Antimicrobial Drugs

Antimicrobial Drugs Details

1.Mention the classification of bacteria.

ব্যাকটিরিয়া গুলিকে তাদের মৌলিক আকার অনুযায়ী পাঁচটি গুরুপে শ্রেণিবদ্ধ করা হয়

• Spherical (Cocci)
• Rod (Bacilli)
• Spiral (Spirilla)
• Comma (Vibrios)
• Corkscrew (Spirochaetes)

They can exist as single cells, in pairs, chains or clusters. Bacteria are found in every habital on Earth, Soil, rock, oceans and even arctic snow.

2.Define antimicrobial drug with example

অনুজীবের বিরুদ্ধে কাজ করে এমন ওষুধগুলিকে antimicrobial drug বলে।

Antimicrobial drug with example

• Antibiotic drugs
• Antiviral drugs
• Antifungal drugs
• Antiprotozoa drugs

3.Classify antimicrobial drugs

Antimicrobial drugs are 4 classes

• Antibiotic drugs
• Antiviral drugs
• Antifungal drugs
• Antiprotozoa drugs

4.Define antibiotic drugs, antiviral drugs, antifungal drugs & antiprotozoa drugs.

• Antibiotic drugs: The drugs that act against bacteria are called antibiotic drugs.
• Antiviral drugs: The drugs that act against virus are called antiviral drugs.
• Antifungal drugs: The drugs that act against fungus are called antifungal drugs.
• Antiprotozoa drugs: The drugs that act against protozoa are called antiprotozoa drugs.

5.Classify antibiotic groups.

Antibiotic groups are

• Macrolide group
• Cephalosporin group
• Fluroquinolone group
• Penicillin group
• Aminoglycocide group
• Tetracycline group
• Lincosamide group
• Carbapenem antibiotic / Carbapenem group
• Glycopeptides and lipoglycopeptides
• Monobactams (aztreonam)
• Oxazolidinones (such as linezolid and tedizolid)

6.Define bactericidal and bacteriostatic antibiotics.

ব্যাকটিরিসাইডেল অ্যান্টিবায়োটিকগুলি ব্যাকটিরিয়া মারে।

ব্যাকটিরিওস্ট্যাটিক অ্যান্টিবায়োটিকগুলি ব্যাকটিরিয়ার বৃদ্ধিতে বাধা দেয়

7.Define Narrow spectrum antibiotic and Broad spectrum antibiotic.

Narrow spectrum antibiotic: অ্যান্টিবায়োটিকগুলি যা গ্রাম পজিটিভ ব্যাকটিরিয়া বা গ্রাম নেগেটিভ ব্যাকটিরিয়া গুলির যে কোন একটির বিরুদ্ধে কাজ করে তাদেরকে Narrow spectrum antibiotic বলে।

Broad spectrum antibiotic: অ্যান্টিবায়োটিকগুলি যা গ্রাম পজিটিভ ব্যাকটিরিয়া এবং গ্রাম নেগেটিভ ব্যাকটিরিয়া উভয়ের বিরুদ্ধে কাজ করে তাদেরকে Broad spectrum antibiotic বলে।

8.Mention the name of Macrolide antibiotic.

• Azithromycin
• Erythromycin
• Clarithromycin
• Roxythromycin
• Spirathromycin

9.Mention the indications of macrolide antibiotics.

Indications of macrolide antibiotics

• Azithromycin (Widely used: RTI, GITI, UTI)
• Erythromycin (Chlamydia infection in pregnancy, Pediatric GITI, Acne Valgaris)
• Clarithomycin (H.pylori infection)
• Roxithromycin (Rare use in RTI)

10.What are the contraindications of macrolide antibiotics?

Contraindications of macrolide antibiotics

• Hepatic impairment
• Renal impairment
• Hypersensitivity reaction to macrolide antibiotics

11.Mention the generic names of Cephalosporin antibiotics.

Generic names of Cephalosporin antibiotics

• Cephalexin
• Cephradine
• Cefaclor
• Cefuroxime
• Cefadroxil
• Cefepime
• Ceftriaxone
• Cefazolin

12.Mention the generation of Cephalosporin antibiotics with examples.

Generation of Cephalosporin antibiotics

• 1st generation: Cephalexin, Cephradine
• 2nd generation; Cefaclor, Cefuroxime
• 3rd generation: Cefixime, Ceftamet, Ceftriaxone
• 4th generation: Cefepime, Cefpirome

13.What are the common side effects of Cephalosporin antibiotics.

Common side effects of Cephalosporin antibiotics

• Hypersensitivity Reactions– Anaphylaxis, Bronchospasm, Urticaria.
• Nephrotoxicity (Perhaps)
• Diarrhea or any abdominal problem
• Severe bleeding which is related to hypoprothrombinemia, thrombocytopenia and platelet dysfunctions.

14.Mention the generic names of fluroquinolone antibiotics.

Generic names of fluroquinolone antibiotics.

• Nalidexic acid
• Ciprofloxacine
• Levofloxacine
• Lomefloxacine
• Gatifloxacine
• Ofloxacine
• Genifloxacine
• Moxifloxacine

15.Mention the special indications of fluroquinolone antibiotics

Special indications of fluroquinolone antibiotics

• Ciprofloxacin: Bacillary dysentery, Diarrhea, Gonorrhea.
• Levofloxacin: RTI (Respiratory tract Infection)
• Lomefloxacin: Eye Infection (Bacterial conjunctivitis)
• Gatifloxacin: Eye Infection (Bacterial conjunctivitis)
• Ofloxacin: Ear Infection (Otitis externa, Otitis media)
• Moxifloxacin: Eye Infection (Bacterial conjunctivitis)

16.Mention the names of Penicillin antibiotics.

Penicillin antibiotics are

• Penicillin G
• Penicillin V
• Benzathin Penicillin
• Ampicillin
• Amoxicillin
• Cloxacillin
• Flucloxacillin
• Dicloxacillin
• Available dosage form: Tablet, Capsule, PFS, IV/IM Injection

Indication of Penicillin antibiotics:

Penicillin G: Streptococcal Pharyngitis, Arthritis, Meningitis, Endocarditis, Meningococcal diseases, Pneumococcal Pneumonia, Anthrax, Syphilis, Gonorrhea, Actinomicosis, Gas gangrene, Carbuncle, Surgical profylaxis.

Penicillin V: Tonsillitis, Otitis media, Aricepelus, Profilaxis of rheumatic fever, Pneumococcal infection.

Dicloxacillin: Staphylococcal infections resistant to benzyl penicillin

Flucloxacillin: Staphylococcal infections that produces betalectamage, Otitis externa, Adjunct in pneumonia, Impetigo, Cellulitis, Osteomalitis, Staphylococcal endocarditis.

Ampicillin: Prophylaxis of endocarditis, Adjunct in listeria meningitis, Pneumococcal disease, UTI, Otitis media, Sinusitis, Chronic bronchitis, Hemophilus influenza, Invessive salmonelosis, Meningococcal disease, H. pylori, infection.

Side effect of Penicillin: Hypersensitivity, Anaphylactic shock, Cerebral encephalopathy, Accumulation of electrolyte. Diarrhea due to oral administration.

17.Where is the first moving penicillin antibiotic? Mention the indications and dose of that antibiotic

Flucloxacillin is the first moving penicillin antibiotic

Indication

• Staphylococcal infections that produces betalectamage
• SSTI- Boil, carbuncle, cellulitis, Impetigo, Wound Infection.
• Otitis externa, Adjunct in Pneumonia.
• Osteomalitis, Staphylococcal Endocarditis.

Dose: 1 Capsule (250 mg or 500 mg) 6 hourly.

18.Mention the names of Aminoglycoside Antibiotics.

• Streptomycin
• Neomycin
• Gentamycin
• Amikasin
• Kanamycin
• Netilmicin
• Tobramycin
• These drug act by protein synthesis inhibition

19.Mention the uses of Aminoglycoside Antibiotics

Generally at present, Aminoglycoside Antibiotics are used as topical medicine. Such as-

• Eye drops and Eye ointment
• Ear drops
• Skin ointment and Skin cream

20.Mention the names of Tetracycline Antibiotic.

• Tetracycline
• Oxytetracycline
• Doxycycline

21.Mention the names of Lincosamide Antibiotics

Lincosamide Antibiotics are-

• Lincomycin
• Clindamycin
• Pirlimycin

22.Which is the first moving Lincosamide Antibiotics? Mention its indication and dose.

Clindamycin is the first moving antibiotic

Indication: Diabetic Foot Ulcer

Dose: 1 Capsule 6 hourly

23.Mention the generic names of Carbapenem Antibiotics

Names of Carbapenem Antibiotics

• Doripenem
• Imipenem
• Meropenem
• Ertapenem

24.Which is the first moving Carbapenem Antibiotic? Mention its indication and dose.

Meropenem is the first moving carbapenem antibiotic.

Indication

Marram IV is indicated for the treatment of bacterial meningitis caused by Haemophilus influenzae, Neisseria meningitidis and penicillin susceptible isolates of streptococcus pneumoniae.

Dose: 500 mg / 1 gm IV 8 hourly or 12 hourly or 24 hourly as per patients and disease conditions. only registered doctors should prescribe this drug.

25.What are the uses of Glycopeptides and Lipoglycopeptides antibiotics?

Glycopeptides and Lipoglycopeptides are antibiotics used to treat complicated and serious infections caused by gram- positive bacteria

These antibiotics work as cell wall synthesis inhibitors

Glycopeptides antibiotics are

• Vancomycin
• Teicoplanin
• Telavancin
• Ramoplanin
• Decaplanin
• Corbomycin
• Complestatin
• Bleomycin (Antitumor Antibiotic)

Vancomycin is used if infection with methicillin-resistant staphylococcus aureus (MRSA) is suspected.

26.Which is the first moving Glycopeptides antibiotic? Mention its indication and dose.

Vancomycin is the first moving Glycopeptides antibiotic-

Indication

Complicated skin infections, bloodstream infections, endocarditis, bone and joint infections and meningitis caused by methicillin – resistant Staphylococcus aureus.

27.Mention the generics of Glycopeptides and lipoglycopeptides Antibiotics.

• Dalbavancin
• Oritavancin
• Teicoplanin
• Telavancin
• Vancomycin

28.Mention the indication and brand names of Vancomycin.

Indication of Vancomycin

MRSA (Methicillin Resistant Staphylococcus Aureus) -Beta lactam resistant

Brand names of Vancomycin

• Covan- Renata Ltd
• Vancomin- Opsonin
• Vanmycin-Incepta

29.Mention the modes of actions of antibiotics

Mode of actions of antibiotics are-

• Protein Synthesis Inhibition
• DNA Synthesis Inhibition
• Cell wall Synthesis

30.Define combined antibiotic. Mention the names of common combined antibiotics in Bangladesh.

Combined antibiotic: অ্যান্টিবায়োটিকের একাধিক জেনেরিক সমন্বিত একটি ওষুধকে combined antibiotic বলে।

Combined antibiotics are

• Co-Amoxclav (Amoxicillin with Clavulanic Acid)
  • Moxaclav – Square
  • Tyclav – Beximco
  • Clamox – Opsonin
  • Fimoxyclav – Sanofi
• Cefuroxime + Clavulanic Acid
  • Furoclav – Renata
  • Clavusef – Opsonin
  • Cefaclav – Incepta

31.Define drug resistant and antibiotic resistant.

Drug Resistant মানে ড্রাগের বিরুদ্ধে কাজ করা

Antibiotic resistant মানে অনুজীবগুলো ড্রাগ প্রতিরোধের জন্য ড্রাগের পদার্থের বিরুদ্ধে কাজ করে।

32.Mention the mechanism of antibiotic resistant.

কিছু ব্যাকটিরিয়া এনজাইম উৎপাদন করে যা সক্রিয় ওষুধগুলিকে ধ্বংস করে।যেমন: স্টাফিলোক্কাস বিটা ল্যাকটামেস উৎপাদন করে যা পেনিসিলিনকে ধ্বংস করে।আর কিছু ব্যাকটিরিয়া বিকল্প বিপাকীয় পথটি বিকাশ করে। যেমন: কিছু ব্যাকটিরিয়া পিএবিএ ছাড়াই বিপাকীয় ক্রিয়াকলাপ সম্পাদন করতে পারে।

33.Mention the applicable points for antibiotic therapy.

Applicable points for antibiotic therapy

• Right selection, right dose
• Right interval, Right goes (Route)
• Remember the points and complete course
• Otherwise, drug resistant of course

Virus & Antiviral drug

1.Mention the names of common pathogenic viruses

Common pathogenic viruses are:

• Herpes simplex virus
• Varicella zoster virus
• Cytomegalovirus
• Influenza virus
• Respiratory syncytial virus
• Hepatitis virus
• Human immunodeficiency virus

2.Mention the classification of viruses according to their coverage.

• Anti viral drugs for herpes simplex & Varicella zoster
  • Acyclovir
  • famiciclovir
  • Valacyclovir
• Anti Viral Drugs for Cytomegalovirus
  • Cidofovir
  • Ganciclovir
  • valganciclovir
• Drugs for Influenza virus
  • Oseltamivir
  • Zanamivir
• Drugs for Respiratory Syncytial virus
  • Palivizumab
  • Ribavirin
• Drugs for Hepatitis virus
  • Lamivudine
  • Adefovir
  • Entacavir
  • Telbivudine
  • Peginterferon alfa
  • Ribavirin
• Drugs for HIV
  • Zidovudine
  • Lamivudine
  • zalcitabine
  • Indinavir
  • Saquinavir
  • Nelfinavir
  • Efavirenz

3.Mention the drugs for Hepatitis B & Hepatitis C

Drugs for Chronic Hepatitis B

• Lamivudine
• Adefovir
• Entacavir
• Telbivudine

Drugs for Chronic Hepatitis C

• Peginterferon alfa
• Ribavirin

4.Mention the drugs for Human Immunodeficiency virus.

Drugs for Human Immunodeficiency virus

• Zidovudine
• Lamivudine
• Zalcitabine
• Indinavir
• Saquinavir
• Nelfinavir
• Efavirenz

5.Mention the drugs for influenza virus and Respiratory Syncytial virus.

Drugs for Influenza virus

• Oseltamivir
• zanamivir

Drugs for Respiratory Syncytial virus

• Palivizumab
• Ribavirin

Antifungal Drugs & Antiprotozoa Drugs

1.Which are the common Pathogenic fungi?

Common Pathogenic fungi are

• Tinea
• Candida

2.Mention the names of common antifungal drugs

Names of common antifungal drugs

• Fluconazole
• Ketoconazole
• Itraconazole
• Econazole
• Miconazole
• Nystatin
• Terbenafin

3.Mention the names of groups of anti Protozoa drugs.

Groups of anti protozoa drugs

• Anti amoeba drug
• Anti malaria drug
• Anti filarial drug
• Anti leishmania drug (Leishmania is a obligate intracellular protozoa)

4.Mention the names of Anti malaria drugs

Names of Antimalaria drugs are

• Metronidazole
• Orindazole
• Secnidazole
• Tinidazole
• Nitazoxanide

Antiseptic Drugs

1.What is antiseptic?

যে Medicine গুলি sepsis এর বিরুদ্ধে কাজ করে অর্থাৎ sepsis হতে বাঁধা দেয় তাদেরকে antiseptic বলে।

2. Antiseptic গুলি কি কি?

Antiseptic বা cleaner গুলি হচ্ছে-

• Normal saline
• Alcohols
• Chlorhexidine & Chloroxylenol salts
• Chlorine, Iodine & Providone Iodine
• Phenolics
• Cauleonic surfactants and soaps
• Astringents, Oxidisers and dyes

3.Sepsis কি?

রক্তের দূষণকে Sepsis বলে অথবা রক্ত বা অন্য কোন tissue তে pathogenic micro organism অথবা তাদের toxin এর উপস্থিতিকে Sepsis বলে। Pathogenic micro organism দ্বারা রক্ত দূষনকে ‍Sepsis বলে। Sepsis এর adjective হচ্ছে septic .

4.What is Septicemia? ‍

Pathogenic micro-organism এর কারনে যে সকল রোগ দ্বারা sepsis হয় তাদেরকে septicemia বলে।

5.What is septicopyemia ?

Septicemia & Pyemia কে একসঙ্গে septicopyemia বলে। Septicopyemia এমন একটি রোগাব্যস্থা যেখানে Sepsis ও থাকে এবং তার সাথে পুঁজ উৎপাদনকারী pathogenic micro organism ও রক্তে উপস্থিত থাকে।

Chlorhexidine (Savlon Liquid)

• Chlorhexidine gluconate 0.3% w/v
• Cetrimide 3% w/v (solution) [w/v weight in volume]

Indication: General antiseptic , Disinfectant Cleaning purposes.

Caution: Only for external use ব্যবহারের পূর্বে নির্দেশ অনুযায়ী dilute করতে হবে।চোখ, Brain, Meninges & Middle ear এর সংস্পর্শে আনা যাবে না।

Accidental Ingestion: হঠাৎ খেয়ে ফেললে stomach wash/ irritation করতে হবে milk, egg, white, gelatin অথবা mild soap water দ্বারা।

Savlon Cream

Chlorhexidine Hydrochloride 0.1% cetrimide 0.5% antiseptic cream.

Dose: Adult & Children দিনে ২/৩ বার লাগাতে হবে।

Others

• Sepnil
• Kevilon
• Oralon Dental gel
• Chlorhexidine gluconate 1% (w/w)
• Dental Infection. Gum Infection দাঁতে বা মাড়িতে লাগাতে হবে।
• Hexisol Hand Rub
• Chlorhexidine Gluconate 0.5% w/w in 70% isopropanol

Indication

• General antiseptic
• Disinfectant
• Cleansing purpose

Chloroxylenol ( Dettol, Lotion)

Chloroxylenol 1.3% solution

Indication:

• Disinfectant for skin and glove hands
• Obstetrics
• Antiseptic lubricants for vaginal examination

Dilution: 1:3 ভাগ Dettol এর সাথে ১৩ ভাগ পানি মেশাতে হবে। Undiluted Dettol ও ব্যবহার করা যায় তবে sensitive skin এ নয়।

Povidone-Iodine

Polyvinyl pyrrolidine- iodine cream, ointment, solution, pessaries. Povidone Iodine is a complex of iodine and an organic polymer, povidone.

Povidone Iodine এর বৈশিষ্ট গুলি কি কি?

Broad spectrum microbicide rapid & prolong degerming activity kills most bacteria within 15 to 30 sec. Chlorhexidine এর চেয়ে বেশি degerming activity . Blood উপস্থিতিতেই active Non- Irritating. Easily applicable& economic.

Indication:

• Effective against
• Gram Negative bacteria
• Gram Positive bacteria
• Fungi
• Protozoa
• Virus
• Yeasts

Povisep Solution

Povidone-Iodine 10% w/v Antiseptic aqueous solution

Indication: Degerming the skin preoperatively and post operatively for all surgical procedures. For the antiseptic treatment of superficial wounds, traumatic injuries etc.

Use and application:

• Paint এর মত যতটা প্রয়োজন ততোটাই apply করা যাবে।
• Minor wounds এর ক্ষেত্রে সরাসরি ক্ষত স্থানে applyকরতে হবে
• Solution লাগানো স্থানটি gauze অথবা adhesive bandage দ্বারা ঢাকা যেতে পারে।
• Viodin antiseptic solution

Povisep Cream

Povidone-Iodine 6% w/w cream

Indication: For the treatment and prevention of-

• Cut
• ointment
• Ointment dressing
• Minor
• Burns
• Fungal skin infection
• Racterial skin infection
• Decubitus ulcer bed sore
• Stasis ulcer
• Pyodermas

Use and application

• আক্রান্ত skin পরিষ্কার ও শুষ্ক করতে হবে
• প্রয়োজন মতো ointment লাগাতে হবে
• Ointment লাগানো স্থান dressing ও bamclaging দ্বারা ঢাকা যেতে পারে
• Viodin cream