Medical student's note

Antibiotics  Content: 1. Antibiotics classification 2. Mechanism of action antibiotics 3. Cell wall synthesis inhibitors 4. Cell membrane integrity disruptors ------------Part 1 5. Nucleic acid synthesis inhibitors 6. Protein synthesis inhibitors 7. Metabolic pathway inhibitors 8. Reference 1. Antibiotics classification broadly defined as chemical agents that kill or inhibit the growth of microorganisms  classified as  broad-spectrum: act against wide range of microorganisms  narrow-spectrum: act against very few types of microorganisms   bactericidal: kill bacteria bacteriostatic: only stop bacteria from growing  Selection of antibiotic  depends largely on  clinical manifestation of the infection  the patient profile  often guided by Kirby-Bauer method: culture sensitivity dilution test: determine the lowest concentration of antibiotic that inhibits visible bacterial growth known as minimum inhibitory concentration (MIC) the lowest concentration of antibiotic that kills at least 99.9%

Fungal Infection also called mycosis a skin disease caused by a fungus Content: 1. Fungal Infection Symptoms 2. Types of Fungal Infections      a. Athlete's foot      b. Jock Itch      c. Ringworm      d. Yeast infections 3. Fungal diseases that affect people who live in or travel to certain areas 4. Fungal diseases that affect people with weakened immune systems 5. Other diseases and health problems caused by fungi 6. Reference Review: 【Pharmacology】Antifungal drugs 1. Fungal Infection Symptoms A fungal skin infection might cause: Irritation Scaly skin Redness Itching Swelling Blisters  2. Types of Fungal Infections can happen anywhere on your body. Most common: Athlete's foot Jock itch Ringworm Yeast infections a. Athlete's foot also called tinea pedis a fungal infection of foot grow best in warm, moist places such as shoes, socks, swimming pools, locker rooms, and public showers often found in the summer and in hot, humid climates happens in people who  wear tight shoes

Antifungal drugs Difficulty of creating drugs? The similarity of fungal and mammalian cells creates a number of challenges for designing drugs that are selectively toxic to fungal cells but not to our own cells.  The only significant difference between fungal and mammalian cells:   presence of fungal cell walls a small structural difference in the plasma membrane 1. Fungal cell wall Cell wall of most fungi is composed of  mannoproteins   rigid layers of complex polysaccharides β-1,3 and β-1,6-linked glucans chitin Being external, the cell wall offers  mechanical strength and acts as a barrier thus protecting the fungus from the hostile environment.  Underneath this wall  lies the plasma membrane made up of phospholipid bilayer The major sterol found in fungal plasma membranes: ergosterol acts to maintain membrane  integrity in the same capacity as cholesterol,   cholesterol is the major sterol found in mammalian  cell membranes houses multisubunit enzymes responsible for fungal cell wa

Hyperlipidemia  A disorder in which there are abnormally elevated levels of fat particles in the blood known as lipids  these lipids can adhere to the walls of the arteries and restrict blood flow creates significant risk of heart attack and stroke  Content: 1. Lipids 2. HMG-CoA reductase inhibitors  3. Lipid-lowering drugs  4. Fibrates 5. Bile acid sequestrants  6. Cholesterol absorption inhibitors 7. PCSK9 inhibitors 8. Omega-3 fatty acids  9. Reference  1. Lipids Three major lipids in the blood  cholesterol necessary for the synthesis of bile acid steroid hormones maintain the integrity of cell membranes triglycerides composed of glycerol and three fatty acids serve as an important source of energy that can be stored throughout the body phospholipids major component of all cell membranes function as an emulsifiers  These lipids are insoluble in blood plasma, so they have to be transported throughout the body in a protein capsule, known as lipoprotein  lipoproteins consist of  a hydr

Anticoagulants and antiplatelet agents used to treat thrombotic disorders or unwanted clot inside a blood vessel which can lead to heart attack or stroke Review: 【Covid-19】Causes & mechanisms that promote thromboinflammation in COVID-19 【Covid-19】Drug for thrombosis in COVID-19: Western medicine & a TCM Prescription Content: 1. Clotting process 2. Platelet aggregation inhibitors 3. Coagulation cascade 4. Anticoagulants 5. Thrombolytics  6. Reference 1. Clotting process In the absence of injury, the endothelial cells that make up the inner surface of blood vessels release nitric oxide and prostacyclin  nitric oxide: dilate blood vessels prostacyclin: bind to receptors located on platelets  prevent platelet activation and aggregation  When there is a damaged blood vessel,  less nitric oxide and prostacyclin  blood vessels become constricted  platelets become activated with the help of von willebrand factors, platelets adhere to exposed collagen which in turn causes them to change

Drug for Heart Failure Review:  【Pharmacology】Heart Failure Content: 1. Beta-blockers 2. Angiotensin-converting enzyme (ACE) inhibitors 3. Angiotensin receptor blockers (ARBs) 4. Angiotensin receptor-neprilysin inhibitor 5. Aldosterone antagonists 6. Loop diuretics 7. Vasodilators 8. Digoxin 9. Reference 1. Beta-blockers work by binding to beta-1 receptors in the heart blocking the action of norepinephrine reducing heart rate and contractility decreases cardiac output and blood pressure *Decreased heart rate allows more diastolic filling time, so the stroke volume is typically not reduced. via blockade of the alpha 1 receptors of the renal juxtaglomerular complex, certain beta-blockers may also reduce renin secretion reducing the severity of angiotensin II-induced vasoconstriction & aldosterone-induced volume expansion ***however is not beta-blockers primary mechanism of action. Review: 【Pharmacology】Adrenergic drug (adrenergic antagonists) Currently only three have proven to reduc