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    ANTIBAKTERI

    Dripa Sjabana, dr., [email protected]

    Mata Ajar Farmakologi Prodi Pendidikan Dokter

    Universitas Airlangga2006

    (pengantar antibiotik & penghambat sintesis dinding sel bakteri)

    [email protected] 2

    St ruk t u r & Met abo l isme se lbak te r i

    reaksitk.

    I

    reaksitk.

    II

    reaksitk.

    III

    PO43-

    NH4+ SO4

    2-

    glukosa

    Molekulprekursor

    & ATP

    heks

    osam

    in

    Asamamino

    nukleotida

    peptidoglikan

    protein

    RNA

    DNA

    FolatAnalog pirimidin & purin

    Sintesis proteinSintesis peptidoglikanSintesis asam nukleat

    molekul konstituen

    molekul makro

    Modifikasi dari Katzung (2004)

    [email protected] 3

    Target K er ja An t ibak t e r i

    I. Enzim sintesis dinding sel

    II. Ribosom bakteri

    III. Enzim sintesis nukleotida danreplikasi DNA

    [email protected] 4

    Ant ib io t i ka dengan Targe t Ker ja

    Enzim Sintes is Dinding Sel

    A. Beta laktam1. Penicillin2. Cephalosporin3. Monobactam4. Carbapenem5. Inhibitor beta-laktamase

    (clavulanic acid, sulbactam, tazobactam)6. Vancomycin

    B. TeicoplaninC. FosfomycinD. BacitracinE. Cycloserine

    [email protected] 5

    Outer membrane, lipidbilayer, is present ingram (-) but not gram(+).

    The peptidoglycan is

    much thicker in gram(+) than in gram (-).

    Penicilin-bindingproteins (PBPs) aremembrane proteins thatcros-link peptidoglycan.

    Beta-lactamase, ifpresent, reside in theperiplasmic space orthe outer surface of thecytoplasmic membran,when they may destroybeta-lactam antibioticsthat penetrate the outermembrane.

    PBP

    Katzung(2004)[email protected] 6

    Bactoprenol (BP)is the lipidmembranecarrier

    M=N-

    acetylmuramicacid,Glc=glucose,NAcGlc or G= N-acetylglucosamine

    1= fosfomycin,2= cycloserine,3=basitracin,4=vancomycin,5=beta-lactamantibiotics.

    Katzung(2004)

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    Figure 44.3 Schematic diagram of the biosynthesis of peptidoglycan in a bacterial cell (e.g. Staphylococcus aureus) with the sites of action of v arious antibiotics. Thehydrophilic disaccharide-pentapeptide is transferred across the lipid cell membrane attached to a large lipid (C55 lipid) by a pyrophosphate bridge (-P-P-). On the outside,it is enzymically attached to the 'acceptor' (the growing peptidoglycan layer). The final reaction is a transpeptidation, in which the loose end of the (gly)5 chain is attached

    to a peptide side-chain of an M in the acceptor and during which the terminal amino acid (alanine) is lost. The lipid is regenerated by loss of a phosphate group (Pi)before functioning again as a carrier. (M, N-acetylmuramic acid; G, N-acetylglucosamine.)

    Downloaded from:StudentConsult(on 3 May2005 08:34 AM)

    2005Elsevier [email protected] 8

    t o f o rm a c ross l i nk f o r ce l l w a l l r i g id it y s t ruc tu re

    transpeptidase

    -lactam AB

    inhibitor

    Autolytic enzimes

    bacterial lysisbacterial

    bound to PBP

    analog D-AlaD-Ala

    Modifikasi dari Katzung (2004)

    [email protected] 9

    Figure 44.2 Schematic diagram of a single layer of peptidoglycanfrom a bacterial cell (e.g. Staphylococcus aureus) showing the site of action of the -lactamantibiotics( more detail in Fig. 44.3).In Staphylococc usaure usthe peptide cross-links consist of five glycine residues. Gram-positive bacteria have several layers of

    peptidoglycan. (NAMA,N-acetylmuramic acid;NAG,N- acetylglucosamine.)

    Downloaded from:StudentConsult(on 3 May2005 08:34 AM)

    2005Elsevier [email protected] 10

    PENICILLINSubsituted 6-aminopenicillanic acid

    CEPHALOSPORINSubsituted 7-aminocephslosporic acid

    A = thiazolidine ring Katzung(2004)

    [email protected] 11

    MONOBACTAMSubsituted 3-amino-4-methylmonobactamic acid

    CARBAPENEMSubsituted 3-hydroxyethylcarbapenemic acid

    Katzung(2004)

    [email protected] 12

    Penic i l l in

    Penicillin G (iv), VK (po)

    Antistaphylococcus

    Cloxacillin, dicloxacillin (po)

    Nafcillin, oxacillin (iv)

    Extended-spectrum

    Amoxicillin, +clav (po)

    Piperacillin (iv)

    Ticarcillin (iv)

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    [email protected] 13

    Cephalosporin (1)

    1st generation:

    Cefadroxil, cefazolin, cephalexin, cepharpirin,cephradine

    Very active againts gram(+) cocci.

    2nd generation:

    Cefaclor, cefamandole, cefonicid, cefuroxime,cefprozil, loracarbef, ceforanide,

    cephamycins, cefoxitin, cefmetazole, cefotetan

    Extended gram(-) coverage

    [email protected] 14

    Cephalosporin (2)

    3rd generation:

    Cefoperazone, cefotaxime, ceftazidime,ceftizoxime, ceftriaxone, cefixime, cefpodoximeproxetil, ceftibuten, moxalactam

    Expanded gram(-) coverage, + bbb.

    4th generation:

    cefepime

    More resistant to hydrolysis by chromosomalbeta-lactamases (eg. enterobacter) and someextended spectrum betalaktamases

    [email protected] 15

    Monobac tam

    Aztreonam

    Spektrum ~ aminoglycoside

    [email protected] 16

    Jelask an hubungan:

    Sulphonamide

    PABA

    Folate

    Bakteri vs. manusia ?

    [email protected] 17

    Jelask an hubungan:

    Trimethoprim

    Tetrahydrofolate Thymidylate

    Dihydrofolate reductase

    Bakteri vs. manusia ?

    [email protected] 18

    Bacaan lan ju t

    Katzung BG ed.(2004). Farmakologi Dasar & Klinik, ed.8,buku 3. Jakarta: Salemba Medika, hal.3-33.

    Rang HP et al. (2003). Pharmacology, ed.5.

    London: Elsevier, p.620-643.

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