Protein synthesis inhibitors: Aminoglycosides

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Protein synthesis inhibitors: Aminoglycosides

Prerequisite basic sciences

Prerequisite basic sciences

Attributable risk (AR)

Bias in interpreting results of clinical studies

Bias in performing clinical studies

Clinical trials

Confounding

DALY and QALY

Direct standardization

Disease causality

Incidence and prevalence

Indirect standardization

Interaction

Mortality rates and case-fatality

Odds ratio

Positive and negative predictive value

Prevention

Relative and absolute risk

Selection bias

Sensitivity and specificity

Study designs

Test precision and accuracy

Acyanotic congenital heart defects: Pathology review

Adrenal masses: Pathology review

Bacterial and viral skin infections: Pathology review

Bone tumors: Pathology review

Coagulation disorders: Pathology review

Congenital neurological disorders: Pathology review

Cyanotic congenital heart defects: Pathology review

Extrinsic hemolytic normocytic anemia: Pathology review

Eye conditions: Inflammation, infections and trauma: Pathology review

Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review

Headaches: Pathology review

Intrinsic hemolytic normocytic anemia: Pathology review

Leukemias: Pathology review

Lymphomas: Pathology review

Macrocytic anemia: Pathology review

Microcytic anemia: Pathology review

Mixed platelet and coagulation disorders: Pathology review

Nasal, oral and pharyngeal diseases: Pathology review

Nephritic syndromes: Pathology review

Nephrotic syndromes: Pathology review

Non-hemolytic normocytic anemia: Pathology review

Pediatric brain tumors: Pathology review

Pediatric musculoskeletal disorders: Pathology review

Platelet disorders: Pathology review

Renal and urinary tract masses: Pathology review

Seizures: Pathology review

Viral exanthems of childhood: Pathology review

Pharmacodynamics: Agonist, partial agonist and antagonist

Pharmacodynamics: Desensitization and tolerance

Pharmacodynamics: Drug-receptor interactions

Pharmacokinetics: Drug absorption and distribution

Pharmacokinetics: Drug elimination and clearance

Pharmacokinetics: Drug metabolism

Prerequisite basic sciences

Growth hormone and somatostatin

Prerequisite basic sciences

Breastfeeding

Prerequisite basic sciences

Androgens and antiandrogens

Estrogens and antiestrogens

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Antihistamines for allergies

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Antimetabolites: Sulfonamides and trimethoprim

Antituberculosis medications

Cell wall synthesis inhibitors: Cephalosporins

Cell wall synthesis inhibitors: Penicillins

DNA synthesis inhibitors: Fluoroquinolones

DNA synthesis inhibitors: Metronidazole

Miscellaneous cell wall synthesis inhibitors

Miscellaneous protein synthesis inhibitors

Protein synthesis inhibitors: Aminoglycosides

Protein synthesis inhibitors: Tetracyclines

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Glucocorticoids

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Azoles

Glucocorticoids

Pulmonary corticosteroids and mast cell inhibitors

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Antimetabolites: Sulfonamides and trimethoprim

Cell wall synthesis inhibitors: Cephalosporins

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Pharmacodynamics: Agonist, partial agonist and antagonist

Pharmacodynamics: Desensitization and tolerance

Pharmacodynamics: Drug-receptor interactions

Pharmacokinetics: Drug absorption and distribution

Pharmacokinetics: Drug elimination and clearance

Pharmacokinetics: Drug metabolism

Cell wall synthesis inhibitors: Cephalosporins

Glucocorticoids

Miscellaneous protein synthesis inhibitors

Anticonvulsants and anxiolytics: Barbiturates

Anticonvulsants and anxiolytics: Benzodiazepines

Nonbenzodiazepine anticonvulsants

Cell wall synthesis inhibitors: Cephalosporins

Cell wall synthesis inhibitors: Penicillins

Miscellaneous cell wall synthesis inhibitors

Assessments

Protein synthesis inhibitors: Aminoglycosides

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Protein synthesis inhibitors: Aminoglycosides

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External References

First Aid

2022

2021

2020

2019

2018

2017

2016

Amikacin p. 184, 188

Transcript

Aminoglycosides are antimicrobial antibiotics that inhibit bacterial ribosomes, which are the organelles that make proteins.

Genes are used to synthesize proteins in two steps: transcription and translation.

During transcription, a specific gene on the DNA is “read,” and a copy is made called a messenger RNA, or mRNA.

Translation is also known as protein synthesis, and it’s when ribosomes use mRNA to assemble proteins from amino acids within the cytoplasm.

Now, prokaryotic cells, like bacteria, have smaller ribosomes than eukaryotic cells, like those found in humans.

Bacterial ribosomes are made up of a 50S subunit and a 30S subunit which combine to form a 70S ribosome.

Eukaryotic ribosomes are made up of a 60S and a 40S subunit that form a 80S ribosome.

Since these proteins are different, we can create medications that selectively interfere with the bacterial ones.

In both eukaryotic and prokaryotic cells, protein synthesis involves initiation, elongation, and termination.

In bacteria, initiation occurs when the 50S and 30S subunits bind to the mRNA sequence to form a ribosome-mRNA complex, also known as initiation complex.

The mRNA serves as a blueprint for the protein that will be synthesized.

It’s made up of three nucleotide long sequences, called codons.

Transport RNA, or tRNA, carrying different amino acids can bind to these codons with their matching anticodons.

The complete ribosome-mRNA complex has 3 sites where tRNA can enter and bind.

These are called the A, or aminoacyl site, the P, or peptidyl site, and the E, or exit site.

Elongation starts when the first tRNA, carrying a formylmethionine amino acid, enters the P site and binds to the start codon.

This causes a conformational change in the ribosome, which unlocks the A site for the next tRNA.

A process called proofreading occurs here where only tRNAs with the matching anticodon can bind to corresponding mRNA codon.

After the next tRNA binds at the A site, the amino acid detaches from the tRNA in the P site, and gets attached to the amino acid in the A site by the enzyme peptidyl transferase.

This step is called transpeptidation because the peptide chain is transferred from the P site tRNA to the A site tRNA.

Now, the A site has the newly formed peptide chain dangling from it, while the P site has an empty tRNA with no amino acids.

In the final stage of elongation, called translocation, the ribosome slides across the mRNA, and the A site sits above a new codon, the tRNA that was in the A site slides over to the P site, and the tRNA in the P site slides over to the E site.

Summary

Aminoglycosides are a class of antibiotics that inhibit bacterial protein synthesis by binding to the 30S subunit of their ribosomes. This binding disrupts proofreading in bacterial protein synthesis, leading to the production of non-functional or truncated proteins. Examples of the aminoglycoside family include amikacin, gentamicin, neomycin, streptomycin, and tobramycin. Alone, aminoglycosides are effective against Gram-negative aerobic bacteria, but could also treat Gram-positive bacteria if combined with a cell wall synthesis inhibitor, like a beta-lactam antibiotic, or with vancomycin. Notable adverse drug reactions include nephrotoxicity, ototoxicity, neuromuscular blockade, nausea, and allergic reaction.

Sources

  1. "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
  2. "Rang and Dale's Pharmacology" Elsevier (2019)
  3. "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
  4. "Parenteral Aminoglycoside Therapy" Drugs (1994)
  5. "Aminoglycosides: activity and resistance" Antimicrob Agents Chemother (1999)
  6. "Versatility of Aminoglycosides and Prospects for Their Future" Clinical Microbiology Reviews (2003)
  7. "Aminoglycoside-Induced Ototoxicity" Current Pharmaceutical Design (2007)
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