Tetracyclines and Glycylcyclines Flashcards

1
Q

What are tetracyclines (TCNs) useful alternatives of?

A

Common respiratory tract infections

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2
Q

What are TCNs a DOC for?

A

Uncommon infections

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3
Q

Which TCN is preferred over the other TCNs?

A

Doxycycline is preferred over minocycline and tetracycline

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4
Q

Which medication is a novel agent and glycylcyclines?

A

Tigecycline

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5
Q

What is beneficial of tigecycline?

A

Evades most TCN resistant mechanisms and has broad spectrum activity

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6
Q

Which medication is a novel aminomethylcycline, within the TCN class with a broad-spectrum activity?

A

Omadacycline

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7
Q

What is the MOA of the TCNs?

A

Binding to the 30s ribosomal subunit blocking the bacterial protein synthesis leading to a bacteriostatic activity

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8
Q

What are the mechanism of resistance for TCNs?

A
  • Modification of the 30s subunit

- Efflux pumps

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9
Q

TCNs have a good spectrum over which bacteria?

A
  • Atypicals
  • Rickettsia
  • Spirochetes
  • Plasmodium spp (malaria)
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10
Q

Glycylcylines have a good spectrum over which bacteria?

A
  • Enterococci (including VRE)
  • Staphylococcus (including MRSA)
  • S. pneumoniae
  • Atypicals
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11
Q

Aminomethylcyclines have a good spectrum over which bacteria?

A
  • Enterococci (including VRE)
  • Staphylococcus (including MRSA)
  • Atypicals
  • S. pneumoniae
  • H. influenzae
  • Klebsiella pneumoniae
  • Enterobacteriaceae
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12
Q

What common adverse events occur with TCNs/glycylcyclines?

A
  • GI effects
  • Photosensitivity
  • Discoloration of developing teeth
  • Esophageal irritation
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13
Q

What are the contraindications of TCNs/glycylcyclines?

A
  • Pregnant pts

- Child < 8 yo

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14
Q

Which medications are IV only?

A
  • Tigecycline

- Omadacycline

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15
Q

Which medications are 100% bioavailable?

A
  • Minocycline

- Doxycycline

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16
Q

What could decrease the oral bioavailability of TCNs?

A
  • Cations (Mg, Ca, Fe, milk, MVIs, anatacids)
17
Q

What should be done if TCNs and cations are being taken?

A

Separate by at least 2 hours

18
Q

Which medication does not need to be renally or hepatically adjusted?

A

Doxycycline

19
Q

Which medication is eliminated renally and should be avoided in renal insufficient patients because it can worsen kidneys?

A

Tetracycline

20
Q

What are the main utilizations of TCNs/glycylcyclines?

A
  • CAP
  • Sinusitis
  • Uncomplicated respiratory tract infections
  • Acute exacerbations of chronic bronchitis
  • Malaria prophylaxis and treatment
21
Q

What is the DOC for TCNs/glycylcyclines?

A

Tick borne diseases

22
Q

Tigecycline has a great activity against?

A

Polymicrobial complicated infections

23
Q

Omadacycline was approved in 2019 for which indication(s)?

A
  • CAP

- SSTIs

24
Q

What is a great counseling point for patients taking TCNs/glycylcylines?

A

Ask pts about supplemental use at home? Even if they use milk in coffee or tea