ID Pharm Part II (6) - Basic Concepts of Pharmacology Therapeutics Drugs for Infectious Diseases Part II Drugs for Infectious Diseases Basic

ID Pharm Part II (6) - Basic Concepts of Pharmacology...

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1 Drugs for Infectious Diseases Basic Concepts of Pharmacology & Therapeutics - Part II Part II - J. Boullata, PharmD, RPh, BCNSP Professor of Pharmacology & Therapeutics Penn Nursing Drugs for Infectious Diseases Basic Antimicrobial Principles Antibacterial Agents • Antifungal Antifungal Agents Agents Antifungal Agents Antiviral Drugs Antibacterial Agents 1. Cell wall active antibacterials Beta-lactam antibiotics Glycopeptide antibiotics 2 I t f ith t i th i 2. Interfere with protein synthesis Bactericidal versus bacteriostatic 3. Interfere with nucleic acids 4. Anti-metabolite antibacterials Antibacterial Agents 2. Interfere with Protein Synthesis Bactericidal – Aminoglycosides – Cyclic lipopeptides (daptomycin) • Bacteriostatic Bacteriostatic – Macrolides – Tetracyclines – Others • Clindamycin, linezolid, quinupristin/dalfopristin Bacterial Protein Synthesis
2 Antibacterial Agents 2. Interfere with Protein Synthesis Bactericidal Aminoglycosides – Cyclic lipopeptides (daptomycin) • Bacteriostatic – Macrolides – Tetracyclines – Others • Clindamycin, linezolid, quinupristin/dalfopristin Gentamicin (Garamycin ® ) Indication – serious infections caused by susceptible strains of GN bacilli MOA – binding to 30-S ribosomal subunit to disrupt bacterial protein synthesis Dose – based on several factors including body weight; /k IV d il ( di id d d ) ~5-7 mg/kg IV once daily (or divided doses) Distribution – well distributed in ECF space, crosses placenta, concentrates in renal and inner ear cells (t½ ~2 h) Elimination – renally (unchanged) Adverse effects – ototoxicity (auditory & vestibular), nephrotoxicity, hypersensitivity reaction; interaction penicillins, NM blockers, oto- & nephrotoxins Gentamicin Antibacterial Agents 2. Interfere with Protein Synthesis Bactericidal – Aminoglycosides Cyclic Cyclic lipopeptides lipopeptides • Bacteriostatic – Macrolides – Tetracyclines – Others • Clindamycin, linezolid, quinupristin/dalfopristin