Write the prescriptions

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, lincomycin, teicoplanin.

 

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

 

2. Determine the mechanism of action and effect of drugs and fill in the table:

Name of the group	Type of action	Mechanism of action
Group of Levomycetin
Aminoglycosides
Tetracyclines
Glycopeptides
Polymyxins

1. Drugs change the configuration of the 30S subunit, which leads to incorrect reading of the mRNA code. They disrupt the initiation of protein synthesis, cause premature termination of translation and use of incorrect amino acids in the synthesis. As a result, abnormal proteins are synthesized. Drugs also violation of the permeability of the cytoplasmic membrane.

2. The drugs bind to the 30s ribosome subunit, blocking the attachment of aminoacyl-tRNA to the aminoacyl site of the ribosome-mRNA complex. As a result, drugs inhibit of protein synthesis.

3. The drug binds to the 50s subunit of the ribosome and inhibits peptidyltransferase (an enzyme that catalyzes the inclusion of amino acids in the growing polypeptide chain) in the peptide site. As a result, drugs inhibit of protein synthesis.

4. The drugs block the final stage of peptidoglycan synthesis. The antibiotic molecule binds to the terminal amino acids in the side peptide chain and blocks the cross-linking of peptidoglycan, thus disrupting the synthesis of the bacterial cell wall.

5. Drugs are cationic main polypeptides that attach to the bacterial cell membrane, disrupt its permeability and transport mechanisms, which lead to bacterial lysis.

 

3. Indicate on which pathogens tetracyclines:

a) act

b) do not work

Cocci, Haemophilus influenza, Neisseria, Escherichia coli, Shigella, Salmonella, Clostridia,Chlamydia, Rickettsia, pathogens of especially dangerous infections (cholera, plague, brucellosis, tularemia, anthrax), Pseudomonas aeruginosa, mycobacterium tuberculosis, fungi, viruses, Plasmodium falciparum.

4. Complete the statements:

Tetracyclines are used in bile duct infection, since...

Doxycycline is not used to treat meningitis, since....

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

Situationic task

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

6. 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	The bad	Very good
Penetration into the focus of infection	Slow and incomplete	Good	Fast and good
Excretion	Primarily the kidneys are unchanged	Kidney and bile	Primarily, the kidneys in the form of inactive metabolites

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

Generation (3), 2 generation (1), 3 generation (3).

 

Identify kanamycin, gentamicin, amikacin

Range	А	B	C
Cocci	+	+	+
E. coli, Shigella, Salmonella	+	+	+
Pathogens of plague, tularemia, brucellosis	+	+	+
Mycobacteria	+	-	+
Pseudomonas aeruginosa	+	+	-

9. Complete the statements:

Chloramphenicol is an antibiotic of the reserve, since...

Streptomycin should not be administered together with furosemide, since...

Neomycin is applied topically in combination with glucocorticoids in order to...

Situational task

The dentist discovered a child with three years of multiple caries, a delay in the development of teeth, their deformation, yellowing. What antibiotic was the mother taking during pregnancy?

11. Identify tetracycline, chloramphenicol, streptomycin:

Complication	A	B	C
Syndrome of irritation of mucosa	+	-	+
Hepatotoxic effect	+	-	+
Ototoxic effect	-	+	-
Nephrotoxicity	-	+	-
Inhibition of hematopoiesis	+	-	±
Violation of neuromuscular conduction	-	+	-
Defect in the rudiment of teeth and bones	-	-	+

12. Choose the correct answer:

Polymyxin M in the microbial cell disrupts (protein synthesis / permeability of the cytoplasmic membrane), acts (bacteriostatic / bactericidal) on (Gr + / Gr-flora), the resistance of microorganisms develops (fast / slow), appointed (inside and locally / parenterally only).

 

13. Classify anti-tuberculosis drugs:

Antibiotics

Synthetic drug

streptomycin, kanamycin, isoniazid, rifampicin, ethambutol, pyrazinamide, aminosalicylic acid - on antibiotics and synthetic drugs.

 

14. Answer the questions:

Isoniazid and rifampicin are class A antituberculosis drugs, since...

In the treatment of patients with tuberculosis, several drugs are prescribed simultaneously, since...

Aminosalicylic acid enhances the action of isoniazid, since...

It is advisable to administer isoniazid with vitamin B6, since...

15. Determine anti-TB drugs ethambutol, isoniazid, kanamycin, rifampicin.

	Spectrum	Mechanism of action	Resistance	Side effects
А	Wide	Block of DNA-dependent RNA polymerase	Fast	Allergic reactions, hepatotoxicity, dysbacteriosis
B	Mycobacteria	Violation of the synthesis of mycolic acids, violation of cellular respiration.	Slow	Peripheral neuritis, convulsions, insomnia.
C	Wide	Violation of protein synthesis, violation of the permeability of the cytoplasmic membrane	Fast	Hearing loss, vestibular disorders, impaired renal function, allergic reactions.
D	Mycobacteria	Disturbance of the synthesis of RNA and proteins	Slow	Visual impairment, allergic reactions

 

Write the prescriptions

1. Drug for the treatment of meningococcal infection in tablets
2. An antibiotic for the treatment of conjunctivitis
3. Drug for the treatment of brucellosis (Lyme disease) in tablets
4. Drug for the treatment of pseudomembranous enterocolitis caused by Clostridium difficile
5. The drug from the group of lincosamide, oppresses the synthesis of protein, acts bacteriologically on anaerobes, cocci. Well penetrates into bone tissue. It is prescribed for infections of the abdominal cavity, ENT organs, with diseases of bones, joints. It is used orally, parenterally, topically. May cause pseudomembranous colitis.
6. It is a first-line anti-tuberculosis drug, block of DNA-dependent RNA polymerase, it is also used to treat leprosy and to prevent meningococcal meningitis in people who have been in close contact with the diseased.