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Antimetabolites: Sulfonamides and trimethoprim
Cell wall synthesis inhibitors: Cephalosporins
Cell wall synthesis inhibitors: Penicillins
DNA synthesis inhibitors: Fluoroquinolones
DNA synthesis inhibitors: Metronidazole
Mechanisms of antibiotic resistance
Miscellaneous cell wall synthesis inhibitors
Miscellaneous protein synthesis inhibitors
Protein synthesis inhibitors: Aminoglycosides
Protein synthesis inhibitors: Tetracyclines
Miscellaneous antifungal medications
Anti-mite and louse medications
Integrase and entry inhibitors
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Nucleoside reverse transcriptase inhibitors (NRTIs)
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Sulfa Drug Allergies
Sulfonamides Side Effects
sulfa drug allergies p. 251
sulfa drug allergies as cause p. 251
sulfonamides for p. 191
sulfonamides as cause p. 191
sulfonamides p. 191
acute pancreatitis p. 404
erythema multiforme p. 490
G6PD deficiency from p. 415
megaloblastic p. 249
rash p. 249
acute interstitial nephritis from p. 622
cytochrome P-444 and p. 251
hemolysis in G6PD deficiency p. 249
hypothyroidism p. 248
mechanism p. 184
Nocardia spp. p. 137
photosensitivity p. 249
pregnancy contraindication p. 200
trimethroprim p. 191
vitamin BNaN deficiency p. 66
sulfa drugs for p. 251
Antimetabolites are medications that interfere with the synthesis of DNA.
Some antimetabolites are used in chemotherapy to kill cancer cells, while others are used as antibiotics since they inhibit bacterial folate synthesis.
Folate, or folic acid, also known as vitamin B9, is necessary for the synthesis of nucleic acids, which are the building blocks of DNA and RNA.
Simply put, a lack of folate results in a lack of nucleic acids, which then results in decreased DNA and RNA synthesis, leading to hindered cell division and function.
Now, a key difference between our cells and bacterial cells is that we get all of our folate through our diet, while bacteria can make their own folate from scratch.
Because of this, we can target the bacterial folate synthesis pathway to minimize the damage done to our cells.
So in order to synthesize folate, the bacteria will first use the host’s para-aminobenzoic acid, or pABA, and convert it to dihydropteroic acid via the enzyme dihydropteroate synthetase, or DHPS.
In the second step, dihydropteroic acid is converted into dihydrofolic acid by dihydrofolate synthetase.
The third step is the conversion of dihydrofolic acid into tetrahydrofolic acid via dihydrofolate reductase.
Tetrahydrofolic acid is a folic acid derivative and can be used to synthesize purines like adenine and guanine, which are used to build DNA and RNA, as well as thymidine, which is only used in DNA.
Now, the first group of antimetabolite antibiotics are the sulfonamides, which include sulfamethoxazole, or SMX, sulfisoxazole, and sulfadiazine.
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