adverse drug reactions of antimicrobial agents(1)

8/13/2019 Adverse Drug Reactions of Antimicrobial Agents(1)

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ADVERSE DRUG REACTIONS

OF ANTIMICROBIAL AGENTS

PRESENTED BY:-

Y.VENKATA VYBHAV REDDYROLL-10T21R0099IV/IV B. Pharmacy

I-SEM(B-sec)

CMR COLLEGE OF PHARMACY

GUIDED BY:-

Mr. M. RAGHAVENDRAM. Pharm(Ph.d)

Dept. of. Pharmacology


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ADVERSE DRUG REACTIONS

An Adverse Drug Reaction (abbreviated ADR) is an

expression that describes harm associated with the use ofgiven medications at a normal dosage during normal use.

The study of ADRs is the concern of the field known

as PHARMACOVIGILANCE.


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ANTIMICROBIAL AGENTS

An Antimicrobial is an agent that

kills microorganisms or inhibits their growth.

Antimicrobial medicines can be grouped according to the

microorganisms they act primarily against. For example, antibacterials (commonly known as

antibiotics) are used against bacteria and antifungals are

used against fungi. They can also be classed according to

their function. Antimicrobials that kill microbes arecalled microbicidal; those that merely inhibit their growth

are calledMicrobiostatic.

Disinfectants such as bleach are non-selective

antimicrobials.


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HISTORY

Paul Ehrlich and Sahachiro

Hata developed Salvarsan

(Arsphenamine) against syphilis

in 1910: The concept ofchemotherapy to treat microbial

diseases was born.

Sulfa drugs (sulfanilamide)discovered in 1932 against

Gram+ bacteria


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EXAMPLES OF ANTI MICROBIAL

AGENTS

PENICILLINS

CEPHALOSPORINS

STREPTOMYCIN

BACITRACIN

TETRACYCLINES

SULPHONAMIDES

VANCOMYCIN CIPROFLOXACIN

RIFAMPIN


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PENICILLINS

Penicillin was the first antibiotic to be used clinically in

the treatment of pathogenic diseases.

It was discovered as a natural product obtained from the

moulds of penicillium genus.

It is a member of broad class of -lactam antibiotics.


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ADVERSE EFFECTS OF PENICILLINS

Allergy and Anaphylaxis : skin rashes with pruritus,

haematuria, albuminuria and rarely haemolytic anaemia.

Anaphylaxis occurs rarely but may be fatal.

It typically causes a number of symptoms including an

itchy rash, throat swelling, and low blood pressure.


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Local Irritancy: oral route: nausea, vomiting and diarrhea.

Prolonged iv: thrombophlebitis of injected vein.

Large iv: mental confusion, convulsions and coma.

Super infections: by suppressing the micro flora of GIT.

Hyperkalaemia: causes in renally impaired patients.


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STREPTOMYCIN

It was the first amino glycoside antibiotic to be used

chemotherapeutically.

It is isolated from the actinomycetes bacteriaStreptomyces griseus.

Resistance is one of the major factors that has limited its

use.

Hence, it is given along with -lactum antibiotics.


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ADVERSE EFFECTS OF STREPTOMYCIN

All amino glycosides are ototoxic, nephrotoxic.

Streptomycin has greater potential to cause vestibular

damage whereas cochlear damage and nephrotoxicity arerelatively less.

It commonly causes pain at the site of injection.

Allergic reactions like rashes, eosinophilia, fever and

exfoliative dermatitis may also occur.


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TETRACYCLINES

Tetracyclines are potent, broad spectrum antibiotics,

effective against a wide variety of microorganisms.

Tetracyclines include both natural and semi syntheticagents.

Chlortetracycline is regarded as the prototype of all the

existing tetracyclines.


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ADVERSE EFFECTS OF TETRACYCLINES

Irritative effects: nausea, vomiting, epigastric pain and

diarrhoea.

Dose related effects: A)Teeth and bones

B)Hepatic damage

C)Renal damage D)Phototoxicity

E)Diabetes Insipidus


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Super infections: Prolonged usage of tetracyclines

particularly in diabetes, leucopenia or leukaemia causes

superinfections due to suppression of resident flora.

Hypersensitivity: it is rarely seen with tetracyclines,

rashes, urticaria, pruritus, glossitis, vulvae and dermatitis

can occur.


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SULFONAMIDES

Sulfonamides contain a sulfanilamide moiety in their

chemical structure and possess antibacterial property.

They are used to treat bacterial infections that havepyogenic (pus forming) property.

They act by inhibiting the synthesis of folic acid which is

essential for bacterial metabolism.


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ADVERSE EFFECTS OF SULFONAMIDES

Hypersensitivity/Allergic Reactions: Drug fever, skin

rash, urticaria.

Renal toxicity

Haemopoietic toxicity Gastrointestinal Manifestations

Kernicterus

Nervous system toxicity Endocrinal toxicity


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ADVERSE EFFECTS OF CIPROFLOXACIN

Gastrointestinal Manifestations: Nausea, vomiting,

stomach ache, digestion disorders.

CNS Manifestations: Dizziness, headache, restlessness,anxiety, insomnia.

Hypersensitivity Reactions: Skin rashes, photosensitivity,

swelling of lips etc.

Tendonitis and tendon ruptures.


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RIFAMPIN

Rifampin is a semi synthetic derivative of rifamycin-B.

It acts by inhibiting DNA-dependent RNA polymerase of

micro organisms leading to the suppression of chaininitiation in RNA synthesis.

It does not interfere with mammalian RNA polymerase.


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ADVERSE EFFECTS OF RIFAMPIN

Rifampin causes hepatitis in patients with pre-existing

hepatic disease.

Other side effects are as follows A) Cutaneous syndrome: Flushing, rash, pruritus, redness

and watering of eyes.

B) Abdominal syndrome: Nausea, vomiting.

C) Flu syndrome: Fever, chills, headache and body pain.


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Urine, faeces, saliva, tears, sweat and sputum of thepatients may acquire a harmless orange-red colour.

Other serious but rare adverse effects are,

A) Respiratory syndrome: Breathlessness associated with

shock and collapse.

B) Haemolysis and renal failure.


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REFERENCE

Pirmohamed M, Breckenridge AM, Kitteringham NR,

Park BK. Adverse drug reactions. BMJ. 1998; 316: 1295-

8.

Cluff LE. Adverse drug reactions: the need for detectionand control. Am J Epidemiol. 1971 Nov;94(5):405408.


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adverse drug reactions of antimicrobial agents(1)

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