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54 Cards in this Set

  • Front
  • Back

The protein synthesis inhibitors are what type of antibiotics?

baceriostatic

Chloramphenicol, Macrolides, telithromycin, and clindamycin, inhibit protien synthesis by binding to what?

The 50s ribosomal subunit

Tetracyclin block protein synthesis by binding to what?

The 30s ribosomal subunit, preventing the binding of amino acid charged tRNA to the acceptor site of the ribosome mRNA complex

Which antibiotic that binds to the 50s ribosomal subunit is bactericidal?

Streptogramins
The protein synthesis inhibitors are what type of antibiotics?
baceriostatic

Chloramphenicol, Macrolides, telithromycin, and clindamycin, inhibit protien synthesis by binding to what?

The 50s ribosomal subunit
Tetracyclin block protein synthesis by binding to what?
The 30s ribosomal subunit, preventing the binding of amino acid charged tRNA to the acceptor site of the ribosome mRNA complex

Which drug is reserved for VRE?

Streptogramins (combo Quinupristin/ dalforpristin)

Which drug binds to a unique site on the 50s subunit blocking the formation of the tRNA-ribosome-mRNA tertiary complex

Linezolid

Which drug has a selective inhibition for mammalian mitochondrial ribosomes, which contain the 70s subunit

chloramphenicol
Wide spectrum bacteriostatic drug that cross es the blood brain, and placental barrier. used both orally and parenternally to treat Haemophilus, Neisseria, and Baceriodes
Chloramphenicol

Drug that causes erythrocytopenia, and rarely aplastc anemia, also can cause "gray baby syndrome"

Chloramphenicol

Chloramphinicol has what effects on the CYP450 enzymes

It has an inhibiting effect, increasing half lives of other CYP450 metabolized drugs

Broad spectrum antibiotics with activity against gram + and gram - species of Rickettsia, Chlamydia, Mycoplamsa, and protozoa

tetracyclines
Tetracycline that undergoes hepatic cycling, and is excreted mainly in the feces
Doxycycline
Specific drug used for the treatment Gastric ulcers caused by H pylori
tetracycline
Specific drug used for the treatment of Lymes disease, and amoebiasis, as well as prevention of malaria
doxycycline
Tetracycline used to treat patients with ADH secreting tumors

Demeclocycline

Clinical uses of Tigecycline

gram + MRSA and VRE, gram -, anaerobes, chlamydiae, and mycobacteria. only IV available

Toxicities of tetracyclines
mild nausea and diarrhea to life threatening enterocolitis. candidiasis (oral and vaginal), and bacterial superinfections with S aureus and Clostridium D
Fetal exposure to this drug may cause tooth enamel dysplasia and irregularities in bone growth
tetracycline

High doses of tetracyclines in pregnant patients, or those with preexisting hepatic disease may cause

hepatic necrosis/ fatal hepatotoxicity

Other side effects/toxicities of tetracyclines

photosensitivity to UV light, fanconi's syndrome, dizziness and vertigo

What are the macrolide antibiotics?

erythromycin, azithromycin, and clarithromycin
Erythromycin is most against which organisms?
Campylobacter, Chlamydia, Mycoplasma, legionella, gram + cocci, and some gram -

Azithromycin and Clarithromycin have a greater activity against which organisms that erythromycin

Chlamydia, H. influenzae, Moraxella

Resistance to macrolides are by what mechanism?

gram + is through an efflux pump, and production of a methylase that binds to binding site

Drug of choice for legionella
erythromycin
Azithromycin is used for single dose treatment of what, and a four day treatment of what?

urinary tract infections caused by C trachomatis, and 4 day is for community acquired pneumonia

Toxicities associated with erythromycin:

GI irritation, skin rashes, and eosinophelia. It is also an inhibitor of CYP450 enzymes

Which ketolyde is a good substitute for some macrolide resistant strains due to its increased binding capability, and poor role as efflux pump substrate

telithromycin

This drug binds to the 50 s subunit and inactivates bacterial enzymes. Used to treat severe infections by Bacteroides, as well as MRSA

Clindamycin

Drug in this group that is most associated with supperinfection infection by clostridium difficile, causing pseudomembraneous colitis

clindamycin

Drugs used in combination against MRSA, PRSP, and VRE

Streptogramins. are potent inhibitors of CYP3A4.
New drug also used to treat MRSA, PSRP, and VRE. Binds to the 23S ribosomal RNA of the 50s ribosomal subunit. (no cross resistance)
Linezolid. is both oral and parenternal
toxicities of Linezolid:

can cause neutro and thrombocytopenia, especially in the immunosuppressed. and implicated in serotonin syndrome in those taking SSRI's

What is the resistance mech for Tetracycline?

Mg2+ dependent active efflux of the drug mediated by plasma resistance protein TetA

Why would you not take antacids with tetracyclines?

formation of nonabsorbable chelates with calcium ions, also magnesium and aluminum

What is DOC for cholera?

Doxycycline and rehydration

DOC for chlamydial infections (trachomatis, psittaci)?

Docycyline or azithromycin

What tetracycline is used to eradicate meningococcal carrier state because of how it enter the brain without inflammation?

Minocycline; not effective however for CNS infections

How are tetracyclines excreted?

The bile (conjugated to glucuronides for urine) Doxycycline can be given in pts renally compromised only excreted by bile

Which tetracycline causes vestibular problems?

Minocycline concentrates in the endolymph of the ears (also doxycycline)

What drug can cause pseudotumor cerebri (benign intracranial hypertension)?

Tetracyclines

What should you not treat with Tigecycline?

bacteremia- IV tigecycline distributes rapidly into body tissues (cytokine storm)



MOA Tigecycline

Tigecycline is a Glycycline (related to tetracycline reversibly binds to 30s subunit and inhibits protein translation

What macrolide is drug of choice for Mycobacterium avium-intracellulare?

Azithromycin


Which drug has less incidence of thrombophlebitis when administered IV?

Azithromycin < erythromycin

Macrolide counterindicated in pts with proarrhythmic conditions, myasthenia gravis, or who are renal compromised?

Telithromycin


- prolongs QT interval

Drug causes hemolytic anemia in G6PD?

Chloramphenicol

Adverse effects of administration of Quinupristin/dalfopristin?

1. venous irritation


2. arthralgia/myalgia


3. hyperbilirubinemia


3. inhibition CYP3A4 (increase cyclosporine, nifedipine, diltiazem, carbamazepine, warfarin, phenytoin...etc)

What are the two bacteria that linezolid are bacterial cidal?

Streptococci and C. perfringens

Why are pts on linezolid advised not to consume quantities of tyramine-containing foods?

inhibits monoamine oxidase

what do you have to be aware of in a pt taing SSRI and the possibility of giving linezolid?

serotonin syndrome