Protein synthesis inhibitors: Tetracyclines

Last updated: November 01, 2022

Protein synthesis inhibitors: Tetracyclines

Pediatrics

Pediatrics

Approach to acid-base disorders: Clinical sciences
Approach to metabolic acidosis: Clinical sciences
Approach to metabolic alkalosis: Clinical sciences
Approach to respiratory acidosis: Clinical sciences
Approach to respiratory alkalosis: Clinical sciences
Approach to hypernatremia (pediatrics): Clinical sciences
Approach to hypocalcemia (pediatrics): Clinical sciences
Approach to hypoglycemia (pediatrics): Clinical sciences
Approach to hyponatremia (pediatrics): Clinical sciences
Adrenal insufficiency: Clinical sciences
Syndrome of inappropriate antidiuretic hormone secretion: Clinical sciences
Adnexal torsion: Clinical sciences
Appendicitis: Clinical sciences
Approach to abdominal wall and groin masses: Clinical sciences
Approach to dysmenorrhea: Clinical sciences
Cholecystitis: Clinical sciences
Ectopic pregnancy: Clinical sciences
Henoch-Schonlein purpura: Clinical sciences
Inflammatory bowel disease (Crohn disease): Clinical sciences
Inflammatory bowel disease (ulcerative colitis): Clinical sciences
Intussusception: Clinical sciences
Irritable bowel syndrome: Clinical sciences
Pelvic inflammatory disease: Clinical sciences
Testicular torsion (pediatrics): Clinical sciences
Urinary tract infection (pediatrics): Clinical sciences
Approach to anemia (destruction and sequestration): Clinical sciences
Approach to anemia (underproduction): Clinical sciences
Approach to anemia in the newborn and infant (destruction and blood loss): Clinical sciences
Approach to anemia in the newborn and infant (underproduction): Clinical sciences
Approach to leukemia: Clinical sciences
Iron deficiency and iron deficiency anemia (pediatrics): Clinical sciences
Sickle cell disease: Clinical sciences
Approach to bleeding disorders (platelet dysfunction): Clinical sciences
Approach to bleeding disorders (thrombocytopenia): Clinical sciences
Immune thrombocytopenia: Clinical sciences
Meningitis (pediatrics): Clinical sciences
Sepsis (pediatrics): Clinical sciences
Celiac disease: Clinical sciences
Asthma: Clinical sciences
Bronchiolitis: Clinical sciences
Congestive heart failure: Clinical sciences
COVID-19: Clinical sciences
Croup and epiglottitis: Clinical sciences
Cystic fibrosis and primary ciliary dyskinesia: Clinical sciences
Influenza: Clinical sciences
Pneumonia (pediatrics): Clinical sciences
Tuberculosis (pulmonary): Clinical sciences
Upper respiratory tract infections: Clinical sciences
Clostridioides difficile infection: Clinical sciences
Approach to a fever (over 2 months): Clinical sciences
Acute rheumatic fever and rheumatic heart disease: Clinical sciences
Osteomyelitis (pediatrics): Clinical sciences
Otitis media and externa (pediatrics): Clinical sciences
Pharyngitis, peritonsillar abscess, and retropharyngeal abscess (pediatrics): Clinical sciences
Septic arthritis and transient synovitis (pediatrics): Clinical sciences
Stevens-Johnson syndrome and toxic epidermal necrolysis: Clinical sciences
Tuberculosis (extrapulmonary and latent): Clinical sciences
Approach to bacterial causes of fever and rash (pediatrics): Clinical sciences
Acute group A streptococcal infections and sequelae (pediatrics): Clinical sciences
Approach to congenital infections: Clinical sciences
Juvenile idiopathic arthritis: Clinical sciences
Kawasaki disease: Clinical sciences
Lyme disease: Clinical sciences
Periorbital and orbital cellulitis (pediatrics): Clinical sciences
Toxic shock syndrome: Clinical sciences
Staphylococcal scalded skin syndrome and impetigo: Clinical sciences
Approach to a murmur (pediatrics): Clinical sciences
Approach to congenital heart diseases (acyanotic): Clinical sciences
Approach to congenital heart diseases (cyanotic): Clinical sciences
Hypertrophic cardiomyopathy: Clinical sciences
Approach to hepatic masses: Clinical sciences
Hepatitis A and E: Clinical sciences
Hepatitis B: Clinical sciences
Hepatitis C: Clinical sciences
Approach to a limp (pediatrics): Clinical sciences
Approach to a suspected bone tumor (pediatrics): Clinical sciences
Developmental dysplasia of the hip: Clinical sciences
Legg-Calve-Perthes disease and slipped capital femoral epiphysis: Clinical sciences
Approach to peripheral lymphadenopathy (pediatrics): Clinical sciences
Approach to a red eye: Clinical sciences
Approach to vomiting (newborn and infant): Clinical sciences
Acetaminophen (Paracetamol) toxicity: Clinical sciences
Approach to recreational substance exposure (pediatrics): Clinical sciences
Diabetes mellitus (pediatrics): Clinical sciences
Large bowel obstruction: Clinical sciences
Pyloric stenosis: Clinical sciences
Small bowel obstruction: Clinical sciences
Approach to a fever (0-60 days): Clinical sciences
Approach to jaundice (newborn and infant): Clinical sciences
Non-accidental trauma and neglect (pediatrics): Clinical sciences
Necrotizing enterocolitis: Clinical sciences
Neonatal respiratory distress syndrome: Clinical sciences
Approach to respiratory distress (newborn): Clinical sciences
Approach to cyanosis (newborn): Clinical sciences
Approach to shock (pediatrics): Clinical sciences
Approach to lower airway obstruction (pediatrics): Clinical sciences
Approach to upper airway obstruction (pediatrics): Clinical sciences
Anaphylaxis: Clinical sciences
Foreign body aspiration and ingestion (pediatrics): Clinical sciences
Approach to a first unprovoked seizure (pediatrics): Clinical sciences
Febrile seizure (pediatrics): Clinical sciences
Approach to bradycardia: Clinical sciences
Approach to tachycardia: Clinical sciences
Brief, resolved, unexplained event (BRUE): Clinical sciences
Approach to hematochezia (pediatrics): Clinical sciences
Burns: Clinical sciences
Neurogenic shock: Clinical sciences
Approach to delayed puberty: Clinical sciences
Approach to feeding and eating disorders: Clinical sciences
Approach to neurodevelopmental disorders: Clinical sciences
Approach to precocious puberty: Clinical sciences
Approach to short stature: Clinical sciences
Autism spectrum disorder: Clinical sciences
Approach to a child with Down syndrome (trisomy 21): Clinical sciences
Dyslipidemia: Clinical sciences
Essential hypertension: Clinical sciences
Developmental milestones (newborn and infant): Clinical sciences
Developmental milestones (toddler): Clinical sciences
Developmental milestones (childhood): Clinical sciences
Approach to a rash in the well newborn and infant: Clinical sciences
Immunizations (pediatrics): Clinical sciences
Well-child visit (adolescent): Clinical sciences
Well-child visit (newborn and infant): Clinical sciences
Well-child visit (toddler and child): Clinical sciences
Well-patient care (GYN): Clinical sciences
Sports physical (pediatrics): Clinical sciences
Antidiuretic hormone
Body fluid compartments
Movement of water between body compartments
Sodium homeostasis
Acid-base disturbances: Pathology review
Diabetes insipidus and SIADH: Pathology review
Electrolyte disturbances: Pathology review
Renal failure: Pathology review
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
Adrenal insufficiency: Pathology review
Central nervous system infections: Pathology review
Childhood and early-onset psychological disorders: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diabetes mellitus: Pathology review
Environmental and chemical toxicities: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Medication overdoses and toxicities: Pathology review
Obstructive lung diseases: Pathology review
Pneumonia: Pathology review
Psychiatric emergencies: Pathology review
Shock: Pathology review
Supraventricular arrhythmias: Pathology review
Traumatic brain injury: Pathology review
Ventricular arrhythmias: Pathology review
Congenital TORCH infections: Pathology review
Jaundice: Pathology review
Respiratory distress syndrome: Pathology review
Autosomal trisomies: Pathology review
Cystic fibrosis: Pathology review
Disorders of sex chromosomes: Pathology review
HIV and AIDS: Pathology review
Miscellaneous genetic disorders: Pathology review
Papulosquamous and inflammatory skin disorders: Pathology review
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Developmental and learning disorders: Pathology review
Eating disorders: Pathology review
Mood disorders: Pathology review
Breastfeeding
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
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
DNA synthesis inhibitors: Fluoroquinolones
DNA synthesis inhibitors: Metronidazole
Miscellaneous protein synthesis inhibitors
Protein synthesis inhibitors: Aminoglycosides
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Glucocorticoids
Azoles
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants

Transcript

Watch video only

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

Genes become 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, which is like a blueprint with instructions on what protein to build.

Translation is also known as protein synthesis, and it’s when organelles called ribosomes assemble the protein 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 subunits that form an 80S ribosome.

Since these proteins are different, we can created 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.

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, the ribosome slides across the mRNA, and the A site sits above a new codon, the tRNAs 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.

Now, a new tRNA with the matching anticodon binds, and the process repeats until a long peptide chain, called a protein, is synthesized.

Finally, termination happens when the ribosome comes across a termination codon on the mRNA.

There are no tRNA anticodons that can bind to these, so they signal the end of protein synthesis.

Tetracyclines were originally derived from soil-dwelling Streptomyces bacteria. They get their name from their structure, which involves four rings bound together, so “tetra” for four, and “cyclins” for rings.

Tetracyclines bind to the A-site on the 30s subunit of the ribosome which inhibits the binding of tRNAs to the mRNA-ribosome complex, and shuts down protein synthesis before it even begins.

Tetracyclines are divided according to their duration of action.

Short acting tetracyclines, like tetracycline itself, have a half life of around 8 hours, and long acting ones like doxycycline and minocycline last for 16 hours or more.

Now, some bacteria developed enzymes that can break down tetracyclines, or they have proteins on their membrane that could pump the medication out.

Key Takeaways

Tetracyclines are a class of antibiotics that inhibit bacterial protein synthesis by binding to the 30s subunit of their ribosomes and preventing tRNA from binding. Tetracyclines are broad-spectrum antibiotics, effective against many common gram-positive and gram-negative bacteria, as well as certain types of anaerobic and atypical bacteria. They are often used to treat respiratory and urinary tract infections, skin and soft tissue infections, and sexually transmitted diseases. Common side effects of tetracyclines include phototoxicity, tinnitus, teeth staining, bone growth delay, nephrotoxicity, and hepatotoxicity.

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. "Tetracyclines: antibiotic action, uptake, and resistance mechanisms" Archives of Microbiology (1996)
  5. "Tigecycline: A Critical Analysis" Clinical Infectious Diseases (2006)
  6. "Tetracyclines" Medical Clinics of North America (1995)
  7. "The Glycylcyclines" Drugs (2004)