RO L6 Flashcards
Antimicrobial agent/drug:
Chemical substance used to treat diseases caused
by pathogenic microbes
Antibiotic:
Chemical substance (/drug) produced by microorganisms, with the
capacity to control growth/kill microbes
Penicillin
Penicillium notatum inhibited
S.aureus
Properties of Useful Chemotherapeutic Agents
- Selectively toxic to pathogens; non-toxic to host and minimal effect
on normal microbial flora – determine chemotherapeutic index - Should not stimulate an allergic reaction (hypersensitivity)
- Host should not destroy or neutralise drug before effective
- Pathogens should not easily become resistant to the drug
- Agent should reach the site of infection (solubility)
Spectrum of activity
Range of different microorganisms treatable
with an agent
- Broad spectrum
Active across a wide range of taxonomic
groups; useful for untargeted treatment without pathogen
identification
Narrow spectrum:
Specifically targets small number of
organisms; may protect host microflora; reduces development
of drug resistance
Five major modes of action of common
antimicrobial agents
- Inhibition of cell wall synthesis
- Disruption of cell membrane function
- Inhibition of protein synthesis
- Inhibition of nucleic acid synthesis
- Action as antimetabolites
1 – Inhibition of Cell Wall Synthesis
Peptidoglycan in Bacterial Cell Wall; not found in mammalian cells
Disruption of Cell Wall integrity cell lysis (osmotic pressure)
* Enzyme interference
* Actively dividing cells
Penicillin inhibits linking of
peptidoglycan rows by binding
to transpeptidase (PBP)
Interfere
with PG
crosslinking:
Targets
PBP
Penicillins: Bactericidal; All contain a β-lactam ring;
Natural penicillins (G, V) are penicillinase sensitive and
narrow spectrum. Semi-synthetic penicillins are modified
to increase penicillinase resistance and broaden spectrum
(e.g.methicillin, ampicillin, amoxicillin)
* Cephalosporins: Effective against more Gram-negatives;
Resistant to Penicillinases; More expensive; Mainly IV/IM
Interfere
with linear
PG strand
formation
Bacitracin: Polypeptide antibiotic; Effective against Gram
positives; Topical application
* Vancomycin: Glycopeptide antibiotics; narrow spectrum;
toxic; Penicillinase-resistant
2 – Disruption of Cell Membrane Function
Alter permeability of bacterial cell membranes; Polypeptide
antibiotics; clinical application limited to certain members due to
similarities between host and bacterial cell membranes
* Polymyxins: (A, B, C, D, E) used only when pathogen is
resistant to other less toxic antibiotics; Gram negatives; Topical
* Nystatin: combine with sterols; therefore effective against
mycoplasmas (and also systemic fungal infections).
* Colicins: Bacteriocin of E.coli; encoded by Col plasmid, which
also codes for immunity protein. Kills bacterial cells not
carrying the plasmid e.g. cells of same species
3 – Inhibition of Protein Synthesis
Takes advantage of differences between bacterial and eukaryotic
ribosomes – selective toxicity
Aminoglycosides: Amino sugars linked by glycoside bonds. Broad
spectrum. Bacteriocidal; bacteriostatic at lower doses. Work
synergistically with other compounds (e.g. penicillin)
Streptomycin (1940s); now has high resistance levels; toxic. Other
compounds (kanamycin, gentamicin etc.)
* Tetracyclines: Interfere with tRNA attachment. Bacteriostatic; very
broad spectrum; can inhibit intestinal microflora
* Chloramphenicol: Bacteriostatic; Broad Spectrum; Inhibits
peptide bond formation. Damages bone marrow
* Macrolides: Erythromycin – Bacteriostatic. Can not penetrate
Gram negative cell walls. Used as an alternative to Penicillin
4 – Inhibition of Nucleic Acid Synthesis
Can be Toxic to host cells due to common targets
Rifampin: Inhibits mRNA synthesis by binding RNA polymerase;
High absorbance into tissues and cells; Bactericidal; Broad
Spectrum; Interacts with other drugs; Treatment of mycobacteria
infections-leprosy and tuberculosis
* Quinolones: Blocks bacterial enzyme that unwinds DNA prior to
replication; Broad spectrum; Used for UTIs; Can affect cartilage
development
5 – Action as Antimetabolites
Compounds that interfere with metabolic reactions by:
1) Competitive inhibition of enzymes or
2) Erroneous incorporation into important molecules
Antimetabolites are structurally similar to normal
metabolites – molecular mimicry