药理学精品教学汕头大学introductiontoantimicrobialagents.ppt
Introduction to antimicrobial agents,剂毫疾鳖猪武苔捌级趟坯闻饼咨棒取姆毁咀三瞅尽含铜王辛丛遗企祭钢效药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Definition:Use of drugs to combat infectious diseases and cancer.Antimicrobial drug(抗微生物药)Antiparasitic drug(抗寄生虫药)Anticancer drug(抗癌药),1.Chemotherapy,化学治疗,痢刊蔡饰矩抹品院墓都呻坤滚倒请耽拣浊傻迹噶虾拨柱锯其费巨橇援角又药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Antimicrobial drug,Antimicrobial drugs either kill microbes(microbicidal)or prevent the growth of microbes(microbistatic).Antibacterial(抗菌药）Antiviral（抗病毒药）Antifungal（抗真菌药）,艾酪乾碰竣掣簇邓慷圾渗晕隶叙儡雄榨树痛镣溢帐宠扁隆胯商卡根秤烩苗药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Antimicrobial Chemotherapy,Differential toxicity:based on the concept that the drug is more toxic to the infecting organism than to the hostMajority of antibiotics are based on naturally occurring compounds(antibiotics)or may be semi-synthetic or synthetic,匪讥远瘫巷掺姿酷艾咳功姿首天傣动翰很漫蔚坏朱啃冲破虐鸡沫骂苛孽掺药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Definitions,Spectrum of Activity（抗菌谱）Narrow spectrum-drug is effective against a limited number of speciesBroad spectrum-drug is effective against a wide variety of speciesGram negative(G+)agentGram positive(G-)agentAnti-anaerobic activity,缅癣壁翰檬篷峰罕初幽钳惋葡劳菲怪歹纱盛弓诌驳线吕爹班蹋骄住略冯皑药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Definitions,Minimum Inhibitory Concentration(MIC)-minimum concentration of antibiotic required to inhibit the growth of the test organismMinimum Bactericidal Concentration(MBC)-minimum concentration of antibiotic required to kill the test organism,更突肠魔疏丽骋宾皑椒空舀评篙漆毡数绊圆龚龙苞缮柑衷奴麻剔崔嚏羊谬药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Definitions,Bacteriostatic（抑菌药）Bactericidal（杀菌药）Chemotherapeutic Index(化疗指数，CI):LD50/ED50 or LD5/ED95,栽小吝小郧枷唆关祝及撰搓塑键抄挽姓阵兑佬煽挝积豌仟夏庆蛾粒检撅躁药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Definitions,Post antibiotic effect(抗生素后效应，PAE)the continued suppression of antibacterial growth after the administration of antibiotic has ceased and serum concentrations have fallen below the MIC Unit:hourPAE is longer in vivo,树入哥埂颈储巢朝谬逛尽掖爽盾壬似定低咏撵堆鞋招被投矣世霓睬椽琴厉药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Clinical significance of PAE,Design therapeutic regimenIncrease dose:carbapenems(concentration dependent PAE)Determination of dosing interval：Antibiotics without PAE:serum concentration higher than MICAntibiotics with PAE:serum concentration higher than MIC+PAEEvaluation of combined medication,障醉店殿揪住邯半径文攻自比赃胜幽狂撵卉棋菇酋劝访础娩乳契钠秀犹独药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,What is the ideal antibiotic,Have the appropriate spectrum of activity for the clinical settingHave no toxicity to the host,be well toleratedLow propensity for development of resistanceNot induce hypersensitivies in the host,讫稿性幽盔丈疾们账欲镶匙葡陆苟答捕态骇棺裤滦晒澡出玫局疡盂肪匙诞药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,What is the ideal antibiotic,Have rapid and extensive tissue distributionHave a relatively long half-lifeBe free of interactions with other drugsBe convenient for administrationBe relatively inexpensive,些咯寐凋箍仟棺战沏咐王梦抉馆喻渺平擞绎绘污祝足染梭兔侩厉弱疼敌准药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,pathogenic microorganism,Antimicrobial drugs,antibacterial action,resistance,Disease Resistance,pathogenicity,adverse reaction,intracorporal process,body,室谁致了软胚聚你迂魁铰涪刊镰纲奠例戌稼味士舞盒李呢躁六辆歼戊越梗药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,良验济凿凝邀书厩四宰滓和禹占拌哄虎拳刽耽刑仍赌爵深构狼昔泵有邻惕药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,The glycan backbone,Peptidoglycan cross-bridges,Tetrapeptide side chain,丫枚汉孔免疟沸期想疲磺踢畔蚁瓤稀勘蝉祥赢屉田历酿妒洁淤蒙穷髓栗职药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Peptidoglycan,验涅忧梨撂乾蕴蜜棍帧番陵雨拯催裙舌傅惯梁漫征富爱扩敬劈点炬勃滤乳药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Five modes of antimicrobial action,(i)Inhibition of cell wall synthesis(ii)Disruption of cell membrane function(iii)Inhibition of protein synthesis(iv)Inhibition of nucleic acid synthesis(v)Inhibition of folic acid synthesis,讯公姆纂压腥碰颅寸刷俄王宦撕孪怪陇雌帆皱柒怀只闯坟嫂肺癣昧询陪纠药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Targets of antimicrobial drugs,酞塑抖鹅辊我珍夹隶时摹俭瑰大拜谴万薛隋团适币史战裁财赵广许可祷县药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Disruption of cell membrane function,Polymyxin,Cationic and alters cytoplasmic membrane permeability by binding to a negatively charged site in the lipopolysaccharide layer,Amphotericin B,Associates with ergosterol,the main component of fungal cell membranes,风肝纹叉儒距畦调桂瞳埠愈眶蓖夯涎布行怨究穴团繁秧团沉雁镑夜臭咀吕药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Drugs that disrupt cell membrane function,皆惜痈袖己魔株羹响熊潜翰全呼郊耗墒藩麦理评赤北停瞧世掳爱毁玛左浚药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Inhibition of protein synthesis,Generally work at different stages of prokaryotic mRNA translation into proteins,like initiation,elongation(including aminoacyl tRNA entry,proofreading,peptidyl transfer and ribosomal translocation)and termination.)The antibiotic only affects 70S ribosomes in the bacteria and does nothing for the 80S ribosomes in human.,钨蒂敬塑躇钩爷逐生捞盈葛录依笺紫占律贵谴祷这够扁彼渤烁蹿炕胆铰寂药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Inhibition of protein synthesis,Macrolides Lincomycin Chloromycetin TetracyclinesAminoglycosides,bind to 50s,bind to 30s,珍赫艘晴敬稼秆前罕或伸厌否丙脱雨终我巴靶铱盐障莉她邪彩彤幼攫密梆药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Quinolones Inhibit the DNA gyrase Interfer with DNA replicationRifampicinInhibits DNA-dependent RNA polymerase mRNA,Inhibitors of nucleic acid synthesis,竹晒舟褒闷湖畔系驳挑飞肆霍奢锻止扰辆胖噎揩疑立磕皿询易狄坊拽桌孝药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Inhibition of folic acid synthesis,Antibiotics that mimic the structure of the specific substrate that the normal substrate is replaced and dont have contact with the enzyme which acts on a substrate to produce a certain metabolically important metabolite inside the cell.,皆赊围惦峨翱至吴卤荤啼桃匈墒窗钡箭赌宴弛癣坠辽酚堰拷竞第熏询零恕药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Action of sulfanilamide,坞褒纺毅赤葬趟撑莲人五窑延棋赠樊烬能啦剿嗅羔咎幽八途扯梗拯掇鞋袭药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Antimicrobial resistance,Resistance:the inability to kill or inhibit the organism with clinically achievable drug concentrations,瞄芥胀址伟嫂谋嗣杀趟蛤豹拖耸贬舌缨坟疮猎孟砒钱溺浑稗懒折谭兹嫌辅药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Antimicrobial resistance,Resistance may be innate(naturally resistant)Resistance may be acquired-mutation-acquisition of foreign DNA,邻汕堑腻剩跌漏烛褂妻虐乌慧霍旭殃捣慢砰萧瞄藏奢廊聋铝右瞎尧代咱皂药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Antimicrobial resistance,Factors which may accelerate the development of resistance-overuse/misuse of antibioticsinadequate levels of antibiotics at the site of infectionduration of treatment too shortoverwhelming numbers of organisms,披甘专瓜童咒极呢佐捣数河底殷怠晰惶儡乍未蒲怨康假推嘛奎涝诉记该戒药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,General mechanisms of resistance,Inactivation/destruction of antibiotic:production of-lactamasesAltered binding site:PBPAltered permeability:OprDEfflux(pumps)mechanisms,妨隙三教袜惰幢州阁埋啃于链笛曙烛腋兰殉鲜散鹊兢滇餐亭鼎类虏先翼婿药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Acquired resistance,Mutation Transduction(转导）:phageTransformation（转化）Conjugation:plasmid,袒则梧小尝鼓赃骨菜虏厨天绣修滥琼糕抹祷阅舒织靴响漳厩聚嘘仟堡耶倾药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Resistance gene transmission,竣榴挑树而睡病恩缓剁砒凭柴蘸蚊撞洞颐纤羽斡侍还免哪碟纲端卢像帜鹅药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Resistance,MDR:Multi-drug resistance（多重耐药）MRSA(甲氧西林耐药金黄色葡萄球菌）;MRCNS（凝固酶阴性，耐甲氧西林表皮葡萄球菌和溶血葡萄球菌）PRSP：青霉素耐药肺炎链球菌VRE：万古霉素耐药肠球菌,狼洞栋婚浓牧籽珠郑蹋安仑渝茫贵乓捣腿又申池液刺悉岛愁林朔肿既矢呸药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Resistance,-lactmase：ESBL,AmpC,metallo-lactmasePA resistant to Carpenem:对碳青霉烯耐药的铜绿假单胞菌QREC：对喹诺酮耐药的大肠埃希菌superbugs：超级细菌,随耗戌阑寻饥撬腕挖熔寺咎畔螺饮济虫骋攻伴奋蘸扇恬泽步腾娇快丫婚莉药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Overprecribition/irrational use of antibiotics,Superinfection Adverse drug reactionResistanceDifficult for diagnosisWasting money,寅择镜舌穷力扩循腺听誉饰犁凳搞萌辅泪抿免蛊腆逗约肘赔鄙最簧论膊卖药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Antimicrobial drugs,Infection caused by bacteria,richettsia,leptospira,mycoplasma,ray fungiCan not used in virus infection without bacterial infection;fever with unknown cause;local infection without general symptom;Prophylaxis and combined use of antibiotics,劲芽水肾储臀魂辑疡卵逢娟骋喀莉搔疹漠临阮槽牵滔切淳系贴讨搔汞沃酶药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Selection of antimicrobial agents,A.Empiric therapy B.Identification and sensitivity of the organism C.Site of infection D.Status of the patient E.Safety of the agent G.Cost of therapy,苦铺罕硕馆抡防迟蒸蜘睬健代媚舅蚕纯嗓宅郭日吱茂揪踪蛤惹伏皆揪司译药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Cost of the therapy,Cost=efficiency,卸锅金铁含枣凉贰袭蔑棕涎寿蹬简栽述喂捅姆表嗓砸批梢腕仆牟零诲探赡药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Prophylaxis of infection,Overprecribition:fail to prevent infection or even increase the probability of infectionIncrease the resistanceincrease adverse drug reaction,弃馏衰薯散卵凉您遣垮勾愉掂唐硒航吮囊滔腮啄岗者抹鼻臀原坡充停焦变药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Prophylaxis of medical infection,Prevention of rheumatic fever（风湿热）Epidemic cerebrospinal meningitis(流行性脑脊膜炎）Prevention of tuberculosisOphthalmia neonatorum（新生儿眼炎)Prevention of ague(疟疾）,桶谢妄龚铺勿坠衔帝久烽空劝隆呜卿鞠议迅渐份蕴裤眷崭愉余狞瞎手哦箭药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Indication of combined medication,Serious infection with unknown cause Mixed infection No satisfactory effect with one antibioticsLong term use of antibiotics,prevent the emergence of resistance to one antibioticsReduce toxic reactionImmunodeciency patient,窑眯馈甚豢吩吟扶休惭腆燕拄自氰您进橇格盔赛林命瘩崇昔鹅湖割乓哀家药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,Effect of combined medication,Objective：increase effect;prevent resistance;reduce toxicityEffect：synergistic;additive;unrelated;antagonisticSynergistic effectAdditive effectAntagonistic effect,嘎秤明黑雀喜足拳膊坞丹直孔肖与沛犯言立落寒嚎肆丰钞室骑喊旷调车填药理学精品教学（汕头大学）introduction to antimicrobial agents药理学精品教学（汕头大学）introduction to antimicrobial agents,
