Brief description of Anti bacterial drugs and it's mechanism , side effect, therapeutic effects etc.

1. CHEMOTHERAPY &
ANTI-BACTERIAL DRUGS
SUBMITTED BY-
DEEPMALYA GHOSH
000RDMPFP1920007
IRD,GFSU
SUBMITTED TO-
Mr. JASMIN KUBAVAT
IRD,GFSU

2. WHAT IS CHEMOTHERAPY ?
Chemotherapy = Chemical + Treatment
Chemotherapy refers to the treatment of certain diseases using specific
chemicals that are destructive to malignant cells or to the causative agent of a
disease such as a bacteria or virus.
Various types of chemotherapeutic agents –
Anticancer chemotherapy.
Antimicrobial chemotherapy.
Antifungal chemotherapy
Antiprotozoal chemotherapy
Antiviral chemotherapy
Antibacterial chemotherapy

3. TYPES OF CHEMOTHERAPY-
1. Primary induction Chemotherapy.
2. Neo-Adjuvant Chemotherapy.
3. Adjuvant treatment.
4. Combination Chemotherapy.

4. PRINCIPLE OF CHEMOTHERAPY-
• Combination chemotherapy using conventional cytotoxic agents is more
effective than single agents monotherapy, because-
1. Maximal cells are killed with in the range of toxicity tolerated.
2. Broader range of interaction between drugs and tumour cells.
3. This may prevent or slow the subsequent development of cellular drug
resistance.
• There should be sufficient time interval between termination of primary
induction chemotherapy and onset of progressive disease.
• The induction chemotherapy must be shown sufficient clinical efficacy and
duration.

5. Anti-bacterial agents-
Substances that inhibit the growth of bacterial cell or kill bacteria or other
microorganisms (microscopic organisms = bacteria, viruses, fungi, protozoa).
Mainly two types-
Bacteriostatic = Inhibits growth of bacteria.
Bactericidal = Kills bacteria.
Antibacterial agents may be –
 Chemicals that are produced by microorganism: Such as Penicillin,
Cephalosporin, Tetracycline and Chloramphenicol.
 Synthetic agents: Such as Sulfonamides and Quinolones.

6. Classification of Anti-bacterial agents-
1. INHIBITORS OF CELL WALL SYNTHESIS-
1. BETA lactam antibiotics- Penicillin, Cephalosporin, Carbapenems
2. Glycopeptide antibiotics — Vancomycin, Teicoplanin, Bleomycin
2. INHIBITS OF CELL MEMBRANES-
1. Polypeptides- Polymyxins (In bacteria)
2. Polyenes—Amphotericin B, Nystatin, Hamycin.
3. INHIBITORS OF PROTEIN SYNTHESIS-
1. Aminoglycosides- Gentamycin
2. Tetracyclines- Doxycycline, Tetracycline, Oxytetracycline
3. Macrolides antibiotics- Erythromycin, Azithromycin, Clarithromycin
4. Lincosamide antibiotics- Clindamycin, Lincomycin
5. Broad spectrum antibiotics-Chloramphenicol
4. INHIBITOR OF NUCLEIC ACID SYNTHESIS-
1. Ansamycin/Rifamycin- Rifampicin
2. Quinolines- Nalidixic Acid, Ciprofloxacin, levofloxacin
5. ANTIMETABOLITES & OTHER ANTIBACTERIAL AGENTS-
1. Sulphonamide- Sulfadiazine, Sulfamethoxazole, Sulfadoxine, Sulfasalazine
2. Other antibacterial agents- Isoniazid, Ethambutol, Pyrazinamide.

7. Drugs Used in BACTERIAL INFECTION

8. MECHAISM OF ACTION, CLINICAL USE & SIDE EFFECT

9. INHIBITORS OF CELL WALL SYNTHESIS-
CATEGORY MECHANISM OF ACTION DRUGS SIDE EFFECT CLINICAL
USE
BETA lactam
antibiotics
Act by inhibiting the synthesis of the
peptidoglycan layer of bacterial cell
walls.
This irreversible inhibition of the
penicillin binding protein(PBPs) prevents
the final crosslinking (trans-peptidation)
of the peptidoglycan layer, disrupting cell
wall synthesis.
Penicillin- Penicillin G,
Penicillin V, Amoxicillin
Cephalosporin-
Cefuroxime, Ceftazidime
Carbapenems- Imipenem,
Meropenem, Doripenem,
Faropenem
Hypersensitivity
Reaction,
Diarrhea,
Nephrotoxicity,
Electrolyte
disturbance.
STD, Bronchitis,
Bacterial
Infection,
Urinary tract
infection
Glycopeptide
antibiotics
Inhibit the synthesis of cell walls by
inhibiting cross-linking of peptidoglycan.
They bind to the peptide chain with in the
cell wall and preventing the addition of
new units to the peptidoglycan.
Vancomycin, Teicoplanin,
Bleomycin
Ototoxicity,
Nephrotoxicity,
Dry cough,
Confusion,
Itching,
Headache,
Diarrhea,
Vomiting, Nausea
Staphylococcus
aureus (MRSA)
infections and
Pseudo
membranous
colitis

11. INHIBITS OF CELL MEMBRANES-
CATEGORY MECHANISM OF ACTION DRUGS SIDE EFFECT CLINICAL USE
Polypeptides After binding to lipopolysaccharide (LPS)
in the outer membrane of Gram-negative
bacteria, polymyxins disrupt both the
outer and inner membranes.
Polymyxins,
Colistin
Nephrotoxicity,
Muscle weakness,
Respiratory difficulty
Gram negative
infections,
Pneumonia.
Polyenes Disruption of the fungal cell membrane
by binding to ergosterol. This results in
pore formation and leakage of cellular
cations and anions, leading to fungal cell
death
Amphotericin B,
Nystatin,
Hamycin
Diarrhea,
Abdominal pain,
Tachycardia,
Convulsions,
nausea, vomiting,
Stomach pain,
Diaper rash,
Vaginal yeast
infections.

13. INHIBITORS OF PROTEIN SYNTHESIS-
CATEGORY MECHANISM OF ACTION DRUGS SIDE EFFECT CLINICAL USE
Aminoglycoside Inhibiting bacterial protein synthesis,
by binding bacterial ribosomal
subunit(30s & 50s), inhibiting the
translocation of the peptidyl- tRNA.
Gentamycin
Streptomycin
Ototoxicity,
Nephrotoxicity, Rash,
Blood disorders
Septicaemia,
Pyelonephritis,
Endocarditis,
Pneumonia.
Tetracycline Interferes with bacterial protein
synthesis by competing with tRNA &
inhibiting its binding to the mRNA
codons in the 30s subunit.
Doxycycline,
Tetracycline,
Oxytetracycline
Staining of the teeth,
GIT disturbances,
Hepatotoxicity,
Hypersensitivity
Influenza, Syphilis,
Lyme disease and in
treatment of malaria
Macrolides
antibiotics
Inhibition of bacterial protein
biosynthesis, as well as inhibiting
ribosomal translation.
Erythromycin,
Azithromycin
Clarithromycin
GIT disturbances.
Allergic reactions,
Jaundice
Skin infection,
Syphilis, Diphtheria,
Whooping cough
Lincosamide
antibiotics
Prevent bacterial replication by
interfering with the synthesis of
proteins.
Clindamycin,
Lincomycin
Stomach pain.
Nausea, Vomiting.
Diarrhea, Rash
Bone, joint, skin and
soft tissue infections
Broad spectrum
antibiotics
It prevents protein chain elongation
by inhibiting the peptidyl transferase
activity of the bacterial ribosome.
Chloramphenicol Vomiting
Grey baby syndrome
Topically for bacterial
eye infections

15. INHIBITOR OF NUCLEIC ACID SYNTHESIS-
CATEGORY MECHANISM OF ACTION DRUGS SIDE EFFECT CLINICAL USE
Ansamycin/
Rifamycin
Reduced RNA synthesis by physically
blocking elongation, and thus
preventing synthesis of bacterial
proteins.
Rifampin
Rifampicin
GIT disturbances,
Hepatitis,
Rash,
Sweat & tears,
Influenza
Brucellosis,
Endocarditis,
Serious
staphylococcal
infections
Quinolones/
Fluoroquinolones
Inhibit the replication of bacteria by
interfering with the action of DNA
gyrase during bacterial growth and
development.
Nalidixic Acid,
Ciprofloxacin,
Levofloxacin
Diarrhea,
Nausea,
Vomiting,
Stomach pain,
Headache,
Constipation,
Pale skin,
Vaginal itching
Plague,
Pneumonia,
Sinus infection,
Chronic bronchitis,
Skin infections,
Urinary tract
infections

17. ANTIMETABOLITES & OTHER ANTIBACTERIAL AGENTS-
CATEGORY MECHANISM OF ACTION DRUGS SIDE EFFECT CLINICAL USE
Sulphonamide P – amino benzoic acid (PABA)
which is an essential
precursor in the synthesis of
folic acid, required for the
synthesis of DNA and RNA
in bacteria.
Sulfonamides interfere with folic
acid synthesis by preventing
addition of PABA.
Sulfadiazine,
Sulfamethoxazole,
Sulfadoxine,
Sulfasalazine
Hepatitis,
Hypersensitivity
reactions
Urinary tract
infections,
Bronchitis,
Eye infections,
Pneumonia,
Ear infections,
Severe burns,
Diarrhea,
Other
antibacterial
agents
Disrupts membrane energetics and
inhibits membrane transport
Isoniazid,
Ethambutol,
Pyrazinamide
Joint pains,
GIT disturbances,
Anaemia,
Rash
Tuberculosis (in
combination with
other drugs)