Pharm 44 Protein Synth Inhibitor Abx

Front 1

What bacterial protein synthesis inhibitors are broad spectrum?

Back 1

chloramphenicol, tetracyclines

Front 2

What bacterial protein synthesis inhibitors are moderate spectrum?

Back 2

macrolides, ketolide

Front 3

What bacterial protein synthesis inhibitors are narrow spectrum?

Back 3

lincosamides, streptogramins, linezolid

Front 4

all the bacterial protein synthesis inhibitors, except tetracyclines and aminoglycosides, bind where?

Back 4

50S subunit of ribosomes

Front 5

MOA chloramphenicol?

Back 5

inhibits transpeptidation by binding to 50S subunit and blocking binding of tRNA to mRNA complex

Front 6

MOA of tetracyclines?

Back 6

bind 30s subunit and prevent binding of incoming charged tRNA

Front 7

MOA macrolides?

Back 7

bind 50s subunit and block transpeptidation

Front 8

MOA streptogramins?

Back 8

bind 50s subunit, constricting exit channel and inhibit tRNA synthetase --> decreased free tRNA

Front 9

MOA linezolid?

Back 9

binds to 50s, inhibits inititation by blocking formation of tRNA-ribosome-mRNA complex

Front 10

chloramphenicol - static or cidal?

Back 10

static

Front 11

resistance to chloramphenicol?

Back 11

formation of drug-inactivating acetyltransferases

Front 12

clinical use of chloramphenicol?

Back 12

backup for severe salmonella infxn and tx of meningitis in beta-lactam allergic pts. Commonly used as topical antimicrobial.

Front 13

why does chloramphenicol have limited use as a systemic drug?

Back 13

toxicity

Front 14

which drug causes gray baby?

Back 14

chloramphenicol

Front 15

toxic effects of chloramphenicol?

Back 15

gray baby, inhibits P450s, inhibits RBC maturation--> anemia, GI upset

Front 16

resistance to chloramphenicol?

Back 16

formation of drug-inactivating acetyltransferases

Front 17

clinical use of chloramphenicol?

Back 17

backup for severe salmonella infxn and tx of meningitis in beta-lactam allergic pts. Commonly used as topical antimicrobial.

Front 18

why does chloramphenicol have limited use as a systemic drug?

Back 18

toxicity

Front 19

which drug causes gray baby?

Back 19

chloramphenicol

Front 20

toxic effects of chloramphenicol?

Back 20

gray baby, inhibits P450s, inhibits RBC maturation--> anemia, GI upset

Front 21

tetracyclines - static or cidal?

Back 21

static

Front 22

which tetracyclines have the longest half-lives?

Back 22

doxy and minocycline

Front 23

resistance to tetracyclines?

Back 23

efflux pumps, formation of ribosomal protection proteins

Front 24

which tetracycline is immune to normal methods of resistance?

Back 24

tigecycline

Front 25

tetracyclines are DOC for what organisms?

Back 25

Mycoplasma pneumoniae, Chlamydia, Rickettsia, Vibrio

Front 26

toxicity of tetracyclines?

Back 26

GI upset (can be severe), tooth and bone growth abnormalities

Front 27

resistance to macrolides and clindamycin?

Back 27

methyltransferases alter binding site

Front 28

drug used continuously for prophy for chronic bronchitis and acne?

Back 28

tetracyclines

Front 29

has usefulness in prostatitis?

Back 29

doxycycline (high levels in prostatic fluid)

Front 30

reaches high levels in saliva and is used in meningococcal carrier state?

Back 30

Minocycline

Front 31

tetracycline used to treat SIADH

Back 31

demeclocycline

Front 32

most tetracyclines are excreted by what organ?

Back 32

Kidneys, except doxycycline (only 50%)

Front 33

why are tetra's contraindicated in pregnancy?

Back 33

tooth/bone formation in fetus, liver dysfxn in mother

Front 34

chloramphenicol is metabolized by _____ and dose reduction is needed in _______

Back 34

hepatic glucuronidation

liver dysfxn and neonates

Front 35

may cause enhanced skin sensitivity to UV light --> rash?

Back 35

tetracyclines, esp demeclocycline

Front 36

absorption of which macrolide is impeded by food?

Back 36

azithromycin

Front 37

macrolides?

Back 37

Azithro, Clarithro, Erythro

Front 38

Macrolide whose levels in tissues and in phagocytes are higher than in plasma?

Back 38

azithromycin

Front 39

this macrolide is eliminated slowly mainly unchanged in urine

Back 39

azithromycin

Front 40

commonly used in tx of community acquired pneumonia (mycoplasma and chlamydia)?

Back 40

macrolides

Front 41

d/t it's half-life, a single dose of which drug is effective in tx of UG Chlamydial infxn?

Back 41

Azithromycin

Front 42

common abx spectrum of macrolides?

Back 42

G+ cocci (not MRSA or PRSP)
Atypicals (chlamydia, mycoplasma, ureaplasma)
Legionella pneumophila
C. jejuni

Front 43

d/t it's half-life, a single dose of which drug is effective in tx of UG Chlamydial infxn?

Back 43

Azithromycin

Front 44

d/t it's half-life, a single dose of which drug is effective in tx of UG Chlamydial infxn?

Back 44

Azithromycin

Front 45

common abx spectrum of macrolides?

Back 45

G+ cocci (not MRSA or PRSP)
Atypicals (chlamydia, mycoplasma, ureaplasma)
Legionella pneumophila
C. jejuni

Front 46

which drug has increased activity against agents of otitis media/sinusitis?

Back 46

Azithromycin

Front 47

which macrolide is active against M. avium?

Back 47

Clarithromycin

Front 48

common abx spectrum of macrolides?

Back 48

G+ cocci (not MRSA or PRSP)
Atypicals (chlamydia, mycoplasma, ureaplasma)
Legionella pneumophila
C. jejuni

Front 49

which drug has increased activity against agents of otitis media/sinusitis?

Back 49

Azithromycin

Front 50

which macrolide is active against M. avium?

Back 50

Clarithromycin

Front 51

are macrolides safe in pregnancy?

Back 51

NO - Clarithromycin, erythromycin

YES - Azithromycin

Front 52

which drug has increased activity against agents of otitis media/sinusitis?

Back 52

Azithromycin

Front 53

which macrolide is active against M. avium?

Back 53

Clarithromycin

Front 54

are macrolides safe in pregnancy?

Back 54

NO - Clarithromycin, erythromycin

YES - Azithromycin

Front 55

are macrolides safe in pregnancy?

Back 55

NO - Clarithromycin, erythromycin

YES - Azithromycin

Front 56

toxicity of erythromycin?

Back 56

GI upset (stim via motilin receptors)
Inhibits P450s
Auditory dysfxn (high dose)
Cholestasis (estolate form)

Front 57

toxicity of clarithromycin (compared to erythromycin)?

Back 57

less GI upset, but also inhibits P450s and causes reversible deafness at high doses

Front 58

drug structurally related to macrolides w/ same MOA, but binds more tightly to ribosomes?

Back 58

telithromycin

Front 59

use of telithromycin is limited by what effects?

Back 59

sev hepatotoxicity
visual disturbances
fainting

Front 60

spectrum of abx activity of clindamycin?

Back 60

GPC (not MRSA), anaerobes including B. fragilis;

has been used in toxo

Front 61

drug that causes pseudomembranous colitis?

Back 61

clindamycin

Front 62

drug whose concentration in bone makes it useful in osteomyelitis (d/t GPC)?

Back 62

clindamycin

Front 63

backup to penicillin G in syphilis?

Back 63

tetracyclines

Front 64

oral absorption of tetracyclines may be reduced by what?

Back 64

multivalent cations (Ca, Mg, Fe)

Front 65

DOC for prophylaxis of endocarditis in valvular dz pts allergic to pnicillin?

Back 65

Clindamycin

Front 66

Streptogramins?

Back 66

Quinupristin-dalfopristin

used against MRSA, VRSA

strong inhibitor of CYP3A4

Front 67

Streptogramins - static or cidal?

Back 67

static

Front 68

which drug may cause pain and arthralgia-myalgia when given IV?

Back 68

streptogramins

Front 69

spectrum of abx activity of linezolid?

Back 69

drug resistant GPC (MRSA, PRSP, VRE)
Listeria, corynebacteria

Front 70

MOA of linezolid?

Back 70

binds 23s rRNA of 50s ribosomal subunit

Front 71

linezolid is part of a new class of abx called what?

Back 71

oxazolidinones

Front 72

toxicity of linezolid?

Back 72

HA, GI upset, BMS if used > 2 wks