1 With Examples 1 Alkylation Agents (a) Netrogen

1          Write An Essay  On The Importance Of Monitoring Fungal Infection In The ClinicalEnvironment. 2          The first- lineanatomical barriers of defense are the skin and Mucosal surfaces, which protectthe Human body with an acidic ph, enzymes, mucus.  When this barriers are broken by Sirgery orindwelling catheters, radiotherapy, burns or chemotherapy, fungal agents canreach the deep tissues. The clinical forms and severity and the diseasemanifestations dispends on the host’s defenses and immune response.

IMPORTANCE OF MONITORING FUNGAL INFECTORv Toprevent infection in immune compromised patients, exposure to fungal sporesmust be limited with high efficiency particulate air filters and positivepressure in the patient’s room and high risk should avoid contact with soil,tap water and shower facilities. v Thebest approach to the optimal management of fungal infection is early detectionand identification of causal agent so that appropriate treatment can beinitiated as soon as possible.v TheSerum concentration of anti fungal should be monitored to record both theefficacy and toxity of this drugs. 2.   MENTION 3 CATEGORIES OF ANTI-NEOPLASM AGENTWITH NAMED EXAMPLES. DISCUSS BRIEFLY THE MECHANISM OF ACTION OF 1 EXAMPLE INEACH CATEGORY.

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A.    Three Categories Of Anti-Neoplasm AgentsWith Examples1          Alkylation Agents (a)  Netrogen Mustard:  Melphalan, Cyclophosphamicle(b) Platinum coarchination complexes:Ciplatin(2) Antimetabolites(a) Folate Antagonists: Methotrexate(b) Purine Antagonist(3) Hormones:(a) Corticcosteroids: Prednisone,Dexamethasone(b) Antiestrogens:  Tomoxifen MECHNISM OF ACTION OF MEPHALAN Mephalanalkylates DNA at the N7 position of guanine and induces DNA interstrandcross-linkages resulting in the inhibition of DNA and RNA synthesis andcytotoxicity against both dividing and non-in dividing tumor cells. MECHANISM OF ACTION OF METHOTREXATEMethotrexateis an anti-methabolite  of the antipolatetype.  It competitively inhibitsdihydrofolate reductase (DHFR), an enzyme that participates in thetetrahydrofolate synthesis. The affinity of methotrexate for DHFR is about1000-fold that of folate.

DHFR catalyses the conversion of dihydrofolate to theactive tetrahydrofolate.  Foli acid isneeded for the de novo synthesis of the nucleoside thymidine, required for DNASynthesis. Also, folate is essentialfor purine and pyrimidine base biosynthesis,so synthesis will be inhibited. Methotrexate, therefore, inhibit the synthesisof DNA,RNA thymidylates and proteins.     MECHANISM OF ACTION OF PREANISONEThemechanism of glucocorticoid  action inreduction of serum calcium are thought to be cytolitic effects on lymphoidcells, decreased lymphocyte secretion, and inhibition of vitamin D action oncalcium metabolism. 3 Which of the classes of anti-fungal agents willyou consider to be idea, why or why not . An anti-fungal agent is a drug that selectivelyeliminates fungal pathogens from a host with minimal toxicity to the host.

 Amphotericin B is a polyene anti-fungal agents fortreatment of life – threatening mycoses and for most other mycoses. It wasdiscovered by Gold in 1956, it can truly be said to represent a goal standard.It is broad spectrum of activity includes most of the medically importantmoulcles and yeast, including dimorphic pathogens such as coccidiodes immitis,Histoplasma capsulatum. THE WHY: It is the drug of choice intreating mostopportunistic myoses cause by fungi such as candida species. I solely preferAmphtotericin B to others because resistance to this agent is rare. THE WHY NOT: The drug must be administered intravenously because of numerous effects,ranging from phlebitis at the infusion site and chills to renal toxicity

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