1. 30s subunit
1.1. Aminoglycosides (cidil)
1.1.1. Blocks formation of initiation complex
1.1.2. Enhanced by Active uptake by bacteria
1.1.3. Side effects: ototoxicity and neurotoxicity
1.1.4. Gentamicin / amikacin / kanamycin / neomycin/ tobramycin/ spectinomycin / streptomycin
1.1.4.1. Gentamicin (IV)
1.1.4.1.1. Against pseudomonas (in combination)
1.1.4.2. Neomycin
1.1.4.2.1. OTC topical
1.1.4.2.2. Skin and eye
1.1.4.3. Tobramycin
1.1.4.3.1. Eye infections
1.1.4.4. Kanamycin
1.1.4.4.1. Active in low concentration
1.1.4.4.2. Used 2nd Line in TB treatment
1.1.5. Streptomycin
1.1.5.1. The oldest (treat TB)
1.1.5.2. 1. Prevent assembly of the ribosome
1.1.5.2.1. By block the initiation step
1.1.5.3. 2. Misreading of codon
1.1.5.3.1. Distortion of the 30s subunit
1.1.5.4. Ototoxicity
1.1.5.5. Rapid development of resistance
1.2. Tetracyclines (static)
1.2.1. Natural
1.2.1.1. Tetracycline
1.2.1.2. Oxytetracycline
1.2.1.3. Chlortetracycline
1.2.2. Semi synthetic
1.2.2.1. Doxycycline
1.2.2.2. Minocycline
1.2.2.3. Retained in body longer
1.2.3. Attachment of the tRNA carrying amino acids to the mRNA ribosome complex
1.2.3.1. 30s active uptake 40s not actively uptake (small amount by diffusion)
1.2.4. Resistance
1.2.4.1. Active efflux pump
1.2.4.2. Failure active uptake
1.2.5. Obligate intracellular
1.2.5.1. Rickettsial
1.2.5.2. Chlamydia
1.2.5.3. Urinary tract infection
1.2.5.4. Walking pneumonia
1.2.6. Side effects
1.2.6.1. GI upset
1.2.6.2. Superinfection
1.2.6.2.1. Candida albicans
1.2.6.2.2. Fungi in mouth
1.2.6.2.3. GIT
1.2.6.2.4. Upper respiratory tract
1.2.6.3. Photo toxicity
1.2.6.4. in children brownish discoloration of the teeth🦷
1.2.6.5. Toxic to kidneys
1.2.6.5.1. After expiration date ☠️
1.3. Glycylcyclines
1.3.1. Ex: tygecycline
1.3.2. Similar to tetracycline
1.3.3. Inhibit the effects of rapid efflux pump
1.3.4. Against
1.3.4.1. MRSA
1.3.4.2. Multi drug resistance strains of Acinetobacter baumanii
1.3.4.2.1. Respiratory pathogens
2. 50s subunit
2.1. Chloramphenicol (static)
2.1.1. High toxicity
2.1.1.1. Suppress bone marrow
2.1.1.1.1. Affects formation of blood cells
2.1.1.2. Cause aplastic anemia
2.1.2. Orally as palmitate (tasteless)
2.1.3. G+ & G-
2.1.3.1. Mycoplasma
2.1.3.2. Rickettsia
2.1.3.3. Chlamydia
2.1.4. Prevent the binding of the amino acid containing end of the aminoacyl tRNA
2.1.4.1. Mmmmmmmm
2.2. Macrolids
2.2.1. Macrocyclic lactose ring linked through glycosidic bonds with amino sugars
2.2.2. Erythromycin
2.2.2.1. Blocks the translocation step
2.2.2.1.1. When ribosome moves along mRNA
2.2.2.2. Spectrum like penicillin G
2.2.2.2.1. Not able to penetrate cell wall(G-)
2.2.2.3. Legionellosis
2.2.2.4. Mycoplasma pneumonia
2.2.3. Azalides
2.2.3.1. Azithromycin
2.2.3.2. Clarithromycin
2.2.3.3. Better intracellular penetration than macrolides
2.2.4. Semi synthetic
2.2.4.1. Ketolides
2.2.4.1.1. Upper respiratory infections
2.2.4.1.2. Side effects
2.2.4.2. Telithromycin
2.3. Streptogramins
2.3.1. Dalfopristin
2.3.1.1. Block early protein synthesis
2.3.2. Quinupristin
2.3.2.1. Block later step
2.3.3. Synercid