Lecture 11: Antimicrobial drugs Flashcards

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1
Q

Antimicrobial Drugs are used when?

A

Used when immunization has not occurred (no successful vaccine) and the immune system has difficulty to eliminate infection (ex: HIV)
• Useful against bacterial infection (antibiotics), very few antivirals (used for viral infection) are available (& those avail. are so restricted/limited)

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2
Q

Antimicrobial Drugs

A

These are compounds that…kill (cidal/lytic) or control the growth (static) of microorganisms in the host
• These drugs MUST display SELECTIVE TOXICITY or they will cause damage to the host
- b/c an antibiotic not used topically, is being let loose in body (full access to tissues) - ensure it won’t do non-specific tissue damage

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3
Q

What are the Two broad categories of antimicrobial drugs>

A

SYNTHETIC (mostly failed - b/c have to design drug that has appro. polarity, size characteristics, no natural transporters exist, therefore, challenging & has to get to min. inhibitory [ ] in tissue (bone, or nervous tissue for ex which is diff) AND NATURAL (out #)

• Large number of naturally occurring antibiotics with no clinical use
- (naturally) Produced by bacteria and fungi (penicillium or straphylosporium for ex)

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4
Q

Antimicrobial Drugs

Can also be described based on whether they are:

A

Bacteriostatic or bacteriocidal

• Broad spectrum or narrow spectrum
- broad could be: target all gram + & gram - (broad over 1 that only targets gram -), BUT can also be broad if target all gram - (vs. 1 that targets just E. coli)

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5
Q

Antibiotic targets include:

Cytoplasmic membrane structure & function

A

anything that targets cytoplasmic mem, mostly has:

TOXICITY TO US –> NOT AS WIDELY USED
- b/c our PM as Euk cells & their PM as a prok. cell are comparable to 1 another which means not something you can easily target without causing harm to your cell

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6
Q

Cell Wall Active Antimicrobial Drugs

A
Cell wall active agents offer EXCELLENT SELECTIVE TOXICITY
• MOST WIDELY USED class of antibiotics
  • no harm to OUR own cell b/c we lack PD, therefore don’t target anything we have apart of our cell
  • but can dev. allergy if it complexes with proteins in our blood for ex, behaving like a hapten & manages to get attention of immune system (not common)
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7
Q

The largest class of cell wall active antimicrobial drugs are….

A

beta lactam antibiotics

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8
Q

Describe the characteristics of beta lactam antibiotics

A

Common feature is the b-lactam ring
- core for all this category of antibiotic (can be dressed up with diff functional groups –> will determine where drug could go & conseq. for inside of cell & what the targets will be & how will it be given (orally or IV)

• NATURALLY occurring: produced by Penicillium and Cephalosporium fungi

  • found as products of microbial metabolism
  • each produce diff. categories of B-lactam; *all have ring but dressed up differently

• Example: penicillins and cephalosporins

• Can be MODIFIED in the lab to produce SEMI-SYNTHETIC drugs that have a modified spectrum of activity
- Reason for this: to change spectrum of activity; give it more activity against a gram - or gram +, more activity against a partic. species of bact.

• Susceptible to beta-lactamases

  • Enzyme produced by some bugs to cut and inactivate beta-lactams (drug no longer works - good for bact but not for us)
    • THEREFORE, B-lactamase is a FORM OF ANTIBIOTIC RESISTANCE
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9
Q

Penicillins

A

Cell Wall Active Antimicrobial Drug

Penicillins have a NARROW spectrum of activity
- prod. by penicillum mold (natural)

• Characterized by a FIVE membered ring (thiazolidine) attached to the beta-lactam component

*• Target TRANSPEPTIDATION in GRAM POSITIVE bacteria

• CANNOT PENETRATE outer membrane of GRAM NEGATIVE bacteria (don’t work against gram -)

  • SEMI-SYNTHETIC penicillin are modified to provide SOME ACTIVITY AGAINST gram NEGATIVE bugs
    • Example: ampicillin

*(can’t predict these sorts of things, so have to test antimicrobial in lab to see if these drugs will work against gram +/- experimentally)

Explain Ampicillin

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10
Q

Explain how Penicillins target transpeptidation in gram +’s

A

transpeptidation: creates perpendicular cross-links using peptide chains

penicillin drug binds to transpeptidase (enzyme respon. for formation of cross-links)

outcome: WEAK CELL WALL
- when H20 rushes into hypertonic envir. of cell, it’ll cause cell to rupture –> bact no longer viable

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11
Q

Not all penicillins will be.

A

susceptible to B-lactamase enzymes

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12
Q

Cephalosporins

A

Cell Wall Active Antimicrobial Drugs
• Structurally distinct from penicillins (despite sharing B-lactam ring)
- SIX membered ring is attached to the beta-lactam component

  • Also target transpeptidation of peptidoglycan (like penicillin)
  • Many semi-synthetic examples (enhance activity & increase spectrum of activity etc.)
  • BROADER SPECTRUM of activity than penicillin (cast wider net –> target more than penicillin can target)
  • BETTER RESISTANCE against beta lactamases (harder for B-lactamase enzyme to activate & cut same B-lactam ring the penicillum’s had b/c less accessible due to change of chem)
  • Grouped into GENERATIONS
  • 1st generation cephalosporin, 2nd generation cephalosporin etc.
    • each gen. will have its own characteristic target & outcome - what its able to go after (gen categories play role in est. & understanding what the function of category will be)
  • all have cepha as route –> cepha - beginning of each antibiotic
  • associate ending with what gen it belongs to & will then associate that with which gen will work against gram -‘s better etc. to choose best for situation
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13
Q

Growth Factor Analogs

A

Growth factor analogs (drugs) are structurally similar to growth factors but do not function (behave) in the cell
• Analogs similar (resemble) to vitamins, amino acids, and other compounds (necessary in process)

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14
Q

Give an example of growth factor analogs

A

FULL SYNTHETIC category (man-made)

  • recently quite lost efficiency –> don’t use them to same degree as before
  • even when might be useful, they have a *lot of resistance (organism may have resistance to drug)

• Discovered by Gerhard Domagk in the 1930s
- Example: sulfanilamide

• Inhibit growth of bacteria by INHIBITING FOLIC ACID SYNTHESIS and thus NUCLEIC ACID SYNTHESIS

  • needed for syn of nitrogenous bases; to be able to assemble in bact cell, things like purines & pyrimides & also in biosyn. of some AA’s as well
    • BACT has a biosyn pathway that does this - BUT for humans we get folic acid from our diet to satisfy req’s, therefore safe for us (no issue with toxicity b/c of that –> PERFECT SELECTIVE TOXICITY)

• Often used in COMBINATION with another analog –> TRIMETHOPRIM
- Combination therapy MINIMIZES the LIKELIHOOD of RESISTANCE

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15
Q

Isoniazid

A

Growth Factor Analogs
• Extremely narrow spectrum cell wall active agent
• Analog of mycolic acid component needed by Mycobacterium spp.

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16
Q

Quinolones

A

Nucleic Acid Synthesis Inhibitors

Synthetic antimicrobials

  • Inhibit DNA gyrase; prokaryotic enzyme; we don’t have it so good selective toxicity
  • Prevents supercoiling of DNA

• Active against both Gram-negative and Gram-positive bacteria

17
Q

Provide an ex of Quinolones

A
  • Example: ciprofloxacin a fluorinated quinolone (fluoroquinolone)
  • Useful against life threatening infections
  • complex chest infection, uti thats complicated
18
Q

What is the problem with ciprofloxacin

A

it interferes with cartilage development; if women is pregnant can’t give them this b/c entire fetal skeleton is 1st cartilage then forms into bone

19
Q

• Rifampin:

A

Nucleic Acid Synthesis Inhibitors

: binds to RNA polymerase preventing transcription

20
Q

• Actinomycin

A

: Binds to DNA template blocking transcription elongation

21
Q

Protein Synthesis Inhibitors

A

• Protein synthesis inhibitors target 70S ribosomes; inhibit translation
• Good selective toxicity
• Some issues because human cells have 70S ribosomes in the mitochondrial
matrix

22
Q

Aminoglycosides

A

Protein Synthesis Inhibitors

  • Bind to the 30S subunit of 70S ribosomes
  • Block translation
  • Narrow spectrum
  • Useful against gram negative bugs
  • Often used as a last resort drug
  • Damaging to the kidneys and ears

• Examples include streptomycin,
gentamycin and neomycin

23
Q

Tetracycline

A

Protein Synthesis Inhibitors
• Broad spectrum
• Produced by species of the Streptomyces genus
• Bind to the 30S subunit
• Consist of both natural and modified semisynthetic
drugs
• Binds to calcium damaging teeth and bone
• Shouldn’t be used in children and pregnant
women
• Used in veterinary medicine and to promote
animal growth
• Creates problems with resistance

24
Q

• Macrolides

A

• Broad spectrum of activity

  • Bind to the 50S ribosomal subunit
  • Only inhibits translation of some proteins
  • Some proteins are preferential translated and others are not
  • Creates a detrimental protein imbalance inside of the cell
  • Useful to treat infection in patients with allergies to beta lactam antibiotics
  • Example: erythromycin and azithromycin
  • Produced by Streptomyces spp.
25
Q

Daptomycin

A

• Produced by Streptomyces spp.

• Cyclic lipopeptide
• Active against Gram-positives
• Pathogenic Staphylococcal spp. and
Streptococcal spp.

• Forms pores in the plasma membrane causing
depolarization
• Cell cannot synthesize necessary biomolecules
• Cell death occurs
• Resistance can occur when bacteria alter plasma
membrane composition

26
Q

Platensimycin

A
  • Inhibits fatty acid biosynthesis
  • Produced by Streptomyces platensis
  • Broad spectrum of activity against gram positive bacteria
  • Useful against important resistant gram positive pathogens
  • MRSA and VRE
  • Does not cause toxicity in the host
27
Q

Antibiotic Resistance

A

Antibiotic resistance occurs when an organism develops a mechanism
to elude the activity of an antimicrobial drug that it should otherwise
be susceptible to
• Genes for antibiotic resistance can either be encoded on a plasmid or directly
within the genome

28
Q

Describe

A

Reduced permeability Penicillins
Inactivation of antibiotic Penicillins, chloramphenicol, aminoglycosides
Alternation of target Erythromycin, streptomycin, norfloxacin
Development of resistant biochemical pathway Sulfonamides
Efflux- multi drug resistance