tailieunhanh - CLINICAL PHARMACOLOGY 2003 (PART 14)

Lesser categories of (3-lactams include — carbapenems (. meropenem) — monobactams (. aztreonam) and — p-lactamase inhibitors (. clavulanic acid). Other inhibitors of cell wall synthesis include vancomycin and teicoplanin. INHIBITION OF PROTEIN SYNTHESIS . The names of those that are derived from streptomyces end in 'mycin', . tobramycin. Others include gentamicin (from Micromonospora purpurea which is not a fungus, hence the spelling as 'micin') and semisynthetic drugs, . amikacin. Tetracyclines as the name suggests are four-ringed structures and their names end in '-cycline'. Macrolides: . erythromycin. Clindamycin, structurally a lincosamide, has a similar action and overlapping antibacterial activity | 12 SECTION 3 Antibacterial drugs SYNOPSIS The range of antibacterial drugs is wide and affords the clinician scope to select with knowledge of the likely or proved pathogen s and of factors relevant to the patient . allergy renal drugs are here discussed in groups primarily by their site of antibacterial action and secondly by molecular structure because members of each structural group are usually handled by the body in a similar way and have the same range of adverse effects. Table p. 211 is a general reference for this chapter. Classification INHIBITION OF CELL WALL SYNTHESIS P-lactams the structure of which contains a p-lactam ring. The major subdivisions are a penicillins whose official names usually include or end in cillin b cephalosporins and cephamycins which are recognised by the inclusion of cef or ceph in their official names. In the UK recently all these names have been standardised to begin with cef . Lesser categories of ß-lactams include carbapenems . meropenem monobactams . aztreonam and ß-lactamase inhibitors . clavulanic acid . Other inhibitors of cell wall synthesis include vancomycin and teicoplanin. INHIBITION OF PROTEIN SYNTHESIS Aminoglycosides. The names of those that are derived from streptomyces end in mycin . tobramycin. Others include gentamicin from Micromonospora purpurea which is not a fungus hence the spelling as micin and semisynthetic drugs . amikacin. Tetracyclines as the name suggests are four-ringed structures and their names end in -cycline . Macrolides . erythromycin. Clindamycin structurally a lincosamide has a similar action and overlapping antibacterial activity. Other drugs that act by inhibiting protein synthesis include quinupristin-dalfopristin linezolid chloramphenicol and sodium fusidate. INHIBITION OF NUCLEIC ACID SYNTHESIS Sulphonamides. Usually their names contain sulpha or sulfa . These drugs and trimethoprim 215 SECTION 3 ANTIBACTERIAL DRUGS with which they may be