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54 Cards in this Set
- Front
- Back
The protein synthesis inhibitors are what type of antibiotics? |
baceriostatic
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Chloramphenicol, Macrolides, telithromycin, and clindamycin, inhibit protien synthesis by binding to what? |
The 50s ribosomal subunit
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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
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Which antibiotic that binds to the 50s ribosomal subunit is bactericidal? |
Streptogramins
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The protein synthesis inhibitors are what type of antibiotics?
|
baceriostatic
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Chloramphenicol, Macrolides, telithromycin, and clindamycin, inhibit protien synthesis by binding to what? |
The 50s ribosomal subunit
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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
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Which drug is reserved for VRE? |
Streptogramins (combo Quinupristin/ dalforpristin) |
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Which drug binds to a unique site on the 50s subunit blocking the formation of the tRNA-ribosome-mRNA tertiary complex |
Linezolid |
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Which drug has a selective inhibition for mammalian mitochondrial ribosomes, which contain the 70s subunit |
chloramphenicol
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Wide spectrum bacteriostatic drug that cross es the blood brain, and placental barrier. used both orally and parenternally to treat Haemophilus, Neisseria, and Baceriodes
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Chloramphenicol
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Drug that causes erythrocytopenia, and rarely aplastc anemia, also can cause "gray baby syndrome" |
Chloramphenicol |
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Chloramphinicol has what effects on the CYP450 enzymes
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It has an inhibiting effect, increasing half lives of other CYP450 metabolized drugs |
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Broad spectrum antibiotics with activity against gram + and gram - species of Rickettsia, Chlamydia, Mycoplamsa, and protozoa |
tetracyclines
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Tetracycline that undergoes hepatic cycling, and is excreted mainly in the feces
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Doxycycline
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Specific drug used for the treatment Gastric ulcers caused by H pylori
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tetracycline
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Specific drug used for the treatment of Lymes disease, and amoebiasis, as well as prevention of malaria
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doxycycline
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Tetracycline used to treat patients with ADH secreting tumors
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Demeclocycline |
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Clinical uses of Tigecycline
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gram + MRSA and VRE, gram -, anaerobes, chlamydiae, and mycobacteria. only IV available |
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Toxicities of tetracyclines
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mild nausea and diarrhea to life threatening enterocolitis. candidiasis (oral and vaginal), and bacterial superinfections with S aureus and Clostridium D
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Fetal exposure to this drug may cause tooth enamel dysplasia and irregularities in bone growth
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tetracycline
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High doses of tetracyclines in pregnant patients, or those with preexisting hepatic disease may cause |
hepatic necrosis/ fatal hepatotoxicity |
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Other side effects/toxicities of tetracyclines
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photosensitivity to UV light, fanconi's syndrome, dizziness and vertigo |
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What are the macrolide antibiotics? |
erythromycin, azithromycin, and clarithromycin
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Erythromycin is most against which organisms?
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Campylobacter, Chlamydia, Mycoplasma, legionella, gram + cocci, and some gram -
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Azithromycin and Clarithromycin have a greater activity against which organisms that erythromycin |
Chlamydia, H. influenzae, Moraxella |
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Resistance to macrolides are by what mechanism?
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gram + is through an efflux pump, and production of a methylase that binds to binding site |
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Drug of choice for legionella
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erythromycin
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Azithromycin is used for single dose treatment of what, and a four day treatment of what?
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urinary tract infections caused by C trachomatis, and 4 day is for community acquired pneumonia |
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Toxicities associated with erythromycin:
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GI irritation, skin rashes, and eosinophelia. It is also an inhibitor of CYP450 enzymes |
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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
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This drug binds to the 50 s subunit and inactivates bacterial enzymes. Used to treat severe infections by Bacteroides, as well as MRSA |
Clindamycin
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Drug in this group that is most associated with supperinfection infection by clostridium difficile, causing pseudomembraneous colitis |
clindamycin |
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Drugs used in combination against MRSA, PRSP, and VRE |
Streptogramins. are potent inhibitors of CYP3A4.
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New drug also used to treat MRSA, PSRP, and VRE. Binds to the 23S ribosomal RNA of the 50s ribosomal subunit. (no cross resistance)
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Linezolid. is both oral and parenternal
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toxicities of Linezolid:
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can cause neutro and thrombocytopenia, especially in the immunosuppressed. and implicated in serotonin syndrome in those taking SSRI's |
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What is the resistance mech for Tetracycline? |
Mg2+ dependent active efflux of the drug mediated by plasma resistance protein TetA |
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Why would you not take antacids with tetracyclines? |
formation of nonabsorbable chelates with calcium ions, also magnesium and aluminum |
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What is DOC for cholera? |
Doxycycline and rehydration |
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DOC for chlamydial infections (trachomatis, psittaci)? |
Docycyline or azithromycin |
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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 |
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How are tetracyclines excreted? |
The bile (conjugated to glucuronides for urine) Doxycycline can be given in pts renally compromised only excreted by bile |
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Which tetracycline causes vestibular problems? |
Minocycline concentrates in the endolymph of the ears (also doxycycline) |
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What drug can cause pseudotumor cerebri (benign intracranial hypertension)? |
Tetracyclines |
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What should you not treat with Tigecycline? |
bacteremia- IV tigecycline distributes rapidly into body tissues (cytokine storm)
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MOA Tigecycline |
Tigecycline is a Glycycline (related to tetracycline reversibly binds to 30s subunit and inhibits protein translation |
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What macrolide is drug of choice for Mycobacterium avium-intracellulare? |
Azithromycin
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Which drug has less incidence of thrombophlebitis when administered IV? |
Azithromycin < erythromycin |
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Macrolide counterindicated in pts with proarrhythmic conditions, myasthenia gravis, or who are renal compromised? |
Telithromycin - prolongs QT interval |
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Drug causes hemolytic anemia in G6PD? |
Chloramphenicol |
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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) |
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What are the two bacteria that linezolid are bacterial cidal? |
Streptococci and C. perfringens |
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Why are pts on linezolid advised not to consume quantities of tyramine-containing foods? |
inhibits monoamine oxidase |
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what do you have to be aware of in a pt taing SSRI and the possibility of giving linezolid? |
serotonin syndrome |