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30 Cards in this Set

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Macrolides: Common Examples
- Azithromycin (Z-pak)
- Clarithromycin
- Clindamycin
- Erythromycin
Mechanism of Action
- Reversibly binds to 50S ribosome
- Prevents protein elongation
- Bacteriostatic
Typical Uses
- Broadly active against gram+ organisms, some gram-.
- Community acquired pneumonia
- Skin infections (not MRSA)
- URIs
- Legionella, Chlamydia, Mycoplasma
Side Effects
Well tolerated
Resistance Mechanisms
- Methylation of 23S RNA of 50S subunit prevents binding of drug
- hydrolysis of drug's lactone ring
- efflux of drug
aminoglycosides: common examples
- streptomycin
- gentamycin
- tobramycin
- amikacin
- neomycin
Mechanism of action
- bind irreversibly to 30S subunit
- bactericidal
- transport across cell membrane requires O2, so not effective against anaerobes.
- Synergy: work well with beta-lactams
Uses
- gram negatives, particularly pseudomonas
- complicated UTIs
- Gentamycin at HUP frequently administered with a beta lactam
side effects
- Nephrotoxicity
- Ototoxicity
Resistance
- Most common mechanism is modification of the drug
Tetracyclines: Common examples
- doxycycline
Mechanism of action
- Bind to 30S subunit
- Prevent attachment of tRNA
- Broad spectrum, bacteriostatic
Uses
- Acne
- Chronic bronchitis
- Lyme disease
- Mycoplasma pneumoniae
- Rickettsia
- Chamydia
Side Effects
- Discolored teeth in children - do not give to children or pregnant women
- Phototoxic dermatitis
Resistance
- Increased efflux from cells
- Decreased penetration
Chloramphenicol
blank
Mechanism of action
- binds to 50S subunit
- prevents peptide bonds from forming
Uses
- very wide spectrum
- Used as last resort due to rare/deadly side effects
- Example: meningitis of unknown origin and patient has penicillin allergy
- Example: Rocky mountain spotted fever in young children and pregnant women: can't use tetracycline
- Used widely in 3rd world due to very low cost
Side effects
- aplastic anemia: bone marrow wiped out - very rare
- can't give to neonates
Resistance
none listed
Oxazolidones: Common examples
Linezolid - the 'L' in 'clean tag'
Mechanism of Action
- Binds to 50S subunit
- bacteriostatic
Uses
- staph, strep, enterococci
Resistance
none listed
Side effects
- very high cost: $163/day at Penn
- myelosuppression
Lincosamides: Example
Clindamycin
Mechanism of Action
- Targets 50S subunit
- Inhibits toxin production
Uses
- Excellent gram pos. activity against S. aureus and streptococci.
- Bacteriocidal
Resistance Mechanisms
Ribosomal mutation
Side effects
diarrhea