Chapter 17: Anti-Ribosomal Antibiotics

Front 1

What are the anti-ribosomal antibiotics?

Back 1

buy AT 30S, CELL at 50S: Aminoglycosides, Tetracycline, Chloramphenicol, Erythromycin, Linezolid, cLindamycin

Front 2

Which anti-ribosomal drug cannot be absorbed orally?

Back 2

aminoglycosides

Front 3

What are the adverse effects of chloramphenicol?

Back 3

2 types of bone marrow depression and "gray baby syndrome"

Front 4

What are the clinical uses of chloramphenicol?

Back 4

1. bacterial meningitis when cause unknown and patient can't tolerate penicillins; 2. young kids and pregnant women with Rocky Mountain spotted fever who can't be treated with tetracycline

Front 5

Where is chloramphenicol widely used?

Back 5

3rd world countries because of the broad spectrum coverage

Front 6

What makes chloramphenicol unique?

Back 6

it's the "chlorine" that kills all (almost) all germs; gram +, gram -, and even anaerobes are susceptible (can kill bacteroides fragilis)

Front 7

What bugs are targeted by clindamycin?

Back 7

ANAEROBES! and gram +

Front 8

What is the DOC for penetrating wounds to the abdomen?

Back 8

clindamycin for the anaerobes and aminoglycosides for the aerobic gram - bacteria

Front 9

What is the DOC for infections of the female genital tract, esp. after septic abortions?

Back 9

clindamycin; its oral preparation and vaginal cream are alternatives to metronidazole for the treatment of bacterial vaginosis

Front 10

What is the key problem with clindamycin?

Back 10

pseudomembranous colitis caused by clostridium difficile (CLindamycin and CLostridium)

Front 11

How is pseudomembranous colitis treated?

Back 11

vancomycin or metronidazole

Front 12

What are the clinical uses and toxicity of linezolid?

Back 12

C: new agent to fight resistant gram + bugs; T: headache and GI upset

Front 13

What are the clinical uses of erythromycin?

Back 13

community-acquired pneumonias that do NOT require hospitalization: s. pneumoniae, mycoplasma pneumoniae, chlamydia trachomatis; also, gram + bacteria and legionella

Front 14

What is used in patients with streptococcal and staphylococcal infections who are sensitive to penicillin?

Back 14

erythromycin

Front 15

What is the DOC for Legionnaire's disease?

Back 15

erythromycin ("a wreath" omycin)

Front 16

What are some side effects from erythromycin?

Back 16

it's considered a very safe drug! 1. abdominal pain from peristalsis stimulation; 2. rare cholestatic hepatitis (swallow a "wreath")

Front 17

What are the 4 macrolide antibiotics?

Back 17

CARE: clarithromycin, azithromycin, roxithromycin, erythromycin

Front 18

How are the CAR macrolides different from erythromycin?

Back 18

Show promise in covering severe staph infections, H. influenza, and even some atypical mycobacteria (Mycobacterium avium-intracellulare, MAI)

Front 19

What can be used as an alternative to doxycycline for treatment of chlamydial non-gonococcal urethritis?

Back 19

azithromycin

Front 20

Compare tetracycline and doxycycline.

Back 20

They have the same clinical use, but doxycycline is better absorbed since it doesn't chelate with cations in the diet. IV tetracycline is no longer available.

Front 21

What are the 4 clinical uses of doxycycline?

Back 21

Fights things a soldier would get in the "TET offensive": 1. VDs by chlamydia trachomatis; 2. walking pneumonia by mycoplasma pneumoniae; 3. animal and tick-borne diseases caused by brucella and rickettsia; 4. good for acne, too!

Front 22

Doxycycline's side effects?

Back 22

1. GI irritation, nausea; 2. phototoxic dermatitis; 3. renal and hepatic toxicity; 4. discolored teeth and depressed bone growth

Front 23

How are the aminoglycosides often used?

Back 23

Since they must diffuse across the cell wall, they are used with penicillins

Front 24

Clinical use of aminoglycosides?

Back 24

aerobic gram-negative enteric organisms and kills the terrible pseudomonas aeruginosa

Front 25

What are the 6 aminoglycosides?

Back 25

"TANNGS": Tobramycin, Amikacin, Neomycin, Netilmicin, Gentamicin, Streptomycin

Front 26

What is streptomycin?

Back 26

Oldest aminoglycoside in the family; many bugs are resistant to it.

Front 27

Use of gentamicin?

Back 27

A lot of GENeral use in the "GENeral" hospital; most commonly used of the aminoglycosides; combined with penicillins for in-hospital infections. Many bacterias are resistant to it.

Front 28

Use of tobramycin?

Back 28

The "COBRA" to fight the Terrible pseudomonas aeruginosa.

Front 29

Use of amikacin?

Back 29

Has broadest spectrum of the AGs and is good for hospital-acquired infections.

Front 30

Use of neomycin?

Back 30

Broad coverage, but too toxic; good only for skin infections.

Front 31

Use of netilmicin?

Back 31

Preoperative coverage before GI surgery.

Front 32

Side effects of aminoglycosides?

Back 32

8th cranial nerve toxicity (vertigo, hearing loss); renal toxicity; neuromuscular blockade. To remember, remember "a mean guy" boxing to the head, the kidney, and then a KO.

Front 33

How is spectinomycin administered?

Back 33

Intramuscular injection.

Front 34

What is the clinical use of spectinomycin?

Back 34

Gonorrhea caused by neisseria gonorrhoeae as an alternative to penicillin and tetracycline (doxycycline) since many strains are resistant to these bugs.

Front 35

What are 3 ways to treat gonococcal ureathritis?

Back 35

1. ceftriaxone with doxycycline (to get the chlamydia trachomatis that is often involved); 2. quinolone antibiotics (ciprofloxacin, ofloxacin) with doxycycline; 3. spectinomycin wiht doxycycline.