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urinary tract infections (1).ppt........
- 3. URINARY TRACT INFECTIONS(UTI’S) 1Upperurinary tract (kidney &ureters) infections: Kidney infection- pyelonephritis ureters-- ureteritis 2.Lower urinary tract (bladder, urethra & prostate): Bladder-cystitis urethra –(urethritis) ** Upper urinary tract infections are more serious.
- 4. URINARY TRACT INFECTIONS(UTI’S) It is more common in women more than men 30:1 (Why?). Females naturally have a shorter urethra than males, whichmeans that there is less distance for bacteria to travel to reach the bladder
- 5. digestive tract toopening of the urethra. • Obstruction of the flow of urine(e.g. kidney stone) • Enlargement of prostate gland in men(common cause) • Catheters placed in urethra and bladder. • Not drinking enough fluids. •Waiting too long to urinate. • Large uterus in pregnant women. • Poor toilet habits(wiping back to front for women) • Disorders that suppress the immune system(diabetes & cancer chemotherapy).
- 6. BACTERIA RESPONSIBLE OFURINARY TRACT INFECTIONS Gm- bacteria (most common): •E.coli (approx. 80% of cases) •Proteus •Klebsiella •Pseudomonas Gm+ bacteria ( less common): • Staphylococcus species(S.aureus and Saprophyticus) •Chlamydia trachomatis ,Mycoplasma & N. gonorrhea (limited to urethra, unlike E.coli may be sexually transmitted)
- 7. 4.Chemical Classification ofUTI Nitro furan derivative : Nitrofurantoin Urinary Analgesic: phenazopyridine amines: Methanamine Tetracyclines: Doxycycline , chlortetracycline Fluroquinolnes- ciprofloxacin sulfonamides: Co-trimoxazole Aminoglycosides:Gentamicin β-Lactam antibiotics –Unasyn and Augumentin 7
- 8. 1) SULFONAMIDES – CO-TRIMOXAZOLE( BACTRIM, SEPTRA ): IT IS A COMBINATION OF SULFAMETHOXAZOLE (5%)+ TRIMETHOPRIM(TMP)(1%) Alone, each agent is bacteriostatic but together they are combine act as bactericidal Reduce bacterial resistance Kills the more no of microorganisms Inhibits folic acid synthesis act as Antifolate
- 9. PHENAZOPYRIDINE Urinary Analgesic;it reduce burning after urination, Also reduce Dysuria,(paiful urination) urgency it does not have anti-bacterial property 2) Urinary Antiseptic
- 10. 3) Amine -METHENAMINE (HEXAMINE) Mechanism of Action: It act as prodrug - taken as orally when it enters to the urinary tract Decomposes slowly in acidic urine( Ph 5.5 or less) to release formaldehyde which inhibits all bacteria No antimicrobial activty in blood and tissues. Needs to be administered with mandelic acid or hippuric acid
- 13. 3) NITROFURANTOIN Antibacterial Spectrum:It shows broad-spectrum action effective against Gram negative E. Coli and gram positive streptococci . Mechanisam : It damages bacterial DNA Adverse effects: bleeding of the stomach,nausea, vomiting and diarrhea(must be taken with food).Pulmonary fibrosis Contraindication :should not be taken in Renal failure, neonates, pregnancy It is a furan derivbatives
- 14. 4.AMINOGLYCOSIDES- GENTAMICIN Aminoglycoside- Inhibits protein synthesis by blocking to 30 S ribosome subunit Bactericidal 5 NOS- 1) No To pregnacy woman 2) No protein synthesis 3) Not orally( IM) Effective against Aerobic 4) NO- negative- organisaM 5) NO- nephrotoxicty
- 15. 5. TETRACYCLINES (E.G. DOXYCYCLINE) Itis a long acting broad spectrum and bacteristatic tetracycline Mechanism of action Inhibit protein synthesis by binding reversibly to 30 s subunit •Uses: Treatment of UTI’s due to Mycoplasma & Chlamydia, Adverse effects- Discoloration of teeth phototoxicity
- 16. 6) Β-LACTAM ANTIBIOTICS Unasyn– its is Combinations of ampicilin + sulbactum Augumentin - its is Combinations of amoxacillin+ clavulanic acid 16 Mechanism: act as Bactericidal ,cell wall synthesis blocker
- 17. 7) FLUROQUINOLONES e.g. ciprofloxacin Mechanismof action-act as bactericidal Inhibits DNA gyrase enzyme there by inhibits DNA synthesis