Download INTRODUCTION TO CHEMOTHERAPEUTIC DRUGS

INTRODUCTION TO CHEMOTHERAPEUTIC DRUGS
1. Brief History of Chemotherapeutic Drugs
2. Several Terms related to Chemotherapy
Chemotherapy/Chemotherapeutic index(CI)/Antibacterial drugs/Antibiotics/Antibacterial spectrum/Bacteriostatic
drugs/Bactericidal drugs/Minimum inhibitory concentration(MIC)/Minimum bactericidal concentration(MBC)
/PAE
3．Mechanism of action of Antimicrobial Agents
（1）Inhibition of cell wall synthesis : β-lactam/ vancomycin
（2）Interfering with cell membrane permeability: Polymixins/Amphotericin B
（3）Inhibition of protein synthesis: Aminoglycosides/Tetracyclines/Chloramphenicol/Macrolides/Clindamycin
（4）Inhibition of nucleic acid synthesis: Rifampicin/Quinolones/Sulfonamides/ TMP
4. Bacterial resistance to antimicrobial agents
（1）Reasons : Antibiotics abuse
（2）Classification: Intrinsic resistance /Acquired resistance
（3）Mechanism of microbial resistance
①Production of enzyme that destroy the drugs： β-lactamase /Adenylase, phosphorylase, acetyltransferase
②Alteration of target for the drugs
③Alteration of membrane permeability
④Active efflux system
⑤Alteration of the metabolism route
（4）Brief introduction: ESBLs: extended spectrum β-Lactamases/ Pseudomonus aeruginosa
MRSA: Methicillin resistant Staphylococcus aureus/ VRE: Vancomycin resistant Enterococci
（5）Rational use of antimicrobial agents
①Basic principles: Diagnosis \Rational use: Newborn/Pregnancy/Elderly/Immune function
②Misuse: Virus infection/Unknown fever/Topical use
③Antimicrobial prophylaxis
Surgical prophylaxis: Infectious endocarditis/Trauma, burn/operation
Nonsurgical prophylaxis: Rheumatic fever/Epidemic meningitis/Malaria, Tuberculosis
④Antimicrobial agents combination
Synergism & antagonism
Drug categories: 1.β-Lactam antibiotics/2.Aminoglycosides
3.Tetracyclines, macrolide ,chloramphenicol/ 4.Sulfonamides
Rational use of antimicrobial agents
1+2: Synergism/ 1+3:antagonism/ 2+3:synergism or plus/ 3+4: plus
⑤Rationale for combination antimicrobial therapy
To Provide broad-spectrum empirical therapy in seriously ill patients/ Serious infection that can not be
controlled by one drug/ To decrease the emergence of resistant strains / To decrease dose-related
toxicis.
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