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27 Cards in this Set
- Front
- Back
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What kind of spectrum are Tetracyclines and what is their mechanism of action? |
Broad-Spectrum, they enter the cell by energy dependent system, bind to 30s ribosomal subunit & inhibit binding of transfer RNA to the mRNA so they inhibit protein synthesis. |
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Is it Bacteriocidal or Bacteriostatic? |
Bacteriostatic |
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They are drug of first choice for what diseases? |
Rickettsial disease, infections caused by Chlamydia trachomatis, brucellosis, cholera, pneumonia caused by mycoplasma pneumonia, Lyme disease, anthrax and GI infections caused by H.pylori |
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Topical and oral doses can treat what? |
Acne, peptic ulcer disease, periodontal disease (doxycycline & minocycline), Rheumatoid arthritis (minocycline) |
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What route are they administered? |
All oral, plus Doxycycline & Minocycline can be administered IV and topically while Tetracycline and Demeclocycline are only PO |
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How are they eliminated? |
Tetracycline & Demeclocycline eliminated in urine (don't give to pt. with renal failure), Doxycycline & Minocycline are eliminated by the liver (these are safe for kidney failure pt.) |
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Adverse effects? |
Irritate the GI: epigastric burning, cramps, nausea, vomit, diarrhea. Effect bones & teeth: if they bind with Ca+ in developing teeth it will turn them yellow/brown & can also suppress long bone growth in premature infants Superinfection: C.diff & Candida Albicans Hepatotoxicity: pregnant & postpartum women with kidney disease are at high risk Renal toxicity, photosensitivity ( wear sunscreen), vestibular toxicity (dizzy, unsteady), diabetes insipidus (excessive thirst & urination) |
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What foods & drugs do they interact with? |
Ca+ (Milk products), iron, magnesium (laxatives), aluminum (most antacids b/c contain aluminum & magnesium) All of these will lower therapeutic dose so administer 1hr before or 2hr after these. They also increase Digoxin & Warfarin levels |
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Tetracyclines should not be used in children younger than how many years & why? |
8 years b/c may cause permanent discolaration of teeth (yellow/brown) |
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Are tetracyclines safe during pregnancy & breast feeding? |
No, they should be avoided |
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May they be administered with food? |
No, taken 1hr before meals or 2hrs after with a glass of water, except for Minocycline it can be administered with food |
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What type of antibiotic is Erythromycin? |
Macrolides, broad-spectrum and Bacteriostatic but can be Bacteriocidal |
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Mechanism of action? How does bacteria acquire resistance against this drug? |
Bind to ribosome subunit and block growth By producing a pump that exports the drug and by modifying ribosomes to block binding |
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Therapeutic uses? |
May be used as an alternative for pt. with Penicillin allergy, whooping cough, acute diphtheria & pneumonia caused by M.pnuemonia |
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By what routes is it administered? Instructions for pt. on how to take drug? |
Oral and IV (erythromycin lactobionate), Also topically for acne (Eryderm) Take on an empty stomach, if GI upset occurs than okay to take with meal |
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How is it eliminated? |
By the liver and excreted in bile, metabolism by CYP3A4 |
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Adverse effects |
GI: epigastric, nausea, vomit, diarrhea QT prolongation: fatal cardiac dysrhythmias Superinfection of the bowel, thrombophlebitis, transients hearing loss |
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Drug interactions |
Elevated levels when also taking Theophylline, Carbamazepine and Warfarin Drugs that inhibit metabolism: Verapamil & Diltiazem (CCB), HIV protease inhibitors and azole antifungals When combined with clindamycin it prevents bindings to ribosomes so antagonizing effect |
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Mechanism of actions of Clindamycin? |
Binds to 50s subunit of ribosome and inhibits protein synthesis (This is also were erythromycin binds so they will antagonize each other) |
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What's its antimicrobial spectrum? |
Gram-positive and gram-negative anaerobic bacteria, most gram-positive aerobic backers |
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Therapeutic uses? |
An alternative to penicillin allergy, streptococcal infections, gas gangrene, abdominal/pelvic infections caused by B.fragilis |
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How is it metabolized? How is it eliminated? |
Hepatic metabolism, eliminated in urine and bile |
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Adverse effects? |
C diff.(10-20 watery diarrheas, mucus & blood in diarrhea), diarrhea unrelated to C diff., rashes, hepatotoxicity, blood daycarias (agranulocytosis, thrombocytopenia), rapid IV infusion can cause hypotension, cardiac arrest |
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What are the routes they can be administered? Clindamycin Hydrocholoride Clindamycin Palmitate Clindamycin phosphate |
Hydrochloride & Palmitate Oral, Phosphate can be IM, IV, topical (vaginal dosing) |
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Can all of these routes be used for pregnant women? |
No, vaginal suppositories can not. Only cream can be used during the 2nd and 3rd trimester |
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How do you instruct the pt. to take his pills? |
With a glass full of water |
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If C. Diff occurs with any of thesedrugs as a superinfection what do you do? |
Stop taking the current antibiotic that caused it, treat with Vancomycin or Metronidazole and fluid replacement |
