18. TREATMENT OF ACUTE INFLAMMATION. BASIC PRINCIPLES OF MEDICATION. ANTIBIOTICS

what are antibiotics?

antimicrobials used to treat bacterial infection. they either kill bacteria (bactericidal) or stop the growth of bacteria (bacteriostatic )

what are the 4 main mechanisms of antibiotics?

1. inhibit or regulate enzymes involved in cell wall synthesis

2. inhibit or regulate nucleic acid metabolism or repair

3. inhibit or regulate protein synthesis

4. disrupt membrane structures

what are beta lactams?

beta lactam ring containing broad spectrum antibiotics

what is the classification of beta lactams?

1. penicillin derivatives

2. cephalosporins

3. carbapenems (broad spectrum)

4. monobactams (narrow spectrum)

peniciilin derivative can be subdivided into what

narrow spectrum - penicilin G oxacilin

broad spectrum - amoxiciilin

pencillin with beta lactamase inhibitor - augmentin

penicilin G vs oxacillin

penicilin G is beta lactamase sensiitve

oxacillin beta lactamase resistant

what is augmentin?

amoxicillin + clavulanic acid

what are aminioglycans?

antibiotics which inhibit protein synthesis

they pass through the cell wall into the cytoplasm and bind to the 30s ribosomal unit

which bacteria do aminoglycans work against?

gram - aerobes

give examples of aminoglycans

gentamycin

kanamycin

what are tetracyclines?

broad spectrum, bacteriostatic antibiotics

effective against gram + and - bacteria

give examples of tetracyclines

tetracycline 0.25 caps 4x1/24h

doxycycline 0.1 caps

what are macrolides?

bacteriostatic broad spectrum antibiotics

their activity is enhanced at an alkaline pH

give examples of macrolides

erythromycin 250-500mg every 6-8h

what is metranidazole?

an antibiotic which is effective in serious anaerobic infections

give examples of metronidazole?

trichomonacid 250mg, 3x1-2 tablets per day

what is the principle for combining antibiotics?

single antibiotics is the preferred method- it should justified when we combine antibiotics

what are the indications for combining antibiotics?

prevent resistant organisms

polymicrobial infections

initial therapy

decreased toxicity

synergism

what are the possible effects of combining antibiotics?

1. indifferent effect- the activity of 2 drugs are unchanged

2. synergistic effect- the activity of 2 drugs is enhanced

3. antagonist effect- the activity of 2 drugs is less