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36 Cards in this Set
- Front
- Back
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Aminoglycosides: List
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Streptomycin
Neomycin Kanamycin Tobramycin Gentamicin Amikacin Netilmicin |
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Tetracyclines: List
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Tetracycline
Chlortetracycline Doxycycline Minocycline Demeclocycline Methacycline Oxytetracycline |
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Aminoglycosides: Administration
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IV/IM
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Aminoglycosides: Bacteriocidal or bacteriostatic?
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Bacteriocidal
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Aminoglycosides: Mechanism
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Binds to 30S ribosomal subunit-->interferes with protein initiation-->misreading of protein-->decrease protein synthesis.
Abnormal initiation complexes accumulate Freeze 30S-mRNA-tRNA unit-->no further initiation |
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What is special about amikacin?
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It was designed to be resistant to inactivating enzymes. Not a lot of resistance seen with this drug
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What are the mechanisms of resistance to aminoglycosides?
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Inactivating enzymes
Altered ribosomal binding site Altered uptake |
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What are enzymes that cause resistance to aminoglycosides?
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Adenyltransferase
Acetyltransferase Phosphotransferase |
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Aminoglycosides: Toxicity
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Neurotoxicity
Ototoxicity-vestibular and auditory. (signs include tinnitus, headache, vomiting) Neuromuscular blockade |
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What type of bacteria are aminoglycosides particularly useful against?
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Aerobic gram negative bacteria
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Tetracyclines: administration
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Oral-cannot be taken with food
Sometimes IV/IM |
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Chloramphenicol: Administration
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Oral
Sometimes IV/IM |
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What are the classes of drugs that are protein synthesis inhibitors?
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Aminoglycosides
Tetracyclines Chloramphenicol |
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Chloramphenicol: Elimination
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Liver biotransformation-inactivated by glucoronidation
Excreted in urine |
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Chloramphenicol: contraindications
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Depressed liver function-however for some just lower dose
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Chloramphenicol does not interact with CYP450. True or false.
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False. Can inhibit and induce drug metabolism
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Chloramphenicol: mechanism
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Inhibit protein synthesis by binding to 50S ribosomal subunit so aminoacyl-tRNA cannot bind
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Is chloramphenicol bacteriostatic or bactericidal?
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Bactericidal to H. influenzae but bacteriostatic to all others
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Chloramphenicol: side effects
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Hematological *most important
Hypersensitive Neonatal toxicity (gray baby syndrome-glucoronidation) Irritative effects Can inhibit mitochondrial protein synthesis in eukaryotes Can affect erythropoietic cells |
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Chloramphenicol: resistance
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R factor through bacterial conjugation-->increased acetylation of drug
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Describe the reversible hematological effects of chloramphenicol.
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Affects mitochondrial ribosomes-->decrease in iron uptake-->decrease in iron incorporation into heme-->decreased hemoglobin content, increased plasma iron, decreased circulating reticulocytes
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Describe aplastic anemia with chloramphenicol.
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Usually develops after pt stops long term use of drug.
Defective development of bone marrow cells-->decreased leukocytes and blood platelets, decreased # of circulating cells |
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What are some irritable effects of chloramphenicol?
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Nausea, diarrhea, vomiting
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Describe neonatal toxicity associated with chloramphenicol
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Gray baby syndrome-vomiting, failure to nurse, irregular and rapid respiration, cyanosis, decreased temp, passage of loose stools
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Chloramphenicol: spectrum
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Last resort drug.
Broad spectrum. Gram positive and negative cocci Gram positive and negative bacilli Chlamydia Rickettsia |
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Chloramphenicol: uses
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Typhoid fever
Meningitis (H. influenzae, N. meningitis, S. pneumoniae) Abscesses (B. fragilis) Brucellosis (Brucella) Rocky Mountain Spotted Fever (Rickettsie) |
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What is the advantage of Tobramycin over Gentamicin?
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Tobramycin has great effect over Pseudomonas
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What is the difference in administration of aminoglycosides and tetracyclines?
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Tetracyclines can be taken orally
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What two tetracyclines can be taken with food?
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Doxycycline and minocycline
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Short acting tetracyclines:
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Chlortetracycline
Tetracycline Oxytetracycline |
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Intermediate acting tetracyclines:
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Demeclocycline
Methacycline |
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Long acting tetracyclines
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Doxycycline
Minocycline |
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What is the difference between aminoglycosides and tetracyclines in terms of their action?
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Aminoglycosides are bactericidal
Tetracyclines are bacteriostatic |
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What is the difference between aminoglycosides and tetracyclines in terms of their uptake?
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Aminoglycosides cannot passively diffuse through the cell membrane
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Phototoxicity is seen in which tetracycline?
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Demeclocycline
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Tetracyclines: side effects
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Hypersensitivity
Phototoxcity GI Liver toxicity Kidney toxicity Teeth discoloration Suprainfection |
