Erythromycin may possess bacteriocidal activity, particularly at
higher concentrations. The mechanism is not fully elucidated however.
By binding to the 50S subunit of the bacterial 70S rRNA complex,
protein synthesis and subsequently structure/function processes
critical for life or replication are inhibited. Erythromycin interferes
with aminoacyl translocation, preventing the transfer of the tRNA
bound at the A site of the rRNA complex to the P site of the rRNA
complex. Without this translocation, the A site remains occupied
and thus the addition of an incoming tRNA and its attached amino
acid to the nascent polypeptide chain is inhibited. This interferes
with the production of functionally useful proteins and is therefore
the basis of antimicrobial action.
Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma and Legionellosis. It is also used to treat outbreaks of chlamydia, syphilis, acne, and gonorrhea. In structure, this macrocyclic compound contains a 14-membered lactone ring with ten asymmetric centers and two sugars (L-cladinose and D-desoamine), making it a compound very difficult to produce via synthetic methods Sibutramine is taken once daily, generally in the morning. Therapy usually is started with one 10mg tablet per day. The dose may be increased to 15mg by the physician after several weeks to achieve the desired effect.
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In general, sibutramine is well-tolerated. The most common side effects have been constipation, inability to sleep, headache, and dry mouth. Other side effects include abdominal pain, acne, rash, chest pain, anxiety, joint pain, back pain, excitation, depression, sweating, dizziness, drowsiness, changes in taste, irregular or painful menstrual periods, flu-like syndrome, increased cough, muscle pain, nausea, vomiting, neck pain, nervousness, palpitations, tingling of the extremities, sore throat, and sinus congestion.