais e de rotina prestados Ă s mulheres e aos recĂŠm-nascidos, com o objetivo final de melhorar a saĂşde e o bem-estar materno e neonatal.
Uma âexperiĂŞncia pĂłs-natal positivaâ ĂŠ um resultado importante para todas as mulheres que dĂŁo Ă luz e para os seus recĂŠm-nascidos, estabelecendo as bases para a melhoria da saĂşde e do bem-estar a curto e longo prazo. Uma experiĂŞncia pĂłs-natal positiva ĂŠ definida como aquela em que as mulheres, pessoas que gestam, os recĂŠm-nascidos, os casais, os pais, os cuidadores e as famĂlias recebem informação consistente, garantia e apoio de profissionais de saĂşde motivados; e onde um sistema de saĂşde flexĂvel e com recursos reconheça as necessidades das mulheres e dos bebĂŞs e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendaçþes novas e jĂĄ bem fundamentadas sobre cuidados pĂłs-natais de rotina para mulheres e neonatos que recebem cuidados no pĂłs-parto em unidades de saĂşde ou na comunidade, independentemente dos recursos disponĂveis.
Ă fornecido um conjunto abrangente de recomendaçþes para cuidados durante o perĂodo puerperal, com ĂŞnfase nos cuidados essenciais que todas as mulheres e recĂŠm-nascidos devem receber, e com a devida atenção Ă qualidade dos cuidados; isto ĂŠ, a entrega e a experiĂŞncia do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendaçþes da OMS de 2014 sobre cuidados pĂłs-natais da mĂŁe e do recĂŠm-nascido e complementam as atuais diretrizes da OMS sobre a gestĂŁo de complicaçþes pĂłs-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências Ê contemplada.
Recomendamos muito.
Vamos discutir essas recomendaçþes no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação sĂł estĂĄ disponĂvel em inglĂŞs atĂŠ o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganongâs Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
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Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
2. Antibiotics - chemical substances originally produced
by various species of micro-organisms (bacteria, fungi,
actinomycetes) that in high dilution suppress the
growth or cause death of other microorganisms
Objective of Rx- For curative - eradication by lethal
effect,inhibit growth & multiplication,phagocytosis
For preventive
4. Bacteriostatic
⢠inhibiting the growth or multiplication of bacteria
Bactericidal
⢠lethal effect on mature bacteria /kill the bacteria
Antibacterial spectrum
⢠list of bacteria which are normally susceptible to
antibacterial action of a particular agent (group or
particular organisms)
8. Classification
based on their Mechanism of Actions
1. Drugs that inhibit the synthesis of
bacterial cell walls
eg.Penicillins, Cephalosporins, Vancomycin
Clotrimazole
2. Agents that act directly on the cell
membrane
egâ.Nystatin, Amphotericin
Antimicrobial agents 8
9. Cont-
3. Drugs inhibiting microbial protein synthesis by their
effect on bacterial ribosomes
(A) disrupt the function of 30S or 50S ribosomal subunits to reversibly inhibit
protein synthesis (mainly bacteriostatic)
eg â Chloramphenicol, Tetracyclines, Macrolides,
Clindamycin, Lincomycins
(B) agents that bind irreversibly to 30s ribosomal subunit (mainly
bactericidal)
â Aminoglycosides eg. Gentamicin
Antimicrobial agents 9
10. 4. Drugs that affect nucleic acid metabolism
eg.Rifampicin,Fluoroquinolones,Griseofulvin
Metronidazole
5. The antimetabolites - Drugs affecting the intermediary
metabolism which are essential to micro-organisms
Sulfonamides Competitive
antagonist of
Para-aminosalicylic acid PABA
(PAS)
Trimethoprim
inhibit DHFA-reductase enzyme
Pyrimethamine
11. ⢠MOA
-inhibit the bact:cell wall syn by binding to protein,inhibit
crosslinking enz ď â autolysis
12. Classification of Penicillins
1. Penicillin G - Benzyl penicillins
(a) Penicillin G- Crystalline I.V (Aqueous Pen G as K+ salt and Na+ salt)
(2,50000 to 10,00000 units IM, IV)
(b) Penicillin G -Procaine suspension
(3,00000 to 6,00000 units IM)
(c) Penicillin G -Benzathine suspension
(0.6 to 1.2 mega units IM)
2. Penicillins V (oral) Phenoxymethyl penicillin(250-500mg)
3. Penicillinase-resistant penicillins (Anti-staph)
Cloxacillin â orally,IM, IV
Flucloxacillin
Dicloxacillin, Oxacillin
Antimicrobial agents 12
13. ⢠Methicillin - use as a laboratory tool for identification of
methicillin - resistant - Staphylococcus aureus (MRSA)
(MRSA = resistance to all the penicillinase-resistant penicillins and
cephalosporins) (Vancomycin is a drug of choice in MRSA)
4. Broad spectrum penicillins
Ampicillin
Amoxicillin
5. Antipseudomonal penicillins
Carboxypenicillins - Carbenicillin Indanyl (oral), Ticarcillin
Ureidopenicillins - Piperacillin
6. Penicillin β-lactamase inhibitor combination
Co-amoxiclav (Amoxicillin + clavulanic acid)
15. Organisms Usage Dosage/Route
gram (+) bacilli â Diphtheria C/pen 30-50mg/kg 6H
C. diphtheriae, Infection due to
B. anthracis, Bacillus anthracis
Clostridium, Clostridium species
Actinomyces -Actinomyces* and other
gram-positive rods
spirochetes Treponema pallidum C/pen â
(syphilis) and many other
spirochetes
Prophylatic Tx
16. Pen V
Organisms Usage Dosage/Route
â˘gram (+)ve cocci o minor infections oral
(except penicillinase (streptococcal pha- 15 mg/kg 6H (125-
producing ryngitis) 250mg)
staphylococci)
* narrow antibacterial o prophylaxis of 12.5 mg/kg 12 H
spectrum streptococcal infection
following rheumatic
fever and
pneumococcal
infection (following
splenectomy)
fusospirochetel
infection
(gingivostomatitis)
17. Pen resistent pen
Org Usage Dosage
more effective against staphylococcal Cloxacillin â orally,IM, IV
penicillinase producing infections-skin,LRIT 15 mg/kg 6H 12H,4-6H,
25- 50mg/kg
- staphylococci
Flucloxacillin
12.5-25 mg/kg 6H
25-50 mg/kg 8H,6H
less effective than pen. G
and pen. V against Gram
positive bacteria
Some strains of Gram H. influenzae, E. coli,
negative bacteria gonococci, Klebsiella
18. Aminopenicillins (Ampicillin, Amoxicillin)
Org Usage Dosage
gram (-)ve, (+)ve bacteria URTI (sinusitis, otitis Oral/I.M/I.V
(H. influenza, E.coli and Proteus media, acute 10-25 mg/kg 6H /8H
mirabilis)
exacerbations of severe -50mg/kg
chronic bronchitis &
epiglottitis)
Lower RTI,
UTI, Biliary tract
â´
Listeria monocytogen Meningitis,
Salmonella infection
(Enteric fever)
H. pylori
sensitive against Penicillin - β-lactamase
β-lactamase producing inhibitor combination
strains of G (+)ve & G (â)ve
bacteria*.Staph,Gono, (Clavulanic acid or
H. influenzae, E coli, Klebsiella, Sulbactam)
Proteus, 20-25 mg/kg IM,IV 6H
Bacteroides fragalis, Moraxella
catarrhalis
21. Mechanism of Action
⢠similar to penicillin , bactericidal, inhibit bacterial cell
wall synthesis
Classification of Cephalosporins
I. The first generation cephalosporins
Cefalexin
Cefadroxil
Cefazolin
II. The secondgeneration cephalosporins
Cefuroxime axetil ,Cefaclor (Oral)
Cefuroxime
Cefoxitin IV,IM
⢠Cefotetan
22. III. Third generation
Cefixime(oral)
Cefotaxime
Ceftriaxone IV,IM
Ceftazidime
IV. Fourth generation
Cefepime (I.V)
23. The First Gen:Cephalo
Drug Theraputic advantage Dosage
Gram- positive cocci upper and lower RTI Cefalexin- 7.5mg/kg 6h
(except MRSA) Cefadroxil 15-25mg/kg
12h
Cefazolin
Gram-negative bacteria urinary tract infection
Ecoli,Kleb,Proteus surgical prophylaxis
Oral cavity anaerobic
cocci
some β lactamase skin and soft tissue
producing strains infections owing to
(e.g, Staphylococcus) S. aureus and
S. pyogens
24. The second gen:cephalo
Gram + ve RTI (oral) Cefuroxime axetil 10-
15 mg/kg bd
Cefaclor 15mg/kg 8h
anaerobes (Bacteroids anaerobic infection Cefuroxime iv
fragilis) -pelvic inflammatory 25-50 mg/kg 8,12,6 hr
disease,
-Intra-abdominal inf,
- diabetic foot
Gram-ve bacteria G (-)ve bacterial
(< 3rdG)
(Neisseria,H.influenzae,
Enterobacter Proteus,
E.coli, Klebsiella)
25. The third gen:cephalo
less active against G + ve DOC for serious Cefotaxime iv
infn 25-50mg/kg-12 h
(Septicaemia,Pneu 8 h/6 h
monia,Meningitis) Ceftriaxone -iv,im
25-50mg/kg 12h,8h
Oral-Cefixime 5mg/kg od
Cefpodoxime âł bd
more active against G -ve Enteric fever
Severe Lymeâs d/s
Gonococcal
much more active
enterobacteriaceae &
β-lactamase producing
strains
s/a (H. influenzae &
Neisseria)
some - active against P.aerug Ceftaxidime iv,im
15-25mg/kg 8h
30. Mycobacterium Mycobacterial infection Azithromycin
15mg/kg D1
7.5mg/kg D2-5
more potent than Eradication of H.pylori Chlarithromycin
erythromycin in peptic ulcer
strept, staph,Chlamydia
Mycoplsma and
H.pylori
31. Untoward Effects
- not common
⢠cholestatic hepatitis is common with erythromycin
estolate (esp. in pregnancy)
⢠allergy, GI disturbances, arrhythmia*
⢠reversible hearing loss
Contraindication
⢠liver disease, pregnancy
Drug Interaction
Erythromycin and clarithromycin inhibit CYP3A4
potentiate the effects of digoxin, theophylline & valproate
32. LINCOSAMINES
(Lincomycin and Clindamycin)
Antibacterial Activity Therapeutic Uses Dosage
Anaerobic bacteria peritonitis, Lincomycin
(Bacteroides species, pelvic inflammation 10mg/kg 8h oral
Clostridium) IM or IV (over 1h)
10 -20mg/kg (over 2h)6h
Gram +ve bacteria â Bony infections Clindamycin
more effective - osteomyelitis, 6mg/kg 6h oral
(Staph. aureus) sinusitis, periosteitis, IV over 30min,IM 12h
periodontitis 10 -20mg/kg 8h
Aspiration pneumonia,
Lung abscess
Gram - ve bacteria
Less effective
33. Untoward Effects of Lincosamines
⢠Diarrhoea (superinfection)
⢠Pseudomembranous colitis due to Clostridium difficile
which produces enterotoxin(Tx âmetronidazole)
⢠Hypersensitivity (rare);
⢠Granulocytopenia, thrombocytopenia,
⢠Stevens -Johnson Syndrome
(can occur, but not common)
34. Antibact Rx Dose& Route
a wide range of G(+)& (-) IV 1g every 6 hours for 4
Salmonella Enteric fever weeks in enteric fever
Shigella, Bacterial meningitis Chloramphenicol sodium
V . cholerae H.influenza, succinate (1g vial) I.M, I.V
H.influenza N.meningitidis
Bordetella pertussis Strep. Pneumoniae
Brucella, Rickettsia, Anaerobic infections Orally - Chloramphenicol
anaerobic bacteria Rickettsial infection 25mg/kg/D
(typhus fever, Q fever (250 - 500 mg) 6 - 8 hourly
Brucellosis
less effect on
Staphylococcus
Ophthalmic infection Eye drop- 2-6 H
Ear Ear drop- 6H
35. Untoward Effects
less selective toxicity; may inhibit protein synthesis of
mammalian tissues
1. Haematological toxicity - bone marrow depression
(a) true toxic reaction - dose related, common with prolong therapy
or large dose
- anaemia, leucopenia, thrombocytopenia
(b) Idiosyncratic manifestation - not dose related (occurs in
genetically susceptible patients)
- aplastic anaemia --- can be fatal
36. 2. Grey (gray) syndrome (Gray baby Syndrome)
⢠in premature and newborn infants
⢠due to ineffective conjugation & poor renal excretion
with dose above 50 mg/kg/day
⢠dose should be limited to 50 mg/kg/day in full term
infants and 25 mg/kg/day in premature infants
3. Superinfection (oral or vaginal candidiasis) due to
alteration of normal microbial flora
4. Haemolysis in G6PD deficient patients (dose-related)
37. Antimicrobial spectrum Theraputic advantage Dosage
Mainly active against Genta IV,IM
Gram - ve bacteria UTI 7-8 mg/kg/D1,then
(Pseudomonas, Shigella, G -ve bacillary infect: 5mg/kg 12H
E.coli, Proteus, H.influ, Gonorrhoea Neonateď 5-7.5mg/kg/d
Brucella, Klebsiella) Bowel sterilization 24H
active against some Topical â Streptomycin IM 20-
Gram +ve wounds,burns,dermatitis 30mg/kg (max:1G)OD
Intestinal amoebiasis Amikacin IV,IM
Mycobacteria TB Prem -15mg/kg/D
(Streptomycin, Amikacin, D1ď 7.5mg/kg OD
Netilmicin, Kanamycin) Term-15mg/kg/D OD
Anaerobic bacteria are 1 wk to 10yr -15 mg/kg
resistant to Netilmicin IV,IM
aminoglycosides 1wk-10yr= 8mg/kg/D1
then 6mg/kgOD ,>10yr =
7 in D1 then 5mg/kg
Neonateď 5 mg/kg/D
OD
38. Unwanted effects
1. Ototoxicity
⢠irreversible results from progressive destruction of vestibular or
cochlear sensory cells
(a) Vestibular dysfunction
(Gentamicin, Streptomycin, Netilmicin)
(b) Auditory dysfunction â Kanamycin , Amikacin
(potent diuretics potentiate ototoxicity)
2. Nephrotoxicity
⢠due to accumulation of aminoglycosides in the proximal tubular
cells
3. Neuromuscular blockade (reversible)due to inhibition of prejunctional release
of ACh(Aminoglycosides potentiate d-tubocurarine)
4. Others
⢠rare - hypersensitive reactions
⢠vague feelings of paraesthesia of the lips or circumoral region
⢠prolong use -- superinfection, diarrhoea, malabsorption
can occur with neomycin
39. I. First Generation Quinolones
⢠Nalidixic acid
II. Second Generation Quinolones
⢠Norfloxacin
⢠Ciprofloxacin
III. New fluoroquinolones
⢠Gatifloxacin
⢠Moxifloxacin
40. ⢠MOA
⢠Bactericidal
⢠Block bact synthesis by inhibiting bact DNA gyrase and
topoisomerase
⢠Antibact spectrum--
E.coli,Salmonella,Shigella,Enterobacter,Campylo-
bacter,Neisseria
Pseudomonas(Ciprofloxacin)
Staph( not MRSA)
Strep,Chlamydia,Mycoplasma,Legionella,Mycobact
42. ⢠Dosage
Ciprofloxacin- oral= 5-10 mg/kg 12H
IV = 4-7 mg/kg 12 H
Norflox = 10 mg/kg 12H
Prophylaxis
15 mg/kg oral single
43. Side effects
Generally well tolerated
⢠nausea, abdominal discomfort, diarrhoea, headache,
dizziness, allergy, photosensitivity
⢠cartilaginous erosion in foetus and children (arthropathy)
and tendonitis --- limited used in children age <14 years and
pregnancy
⢠Increse BUSE
⢠Transient â in Liver enzymes,Bilirubin
⢠Disturbance in vision,taste and smell
⢠Risk of haemolysis in G6PD def;
45. ⢠Bacteriostatic
⢠Competitive inhibitor of dihydropteroate
synthase which is responsible for the
incorporation of PABA (para-aminobenzoic
acid) which is essential for the formation of
folic acid (pteroylglutamic acid)
47. Untoward Effects
1. Renal toxicity
⢠a local reaction with short-acting sulfonamides
(high doses)
⢠may precipitate in the urine(obstruction,haematuria)
2. Haemopoietic reactions
Anaemia-haemolytic/aplastic,granulocytopenia
Hâlysis in G6PD def:
Neonatal jaundice in new-born babies(especially in last
trimesterâHaemolytic jaundice)
antimicrobial agents III 47
48. Untoward Effects
3. Allergic reactions --- skin rashes, exfoliative
dermatitis, photosensitivity --- more severe with long
acting sulfonamides
⢠Stevens-Johnson Syndrome
- mucosal, dermal, genital and occular lesions; joint pain,
high fever, oedema, ulcerations of the lips and tongue
- erythema multiforme on skin of hands and thighs
- severe urethritis and balanitis in males
antimicrobial agents III 48
50. MOA of Cotrimoxazole
⢠Sulfonamides are the competitive antagonist of PABA. They
inhibit the incorporation of paraaminobenzoic acid(PABA) to
folic acid.
⢠Trimethoprim is a dihydrofolic acid reductase inhibitor. It
prevents the reduction of dihydrofolate to tetrahydrofolate.
⢠Inhibition of two consequent steps in the synthesis of DNA
and RNA of bacteria when a sulfonamide and trimethoprim
are used together.(Sequential Blockade)
⢠Two bacteriostatic compounds act synergistically and become
bactericidal
52. Antibacterial spectrum Rx uses Dosage
Streptococci, (1)Urinary tract TMP 1.5-3mg/kg 12H
Staphylococci, infections IV ,Oral
Neisseria (2) Respiratory tract PCP Tx 250mg/m2 stat
E. coli, infections 150mg/m 2 8H
(3) Gonococcal Prophylaxis
Salmonella, Shigella, infections for UTI- 5 mg/kg oral
Enterobacter Proteus, (4) Enteric fever PCP- 5mg/kg 3days/wk
Klebsiella, Brucella, (5) Malaria
Chlamydia (CQ resistant falciparum
except Pseudomonas malaria)
aeruginosa (6) Brucellosis
Pneumocystis carinii (7) Pneumocystis carinii
infection in AIDS Patient
Untoward effects
-Same as Sâ.Megaloblastic A with prolonged Rx
53. Cont - Synergists of Sâ
2. Pyrimethamine
also an inhibitor of DHFA reductase enzyme of malarial parasites and
toxoplasma
Pyrexine (or)
Fansidar = Sulfadoxine 500 mg + Pyrimethamine 25 mg
Therapeutic Uses --- Malaria, Toxoplasmosis
54. 3. Tetracycline
⢠in combination with sulfonamides produce
synergistic effects because both are
bacteriostatic drugs
4. Penicillin:
⢠although bactericidal, it produces a
synergistic effect when used in combination
with sulfonamides.
55. Drug Interactions with Sulfonamides
⢠warfarin, sulphonylureas,diphenylhydantoin
(1) potentiation of action of other drugs due to
competition at plasma protein binding site
(drug displacement interaction)
(2) inhibition of metabolism
antimicrobial agents III 55
71. Antiviral drugs
1.Nucleoside Acyclovir* HSV1,2 Herpes-oral,genital
Analogues* 20mg/kg iv VZV HS-Encephalitis
(synthesis of DNA 100mgodx 5 d CMV Varicella(immu â)
&RNA) Ginclovir EB CMV retinitis,
Cidofovir HHV6 Pneumonitis
Hepa C
2.Amantadine 100mg OD Influenza A,B Influenza A-H1N1
Rimantadine 200mg OD H1N1,H1N2,
(penetration of cell) H1N3
3.Foscanet CMV,VZV CMV retinitis in HIV p/t
(DNA &RNAsyn:) HSV(Aciclovir
20mg/kg iv over 30â resist)
72. 4.Immunomodulator Hepatitis B &C Chronic hepatitis B
Interferon Îą HPV &C
(inhibit the transcription) CGD
Plavizumab RSV RSV Bronchiolitis
5.Ribavarin RSV RSV Bronchiolitis
(aerosol-20mg/ml 12- Pnâia
18hrly)
(oral5-50mg)
6.Neuraminidase Influenza A & B Influenza A & B
Inhibitors
(release of virus)
Zanamivir/Oseltamivir
73. 7.Antiretroviral HIV Side effects
NRTI-competative inhibit:
activated i/c by A,neutropenia,myopathy
phosphorylation
Zidovudine(2mg/kg) Pancreatitis,Periph neuro,D
Didanosine(ddI ) Peri neuro,pancreatitis,rash
Dideoxycytidine(ddC) Peri neuro,A,Lipoatrophy
Stavudine(d4T) Headche,N,abdo pain
Lamivudine(3TC) Hepa B
Adefovir
NNRTI-inhibit viral HIV
replication by direct binding
to RT
Nevaripine Rash,Steven syn,Hepatitis
120mg/m2 daily oral
74. Protease Inhibitors
-Interfere with post-
translational
processing of HIV Asymptomatic hyper bili-
precursor proteins rubinemia,GI disturbance
Eg.Ritonavir Skin,hair changes
Indinavir
Dose-500mg/m2 8H
oral
81. Management in babies born to infected
mothers
Scenarios Therapy
- HIV mother on HAART Zidovudine
- HIV mother started on zidovudine at 14-28 2mg/kg/dose QIDx 6wks
weeks gestation OR
4mg/kg/does BDx6 wks
-HIV mother at delivery with inadequate Single dose
prophylaxis (<4 weeks) Nevirapine
+
-Infant born to HIV mother without prophylxis
Zidovudine
2mg/kg/dose QID
6 weeks
OR
4mg/kg/does BD 6 weeks
82. Antifungal agents
based on route of administration
1.Systemic
For deep fungal infection Amphotericin B (I.V)
(oral/parenteral) Flucytosine (oral)
Imidazoles and Triazoles
-Ketoconazole, Itraconazole
-Fluconazole
For superficial fungal infections Griseofulvin (Oral)
2.Topical antifungal agents Clotrimazole (CANESTEN)
- Miconazole
-Econazole
-Ketoconazole
-Nystatin (MYCOSTATIN)
Miscellaneous MYCODERM
83. Drug Dose & Rx Side effects
Preparation
Ampho.B IV 1.5 mg/kg/d Local &systemic- Hypersensitivity
(fungistatic/fungicid Intrathecal Meningitis,Endocardit Nephrotoxic
al) Oral 100mg 6h is due to Liver impairment
Cream,ointment Cryptococcus Anaemia,Hypo-k
Local installation Coccidioides
Histoplasma
Candida,
Blastomyces
Aspergillus
Griseofulvin 5-7mg/kg oral Broad spectrum Photosensitivity
(fungiststic) Topical Microsporum,Epider Porphyria
mophyton,
Trichophyton Headache
(Dermatophytosis) Hepatitis
Superficial
ringworm
infestation
(Tineacaptis,Tinea
corporis,Tinea pedis)
85. Summary
⢠Ampho B âdrug of choice except candida
⢠Griseofulvin âdrug of choice for dermatophytes except
aspergillus
⢠Fluconazole ,Miconazole _ for candida/dermatophytes
⢠Nystatin _ for candida
87. Blood schizontocides Alleviate symptoms-a/c attack Photosensitivity,n,v,reti-
CQ Oral 10mg/kg x 3d nal damage
Quinine Oral 8.3mg/kg x7-10 d Tinnitus,Hglycemia
Iv 20mg/kgx4h,8.3mg/kg 8H Hypotension
Mefloquine 15mg/kg stat,10mg/kg a/f 6-8hr (cinchonism)
(Prophylaxis- 5mg/kg wkly) Postural Hypotension
Cardiac conduct defect
Artesunate Oral 5mg/kg D1,2.5mg/kg D2- Relatively safe
D3
IV,IM 2mg/kg then 1 mg/kg 6H
Artemether IM 3.2mg/kg stat 1.6 mg/kg
daily
Sporontocides
Pyrimethamine
Prophylaxis
Primaguine
Proguanil
88. Tissue schizointocides To prevent parasites
becoming established in the
Liver
Pyrimethamine 25mg tab*
0.3mg/kg daily X14 d CI âPregnancy
Primaquine
3.5mg/kg oral Hâlysis in G6PDdef,BMË ,
Proguanil
alopecia
Hypnozoiticides To prevent relaspe
Primaquine
Gametocides
Primaquine
0.7mg/kg od
89. Mgt of Pl.falciparum(Paed:protocol)
⢠Uncomplicated ⢠Complicated
1st line- 1st line
Artesunate odx3D IV Artesunate bdď od
Mefloquine od 2nd line
Alternate: IV Quinine ď oral
Artemether/lumefantrine Doxycycline/Clindamycin
2nd line
Qunine
Clindamycin
90. Antihelminthics
Drugs Rx advantage Mode of Action Adverse Effects
Mebendazole Trichuriasis Broad spectrum, inhibit Worm migration
50-100mg BDx Enterobiasis microtubules, glucose (rare)
3D Ascariasis absorption ď
immobilization ď death
Albendazole Trichuriasis
200-400mg single Enterebiasis
Ascariasis
Hookworm
Pyrantel pamoate Trichuriasis Depolarization of the Mild abdominal pain
10-11mg/kg OD Ascariasis neuromuscular
Repeat in D14 Enterobiasis (Neuromuscular blocking
agent)
Levamizole Ascariasis Immunostimulants Abdominal pain
3mg/kg Enterobiasis Paralysis of the muscle of
the worm â expelled by
Repeat in 1 wk Hookworm peristalsis
Ivermectin Hookworm, filariasis, Membrane Abdominal
0.15-0.4mg/kg strongyloides hyperpolarization ; distension ,
paralysis wheeze, TOC
Thiabendazole Hookworm
200-400mg OD
91. ⢠References:
- Paed:Protocol (2nd edition)
- Nelson Text Book (19th edition)
- Basic and Clinical Pharmacology(11th edition)
- Basic Medical Science(Easterbrook-3rd edition)
Editor's Notes
All cocci are G+ve except Neisseria,All bacilli are G-ve except B,C,C,L.All are anaerobes except Clostridia &BacteroidsRicket and Chlamy are obligate i/c parasites.chlamy- not seen under light microscope and canât produce ATP
(increasing permeability leading to leakage of intracellular compounds)