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Agonist
  Drugs used in Inflammation                                                                                                                             Antagonist
                                                                                                                                                            Enzyme




   Adelimumab                                                                                     lipocortin-1      PLA2
    Infliximab
                               IL-2                                               Aspirin
                                                                                                                 arachidonic acid
         TNF-a, IL-1, ...                                                        Celecoxib
                                                                                                                                               LOX
                                                                                 Ibuprofen COX
                 IL-1R                                                          Paracetamol                                Zileuton
               antagonist
                                                                                                                                  5       12    15
                                                                                   PGD-F      TXA         PGI                    5-HPETE 12-HETE lipoxins
          Cromoloyn sodium/
         Sodium cromoglycate
                                                           Rapamycin
              Anakinra
                                                            Sirolimus                                                             LTA-E
                            IL-1 R                             mTOR      growth, proliferation
   Zafirlukast

                   LT R                                                                           Cyclosporin,
                                                                                                  Tacrolimus
                                                                                     Ca2+         calcineurin
 Alem-
tuzumab
           CD52




                                                                                                  Hsp90
                                                                        Corticosteroids   GCR-a
   Y




Omali-
zumab            IgE


          MHCII
                                            Theophylline
                                           phosphodiesterase

            b2-adreno R               Gs        cAmp
 Salbutamol

                                           Gq       Ca2+         contraction                                                                   DNA precursors
                            mACh R                                                                                                    Methotrexate, Azathiprine,
          Ipratropium                                                                                                                  Mycophenolate Sodium
Antibiotics
                                                      membrane
  b-lactams                                   ionophores
glycopeptides
           wall




                                                                             fluoroquinolones
                                                                                rifampicin
                                          ribosome                        DNA related
                    tetracyclins                                           enzymes
                  aminoglycosides
                     macrolides
                     fusidic acid
                  chloramphenicol

                                                           daunomycin
                                                            bleomycin
                                                            aziridines:
                                                           mitomycin C     DNA

                          sulfa drugs/
                         sulfonamides    DNA precursors
                         trimethoprim
antibiotics that inhibit cell wall synthesis
 b-lactams: penicillins, carbapenems, cephalosporins, monobactams
 glycopeptides: vancomycin
• Fosfomycin                                     - inhibits pyruvyl transferase
• D-cycloserine                                  - inhibits L-Ala racemase, DADA synthase and ligase
• Bacitracin                                     - inhibits bactoprenol
• Penicillin, Amp, Amox, Meth                    - inhibits peptidoglycan transpeptidase
• Vancomycin                                     - complexes D-Ala peptide side-chains
• Clavulanate                                    - inhibits b-lactamase
• Augmentin                                      - mix of amoxicillin and clavulanate
• Isoniazid                                      - inhibits mycolic acid synthesis




antibiotics that inhibit protein synthesis
tetracyclines: tetracycline, spectinomycin
aminoglycosides: streptomycin, gentamycin
macrolides: erythromycin
amphenicols: chloramphenicol

• tetracycline, tetracycline                        - binds 30S, blocks rotation of tRNA in A-site
• spectinomycin, tetracycline                       - binds 30S and inhibits EF-G during translocation
• streptomycin, aminoglycoside                      - binds 30S near A-site, decreases fidelity
• gentamycin, aminoglycoside                        - binds 30S near A-site, decreases fideliy
• erythromycin, macrolide                           - binds 50S exit tunnel
• chloramphenicol, amphenicol                       - binds 50S blocks translocation
• fusidic acid                                      - inhibits EF-G
antibiotics that inhibit DNA replication and transcription
Binding to DNA-related enzymes
Fluoroquinolones: Ciprofloxacin
Rifampicin
• ciprofloxacin               - fluoroquinolone, bactTPII inhibitor, broad spectrum
• rifampicin                 - DNA-dep RNA polymerase, blocks RNA exit tunnel, mycobacteria
Binding to DNA itself:
Anthracycline: Daunomycin
Chelators: Bleomycin
Aziridines: Mitomycin C

• daunomycin                - anthracycline, chelates and blocks hTPII
• bleomycin                 - glycopeptide, chelates to cause ds and ss breaks, toxic
• mitomycin C               - aziridine, alkylates at G-c, used in chemotherapy

antibiotics that inhibit precursor formation
 Sulfa-drugs
 Trimethoprim
• sulfamethoxazole          - inhibits dihydropteroate synthase
• trimethoprim              - inhibits dihydrofolate reductase
• co-trimoxazole

antibiotics that inhibit membrane formation (in bacteria)
 ionophores
• valinomycin               - ring-shaped K+ uniporter
• gramicidin A              - polypeptide dimer
• polymixin                 - micelles
Anti-protozoal drugs
                                                    membrane
                                           amphotericin B
                                            miconazole


                                                                  heme
                                                               degradation
                                                                 chloroquine

                                           ribosome
                            tetracycline




   ATP synthesis
   arsenicals: melarsen
         suramin




                            sulfadoxin DNA   precursors
                          pyrimethamine
                              fansidar

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Drugs used in Inflammation and their Mechanisms of Action

  • 1. Agonist Drugs used in Inflammation Antagonist Enzyme Adelimumab lipocortin-1 PLA2 Infliximab IL-2 Aspirin arachidonic acid TNF-a, IL-1, ... Celecoxib LOX Ibuprofen COX IL-1R Paracetamol Zileuton antagonist 5 12 15 PGD-F TXA PGI 5-HPETE 12-HETE lipoxins Cromoloyn sodium/ Sodium cromoglycate Rapamycin Anakinra Sirolimus LTA-E IL-1 R mTOR growth, proliferation Zafirlukast LT R Cyclosporin, Tacrolimus Ca2+ calcineurin Alem- tuzumab CD52 Hsp90 Corticosteroids GCR-a Y Omali- zumab IgE MHCII Theophylline phosphodiesterase b2-adreno R Gs cAmp Salbutamol Gq Ca2+ contraction DNA precursors mACh R Methotrexate, Azathiprine, Ipratropium Mycophenolate Sodium
  • 2. Antibiotics membrane b-lactams ionophores glycopeptides wall fluoroquinolones rifampicin ribosome DNA related tetracyclins enzymes aminoglycosides macrolides fusidic acid chloramphenicol daunomycin bleomycin aziridines: mitomycin C DNA sulfa drugs/ sulfonamides DNA precursors trimethoprim
  • 3. antibiotics that inhibit cell wall synthesis b-lactams: penicillins, carbapenems, cephalosporins, monobactams glycopeptides: vancomycin • Fosfomycin - inhibits pyruvyl transferase • D-cycloserine - inhibits L-Ala racemase, DADA synthase and ligase • Bacitracin - inhibits bactoprenol • Penicillin, Amp, Amox, Meth - inhibits peptidoglycan transpeptidase • Vancomycin - complexes D-Ala peptide side-chains • Clavulanate - inhibits b-lactamase • Augmentin - mix of amoxicillin and clavulanate • Isoniazid - inhibits mycolic acid synthesis antibiotics that inhibit protein synthesis tetracyclines: tetracycline, spectinomycin aminoglycosides: streptomycin, gentamycin macrolides: erythromycin amphenicols: chloramphenicol • tetracycline, tetracycline - binds 30S, blocks rotation of tRNA in A-site • spectinomycin, tetracycline - binds 30S and inhibits EF-G during translocation • streptomycin, aminoglycoside - binds 30S near A-site, decreases fidelity • gentamycin, aminoglycoside - binds 30S near A-site, decreases fideliy • erythromycin, macrolide - binds 50S exit tunnel • chloramphenicol, amphenicol - binds 50S blocks translocation • fusidic acid - inhibits EF-G
  • 4. antibiotics that inhibit DNA replication and transcription Binding to DNA-related enzymes Fluoroquinolones: Ciprofloxacin Rifampicin • ciprofloxacin - fluoroquinolone, bactTPII inhibitor, broad spectrum • rifampicin - DNA-dep RNA polymerase, blocks RNA exit tunnel, mycobacteria Binding to DNA itself: Anthracycline: Daunomycin Chelators: Bleomycin Aziridines: Mitomycin C • daunomycin - anthracycline, chelates and blocks hTPII • bleomycin - glycopeptide, chelates to cause ds and ss breaks, toxic • mitomycin C - aziridine, alkylates at G-c, used in chemotherapy antibiotics that inhibit precursor formation Sulfa-drugs Trimethoprim • sulfamethoxazole - inhibits dihydropteroate synthase • trimethoprim - inhibits dihydrofolate reductase • co-trimoxazole antibiotics that inhibit membrane formation (in bacteria) ionophores • valinomycin - ring-shaped K+ uniporter • gramicidin A - polypeptide dimer • polymixin - micelles
  • 5. Anti-protozoal drugs membrane amphotericin B miconazole heme degradation chloroquine ribosome tetracycline ATP synthesis arsenicals: melarsen suramin sulfadoxin DNA precursors pyrimethamine fansidar