Antibiotics of a wide spectrum,

Antibiotics of a wide spectrum,

antituberculous agents

1. Determine the group of the drugs:

chloramphenicol, amikacin, tetracycline, gentamicin, clindamycin, vancomycin, polymyxin M, doxycycline, tobramycin, sisomycin.

Tetracyclines (2); gr. levomycetin (1); aminoglycosides (4); glycopeptides (1); lincosamides (1); polymyxins (1).

2. To determine doxycycline, gentamicin and chloramphenicol according to the mechanism and type of action:

Group	Type of action	Mechanism of action
А	Bactericidal	Inhibition of protein synthesis due to action on the 30S subunit of ribosomes; Violation of the permeability of the cytoplasmic membrane.
B	Bacteriostatic	Inhibition of protein synthesis due to action on the 30S subunit of ribosomes
С	Bacteriostatic	Violation of protein synthesis due to action on the 50S subunit of the ribosomes.

3. Indicate on which pathogens tetracyclines: a) act; b) do not work.

Cocci, clostridia, pathogens of especially dangerous infections (cholera, plague, tularemia, brucellosis, anthrax), proteus, Pseudomonas aeruginosa, mycobacterium tuberculosis, chlamydia, fungi, viruses, intestinal infections.

4. Identify tetracycline and doxycycline:

Drug	Absorbtion	Connection with proteins of plasma	Elimination		Frequency of use
Drug	Absorbtion	Connection with proteins of plasma	With urine	With bile	Frequency of use
А	60-70%	33-45%	50%	50%	4-6 times a day
В	100%	90%	10%	90%	1 time a day

5. Complete the statements:

Tetracyclines are used for bile duct infection, because ...

Doxycycline is not used to treat meningitis, because

The use of broad-spectrum antibiotics is accompanied by the development of dysbiosis, because ....

6. Case problem

Patient A. Tetracycline was prescribed for the treatment of urethritis, caused by chlamydia. The patient took it 2 times a day with milk. Explain the reasons for the low effectiveness of the drug.

7. Determine the drugs (tetracycline, chloramphenicol, amikacin) according to pharmacokinetic parameters:

Parameter	А	B	С
Absorption from the digestive tract	Not absorbed	Good	Very good
Penetration in the central nervous system	Does not pass	Bad	Very good
Penetration into the focus of infection	Slow and incomplete	Good	Fast and good
Excretion	Primarily unchanged by kidneys	By kidneys and bile	Primarilyby kidneys in the form of inactive metabolites

8. Classify aminoglycosides (kanamycin, sisomycin, neomycin, amikacin, streptomycin, gentamicin, tobramycin) for generations:

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