FA glycylcycline/fluoroquinolones/daptomycin

Question 1

glycylcycline group agent?

Answer 1

tigecycline

Question 2

tigecycline is derivate of what?

Answer 2

tetracycline

Question 3

tigecycline binds to what?

Answer 3

Bind to 30S subunit → blockage of entry of amino-acyl tRNA into ribosomal A site → inhibition of protein synthesis (bacteriostatic effect)

Question 4

tigecycline cidal or static?

Answer 4

static

Question 5

tigecycline spectrum?

Answer 5

broad

Question 6

tigecycline cover gram what?

Answer 6

Broad spectrum anaerobic, gram -, gram +.

Anaerobes (broad spectrum)
Gram-positive aerobes (not effective against S. viridans or Enterococci; limited efficacy against MSSA)
Partially effective against gram-negative aerobes (no effect against Proteus species)

Multidrug-resistant organisms (MRSA, VRE)

Gram-intermediate bacteria: Borrelia, Mycoplasma, Rickettsia, Chlamydia

Question 7

tigecycline CNS penetration?

Answer 7

poor

Question 8

tigecycline route of ellimination?

Answer 8

oute of elimination: mostly biliary

Question 9

tigecycline should not be taken with what?

Answer 9

Glycylcyclines should not be taken with milk, antacids, or iron supplements because divalent cations inhibit the absorption of glycylcyclines in the intestines.

Question 10

special use of tigecycline?

Answer 10

Good soft tissue penetration: effective for treating deep tissue infections

Question 11

tigecycline adverse?

Answer 11

GI upset (nausea, vomiting)
Hepatotoxicity
Deposition in bones and teeth
Photosensitivity

Question 12

tigecycline contraindications?

Answer 12

Children < 8 years of age
Pregnant women
Breastfeeding women
Cautious use in patients with hepatic dysfunction

Question 13

lipopeptide group agent?

Answer 13

daptomycin

Question 14

daptomycin mechanism?

Answer 14

incorporate K+ channels into the cell membrane of gram-positive bacteria → rapid membrane depolarization → loss of membrane potential → inhibition of synthesis of DNA, RNA, and proteins → cell death (bactericidal effect)

Question 15

daptomycin cidal or static?

Answer 15

cidal

Question 16

daptomycin what gram?

Answer 16

gram +

Question 17

daptomycin route of ellimination?

Answer 17

renal

Question 18

daptomycin use?

Answer 18

Gram-positive bacteria
!!S. aureus, especially MRSA (complicated skin infection)

Mainly used in skin and skin structure infections, bacteremia, and endocarditis

Vancomycin-resistant Enterococci (VRE)

Not used in pneumonia (daptomycin is bound and inactivated by surfactant)

Question 19

why do not prescribe daptomycin for pneumonia?

Answer 19

daptomycin is bound and inactivated by surfactant

Question 20

daptomycin adverse?

Answer 20

Reversible myopathy
Rhabdomyolysis
Allergic pneumonitis

Question 21

daptomycin contraindications?

Answer 21

hypersensitivity

Question 22

daptomycin resistance?

Answer 22

Mechanisms of resistance: repulsion of daptomycin molecules due to the change in the bacterial surface charge