非beta-内酰胺类抗生素(英文教学)Nonbeta-lactam antibiotics讲解说明.pptVIP

Tetracyclines can probably impair hepatic function, especially during pregnancy, in patients with preexisting hepatic insufficiency and when high doses are given intravenously. Hepatic necrosis has been reported with daily doses of ≥ 4 g i.v.Renal tubular acidosis and other renal injury resul- ting in nitrogen retention is a conraindication to the administration of outdated tetracycline preparations. Tetracyclines given with diuretics may produce nitrogen retention. Tetracyclines other than doxycycline may accumulate to toxic levels in patients with impaired kidney function. Intravenous injection can lead to venous thrombosis. Intramuscular injection produces painful local irritation and should be avoided.Systemically administered tetracycline, especially demeclocycline, can induce sensitivity to sunlight or ultraviolet light, particularly in fair-skinned persons.Dizziness, vertigo, nausea, and vomiting have been noted particularly with doxycycline and Minocycline at high doses. The main mechanisms of resistance to tetracycline and its analogues are: impaired influx or increased efflux by an active transport protein pump; (2) ribosome protection due to production of proteins that interfere with tetracycline binding to the ribosome; 3) enzymatic inactivation. III. CHLORAMPHENICOL Chloramphenicol and macrolides bind to the 50S subunit and block transpeptidation and protein synthesis. It has bacteriostatic action. Because of potential toxicity, bacterial resistance, and the availability of many other effective alternatives, chloramphenicol is rarely used. It may be considered for treatment of serious rickettsial infections such as typhus and Rocky Mountain spotted fever. It is an alternative to a beta-lactams for treatment of meningococcal meningitis occurring in patients who have major hypersensitivity reactions to penicillin or bacterial meningitis caused by penicillin-resistant strains of pneumococci. Assoc. Prof. Ivan