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32 Cards in this Set
- Front
- Back
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Chloramphenicol has resistance developed d/t:
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Decreased permeability
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Reserved for the tx of severe infections d/t high toxicity
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Chloramphenical
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Chloarmphenicol resistance: plasmid encoded transferase acetylates chloramphenicol to an:
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Inactive acetylated derivative
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Prototype from the class of macrolide antibiotics
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EES
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EES is :
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Broad spectrum, primarily bacteriostatic
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EES inhibits _____ by binding to 50S ribosomal subunit and interfering with ribosomal translocase activity
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Protein synthesis
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Generally well tolerated but the use of the estolate has been associated in rare instances with hepatotoxicity -- cholestatic jaundice and hepatitis
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EES
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EES has decreased GI distress and:
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Allergic reactions
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Associated with inhibition of metabolism and exaggerated responses of theophylline, terfenadine and warfarin
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EES (macrolides)
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Metabolism by plasmid-coded coenzymes that methylate 23S component
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EES mechanism of resistance
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Esterases that hydrolyze lactone ring
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EES mechanism of resistance
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Cross-resistance to all members in the class is generally observed
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EES
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Interfere with bacterial protein synthesis by binding to receptors on the 30S ribosomal subunit
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Aminoglycosides
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Inhibit formation of the initiation complex; also cause misreading of codons by ribosomal complex
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Aminoglycosides
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Aminoglycosides are not _______
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Orally absorbed
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Marked polarity and size of amino glycosides limits their ability to ______ and penetrate cells or tissues
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Distribute in the body
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Most amino glycosides are excreted _______ by the kidney (reduce dose in pts with compromised renal fx)
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Largely unchanged (>90%)
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The use of amino glycosides is severely limited by their:
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Toxicity
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aminoglycosides have low ______ which necessitate the monitoring of serum concentrations
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TI
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Two severest types of toxicity to aminoglycosides
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Ototoxicity and nephrotoxicity
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Ototoxicity causes:
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Damage to cochlear and vestibular nerves
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Aminoglycosides in large doses have also been associated with _____ resulting in apnea and possible respiratory paralysis
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Curare-like neuromuscular blockade
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The reversibility of ototoxicity and nephrotoxicity to amino glycosides depends on
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Withdrawal of the drug at early stages
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Ribosomal protection
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Aminoglycoside mechanism of resistance
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Esterase mediated hydrolysis
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Aminoglycoside mechanism of resistance
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Enhanced drug efflux
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Aminoglycoside mechanism of resistance
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Chloramphenicol, erythromycin, tetracyclines, streptomycin; all have effects on ________. All are _______, some are bacteriocidal
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Protein synthesis; bacteriostatic
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Imidazoles alter:
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Fx of the membrane
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Ketoconazole, fluconazole, miconazole, clotrimazole
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Imidazoles
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Polyenes act on
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Membrane of fungal cell
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Amphotericin B, nystatin
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Polyenes
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Flucytosine affects
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DNA synthesis
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