This document discusses various types of antibiotics and antimicrobial agents. It categorizes them based on their chemical structure, mechanism of action, spectrum of activity, and organisms they target. Some common antibiotics discussed include penicillin, cephalosporins, sulfonamides, tetracyclines, aminoglycosides, and metronidazole. Their mechanisms of action, resistance, uses, and adverse effects are described. The document provides a detailed overview of classification and properties of different antimicrobial drugs.

1. -SHIVANI BHATIA
-SHIVANI BHATIA
20/7/17

2. 1. GRAM POSITIVE- STREPTOCOCUS,
ENTEROCOCUS,TREPENOMA,CANDIDA
2. GRAM NEGATIVE- FUSOBACTERIUM,
CAMPYLOBACTER,BACTEROIDS
3. OBLIGATE AEROBES- TUBERCLE BACILLI
4. FACULTATIVE ANAEROBES-
STAPHYLOCOCCUS
• VARIOUS TYPES OF
MICROORGANISMS CAN BE SEEN.

3. 5. MICROAEROPHILLIC-STREPTOCOCUS
6. OBLIGATE ANAEROBES- BACTEROIDS

4. ◦ ANTIBIOTICS ARE SUBSTANCES PRODUCED BY
MICROORGANISMS ,WHICH SELECTIVELY SUPRESS
THE GROWTH OF OR KILL OTHER MICROORGANISMS
AT VERY LOW CONCENTRATIONS.

5.  BASED ON CHEMICAL STRUCTURE
1. SULFONAMIDES AND RELATED DRUGS-
SULFADIAZINES
2. DIAMINOPYRIMIDINES- TRIMETHOPRIM
3. QUINOLONES-NALIDIXIC ACID, CIPROFLOXACIN
4. BETA LACTAM ANTIBIOTICS-PENICILLINS
,CEPHALOSPORINS
5. TETRACYCLINE- DOXYCYCLINES
6. NITROBENZENE DERIVATIVES-CHLORAMPHENICOL
7. AMINOGLYCOSIDES-STREPTOMYCIN
8. MACROLIDE- ERYTHROMYCIN
9. LINCOSAMIDE ANTIBIOTICS- CLINDAMYCIN

6. 10. POLYPEPTIDE ANTIBIOTIC- POLYMYXIN B
11. GLYCOPEPTIDES- VANCOMYCIN
12. OXAZOLIDINONE-LINEZOLID
13. NITROFURAN DERIVATIVES- NITROFURATOIN
14.NITROMIDAZOLES- METRONIDAZOLE
15. NICOTINIC ACID DERIVATIVES- ISONIAZID
16. POLYENE ANTIBIOTICS- NYSTATIN
17. AZOLE DERIVATIVES-MICONAZOLE

7. BASED ON MECHANISM OF ACTION
1. INHIBIT CELL WALL SYNTHESIS- PENICILLIN,
CEPHALOSPORINS
2. CAUSE LEAKAGE OF CELL MEMBRANE- POLYPEPTIDES
3. INHIBIT PROTIEN SYNTHESIS-TETRACYCLINES,
ERYTHROMYCIN
4. CAUSE MISREADING OF M-RNA CODE-
AMINOGLYCOSIDES
5. INHIBIT DNA GYRASE-FLOUROQUINOLONES
6. INTERFERE WITH DNA FUNCTION-METRONIDAZOLE
7. INTERFERE DNA SYNTHESIS-ACYCLOVIR

8.  BASED ON ORGANISMS AGAINST WHICH PRIMARILY
ACTIVE
1. ANTIBACTERIAL- PENICILLIN, AMINOGLYCOSIDES
2. ANTIFUNGAL-KETOCONAZOLE
3. ANTIVIRAL- ACYCLOVIR, ZIDOVUDINE
4. ANTIPROTOZOAL- CHLOROQUINE,
METRONIDAZOLE
5. ANTIHELMENTIC-MEBENDAZOLE

9.  BASED ON SPECTRUM OF ACTIVITY
1. NARROW SPECTRUM- PENICLLIN G, STREPTOMYCIN
2. BROAD SPECTRUM- TETRACYCLINE,
CHLORAMPHENICOL

10.  BASED ON TYPE OF ACTION
1. PRIMARILY BACTERIOSTATIC- SULFONAMIDES ,
TETRACYCLINES, CHLORAMPHENICOL
2. PRIMARILY BACTERICIDAL- PENICILLLIN,
AMINOGLYCOSIDES,COTRIMOXAZOLE

11.  PATIENT FACTORS
1. AGE
2. RENAL AND HEPATIC DYSFUNCTION
3. LOCAL FACTORS
4. DRUG ALLERGY
5. IMPAIRED HOST DEFENCES
6. PREGANCY
7. GENETIC FACTORS

13.  DRUG FACTORS
1. SPECTRUM OF ACTIVITY
2. TYPE OF ACTIVITY
3. SENSITIVITY OF ORGANISM
4. TOXICITY
5. ROUTE OF ADMINISTRATION
6. COST
7. CLINICAL EFFICIENCY

14. 1. ANTIBIOTICS CURE PAITENTS
2. ANTIBIOTICS ARE SUBSTITUTES FOR SURGICAL
DRAINAGE
3. THE MOST IMPORTANT DECISION IS WHICH
ANTIBIOTIC TO USE
4. ANTIBIOTIC THERAPY IS SCIENCE AND NOT ART
5. CULTURE AND SENSITIVITY TESTS ARE REQUIRED
6. ANTIBIOTICS INCREASE HOST DEFENSE TO
INFECTION
7. MULTIPLE ANTIBIOTICS ARE SUPERIOR TO SINGLE
ANTIBIOTIC
8. ANTIBIOTIC PROPHYLAXISIS USUALLY EFFECTIVE

15. 9. BACTERICIDAL AGENTS ARE ALWAYS SUPERIOR TO
BACTERIOSTATIC
10. ANTIMICROBIALS ARE EFFECTIVE IN CHRONIC
INFECTIONS
11. ANTIMICROBIALS ARE SAFE AND NON TOXIC
12. ANTIBIOTICS DOSAGES ARE ESTABLISHED FOR
MOST INFECTIONS
13. INFECTIONS REQUIRE COMLETE COURSE OF
THERAPY

17.  SULFONAMIDES WERE THE FIRST ANTIMICROBIAL
AGENT EFFECTIVE AGAINST PYOGENIC INFECTIONS.
 THEY ARE CLASSIFIED AS
1. SHORT ACTING(4-8 HRS)-SULPHADIAZINE
2. INTERMIDIATE ACTING(8-12 HR)-
SULPHAMETHOXAZOLE
3. LONG ACTING(7 DAYS) –SULFADOXINE
4. SPECIAL PURPOSE SULFONAMIDES- SILVER
SULFADIAZINE

18.  ANTIMICROBIAL SPECTRUM
 PRIMARILY BACTERIOSTATIC AGAINST MANY GRAM
POSITIVE AND GRAM NEGATIVE BACTERIA
 STR.PYOGENES, H.INFLUENZAE, H.DUCREYI, VIBRIO.
CHOLOERAE. ARE SENSITIVE

19. SULFONAMIDES
INHIBITION OF UNION OF PABA
WITH PETRIDINE RESIDUES
NO FOLIC ACID IS FORMED

20.  RESISTANCE ARISES DUE TO
1. SPECIES PRODUCE INCREASED AMOUNT OF PABA
2. THEIR FOLATE SYNTHASASE ENZYMES HAVE LOW
EFFINITY FOR SULFONAMIDES
3. ADOPT ALTERNATIVE PATHWAYS IN FOLATE
METABOLISM
 GONOCOCCI, PNEUMOCOCCI,
STAPH.AUREUS,E.COLI,SHIGELLA ARE AMONGST
SOME OF THE RESISTANT SPECIES

21.  ADVERSE EFFECTS
1. NAUSEA,VOMIT,
EPIGASTRIC PAIN,
2. CRYSTALLURIA,HYPERS
ENSITIVITY REACTIONS
3. HEPATITIS,
HAEMOLYSIS IN G6PD
DEFICENT PAITENTS
 USES
1. OCULAR
SULFOACETAMIDE SOD
IS ALTERNATIVE IN
TRACHOMA
CONJUNCTIVITIS
2. TOPICAL SILVER
SULPHADIAZINE IS USED
FOR PREVENTING
INFECTION ON BURN
SURFACES.

22.  FIXED DOSE COMBINATION OF TRIMETHOPRIM AND
SULPHAMETHOXAZOLE IS CALLED COTRIMOXAZOLE

23. PABA
DHFA
THFA
SULFONAMIDE
TRIMETHOPRIM
FOLATE SYNTHASAE
DIHYDROFOLATE
REDUCTASE

24.  SPECTRUM OF ACTION
1. SALMONELLA
TYPHI,SERRATIA,ENTEROBACTER,YERSINIA
ENTERCOLITICA,PNEUMOCYSTIS JEROVECI
2. MANY SULFONAMIDE RESISTANT STRAINS OF
ST.AUREUS, STR.PYOGENES.
 RESISTANCE
 ACQUIRED MOSTLY THROUGH MUTATIONAL
ACQUISITATION OF DHFRASE HAVING LOWER
AFFINITY FOR INHIBITOR.

25.  ADVERSE EFFECTS
1. NAUSEA,VOMITING,STOMATITIS, HEADACHE
2. FOLATE DEFICIENCY
3. IT SHOULD NOT BE GIVEN IN PREGNANCY –
TRIMETHOPRIM IS ANTIFOLATE AND THUS
TERATOGENIC RISK IS INVOLVED
4. NEONATAL HAEMOLYSIS AND
METHHAEMOGLOBINAEMIA CAN OCCUR

26.  USES
 TONSILITIS,PHARYNGITIS,SINUSITIS
 OTIS MEDIA,CHRONIC BRONCHITIS
 URINARY TRACT INFECTION
 BACTERIAL DIARRHOEA, DYSENTRY
 FIRST LINE OF DRUG IN PNEUMOCYSTIS JIROVECI
PNEUMONIA
 OCCASIONALLY EMPLOYED IN ORODENTAL
INFECTIONS IN PATIENTS ALLERGIC TO BETA
LACTAM

27.  THESE ARE QUNILONE ANTIBITICS HAVING ONE OR
MORE FLOURINE SUBSTITUTIONS
 CLASSIFIED AS
•FIRST
GENERATION.
1.CIPROFLOXACIN
•2. NORFLOCACIN
•3.OFLOXACIN
•SECOND
GENERATION
•1.LOMEFLOXACIN
•2.LEVOFLOXACIN
•3.GATIFLOXACIN
•THIRD
GENERATION
•1.GEMIFLOXACIN
•2.PRULIFLOXACIN

28.  MECHANISM OF ACTION
BACTERIAL DNA GYRASE
UNIT A UNIT B
NICKING OF DNA NEGATIVE
SUPERCOILS
RESEALS THE
NICKED ENDS
FQS
BIND

29.  MECHANISM OF RESISTANCE
 CHROMOSOMAL MUTATION PRODUCING A DNA
GYRASE OR TOPOISOMERASE IV WITH REDUCED
AFFINITY FOR FQS.

30.  HIGHLY
SUSPECTIBLE
 E.COLI
 K.PNEMONIAE
 ENTEROBACTER
 N.GONORRHOEA
 H.INFLUENZAE
 MODERATELY
SUSPECTIBLE
 STAPH.AUREUS
 BRUCELLA
 LEGIONELLA
 M.TUBERCULOSIS

31.  ADVERSE
EFFECTS
 NAUSEA,VOMIT,BAD
TASTE
 DIZZINESS, HEADACHE
 RESTLESSNES,ANXIETY
 HYPERSENSITIVITY
 TENDONITIS AND
TENDON RUPTURE
 CONTRAINDICATED IN
PREGNANCY.
 USES
 URINARY TRACT
INFECTIONS
 BACTERIAL
GASTROENTRITIS,TYPH
OID
 GONORHOEA
 SKIN AND SOFT TISSUE
INFECTIONS
 MULTIDRUG RESISTANT
TB
 SKELETAL INFECTIONS

32.  IT IS ABROAD SPECTRUM ANTI PROTOZOAL DRUG
ACTIVE AGAINST ENTAMOEBA HISTOLYTICA AND
GIARDIA LAMBLIA.
 IT IS NOW EXTENSIVELY USED TO TREAT
ANAEROBIC INFECTIONS

33.  ANTIMICROBIAL SPECTRUM
 BACT.FRAGLIS
 BACT.MELANOGENICUS
 FUSOBACTERIUM
 CLOSTRIDIUM.PERFRIGENS
 PERVOTELLA
 VELLIONELLA
 H.PYLORI

34.  MECHANISM OF ACTION

35.  ADVERSE EFFECTS
 ANOREXIA,NAUSEA ,BAD TASTE
 LESS FREQUENT- HEADACHE, GLOSSITIS,DRYNESS
OF MOUTH,DIZZINESS
 PROLONGED ADMINISTRATION MAY CAUSE
SEIZURES
 CONYTAINDICATED IN NEUROLOGICAL DISODERS
AND PREGNANCY.

36.  DENTAL USES
 ORODENTAL INFECTIONS.
 DRUG OF CHOICE FOR ANUG WHERE IT IS
COMBINED WITH AMOX,ERYTHROMYCIN OR
TETRACYCLINE.
 ACUTE APICAL
INFECTION,PERIODONTITIS,PERICORONITIS

37.  MEDICAL USES
 PSEUDOMEMBRANOUS ENTEROCOLITIS CAUSED BY
CL.DIFFICLE.
 H.PYLORI INFECTIONS
 PROTOZOAL INFECTIONS( DYSENTRY,AMOEBIASIS)
 INTESTINAL GIARDIASIS

38.  PENICILLIN
 FIRST ANTIBIOTIC TO BE USED CLINICALLY IN 1941
 IT IS OBTAINED FROM FUNGI PENICILLIN NOTATUM.

39.  MECHANISM OF ACTION
BACTERIA
UDP N ACETYL MURAMIC
ACID
LINKED
TOGETHE
R
UDP SPLIT
OFF

40. D ALANINE
CLEAVAGE
TRANSPEPTIDAS
E
ENERGY
RELEASED
CROSS LINKING
INHIBITED BY BETA
LACTAM
ANTIBIOTICS
NO CROSS
LINKING
CELL WALL DEFICIENT
BACTRIA
SWELL AND
BURST

41.  COCCI- STREPTOCOCCI, PNEUMOCOCCI, N.
GONORRHOEA, N. MENINGITIDIS
 BACILLI- B. ANTHRACIS, C.DIPTHERIA,CLOSTRIDIA,
LISTERIA
 FUSOBACTERIA, PEPTOSTREPTOCOCUS,
EUBACTERIUM, CAMPYLOBACTER.

42.  IN SOME BACTERIA TARGET ENZYMES AND PBPs
ARE LOCATED IN DEEPER LAYERS WHERE PnG IS
UNABLE TO PENETRATE.
 PENICILLINASE PRODUCTION
 PENICILLIN TOLERANT BACTERIA

43.  PAIN AT IM INECTION SITE,
NAUSEA,THROMBOPHLEBITIS OF INJECTED VEIN
 CNS TOXICITY- MENTAL CONFUSION, MUSCULAR
TWICHING,CONVULSIONS
 HYPESENITIVITY REACTION
 JARISCH HERXIMER REACTION
 SUPERINFECTIONS

44.  DENTAL USES
 PERIODONTAL
ABSCESS, PERIAPICAL
ABSCESS,
 PERICORONITIS
 ACUTE SUPPURATIVE
PULPITIS
 ANUG

 MEDICAL USES
 PHARYNGITIS,TONSILIT
IS ,OTITIS MEDIA
 PNEMOCOCAL
INFECTIONS
 MENINGOCOCAL
MENINGITIS
 GONORRHOEA BY NON
PENICILLINASE
PRODUCING N.
GONORRHOEA
 SYPHILIS

45.  CLASSIFICATION
 ACID RESISTANT ALTERNATIVE TO PENICILLIN G-
PENICILLIN V
 PENICILLINASE RESISTANT PENICILLINS-
MITHICILLIN, CLOXACILLIN
 EXTENDED SPECTRUM PENICILLIN
1. AMINOPENICILLINS- AMPICILLIN, AMOXICILLIN
2. CARBOXYPENICILLIN- CARBENICILLIN
3. UREIDOPENICILLINS- PIPERACILLIN
 BETA LACTAMASE INHIBITORS- CLAVULANIC ACID

46.  AMOXICILLIN IS SIMILAR TP AMPICILLIN EXCEPT
1. ORAL ABSORPTION IS BETTER
2. INCIDENCE OF DIARRHOEA IS LOWE
3. LESS ACTIVE AGAINST SHIGELLA AND H .
INFLUENZAE
 IT IS PREFFERD OVER AMPICILLIN AS IT PRODUCES
MORE SUSTAINED BLOOD LEVELS.