Cell wall inhibitors.pptx................

۔.

1. Cell wall inhibitors penicillins By Dr Ayesha Jamil

2. ALEXANDER FLEMING 1881- 1955 Nobel Prize 1945

3. Penicillin  (sometimes abbreviated  PCN  or  pen ) is a group of antibiotics derived from  Penicillium   fungi,including   penicillin G(intravenous use),  penicillin V (oral use), procaine penicillin, and  benzathine penicillin (intramuscular use).

4. The Beta- Lactam Antibiotics Cell wall active agents Prevent the final step in the synthesis of the bacterial cell wall Range from very narrow spectrum to very broad spectrum

5. Classification Penicillins Natural penicillins PenG , PenVK , Benzathine Pen, Procaine Pen Aminopenicillins Ampicillin , Amoxicillin Anti-Staph penicillins Oxacillin , Dicloxacillin Anti- Pseudomonal [ Carboxy ] Ticarcillin [ Ureido ] Piperacillin

6. Mechanism of action The β - lactam binds to Penicillin Binding Protein (PBP) PBP is unable to crosslink peptidoglycan chains The bacteria is unable to synthesize a stable cell wall The bacteria is lysed

7. The β - lactams are BACTERIOCIDAL … (at therapeutically attainable levels)

8. USES OF BENZYLPENICILLIN Beta haemolytic streptococcal infections such as acute tonsillitis, acute pharyngitis , skin infections, bone infections Pneumococcal infections such as pneumococcal pneumonia, pneumococcal meningitis (massive doses) Meningococcal meningitis (massive doses) Staphylococcal infections (non beta – lactamase producing strains only Adverse reactions

9. Anaerobic infections (excluding those caused by b. Fragilis ) Syphilis Actinomycosis Anthrax Leptospirosis ( weil’s disease)

10. USES OF AMINOPENICILLIN Urti Uti (2 nd choice) Meningitis Salmonella infection (2 nd choice) Bacillary dystentary ( 2 ND CHOICE )

11. ADVERSE EFFECTS HYPERSENSITIVITY REACTIONS Maculopapular rash urticaria ANGIO EDEMA (laryngeal obstruction, Respiratory distress) SERUM SICKNESS (fever, joint pains, lymphadenopathy ) EXFOLIATIVE DERMATITIS STEVENS JOHNSON SYNDROME Anaphylaxis (Contd)

12. Phlebitis (i/v) Local pain and inflammation (i/m) DEGENERATION of nerve (radial or sciatic) Neurotoxicity Super infections Haemolytic anemia (benzyl penicillin, massive doses) Renal damage ( methicillin ) Hypokalemic alkalosis Defects in haemostasis Carbenicillin

13. Dental plaque ( strept . Mutans ) Dental caries( strept mutans , lactobacilli) Periodontal disease/ gingivitis (anaerobes, gram – ive rods) Acute bacterial sialoadenitis Sialolithiasis Ludwigs ’ angina Sublingual/ submandibular celluliitis Acute glossitis Cancrum oris USES IN DENTISTRY

14. Classification Cephalosporins 1 st Generation Cephalexin , Cefazolin 2 nd Generation Cefoxitin , Cefuroxime , Cefotetan 3 rd Generation Cefotaxime , Ceftriaxone , Ceftazidime 4 th Generation Cefepime