Pharmacology Spring L6 Inhibitors Of Protein Synthesis 1

Front 1

What is the safest antibiotic in use today?

Back 1

erythromycin

Front 2

How does erythromycin work?

Back 2

this inhibits protein synthesis of G+ bacteria by:

Binding to 50S subunit, and inhibiting translocation

Front 3

What drug competes with binding for the 50S translocation site with erythromycin?

Back 3

chloramphenicol

Front 4

What is the spectrum of erythromycin

Back 4

similar to penicillin G (G+ stuff)

Front 5

What strains is erythromycin best at killing?

Back 5

Listeria, Staph A, Strep pyogenes, S penumoniae
Mycoplasma penumoniae
Chlamydia
Legionella

Front 6

What organisms are resistant to erythromycin?

Back 6

G- organisms

Front 7

What are the four mechanisms of resistance to erythromycin?

Back 7

Active pump
methylase enzymes which modify the ribosomal target
hydrolysis by esterases
alteration of 50S ribosomal protein

Front 8

How does gastric acid affect erythromycin?

Back 8

without a modfication acid destroys erythromycin

Front 9

What forms of erythromycin can be given IV?

Back 9

you can give large doses of:

Erythromycin gluceptate
Erythromycin lactobionate esters

Front 10

What are the GI side effects of erythromycin?

Back 10

GI disturbances

Front 11

What are the liver effects of erythromycin

Back 11

Elevated hepatic enzymes, and choestatic jaundice

Front 12

What are the cardiac effects of erythromycin?

Back 12

long QT, and torsade de pointes that goes with it

Front 13

What neruo effects can happen with erythromycin?

Back 13

ototoxicity

Front 14

How does erythromycin cause drug interactions?

Back 14

inhibits the hepatic metabolism of drugs, and increases their serum concrentration

Front 15

What skin infections is erythromycin used to treat?

Back 15

Group A strep pyogenes

Front 16

What types of pneumonia is erythromycin used to treat?

Back 16

M pneumoiae
Chlamydia
Legionnaires

Front 17

What tissues does Clarithromycin do a good job of penetrating?

Back 17

Lung tissues and macrophages

Front 18

What bugs is clarithromycin particularly good against compared to other macrolides?

Back 18

Mycobacterium avium complex (MAC)

and H pylori duodenal ulcers

and community acquired pneumonia

Front 19

What is clarithromycins method of action?

Back 19

this inhibits 50S subunit with Translocation. inhibits protein synthesis

Front 20

What are the drug interactions of clarithryomycin?

Back 20

this drug is metabolized by the liver, and thus has alot of potential interactions by increasing concentrations of other drugs

Front 21

What is special about Azithromycin? (3 main advantages)

Back 21

it can be dosed once daily
less GI intolerance
and gets High intracellular concentrations

Front 22

What kind of bug coverage does azithromycin have?

Back 22

this covers the same organisms as erythromycin

Front 23

How does food affect the availability of clarithromycin?

Back 23

it does not

Front 24

how does food affect the availability of azithromycin

Back 24

it decreases bioavailability

Front 25

What are the interactions of azithromycin?

Back 25

this does not metabolized by the liver- so few interactions

Front 26

What are single doses of azithromycin approved to treat?

Back 26

chlamydia and gonorrhea

Front 27

What are the specific bugs that azithromycin is good at treating?

Back 27

pediactric otitis media
pharyngitis
MAC porphylaxis

Front 28

What is Telithromycin?

Back 28

this is a Ketolide, a broad spectrum antibiotic

Front 29

What is Telithromycin best at killing?

Back 29

respiratory pathogens like erythromycin and penicillin resistant pneumococci

intracellular and atypicals

Front 30

What is Telithromycin method of action?

Back 30

50S subunit inhibitor

Front 31

How is Telithromycin given?

Back 31

orally

Front 32

What enzyme metabolizes Telithromycin?

Back 32

CYP3A4

Front 33

What is the main side effect of Telithromycin?

Back 33

diarrhea

Front 34

How does Clindamycin work?

Back 34

binds 50S subunit, and inhibits protein synthesis

Front 35

What does clindamycin treat when combined with pyrimethamine?

Back 35

this treats toxoplasmic encephalitis in pts with AIDS

Front 36

what is the major side effect of clindamycin?

Back 36

pesudomembranous colities

Front 37

What is the spectrum of clindamycin?

Back 37

Strep, Staph, and most anaerobes

Front 38

Where does clindamycin get concrentrated in the body?

Back 38

Bone!

Front 39

What is Synercid?

Back 39

this is a combination drug of Dalfopristin and Quinupristin

Front 40

What is Dalfopristins method of action?

Back 40

binds 70S or 50S, and inhibits the Early phase of protein synthesis

Front 41

What is Quinupristins method of action?

Back 41

binds to the 50S subunit of 70S ribosome, and inhibits LATE phase protein synthesis

Front 42

How is Synercid given?

Back 42

IV

Front 43

What are the main side effects of synercid?

Back 43

N/V pain, puritis, rash

Front 44

What enzymes does Synercid inhibit?

Back 44

cytochrome P450 3A4

Front 45

What bug is Linezolid effective against?

Back 45

Aerobic G+ organisms

Front 46

What is Linezolids mechanism of action?

Back 46

Binds 50S subunit, and prevents formation of 70S

Front 47

What is a major side effect of Linezolids action?

Back 47

reversible nonselective inhibition of monoamine oxidase- beware of serotonin syndrome