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Antimicrobials
Metabolism Inhibitors
33
Veterinary Medicine
Graduate
03/07/2012

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Term
Examples of Metabolism Inhibitors
Definition
Folate Synthesis Inhibitors and Energy Production Pathway Inhibitors.
Term
Folate Synthesis Inhibitors
Definition
i.Sulfonamides
ii.Diaminopyrimidines
iii.Combination = “Potentiated Sulfonamides”
Term
Sulfonamides
Definition
Folate Synthesis Inhibitors
Term
Diaminopyrimidines
Definition
Folate Synthesis Inhibitors
Term
Potentiated Sulfonamides
Definition
Combination of sulfonamides and Diminopyrimidines
Term
Energy Production Pathway Inhibitor Examples
Definition
Nitrofurans
Term
Examples of Sulfonamides “Sulfa” drugs
Definition
Sulfamethoxazole

Sulfadiazine

Sulfamethoxine
Term
Sulfamethoxazole
Definition
Sulfonamides
Term
Sulfadiazine
Definition
Sulfonamides
Term
Sulfamethoxine
Definition
Sulfonamides
Term
Sulfonamide Mechanism of Action
Definition
1) penetrate bacteria
2) Compete with PABA and inhibit folic acid synthesis in bacteria and some protozoans
3) activiry decreased in pus or necrotic tissue
Term
Sulfonamides Spectrum of Activity
Definition
1) bacteriostatic
2)Time Dependent
3) broad spectrum (G +, G-, aerobes, not Anaerobes tho)
4) mostly extracellular
5) some protozoa
Term
Sulfonamides PK
Definition
Absorption: partial oral
Distribtution: extracellular, good in fluids
Metabolism:liver metabolism
Elimination:mixed liver and renal elimination
Term
Sulfonamide Combination
Definition
Additive or Synergistic when added with Diaminopyrimidines: "Potenitated Sulfomides"
Term
Sulfonamide Adverse Reactions
Definition
relatively safe.
--dose dependent effects.
--Thyroid function prohibited (dogs)*try to avoid in animals with hypothyroid or adjust T4)
--KeratoConjuctivitis Sicca (KCS) (dogs)
*avoid in dogs with eye disease
--Urinary disturbances (rare)

**Allergic reactions more rare then penicillin reactions but do not use in Dobermans

**Banned off label use in Lactating dairy cows
Term
Diaminopyrimidines Examples
Definition
-"oprim" drugs

-Trimethoprim
-Ormetoprim
Term
Trimethoprim
Definition
Diaminopyrimidines
Term
Ormetroprim
Definition
Diaminopyrimidines
Term
Diaminopyrimidines Mechanism of Action
Definition
Prevent activation of folic acid to folinic acid
Term
Diaminopyrimidines Spectrum of Action
Definition
-Bacteriostatic
-Time-dependent
-Broad Spectrum (not anaerobes tho)
-Protozoa
Term
Diaminopyrimidines PK
Definition
Absorption: well absorbed orally
Distribution: Extra and intra-good for fluids and deep tissues.
Metabolism: liver metabolism
Elimination: liver excretion
Term
Diaminopyrimidines Combinations
Definition
"potentiated sulfonamides"
Term
Diaminopyrimidines Adverse Reactions
Definition
Dose Dependent Folate Deficiency (can hurt mammalian cells too!)
--blood cytopenia (dosed for more than 3 weeks)
--reversible

--avoid in pregnant aniamsl

--supplement with folic acid and folinic acid
Term
Potentiated Sulfonamides Examples
Definition
Sulfamethoxazole + Trimethoprim

Sulfadimethoxine + Oremtoprim

Sulfadiazine + Trimethoprim
Term
Rationale Behind the Potentiated Combinations
Definition
1) sequential mechanisms of action in the folic acid synthesis pathway

2) combination potentially bactericidal

3) extension of the spectrum to intracellular microbes

4) Extension of the tissue penetration (fluids and deep tissues)
Term
Potentiated Sulfonamides Activity
Definition
-Bacteriostatic

-Time-dependent
Term
Energy Production Pathway Inhibitors
Definition
Nitrofurans
Term
Nitrofuran Example
Definition
Nitrofurantoin
Term
Nitrofuran Mechanism of Action
Definition
Deprive bacteria from a key energy production pathway and damage DNA.
Term
Nitrofuran Spectrum of Activity
Definition
1) Bacteriostatic or cidal
2) Broad Spectrum (all four quads!)
3) Extracellular
4)Protozoa
Term
Nitrofuran PK
Definition
Absorption: oral
Distribution: extracellular
Metabolism: liver
Elimination:renal --concentration in the urine
Term
Nitrofuran Adverse Reactions
Definition
dose-dependent toxicity
--ok if used locally or at low dose for UTI

--drug allergies are relatively common
Term
Nitrofuran Clincical Usage
Definition
-Locally: otits
-Systemically: UTI
-Banned in Food Animals completely
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