PREBOARD REVIEW-ANTI INFECTIVE 2024.pdf

PHARMCHEM4 MODULE 4 ANTI- INFECTIVE AGENTS Presentation by Vivienne Bernardio, RPh University of San Agustin - I...

PHARMCHEM4 MODULE 4 ANTI- INFECTIVE AGENTS Presentation by Vivienne Bernardio, RPh University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  PCHEM4 TERMINOLOGIES University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  TERMINOLOGIES GERMICIDES anti-infective agents that are used locally. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  TERMINOLOGIES ANTISEPTIC are compounds that kill (-cidal) or prevent the growth (-static) of microorganisms when applied to living tissue. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  TERMINOLOGIES ANTISEPTIC are compounds that kill (-cidal) or prevent the growth (-static) of microorganisms when applied to living tissue. DISINFECTANTS are agents that prevents transmission of infection by the destruction of pathogenic microorganisms when applied to inanimate objects. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department STANDARDS FOR REMOVING PChem 4 MICROORGANISMS ANTISEPSIS 01 Application of an agent to living tissue for the purpose of preventing infection. DECONTAMINATION 02 Destruction or marked reduction in the number or activity of microorganisms. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department STANDARDS FOR REMOVING PChem 4 MICROORGANISMS DISINFECTION 03 Chemical or physical treatment that destroys most vegetative microbes or viruses, but not spores, in or on inanimate surfaces. SANITIZATION 04 Reduction of microbial load on an inanimate surface to a level considered acceptable for public health purposes. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department STANDARDS FOR REMOVING PChem 4 MICROORGANISMS STERILIZATION 05 A process intended to kill or remove all types of microorganisms, including spores, and usually including viruses with an acceptably low probability of survival. PASTEURIZATION 06 A process that kills nonsporulating microorganisms by hot water or steam at 65°C–100°C.  ALCOHOLS University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOLS Alcohols are molecules containing the hydroxy functional group (-OH) that is bonded to a carbon atom of an alkyl or substituted alkyl group. The hydroxy functional group strongly contributes to the physical properties of alcohols. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL AS THE ALCOHOL CHAIN LENGTH INCREASES: Van der ability to antimicrobial Waals penetrate activity interactions microbial membranes University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL BRANCHING OF THE ALCOHOL CHAIN DECREASES ANTIBACTERIAL POTENCY: weaker van der Waals forces brought about by branching do not penetrate bacterial cell membranes as efficiently. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL THE ISOMERIC ALCOHOLS’ POTENCIES DECREASE IN THE ORDER PRIMARY > SECONDARY > TERTIARY University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL The primary medicinal use of alcohol is external, as an antiseptic, preservative, mild counterirritant, or solvent. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL Rubbing alcohol is used as an astringent, rubefacient, and a mild local anesthetic. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL The anesthetic effect results from the evaporative refrigerant action of alcohol when applied to the skin. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL ETHANOL Product of fermentation Ethyl Alcohol, Wine Spirit, from grain and many other Hydrated Oxide of Ethyl carbohydrates University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL ETHANOL Product of fermentation Ethyl Alcohol, Wine Spirit, from grain and many other Hydrated Oxide of Ethyl carbohydrates It is flammable, miscible with water in all proportions, and soluble in most organic solvents University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL ETHANOL Product of fermentation Ethyl Alcohol, Wine Spirit, from grain and many other Hydrated Oxide of Ethyl carbohydrates It is flammable, miscible with Commercial ethanol contains water in all proportions, and approximately 95% ethanol by soluble in most organic solvents volume University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALCOHOL ETHANOL Ethanol has even been injected Ethyl Alcohol, Wine Spirit, near nerves and ganglia to Hydrated Oxide of Ethyl alleviate pain. It has a low narcotic potency and has been used internally in diluted form as a mild sedative, a weak vasodilator, and a carminative. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  DEHYDRATED ETHANOL Dehydrated ethanol, or absolute ethanol, contains not less than 99% w/w of C2H5OH. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  DEHYDRATED ETHANOL Absolute ethanol has a very This form of ethanol is used high affinity for water and primarily as a chemical must be stored in tightly reagent or solvent but has sealed containers. been injected for the local relief of pain in carcinomas and neuralgias. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ISOPROPYL ALCOHOL Isopropanol (2-propanol) is a colorless, volatile liquid with a characteristic odor and a slightly bitter taste. It is considered a suitable substitute for ethanol in most cases but must not be ingested. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  Used primarily as a disinfectant for the skin and for surgical instruments. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  Isopropyl Azeotropic alcohol is also isopropyl alcohol, used in United States pharmaceutical Pharmacopeia s and toiletries (USP), is used on as a solvent and gauze pads for preservative. sterilization of the skin prior to hypodermic injections. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ETHYLENE OXIDE It has been used to sterilize temperature sensitive medical equipment and certain pharmaceuticals that cannot be heat sterilized in an autoclave. Ethylene oxide forms explosive mixtures in air at concentrations ranging from 3% to 80% by volume. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department ETHYLENE OXIDE Carboxide is a commercial sterilant containing 10% ethylene oxide and 90% carbon dioxide by volume that can be handled and released in air without danger of explosion. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department ETHYLENE OXIDE Ethylene oxide is a nonselective alkylating agent, and for that reason it is extremely toxic and potentially carcinogenic. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  ALDEHYDES University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department FORMALDEHYDE Formalin is a colorless aqueous solution that officially contains not less than 37% w/v of formaldehyde (HCHO), with methanol added to retard polymerization. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department FORMALDEHYDE Formaldehyde readily undergoes oxidation and polymerization, leading to formic acid and para- formaldehyde Should be stored in tightly closed, light-resistant containers and stored at temperatures above 15°C to prevent cloudiness, which develops at lower temperatures. Germicidal action of formaldehyde is slow but powerful. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  CHARACTERISTICS Irritating to mucous membranes and causes hardening of the skin Oral ingestion of the solution leads to severe gastrointestinal distress. Contact dermatitis is common with formalin, and pure formaldehyde is suspected to be a carcinogen. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department GLUTARALDEHYDE SOLUTION Glutaraldehyde (Cidex, a 5- carbon dialdehyde) is used as a dilute solution for sterilization of equipment and instruments that cannot be autoclaved. At higher pH (8.5), glutaraldehyde rapidly polymerizes. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  GLUTARALDEHYDE SOLUTION The preparation actually consists of two components, glutaraldehyde and buffer, which are mixed together immediately before use. The activated solution contains 2% glutaraldehyde buffered at pH7.5 to 8.0. The nonstabilized alkaline solutions lose about 44% of Stabilized glutaraldehyde solutions retain more than 80% of their their activity after 15 days. original activity 30 days after preparation University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  GLUTARALDEHYDE SOLUTION The preparation actually consists of two components, glutaraldehyde and buffer, which are mixed together immediately before use. Nonbuffered solutions of glutaraldehyde are acidic, The acidic solutions are possibly because of an acidic stable but lack sporicidal proton on the cyclic activity. hemiacetal form. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  PHENOLS & THEIR DERIVATIVES University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  PHENOLS & THEIR DERIVATIVES Phenol, USP, remains the standard to which the activity of most germicidal substances is compared. The phenol coefficient is defined as the ratio of a dilution of a given test disinfectant to the dilution of phenol that is required to kill (to the same extent) a strain of Salmonella typhi under carefully controlled time and temperature conditions. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  May 28, 2022 Denature MECHANISM Lysis of bacterial bacterial cell membranes OF ACTION proteins at low occurs at higher concentrations concentrations. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  Phenol exhibits germicidal activity (general protoplasmic poison) PHENOL Caustic to skin Exerts local anesthetic effects University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  Must be diluted to avoid tissue destruction and dermatitis PHENOL Still used occasionally as an antipruritic in phenolated calamine lotion (0.1%–1% concentrations) 4% solution of phenol in glycerin has been used to cauterize small wounds University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department PHENOL: Liquified phenol is simply LIQUIFIED phenol containing 10% water The liquid form is convenient for adding phenol to various pharmaceutical preparations because it can be measured and transferred easily. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  PARA- CHOLOROPHENOL p-Chlorophenol is used in combination with camphor in liquid petrolatum as an external antiseptic and anti-irritant The compound has a phenol coefficient of about 4. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  HEXACHLOROPHENE A biphenol such as hexachlorophene will, in general, possess greater potency than a monophenol. The increased degree of CHLORINATION of hexachlorophene increases its antiseptic potency further. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  HEXACHLOROPHENE Easily adsorbed onto the skin and enters the sebaceous glands, thus, topical application elicits a prolonged ANTISEPTIC EFFECT, even in low concentrations. Used in concentrations of 2% to 3% in soaps, detergent creams, lotions, and shampoos for various antiseptic uses University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department CRESOL Inexpensive antiseptic and disinfectant. Possesses a phenol coefficient of 2.5 The drawback to its use as an antiseptic is its unpleasant odor University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department THYMOL Isopropyl m-cresol is extracted from oil of Thymus vulgaris Has mild fungicidal properties and is used in alcohol solutions and in dusting powders for the treatment of tinea (ringworm) infections University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department OXIDIZING AGENTS: Its structural formula is BENZOYL PEROXIDE [C6H5C(O)]2O2 It releases nascent oxygen which is highly reactive. Its combines with oxidases of necrotic matter and bacteria. University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  OXIDIZING AGENTS: BENZOYL PEROXIDE Both keratolytic and keratogenic Used in the treatment of acne University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  HALOGEN-CONTAINING COMPOUNDS: IODINE Provides a nontoxic, non volatile, & non staining form of iodine that is not irritating to the skin or wounds 01 Used as an aqueous solution for 02 presurgical disinfection of the incision site University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  CATIONIC SURFACTANT BENZALKONIUM CHLORIDE Alkylbenzyldimethylammonium chloride A detergent, an emulsifier, and a wetting agent used as an antiseptic for skin and mucous membranes in concentrations of 1:750 to 1:20,000 University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department CATIONIC SURFACTANT CHLORHEXIDINE GLUCONATE Has broad-spectrum antibacterial activity but is not active Against acid-fast bacteria, spores, or viruses University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  CATIONIC SURFACTANT CHLORHEXIDINE GLUCONATE For topical use as: preoperative skin disinfection, wound irrigation, mouthwash, general sanitization University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  Has weak antiseptic properties that make it useful for the treatment of cystitis and urethritis Reactive against pathogens University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  Action of Methylene Blue is considered to be bacteriostatic This compound colors the urine and stool blue green University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department OTHER/CHEMICAL NAMES: hexamethyl-p-rosaniline chloride crystal violet methyl violet methylrosaniline chloride. Available in VAGINAL SUPPOSITORIES for the treatment of yeast infections University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department Used as a 1% to 3% solution for the treatment of ringworm and yeast infections Used orally as an anthelmintic for strongyloidiasis (threadworm) and oxyuriasis University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  MERCURIALS Elemental mercury incorporated into ointment bases was used topically for the treatment of localized infections and syphilis Several inorganic salts of mercury, such as mercuric chloride (HgCl2) and mercurous chloride (calomel, Hg2Cl2) were at one time widely used as antiseptics University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department  MERCURIALS Ammoniated mercury [Hg(NH2)Cl] is still occasionally used for skin infections such as impetigo, psoriasis, and ringworm Mercuric oxide is sometimes used to treat inflammation resulting from infection of the eye Organomercurials still in use are employed as antiseptics, preservatives, or diuretics University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department PRESERVATIVES METHYL PARABEN used as a safeguard against mold growth PROPYL PARABEN used as a preservative, primarily to retard yeast growth University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department PRESERVATIVES CHLOROBUTANOL a bacteriostatic agent in pharmaceuticals for injection, ophthalmic use, and intranasal administration University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department PRESERVATIVES BENZYL ALCOHOL Used as a preservative in vials of injectable drugs in concentrations of 1% to 4% in water or saline solution Also used in ointments and lotions as an antiseptic in the treatment of various pruritic skin conditions University of San Agustin - Iloilo City College of Pharmacy and Medical Technology - Pharmacy Department