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Questions and Answers
Quae sunt quinque exempla tetracyclinarum?
Quae sunt quinque exempla tetracyclinarum?
Quae sunt duo exempla glycylcyclinarum?
Quae sunt duo exempla glycylcyclinarum?
Quomodo tetracyclinae agunt?
Quomodo tetracyclinae agunt?
Tetracyclinae agunt inhibendo synthesim proteinae in cellulis bacteriae.
Quae sunt duo mechanismi resistentiae quae ad tetracyclinas pertinent?
Quae sunt duo mechanismi resistentiae quae ad tetracyclinas pertinent?
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Quae sunt quattuor viae administrationis pro doxycycline?
Quae sunt quattuor viae administrationis pro doxycycline?
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Cur tetracyclinae non deberent administrari gravidis?
Cur tetracyclinae non deberent administrari gravidis?
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Tetracyclinae cum lacte et antiacidis administrare licet.
Tetracyclinae cum lacte et antiacidis administrare licet.
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Quid sunt probiotica?
Quid sunt probiotica?
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Quae est genus probiotici communissime?
Quae est genus probiotici communissime?
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Quomodo probiotica adiuvant sanitatem?
Quomodo probiotica adiuvant sanitatem?
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Quae sunt tria exempla effectuum probioticorum?
Quae sunt tria exempla effectuum probioticorum?
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Quae sunt quattuor usus therapeutici pro probioticis?
Quae sunt quattuor usus therapeutici pro probioticis?
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Study Notes
Tetracyclines & Glycylcyclines
- Tetracyclines and Glycylcyclines are a group of antibiotics
- Types of Tetracyclines: Doxycycline, Minocycline, Tetracycline, Oxytetracycline, Demeclocycline, Eravacycline, Omadacycline, Sarecycline
- Types of Glycylcyclines: Tigecycline
Mechanism of Action - Bacteriostatic
- Binds with 30S ribosome subunit
- Inhibits protein synthesis
Mechanism of Resistance
- Efflux pump
- Plasmid mediated
- Inactivating enzymes
Antimicrobial Spectrum - Gram-positive Bacteria
- Staphylococcus aureus
- Methicillin-resistant Staphylococcus aureus
- Streptococcus pneumoniae (Pneumococcus)
- Bacillus anthracis
- Erysipelothrix rhusiopathiae
Antimicrobial Spectrum - Gram-negative Bacteria - Aerobes
- Moraxella catarrhalis
- Neisseria gonorrhoeae (Gonococcus)
- Escherichia coli
- Klebsiella pneumoniae
- Acinetobacter
- Haemophilus influenzae
- Haemophilus ducreyi
Antimicrobial Spectrum - Gram-negative Bacteria - Anaerobes
- Brucella
- Yersinia pestis
- Yersinia enterocolitica
- Francisella tularensis
- Vibrio cholerae
- Pasteurella multocida
- Klebsiella granulomatis
- Streptobacillus moniliformis
- Legionella pneumophila
- Burkholderia pseudomallei
- Campylobacter jejuni
Antimicrobial Spectrum - Gram-positive Bacteria - Anaerobes
- Peptostreptococcus anaerobius
- Peptostreptococcus magnus
- Clostridium tetani
- Clostridium perfringens
- Clostridium septicum
- Clostridium novyi
- Clostridium histolyticum
- Propionibacterium acnes
Antimicrobial Spectrum - Gram-negative Bacteria - Anaerobes
- Helicobacter pylori
Antimicrobial Spectrum - Spirochetes
- Leptospira icterohaemorrhagiae
- Treponema pallidum
- Borrelia burgdorferi
- Borrelia recurrentis
Antimicrobial Spectrum - Rickettsiae
- Rickettsia (rickettsi, conorii, akari, typhi)
- Coxiella burnetti
Antimicrobial Spectrum - Actinomycetes
- Nocardia asteroids
- Actinomyces israelli
Antimicrobial Spectrum - Mycobacteria
- Mycobacterium leprae
- Mycobacterium fortuitum, abscessus, chelonae, marinum, ulcerans
Antimicrobial Spectrum - Chlamydiae
- Chlamydia trachomatis, psittaci, pneumoniae
Antimicrobial Spectrum - Parasite - Protozoa
- Plasmodium falciparum
- Entamoeba histolytica
- Dientamoeba fragilis
- Balantidium coli
Antimicrobial Spectrum - Parasite - Filarial Worm-Nematode
- Wuchereria bancrofti
Route of Administration
- Doxycycline: Oral, Intravenous/Infusion, Topical-subgingival gel
- Minocycline: Oral, Intravenous/Infusion, Topical-subgingival gel, microspheres, Intrapleural
- Tetracycline: Oral, Intravenous/Infusion, Topical-subgingival fibres, eye/ear-ointment, drops, Intrapleural
- Demeclocycline: Oral
- Oxytetracycline: Oral, Intravenous/Infusion, Topical-eye/ear ointment, drops
- Tigecycline: Intravenous infusion
Therapeutic Uses - Chronic Periodontitis
- Subgingival gel and microspheres are inserted into periodontal pockets during scaling and root planning.
- Doxycycline - Subantimicrobial, low dose 20mg twice daily; Minocycline
Therapeutic Uses - Bacterial Infections
- Cholera, Brucellosis, plague, Leptospirosis, Tularemia, Bartonellosis
- Non gonococcal urethritis, cervicitis, epididymitis, Gonorrhea, MRSA, Acne
- SDD- 40mg twice daily
Therapeutic Uses - Peptic Ulcer Disease due to H.pylori
- Tetracycline
Therapeutic Uses - Sexually Transmitted Infections
- Lymphogranuloma venereum, nonspecific urethritis, cervicitis, epididymitis
- Pelvic inflammatory disease, Inclusion conjunctivitis, trachoma, Pneumonia, Psittacosis
Therapeutic Uses - Mycobacterium Infections
- Leprosy - Minocycline
- Nontuberculous or atypical Mycobacterium marinum & fortuitum infections
- Doxycycline; Minocycline
Therapeutic Uses - Rickettsial Infections
- Rocky mountain spotted fever, murine typhus, Q fever, rickettsialpox, african tick bite fever.
Therapeutic Uses - Protozoal Infections
- Chloroquine resistant falciparum malaria - Doxycycline, Tetracycline
- Balantidiasis - Tetracycline
- Adjunct to amoebicide in severe amoebic dysentery due to Entamoeba histolytica and in Dientamoeba fragilis infections - Tetracycline
Therapeutic Uses - Filarial Worm Infection
- Lymphatic filariasis - Doxycycline
Therapeutic Uses - Non Antimicrobial Uses
- EROSING agent, given intrapleurally to control pleural effusion in metastatic tumours - Minocycline; Tetracycline
- Treatment of chronic hyponatremia associated with the syndrome of inappropriate antidiuretic hormone secretion (SIAD)- Demeclocycline
Prophylactic Uses
- Tuberculosis (TB) - Doxycycline + Rifampin; Plague - Doxycycline / Tetracycline + Aminoglycoside; Weil's disease - Doxycycline, Tetracycline; Chloroquine resistant falciparum malaria - Doxycycline
Tigecycline Therapeutic Uses
- Complicated skin and intra abdominal infections caused by Staphylococcus aureus and MRSA
- Legionella, Klebsiella & Acinetobacter infections
- Anaerobic infections caused by Bacterioides, Peptostreptococcus, Propionic bacterium & Fusobacterium species
Adverse Drug Reactions
- Bone marrow depression
- Dose related- reversible decreased iron utilisation, reticulocytosis, anaemia, leucopenia, thrombocytopenia
- Unrelated form- irreversible- severe aplastic anaemia, bleeding
Suprainfection
- Grey baby syndrome: Fatal toxic effect of chloramphenicol in neonates, liver's inability to glucuronidate the drug
Hypersensitivity Reactions
- Nausea, vomiting, diarrhoea, glossitis, stomatitis
Therapeutic Uses - Other Indications
- Enteric fever
- Bacterial meningitis
- Severe anaerobic infections
- Typhus & spotted fever
- Eye & ear infections (Anthrax, Severe gastroenteritis, Gas gangrene, Granuloma, Inguinale, Listeriosis, Plague, Psittacosis, Tularemia)
Drug & Food Interactions
- Chelating property with dairy products & Al+++, Mg++, Ca++, Fe++ & bivalent, trivalent ions
- Food inhibits absorption of all TC except Doxycycline & Minocyclines
- Anacids, iron preparations, milk and dairy products should not be coadministered with tetracyclines
Chloramphenicol
- Bacteriostatic
- Mechanism of Action: Inhibits protein synthesis by binding with 50S ribosome
- Spectrum: Gram positive and gram negative bacteria
Mechanism of Resistance - Chloramphenicol
- Oral; intravenous, Topical - eye solution, ointment, ear drops
Other adverse drug reactions
- Intracranial hypertension in infants
- Jarisch - Herxheimer reaction in relapsing fever treated with tetracyclines
- Nephrotoxicity - caused by outdated and degraded tetracyclines; symptoms include polyuria, polydipsia, proteinuria, acidosis, glycosuria & aminoaciduria
Hepatotoxicity
- Increased liver enzymes and fatty liver changes
- Occurs esp. during pregnancy and hepatic insufficiency
Gastrointestinal (GIT) Effects
- Nausea
- Vomiting
- Irritant diarrhea
- Epigastric burning
- Oesophagitis
- Pancreatitis
- Oesophageal ulcers
- Odynophagia
Vestibular Toxicity
- Dizziness
- Vertigo
- Ataxia
- Nausea
- Vomiting
- Primarily with Minocycline & Doxycycline
Phototoxicity
- Patients should avoid direct exposure to sunlight or UV light
Diabetes Insipidus
- Demeclocycline inhibits vasopressin action
- Causes reversible nephrogenic diabetes insipidus
- Symptoms include polyuria, polydipsia, and weakness
Other Tetracycline-related adverse effects
- Tooth discoloration
- Enamel hypoplasia
- Pigmentation
Dental Discoloration
- Deciduous anterior teeth affected by tetracyclines are discoloured yellow or brownish grey, which is pronounced at the time of eruption and becomes more brownish after exposure to light
- Enamel hypoplasia and caries may occur
- Permanent teeth discoloration and pigmentation may happen from 2 months to 5 years of age
Other Effects
- Bone growth interference
- Nail discoloration and onycholysis
- Suprainfections (oral candidiasis, vulvovaginitis and pruritus ani, diarrhea(Pseudomonas, Proteus), pseudomembranous enterocolitis due to clostridium difficile)
Probiotics
- Lactobacillus Species: L.acidophilus, L.sporogens, L.rhamnosus, L.salivarius, L.plantarum, L.brevis, L.fermentum,L.helveticus, L.delbruecki, L.casei
- Bifidobacterium Species: B.longum, B.bifidum, B.infantis, B.breve, B.adolescentis
- Saccharomyces boulardii
- Streptococcus thermophilus
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Quiz de tetracyclines et glycylcyclines, cibler des antibiotiques spécifiques. Explorez leur mécanisme d'action, leur spectre antimicrobien et leurs mécanismes de résistance. Testez vos connaissances sur ces importantes classes d'antibiotiques.
