1. General Pharmacological Principles
    2. 1. Introduction, Routes of Drug Administration
    2. Pharmacokinetics: Membrane Transport, Absorption and Distribution of Drugs
    3. Pharmacokinetics: Metabolism and Excretion of Drugs, Kinetics of Elimination
    4. Pharmacodynamics: Mechanism of Drug Action; Receptor Pharmacology
    5. Aspects of Pharmacotherapy, Clinical Pharmacology and Drug Development
    6. Adverse Drug Effects
  2. Drug Acting on Autonomic Nervous System
    3. 7. Cholinergic Transmission and Cholinergic Drugs
    8. Anticholinergic Drugs and Drugs Acting on Autonomic Ganglia
    9. Adrenergic Transmission and Adrenergic Drugs
    10. Antiadrenergic Drugs (Adrenergic Receptor Antagonists) and Drugs for Glaucoma
  3. Autacoids and Related Drugs
    4. 11. Histamine and Antihistaminics
    12. 5-Hydroxytryptamine, its Antagonists and Drug Therapy of Migraine
    13. Prostaglandins, Leukotrienes (Eicosanoids) and Platelet Activating Factor
    14. Nonsteroidal Antiinflammatory Drugs and Antipyretic-Analgesics
    15. Antirheumatoid and Antigout Drugs
  4. Respiratory System Drugs
    5. 16. Drugs for Cough and Bronchial Asthma
  5. Hormones and Related Drugs
    6. 17. Anterior Pituitary Hormones
    18. Thyroid Hormones and Thyroid Inhibitors
    19. Insulin, Oral Antidiabetic Drugs and Glucagon
    20. Corticosteroids
    21. Androgens and Related Drugs, Drugs for Erectile Dysfunction
    22. Estrogens, Progestins and Contraceptives
    23. Oxytocin and Other Drugs Acting on Uterus
    24. Hormones and Drugs affecting Calcium balance
  6. Drugs acting on Peripheral nervous system
    7. 25. Skeletal muscle relaxants
    26. Local anaesthetics
  7. Drugs acting on Central nervous system
    8. 27. General anaesthetics
    28. Ethyl and Methyl alcohols
    29. Sedative-Hypnotics
    30. Antiepileptic Drugs
    31. Antiparkinsonian Drugs
    32. Drugs used in Mental Illness: Antipsychotic and Antimanic drugs
    33. Drugs used in Mental Illness: Antidepressant and Antianxiety drugs
    34. Opioid analgesics and antagonists
    35. CNS stimulants and Cognitino enhancers
  8. Cardiovascular drugs
    9. 36. Drugs affecting Renin-Angiotensin system
    37. Nitric oxide and Vasoactive peptide signal molecules
    38. Cardiac glycosides and Drugs for Heart failure
    39. Antiarrhythmic drugs
    40. Antianginal and other Anti-ischaemic drugs
    41. Antihypertensive drugs
  9. Drugs acting on Kidney
    10. 42. Diuretics
    43. Antidiuretics
  10. Drugs affecting blood and Blood formation
    11. 44. Haematinics and Erythropoietin
    45. Drugs affecting Coagulation, Bleeding and Thrombosis
    46. Hypolipidaemic drugs
  11. Gastrointestinal drugs
    12. 47. Drugs for Pepric ulcer and gastroesophageal reflux disease
    48. Antiemetic, Prokinetic and Digestant drugs
    49. Drugs for Constipation and Diarrhoea
  12. Antimicrobial drugs
    13. 50. Antimicrobial drugs: General considerations
    51. Sulfonamides, Cotrimoxazole and Quinolones
    52. Beta-lactam antibiotics
    53. Tetracyclines and Chloramphenicol (Broad-spectrum antibiotics)
    54. Aminoglycosides antibiotics
    55. Macrolide, Lincosamide, Glycopeptide and Other antibacterial antibiotics; Urinary antiseptics
    56. Antitubercular Drugs
    57. Antileprotic Drugs
    58. Antifungal drugs
    59. Antiviral drugs (Non-retroviral)
    60. Antiviral drugs (Anti-retrovirus)
    61. Antimalarial drugs
    62. Antiamoebic and Other antiprotozoal drugs
    63. Antihelmintic drugs
  13. Chemotherapy of Neoplastic diseases
    14. 64. Anticancer drugs
  14. Miscellaneous drugs
    15. 65. Immunosuppressant drugs
    66. Drugs acting on Skin and Mucous membranes
    67. Antiseptics, Disinfectants and Ectoparasiticides
    68. Chelating agents
    69. Vitamins
    70. Vaccine, Antisera and Immunoglobulins
    71. Drug interactions
Antimicrobial drugs
53. Tetracyclines and Chloramphenicol (Broad-spectrum antibiotics)
TETRACYCLINES
Tetracycline
Chloramphenicol
Aminoglycoside
Macrolide
MOA
Binds to A site (Step 2) {30S Ribosome}
Prevents transfer of peptide from P to A (P->A) (Step 3) {50S Ribosome}
Binds to P site (Step 1) { 30S + 50S + 30S-50S junction
Prevents transfer of peptide from A to P (A->P) (Step 4) {50S Ribosome}
Uses
  1. Empirical therapy
  2. Mixed infection
  3. First choice drug
    1. Venereal diseases
      1. Chlamydial nonspecific urethritis
      2. Lymphogranuloma venereum
      3. Granuloma inguinale
    2. Atypical pneumonia
    3. Cholera
  4. Second choice drug
    1. To penicillin/ampicillin for tetanus
    2. To Ceftriaxone for Syphilis
    3. To azithromycin fro pneumonia
  5. Others
    1. UTI
    2. Community acquired pneumonia
  1. Pyogenic Meningitis (alternative)
  2. Anaerobic infectsions
  3. Typhoid fever (especially in MDR cases)
  4. Intraocular infections
  5. Topically
    1. Conjunctivitis
    2. External ear infections
  1. Severe gram-negative infections
  2. Subacute bacterial endocarditis
  3. Tuberculosis (Streptomycin)
  4. Plague
  5. tularemia
  1. Respiratory tract infections
  2. Atypical pneumonia
  3. Chlamydia
  4. Pertussis
Adverse effects
  1. Irritative effects
    1. Epigastric pain
    2. Nausea
    3. Vomiting
    4. Diarrhoea
  2. Organ toxicity
    1. Liver damage
    2. Kidney damage
    3. Phototoxicity
    4. Teeth discoloration and bone deformities in children
    5. Vestibular toxicity
  3. Hypersensitivity
  4. Super infection
  1. Gray baby syndrome
  2. Bone marrow suppression (dose-related reversible & idiosyncratic aplastic anemia)
  3. Hypersensitivity reactions
  4. Irritative effects
    1. Epigastric pain
    2. Nausea
    3. Vomiting
    4. Diarrhoea
  5. Hypersensitivity
    1. Fever
    2. Rash
    3. Atrophic glossitis
    4. Angioedema
  6. Super infection
  1. Ototoxicity
    1. vestibular damage
    2. Cochlear damage
  2. Nephrotoxicity
  3. Neuromuscular blockade
  1. Gastrointestinal
    1. Epigastric pain
    2. Nausea
    3. Anorexia
  2. Reversible hearing impairment
  3. Hypersensitivity
Special Points
Contraindicated in children <8 years and pregnancy due to bone/teeth effects
Reserved for life-threatening infections due to toxicity risk and Avoided in neonates
Avoided during pregnancy due to risk of foetal ototoxicity
Safe alternative in penicillin-allergic patients
CHLORAMPHENICOL