Protein Synthesis Inhibitors

Isoniazid

• ANTI TB

• Inhibits MYCOLIC ACID SYNTHESIS

• Major side effect: Peripheral neuropathy

Rifampicin

• ANTI TB

• BLOCKING RNA SYNTHESIS

• Major side effect: ORANGE RED DISCOLORATION

Pyrazinamide

• ANTI TB

• Disrupts mycobacterial membrane METABOLISM AND TRANSPORT

• Major side effect: Uric acid

Ethambutol

• ANTI TB

• Inhibits ARABINOSYL TRANSFERASE

• Major side effect: OPTIC NEURITIS

Nalidixic Acid

• QUINOLONES / nucleic acid inhibitors

• 1st gen

• Gram negative UTI

Oflaxacin

• NUCLEIC ACID INHIBITORS

• 2nd gen

• Gram negative, Pseudomonas

Levofloxacin

• NUCLEIC ACID INHIBITORS

• 3rd gen

• Respiratory pathogens (strep. pneumoniae)

Moxifloxacin

• NUCLEIC ACID INHIBITORS

• 4th gen

• Gram positive + anaerobes

Aminoglycosides

• Irreversibly bind to 30s → cause misreading of mRNA and blox initiation complex

• Major side efffect: Ototoxicity, nephrotoxicity, Neuromascular blockade

• Streptomycin, gentamicin, etc.

Tetracyclines

• Reversibly bind to 30s → prevent attachment of tRNA to the ribosomes

• Major side effects: Teeth discoloration, photosensitivity, GI upset, Hepatotoxicity

• Tetracycline, doxycycline, minocycline

Macrolides

• Bind to 50s → inhibit translocation of the peptide chain

• Major side effect: GI upset, cholestatic hepatitis, QT prolongation

• Erythromycin, clarithromycin, azithromycin

Choramphenicol

• Inhibits peptidyl transferase (peptide bond formation)

• Major side effect: Aplastic anemia, Gray baby syndrome

• Chloramphenicol

Clindamycin

• Binds to 50s → inhibits translocation

• Major side effect: Pseudomembranous colitis

• Clindamycin

Streptogramins

• Bind to 50s → inhibit protein elongation

• Major side effect: Arthralgia, myalgia

• Quinupristin, Dalfopristin

Oxazolidinones

• Bind to 50s → inhibit initiation complex formation

• Major side effect: Bone marrow suppression, peripheral neuropathy, serotonin syndrome

• Linezolid, Tedizolid

Polymyxins

• DISRUPT CELL MEMBRANE INTEGRITY

• Gram negative

• Bind LPS → disrupt membrane

• Nephrotoxicity

Daptomycin

• DISRUPT CELL MEMBRANE INTEGRITY

• Gram positive

• Forms pores → depolarization

• Myopathy

Sulfonamides

• METABOLIC PATHWAY INHIBITORS

• PABA → dihydropteroate synthase

• Prevent formation of dihydrofolic acid

• Bacteriostatic

Timethoprim

• METABOLIC PATHWAY INHIBITORS

• Dihydrofolate reductase → prevents formation of tetrahydrofolic acid

• Blocks later step in folate pathway

• Bacteriostatic