PROTEIN SYNTHESIS

INHIBITORS

Dr. SYED SHEHNAZ ILYAS,

M.B.B.S,M.D.
TETRACYCLINES
 Broad spectrum” antibiotics
 Both gram +ve & gram –ve
 Bacterostatic
 Inhibit Bacterial protein
synthesis
GROUP I
 Tetracycline

GROUP II
 Demeclocycline

GROUP III
 Doxycycline
 Minocycline
 TETRACYCLINES :USES

 Mixed infections
DRUG OF CHOICE IN
 Plague,

 Cholera: Vibrio cholerae

 Atypical pneumoniae: Mycoplasma

pneumoniae,
 Gastric & duodenal ulcer :
Helicobacter pylori (tetracycline)
 Skin inf. & Acne
TETRACYCLINES:
PHARMACOKINETICS
 Absorption occurs in
small intestine & is
impaired by:
 Food
 By dairy products,

 Antacids & alkaline pH.

 TETRACYCLINES:
ADVERSE EFFECTS
 GIT :Nausea, vomiting and diarrhea.
 BONE AND TEETH : chelating
property: bound to calcium in young
children in newly formed:
 Bone : deformity, growth retardation
 Teeth: discoloration and enamel
dysplasia.
 TERATOGENICITY: Deposited in the
fetal teeth & bones. Similar changes
as above
TETRACYCLINES:
ADVERSE EFFECTS
 LIVER and KIDNEY DAMAGE
 Fanconi syndrome : kidney damage
due to out dated tetracyclines
 SUPERINFECTIONS: Modify
normal flora
 PHOTOSENSITIZATION
 Demeclocycline ,Doxycycline
 ↑ Sensitivity to sunlight or
U.V.rays
CHLORAMPHENICOL
 Potent Inhibitor of microbial
protein synthesis.
 Bacterostatic

 Broad spectrum antibiotic

 Effective against both aerobic

and anaerobic gram +ve &
gram -ve organisms.
 CHLORAMPHENICOL:
CLINICAL USES
 Not used ∵
 Potential bone marrow toxicity,
 Bacterial resistance

 Better antimicrobials

 ENTERIC FEVER (Typhoid):14 days

 EYE INFECTIONS :Topically
 CHLORAMPHENICOL:
ADVERSE EFFECTS
 BONE MARROW TOXICITY:
 Dose related reversible anemia
 Idiosyncratic :aplastic anemia: fatal

 GIT :Nausea, vomiting and diarrhea

 SUPER-INFECTION: Oral or vaginal
candidiasis
 GRAY BABY SYNDROME:NEW BORN ADR
 Newborns lack glucuronic acid
 Drug accumulates in newborn

 Vomiting, flaccidity, hypothermia, gray

color, shock and collapse.
MANAGEMENT OF
ENTERIC (TYPHOID) FEVER
 QUINOLONES: Ciprofloxacin:
 THIRD GENERATION
CEPHALOSPORINES :Ceftriaxone
Cefoperazone
 CHLORAMPHENICOL: ↑
Resistance & toxicity
 COTRIMOXAZOLE : ↑resistance

 AMPICILLIN ↑resistance,
prolong carrier state