Antiarrhythmic drugs do not improve the survival of patients with nonlifethreatening arrhythmias and may increase mortality, particularly in patients with structural heart disease. Introduction the macrolides are a group of closely related compounds characterized by a macrocyclic lactone ring usually containing 14 or 16 atoms to which deoxysugars are attached. Mechanisms of resistance to macrolides and lincosamides. Ketolides telithromycin are derivatives of erythromycin a specifically designed for activity against bacteria responsible for communityacquired respiratory tract infections. In addition, most clinically relevant ketolides also contain extended alkylaryl side chain appendages as well as an 11, 12carbamate cycle. A new class of antibacterial agents for treatment of. These drugs are classified based on their electrophysiological effect on the myocardium. Ketolides exhibit increased binding to the ribosome compared to macrolides of previous generations 16,17.
Ketolides telithromycin streptogramins dalfopristin and quinupristin lincosamides clindamycin, lincomycin phenocols chloramphenicol inhibitor of bacterial 23s r rna of 50s subunit in protein synthesis oxazoladinones linezolid protein synthesis trna. This is designed with preference for students of medicinal chemistry. The 3keto group is responsible for the lack of induction of macrolide resistance, high stability in acidic environments, and the ability. Save powerpoint presentations as pdf files office support. They are obtained by removing the 3lcladinose sugar moiety from erythronolide a and oxidation of the resulting 3hydroxyl.
Ketolides are a class of semisynthetic agents derived from erythromycin a that have increased acid stability and increased antibacterial potency against many bacteria resistant to macrolides. Antiarrhythmic drugs knowledge for medical students and. The attending physician suspects mycoplasma pneumonia and wishes to treat the patient with erythromycin. Mandell, douglas, and bennetts principles and practice of infectious diseases eighth edition, 2015. B family, and telithromycin is the first commercially available ketolide. Alcl3 outline three different syntheses for benzaldehyde outline three different syntheses for benzophenone outline a different synthesis for each of the following compounds. New classification and update on the quinolone antibiotics. Macrolides inhibit protein synthesis in bacteria by reversibly binding to the p site of the 50s unit of the ribosome.
Ketolide antibiotics prices and information goodrx. When you save presentation as a pdf file it freezes the formatting and layout. Ketolide antibiotics telithromycin is a ketolide antibiotic. Erythromycin inhibits the cytochrome p450 cyp 3a4 isoenzyme system via mechanism based inhibition. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Introduction to antimicrobial therapy christine kubin, pharm.
People can view the slides even if they dont have powerpoint, but they cant make changes to it. Newer antibiotics and their uses sujit kumar shrestha resident,pediatrics department of child health, tuth 2. Ketolides exhibit increased binding to the ribosome. Oxazolidinones inhibit formation of the 70s initiation complex and ketolides block the protein elongation step by inhibiting peptidyl transferase. The ketolides, of which telithromycin hmr 3647 is the first to undergo clinical development, represent a new family of antimicrobials that are derived chemically from the macrolides and have been developed for use against respiratory pathogens. The ketolides, of which telithromycin is the first to reach clinical development, represent a new generation of antimicrobials that have been developed with a view to overcoming the problem of macrolide resistance.
Ppt cephalosporins powerpoint presentation free to. At least onethird of all patients with epilepsy fail to respond adequately to aeds, and in addition to lack of seizure reduction and control, side effects from medication can contribute towards a poor. Ketolides are antibiotics belonging to the macrolide group. Bono, mda,b erythromycin, the first macrolide antibiotic discovered, has been used since the early 1950s for the treatment of upper respiratory tract and skin and soft tissue infections. They are bacteriostatic at low concentrations and bactericidal at high concentration, so basically exhibit concentration dependent killing. Chapter 19 drug therapy with macrolides ketolides and. Ketolides lack the cladinose sugar, which is replaced with a 3ketone group. Introduction the need for novel antibacterials increasing resistance to the older ones.
An introductory guide for the practical implementation a. Antibioticsantibacterial drug use, their marketing and. It is used to treat certain kinds of bacterial infections. Aldehydes and ketones aldehyde 1o alcohol arch3 acid chloride cro3 h2o aco2o lialhotbu3 k2cr2o7, special cond. Purnima kumar, in pharmacology and therapeutics for dentistry seventh edition, 2017.
Antibiotics simplified, fourth edition is an independent publication and has not been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in. Ketolides are a new generation of macrolide antibiotics designed to overcome issues with bacterial resistance to macrolides. To date, no cross resistance of linezolide with other antibiotic families used for the treatment of grampositive bacteria has been observed. Azithromycin, clarithromycin, telithromycin, tigecycline jerrym. These statements are just predictions and are subject to risks and uncertainties that could cause. These modifications give ketolides much broader spectrum than other macrolides. They are used to treat respiratory tract infections caused by macrolideresistant bacteria. Choose from 147 different sets of ketolides flashcards on quizlet. They are semisynthetic antibiotics derived from erythromycin macrolide antibiotic and the changes give ketolides a broader spectrum of activity. In contrast to expectations, the recently solved structure of a complex of a ketolide, abt773, with the d.
The main structural component of the macrolides is a large. However, the global increase in macrolide resistance among respiratory pathogens, particularly streptococcus pneumoniae, threatens their future usefulness. Tanpa watermark hanya mengkonversi pdf ke ppt dalam hitungan detik. Telithromycin the first and only approved ketolide. Structural basis for the antibiotic activity of ketolides. Ketolides are derived from erythromycin by substituting the cladinose sugar with a ketogroup and attaching a cyclic carbamate group in the lactone ring. No file size restrictions, no ad watermarks just a free online tool for creating pdfs from your ppt slides. Ketolidestelithromycin, an example of a new class of antibacterial. Newer 14, 15 and 16membered ring macrolides such as clarithromycin and the azalide, azithromycin, have been developed to address the limitations of erythromycin. This medicine will not work for colds, flu, or other viral infections. Telithromycin was the first ketolide to be approved by the food and drug administration fda in 2004 for communityacquired pneumonia, acute exacerbations of chronic bronchitis and sinusitis. Chloramphenicol chloromycetin should never be given to neonates because of their immature liver and the risk of gray syndrome.
Scribd is the worlds largest social reading and publishing site. Introduction, history, and recent developments enol k f kr keto 1. Telithromycin is a 14membered macrolide with a 3keto group substitution. They were designed to overcome erythromycin a resistance within grampositive cocci. Fzx, a 41 year old white female, is seen in the outpatient department for complaints of low grade fever, cough, and mild respiratory distress. Ketolides are a class of antibiotics that are structurally related to the macrolides. Since their discovery, the macrolide antimicrobials have proved clinically valuable for the treatment of respiratory tract infections, offering coverage against a broad spectrum of pathogens and excellent tolerability.
They bind to a secondary region on domain ii of the 23s rrna subunit. Ketolides are the most recently introduced generation of macrolides. Analysis of the crystal structures of the large ribosomal subunit from deinococcus radiodurans complexed with azithromycin or abt773 indicates that, despite differences in the. Konversi pdf anda ke presentasi powerpoint gratis dan mudah digunakan. The azalide azithromycin and the ketolide abt773, which were derived by chemical modifications of erythromycin, exhibit elevated activity against a number of penicillin and macrolideresistant pathogenic bacteria. The macrolides, azalides, and ketolides represent an important class of drugs that are used for their antimicrobial and nonantimicrobial properties. This presentation contains forwardlooking statements regarding future events. Ketolides presumably maintain their antimicrobial activity by virtue of their ability to bind to an alternative sitedomain ii of the 23s rrna. Ketolides acquire activity against mlsbresistant pathogens via a featured. Current topics in medicinal chemistry 949961 9 4 9. Structureactivity relationships and mechanism of action of.
Prevalence of phenotypic resistance of staphylococcus aureus isolates to macrolide, lincosamide, streptogramin b, ketolid and linezolid antibiotics in turkey. They represent a potential therapeutic option for asthma, a chronic inflammatory disorder characterised by airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Ketolides bind to the bacterial 50s ribosomal subunit and inhibit rna.
The original quinolone antibiotics included nalidixic acid neggram, cinoxacin cinobac and oxolinic acid no longer available in the united states. Ketolidestelithromycin, an example of a new class of. This presentation is about the chemical aspects and sar of tetracyclins, macrolides and chloramphenicol. Ketolides definition of ketolides by medical dictionary. In the publish as pdf or xps dialog box, choose a location to save the file to. The first macrolide, erythromycin a, demonstrated broadspectrum antimicrobial activity and was used primarily for respiratory and skin and soft tissue infections. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Ketolides drug resistance in community acquired respiratory tract. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Ketolides have a mechanism of action very similar to erythromycin a from which they have been derived. Ch 12 chemotherapy overview antibacterialanbiocs daptomycin metronidazole sulfones, metronidazole oxazolidinones ketolides mechanisms of drug action on eukaryotic pathogens a.
The attending physician suspects mycoplasma pneumonia and wishes to treat the patient with. Ketolides will be a new addition to the antibacterial armamentarium for the treatment of respiratory tract infections as well as other infections for which new agents are needed. Make ppt and pptx slideshows easy to view by converting them to pdf. Ketolides bind to the bacterial 50s ribosomal subunit and inhibit rnadependent protein synthesis. Mechanisms of resistance active efflux accounts for 80% mef gene encodes for an efflux pump which pumps the macrolide out of the cell away from the ribosome. Macrolides, such as clarithromycin and azithromycin, possess antimicrobial, immunomodulatory, and potential antiviral properties. Antimicrobial agent classes and subclasses page 5 of 5 hardy diagnostics 1430 west mccoy lane, santa maria, ca 93455, usa phone. Introduction to antimicrobial therapy columbia university.
Moreover, ketolides are effective against macrolideresistant bacteria, due to their ability to bind. The data on these antimicro bials that are in development will not. Antiarrhythmic drugs are used to prevent recurrent arrhythmias and restore sinus rhythm in patients with cardiac arrhythmias. They potently inhibit protein synthesis by interacting close to the peptidyl transferase site.
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