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Kernicterus and sulphonamides displacement of bilibrubin from albumin Hepatic coma and formation of ammonia use of non-absorbable antibiotics such as neomycin
Tetracyclines
GIT absorption (chelate other compounds, eg Ca++, Mg++, Fe++ give before meals) in renal failure (use doxyclcine: excreted by GIT)
aminoglycosides bind to the 30S ribosomal subunit and disrupt bacterial protein synthesis by misreading of the mRNA template
chloramphenicol binds to the 50S subunit floxacins (cipro-, nor-, o-) DNA gyrase inhibition (DNA Helix). The double helix must separate and unwind for replication and the separated strands tend to supercoil ahead of the separation. Bacterial DNA gyrase imposes a negative supercoil to prevent this happening. When gyrase is inhibited the process does not function and cell replication is affected. No effect on cell wall
penicillins and cephalosporins bind to various penicillin binding proteins (PBPs) linked to a transpeptidase which is inhibited. As this is necessary for the fourth (last) step of peptidoglycan synthesis in the bacterial cell wall, the cell wall is thus defective and is autolysed
sulphonamides : synthesis of folic acid from PABA (sulphonamides are analogues of para amino benzoic acid) only in bacteria that must generate their own folic acid. Bacteria (and humans) who can use preformed folate are not affected
tetracyclines bind to the 30S subunits of bacterial ribosomes trimethoprim : dihydrofolate reductase inhibitor (next step along) therefore synergistic with sulphonamides
vancomycin inhibits the third stage of bacterial wall peptidoglycan synthesis thus causing disruption (see penicillin)