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113 Cards in this Set
- Front
- Back
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Macrolides, tetracyclines, chloramphenicol, and clindamycin are all bacteriostatic or bacteriocidal?
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Bacteriostatic
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Gentamicin, Streptomycin, Neomycin, and Tobramycin are all bacteriostatic or bacteriocidal?
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Bacteriocidal
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Aminoglycosides are highly polar cations T/F?
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True
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Prokaryotes use what kind of ribosomes?
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70S (50S + 30S)
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Ribosomes consist of what two elements?
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rRNA and proteins
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Host cell mitochondria resemble what?
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Bacteria
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Host cell mitochondria use what kind of ribosomes (70S or 80S)
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70S
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What drug binds to 50S and blocks peptide bond formation?
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Chloramphenicol
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What drug binds 50S and inhibits translocation? (Name two)
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Macrolides
Clindamycin |
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What drug binds to 30S and blocks binding of aminoacyl tRNA?
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Tetracyclines
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Macrolides and clindamycin bind at the same unit but different places and different effects. Name that unit:
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50S
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What drug binds to ribosomal protein, blocks translation initiation, causes miscoded proteins, and blocks translocation?
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Aminoglysides
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What antibiotic accumulates in gram + bacteria and macrophages?
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Macrolides
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What antibiotic is especially effective against Listeria?
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Macrolides
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What drug is pumped into the bacteria due to a high differential concentration?
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Tetracyclines
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What drug passively enters the cell and concentrates in the macrophage?
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Clindamycin
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What drug strongly affects mitochondrial protein synthesis and thus is quite toxic?
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Chloramphenicol
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What drug whose entry into bacteria depends on porin that requires energy and O2?
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Aminoglycosides
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What antibiotic should NOT be used on anaerobic bacteria?
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Aminoglycosides
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Name three macrolides:
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Azithromycin
Clarithromycin Erythromycin |
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What drug is used to treat infections by gram + bacteria?
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Macrolides
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Which macrolide works well against several gram -?
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Azithromycin
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Name three macrolides that are effective against Legionella pneumonia (gram -)
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Azithromycin
Clarithromycin Erythromycin |
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Name a macrolide that is effective against Haemophilus influenzae (G-) pneumonia?
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Azithromycin
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Name a macrolide that is effective against Chlamydia and Neisseria?
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Azithromycin (1g of Azithromycin = never good = chlamydia!)
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Name 2 macrolides that is used to treat bronchitis?
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1. Azithromycin
2. Clarithromycin |
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Name a macrolide that is used to treat otitis media:
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Erythromycin/Sulfisoxazole
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Name a macrolide that is used to treat mycobacterium avium complex (AIDS):
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Clarithromycin
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Name 2 macrolides used to treat mycoplasma pneumoniae:
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1. Azithromycin
2. Erythromycin |
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What is the major contraindication against macrolide use?
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Hepatic impairment
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Erm (methyltransferase) methylation of 23S rRNA is called what?
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"Ribosomal protection""
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"Ribosomal protection" increases/decreases affinity for macrolides?
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Decreases
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Increasing efflux of drug from bacterial cells via membrane pumps altered to favor removal of macrolide is an effective form of resistance against macrolides: T/F
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True
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Bacterial esterases can/cannot hydrolyze macrolides to cause resistance?
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Can hydrolyze
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What happens when a bacterium acquires mutant 50S protein?
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Resistance to macrolide
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Name two potent inhibitors of CYP3A4:
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1. Erythromycin
2. Clarithromycin |
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What drug interacts with antacids with Mg and Al?
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Azithromycin
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What drug interaction lowers azithromycin serum peak?
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Azithromycin and antacids (with Mg and Al)
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What drug interacts with chloramphenicol and clindamycin?
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All macrolides
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What drug combination with macrolides antagonize antibiotic effect of macrolides?
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Chloramphenicol and clindamycin
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Wha drug interaction lowers serum clarithromycin?
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Clarithromycin with Rifabutin or rifampin
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Which macrolide causes cramps, diarrhea, vomiting?
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Erythromycin
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What macrolide has a lower frequency of GI distress?
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Clarithromycin
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What macrolide causes cholestatic jaundice (due to thickened bile/plugs)?
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Erythromycin estolate
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What macrolide causes cardiotoxicity?
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Erythromycin
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What macrolide should not be administered with drugs that prolong QT interval?
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Erythromycin
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Food decreases the absorption of what two macrolides:
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1. Erythromycin
2. Azithromycin |
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Food decreases the absorption of what two macrolides?
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Erythromycin and azithromycin
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What drug uses the following dosing regimen: 1st dose is a double-dose, then once-daily for the next 4 days?
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Azithromycin (Z-Pak)
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Are there IV forms of erythromycin and azithromycin?
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Yes there are IV forms
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What drug concentrates well in macrophages and most tissues (not CNS)
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Azithromycin (CNS levels too low for therapy)
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Erythromycin and azithromycin are metabolized by what?
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CYP3A4
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Renal excretion eliminates 30% of what drug?
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Clarithromycin
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Name a tetracycline:
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Doxycycline
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Rickettsia causes Typhus and Rocky Mountain Spotted Fever and is treated by what antibiotic?
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Doxycycline
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Vibrio cholerae is treated by what antibiotic?
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Doxycycline
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Spirochetes causing Lyme disease and syphilis is treated by what antibiotic?
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Doxycycline
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Why should you not give tetracyclines to children under 8 years of age?
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Binds to bone and teeth
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Tetracycline is preganancy category what?
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Category D (use ONLY if benefit outweighs potential risk)
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Should tetracyclines be used in patients with liver impairment?
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Should not
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Efflux mechanisms are the most common mode of resistance to what drug?
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Tetracyclines
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What gene exchanges tetracycline-divalent metal cation complex for a proton (antiporter)?
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TetA gene
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What two genes for tetracycline provide ribosomal protection?
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TetM and TetQ
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What genes code for protein related to GTPase elongation factors that bind ribosomes and blocks binding of drug?
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TetM or TetQ genes
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Food has more of an effect on tetracycline or doxycycline?
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Tetracycline
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Can therapeutic levels of drug be attained with milk and doxycycline?
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Yes it can (Levels are lowered with tetracycline)
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How are therapeutic levels of doxycycline and tetracycline affected when given with antacids?
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Both are less than therapeutic levels
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How are therapeutic levels of doxycycline and tetracyclne affected when given with sodium bicarbonate?
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Both are less than therapeutic levels (doxy is a maybe)
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How are therapeutic levels of doxycycline and tetracyclne affected when given with iron salts?
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Both are less than therapeutic levels
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Can tetracyclines cause GERD?
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Yes
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Photosensitivity is common ADR with what antibiotic?
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Doxycycline
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Doxycycline is highly/not very lipid soluble?
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Highly lipid soluble
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Is doxycycline affected/unaffected by renal function?
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Unaffected by renal function
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Tetracyclines convert to what over time?
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Toxic forms
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What form of tetracyclines can cause kidney damage?
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Expired forms
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Why is it important to dispose of unused tetracycline?
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Expired drug is toxic to kidney
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What antibiotic is indicated for brain abscesses?
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Chloramphenicol
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What antibiotic is indicated for bacterial conjunctivitis?
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Chlorsig
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Can topical chloramphenicol (chlorsig) be used in pregnancy?
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Yes
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Can systemic chloramphenicol be used in pregnancy?
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No
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What drug has resistance due to plasmid encoded CAT gene?
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Chloramphenicol
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Acetylated drug no longer binds to ribosomes - mechanism of action of resistance of what drug?
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Chloramphenicol (CAT gene)
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What antibiotic is an antagonist of erythromycin or clindamycin because they have similar binding sites on 50S?
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Chloramphenicol
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Bone marrow suppression is/is not an adverse effect of chloramphenicol?
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Yes it is
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Bone marrow supression with chloramphenicol is reversible/irreversible and dose-related or not dose-related?
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Reversible, dose-related
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Aplastic anemia with chloramphenicol is dose-related or not dose-related?
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Not dose-related
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Gray-baby syndrome can occur with administration of what antibiotic?
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Chloramphenicol
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Newborns lack liver enzymes to metabolize chloramphenicol. What syndrome can occur?
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Gray baby syndrome
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Cardiovascular collapse can occur due to overdose of what antibiotic?
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Chloramphenicol
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UDP-glucuronyl transferase is a liver enzyme that metabolizes what antibiotic?
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Chloramphenicol
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Brain tissue levels of chloramphenicol may be how many times higher than serum levels?
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9x
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What antibiotic is good for CNS infections if all other treatments fail?
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Chloramphenicol
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Clindamycin is typically used for what type of bacteria?
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Anaerobic bacteria
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Clindamycin phosphate is used to treat what condition?
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Acne (topical)
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What antibiotic should NOT be used to treat colitis caused by Clostridium dificile because they are naturally resistant?
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Clindamycin
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Clindamycin should be avoided in patients with what kind of impairment?
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Hepatic impairment
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What drug is an antagonist of chloramphenicol and macrolides because they have a similar binding site on 50S?
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Clindamycin
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What drug can cause antibiotic associated colitis?
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Clindamycin
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What drug should be given to treat colitis?
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Metronidazole
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Can you achieve therapeutic concentrations of clindamycin in CNS?
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No
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What antibiotic is ONLY effective against AEROBIC bacteria?
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Aminoglycosides
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What antibiotic requires porin pumps that in turn require ATP + O2?
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Aminoglycosides
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What aminoglycosides are used to treat Pseudomonas? (2)
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Gentamicin
Tobramycin |
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What aminoglycoside is used to treat mycobacterium tuberculosis?
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Streptomycin
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Should aminoglycosides be used to treat mild to moderate infections?
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No, reserved for serious infections
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What antibiotic is empiric therapy for serious infections?
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Aminoglycosides
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Aminoglycosides is synergistic with what?
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Beta lactams
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Cephalosporins is contraindicated with aminoglycosides T/F?
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True
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Ototoxicity is an ADR of what antibiotic?
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Aminoglycosides (Dose dep)
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Renal toxicity can/cannot occur with aminoglycosides?
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Can (dose dep)
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Name two cells where aminoglycosides are concentrated?
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1. Renal tubular cells
2. Hair cells of inner ear |
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Cystic fibrosis or burn patients excrete aminoglycosides faster/slower?
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Faster
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Combination of single route of excretion, high individual variability in excretion, and dose-dependent toxicity demands what in administration of aminoglycosides?
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Extreme care
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