Cmmrs Ch. 17

Front 1

antiribosomal antibiotics

Back 1

CLEan
TAG
(remember home plate, 50S on top, 30S on bottom)

50s: chloramphenicol, clindamycin, linezolid, erythromycin

30S: tetracyclines, aminoglycosides

Front 2

Chloramphenicol
- mech
- uses
- SE

Back 2

inhibits 50S ribosome

covers almost everything! gram pos/neg & anaerobes!....but bad SE, so used:
1. Empiric Bacterial meningitis & pt allergic to PCN/ceftriaxone
2. RMSF in young children/pregnant women who can't get doxycycline
3. Less wealthy countries

SE:
- bone marrow suppression- dose-related, reversible anemia
- aplastic anemia (irreversible, usually fatal)
- gray baby syndrome (bc newborns can't fully conjugate it --> shock, cyanosis "gray", abdominal distension)

Front 3

Clindamycin
- mech
- uses
- SE

Back 3

inhibits 50S ribosome

uses:
1. ANAEROBES!! inc Bacteroides. ie anaerobic asp pneumonia (poor dentition)
2. also many gram positive
3. topical for acne
4. TSS- combine with PCN or van bc inhibition of ribosome --> inhibition of toxin formation! --> decreased clinical severity

SE:
1. C diff! (although most cases now caused by PCN family abx)

Front 4

Linezolid
- mech
- uses
- SE

Back 4

inhibits 50S ribosome

GRAM POSITIVES, esp used for resistant ones. great for resistant organisms with no alternative ie VRE, MRSA

SE: (expensive!), bone marrow suppression, H/A, GI irritation

Front 5

Erythromycin
- name of class
- other drugs
- mech
- uses
- SE

Back 5

Macrolides
- erythromycin
- azithromycin
- clarithromycin

mech: inhibits 50S ribosome

uses:
- ~broad spectrum- gram pos/neg & atypicals!
- atypicals/comm aq pneumonia!- Chlamydia, Mycoplasma, Legionella
- URIs ie otitis media, sinusitis
"Z pack"

SE
-very safe! :)
- GI irritation (increase peristalsis----so given to pts with gastroparesis!)
- prolonged QT syndrome (esp erythromycin)

Front 6

Macrolides
- names

Back 6

Erythromycin
Clarithromycin
Azithromycin

Mac scored an ACE!

Front 7

which antibiotic can cause prolonged QT?

Back 7

erythromycin

Front 8

Tetracyclines
- names
- mech
- uses
- SE

Back 8

tetracycline, doxycycline

inhibit 30S ribosome

uses:
1. Rickettsial & Brucella infections
2. doxy- acne
3. Chlamydia
4. walking pneumonia due to Mycoplasma (alternative to erythromycin)

SE:
1. sun sensitivity
2. yellow teeth
3. inhibits bone formation- do not give to children/pregnant women!!
4. GI irritation
5. renal/hepatic toxicity- rare, usually occur in pregnant women

Front 9

aminoglycosides
- names
- mech
- uses
- SE

Back 9

- streptomycin
- gentamycin
- tobramycin-- great for Pseudomonas
- amikacin- broadest spectrum; use for resistant nosocomial infections!
- neomycin but too toxic--just use topically

mech: inhibits 30S ribosomal unit (often give with PCNs bc have to diffuse through wall which PCNs help weaken)

uses:
AEROBIC gram neg rods!! severe infections, including Pseudomonas

SE:
1. ototoxcity- CN VIII-vertigo, hearing loss
2. nephrotoxicity
3. RARE neuromuscular blockade

....therefore check levels after reaching steady state (~3 doses)

Front 10

quinupristin/dalfopristin
- mech
- use
- SE

Back 10

old med, inhibits 50S ribosome, use for bad gram positive infections (ie MRSA, certain strains of VRE)

bad SE! myalgias/arthralgias, hyperbilirubinemia, pain at infusion site (high rate of these)

Front 11

spectinomycin

Back 11

.....sounds like aminoglycoside....but NOT!! even though similar because inhibits 30S.

- gonorrhea alternative


.....SEs are infrequent/minor!

Front 12

tx gonorrhea

Back 12

Ceftriaxone
.......also give doxy (or azithro) for chlamydia

or cipro

or Spectinomycin