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星 Improve grampositive coverage, maintain gramnegative coverage, and gain anaerobic coverage.,Quinolones,Quinolones,第十三頁,共五十四頁。n)桿菌屬. Longer halflives due to slow elimination, distribution into many tissues and body fluids and penetration into human cells.,Quinolones,Quinolones,第十一頁,共五十四頁。,Secondgeneration quinolones (19691979) Pipemidic acid 吡哌酸 Cinoxacin西諾沙星 Expanded gramnegative activity and atypical pathogen coverage, but limited grampositive activity. Most active against aerobic gramnegative bacilli Ciprofloxacin remains the quinolone most active against Pseudomonas aeruginosa,Quinolones,Quinolones,第十頁,共五十四頁。,Typical therapeutic applications of uoroquinolones.,第八頁,共五十四頁。,Generation Examples 1 st (19621969) Nalidixic acid, 萘啶酸 2 nd (19691979) Pipemidic acid 吡哌酸 Cinoxacin 西諾沙星 3 rd (19801996) Norfloxacin 諾氟沙星 Levofloxacin 左氧氟沙星 Ciprofloxacin 環(huán)丙沙星 Ofloxacin 氧氟沙星 sparfloxacin 司帕沙星 4 th (1997) Grepafloxacin 格帕沙星 Clinafloxacin 克林沙星 Gatifloxacin 加替沙星 Moxifloxacin 莫西沙星,Classification,Quinolones,第六頁,共五十四頁。,Chemistry Derived from basic structure of nalidixic acid (萘啶酸)and have substituents at N1, C5, C7, position 8 and a fluorine atom at position 6. Fluorine at position 6 enhances gyrase inhibition and cell penetration.,Quinolones,Quinolones,第四頁,共五十四頁。 Ⅲ. Other synthetic antimicrobial agents: Trimethoprim (甲氧芐啶) Nitrofurans (硝基(xiāo jī)呋喃類), etc.,第二頁,共五十四頁。,Classification of Synthetic antimicrobial agents,Ⅰ. Quinolones(喹諾酮類)。 ch233。Synthetic antimicrobial agents (人工合成(r233。n ɡōnɡ h233。nɡ)抗菌藥),Huifang Tang,第一頁,共五十四頁。 Ⅱ. Sulfonamides(磺胺類)。,General features Broad antimicrobial activity and are effective after oral administration for the treatment of a wide variety of infectious disease. Relatively few side effects. Microbial resistance to their action does not develop rapidly.,Quinolones,Quinolones,第三頁,共五十四頁。,Chemical structure,Quinolones,(諾氟沙星),(環(huán)丙沙星),(萘啶酸),Quinolones,第五頁,共五十四頁。,Summary of antimicrobial spectrum of quinolones.,第七頁,共五十四頁。,Firstgeneration agents(19621969) Nalidixic acid, 萘啶酸 The first generation drug of the quinolone antibiotics Moderate gramnegative activity and minimal systemic distribution Clinical applications Uncomplicated urinary tract infections,Quinolones,Quinolones,第九頁,共五十四頁。,Secondgeneration quinolones (19691979) Active against grampositive and gramnegative bacteria, mycobacteria, mycoplasma支原體and legionella species軍團(jūntu225。,Thirdgeneration quinolones (19801996) Norfloxacin 諾氟沙星, Levofloxacin 左氧氟沙星, Ciprofloxacin 環(huán)丙沙星, Ofloxacin 氧氟沙星, Sparfloxacin 司帕沙星 Adde