第41章 抗菌药概论.pptVIP

抗微生物药概论 抗微生物药 抗菌药 抗真菌药 抗病毒药 抗菌药物分类(结构) Classification and Mechanism of Action Antimicrobial agents are classified based on chemical structure and proposed mechanism of action, as follows: (1) agents that inhibit synthesis of bacterial cell walls, including the b-lactam class (e.g., penicillins, cephalosporins, and carbapenems) and dissimilar agents such as cycloserine, vancomycin, and bacitracin; (2) agents that act directly on the cell membrane of the microorganism, increasing permeability and leading to leakage of intracellular compounds, including detergents such as polymyxin; polyene antifungal agents (e.g., nystatin and amphotericin B) which bind to cell-wall sterols; and the lipopeptide daptomycin; (3) agents that disrupt function of 30S or 50S ribosomal subunits to reversibly inhibit protein synthesis, which generally are bacteriostatic (e.g., chloramphenicol, the tetracyclines, erythromycin, clindamycin, streptogramins, and linezolid); (4) agents that bind to the 30S ribosomal subunit and alter protein synthesis, which generally are bactericidal (e.g., the aminoglycosides); (5) agents that affect bacterial nucleic acid metabolism, such as the rifamycins (e.g., rifampin and rifabutin), which inhibit RNA polymerase, and the quinolones, which inhibit topoisomerases; (6) the antimetabolites, including trimethoprim and the sulfonamides, which block essential enzymes of folate metabolism.. classes of antiviral agents There are several classes of antiviral agents, including: (1) nucleic acid analogs, such as acyclovir or ganciclovir, which selectively inhibit viral DNA polymerase, and zidovudine or lamivudine, which inhibit HIV reverse transcriptase; (2) non-nucleoside HIV reverse transcriptase inhibitors, such as nevirapine or efavirenz; (3) inhibitors of other essential viral enzymes, e.g., inhibitors of HIV protease or influenza neuraminidase; and (4) fusion inhibitors such as enfuvirtide . Additional categories likely will emerge as more complex mechani