** aminos are used in combo with other ABs**
can’t enter the cell unless another ICWS opens the membrane
** what is responsible for pharmakological properties of aminoglycosides?
polarity
MOA of aminos
irreversibly bind to ribosomal unit 30S -> CIDAL
need O2!!!!
need to be actively transported into bacteria (need ATP, need O2)
toxicity with aminos
Ototoxic
nephro
what happens due to post-antibiotic effect
AB is active for couple of hours after admin
can give higher dose once a day
do aminos have high cross-resistance with other aminos?
yes
resistance due to decreased receptors on ribosomes, can’t permeate wall, enzymatic changes by bacteria
Aminos spectrum
AEROBIC only G- enteric rods (often in combo with b-lactams)
what drug to use when suspect sepsis or endocarditis?
Aminos
DOC for enterococcus
gentomycin and pen G
DOC for pseudomonas aeruginosa
Amino and AP pen
DOC for turalemia (francisella tularensis) (rabit hunting dz0
gentamycin
gentomycin and neomycin tx
wounds
what aminos can tx psudomonas aeruginosa in combo with AP pen
gentamycin
tobramycin
amikacin
tx for TB (is it DOC?????????)
streptomycin
fatal aplastic anemia
chloramphenicol
MOA of chloramphenicol
reversibly binds to 50S -> inh protein synthesis
STATIC
chloramphenicol is DOC for
nothing - not 1st choice ever!!! only for life threatening conditions
best CNS penetration, and eyes (wide spread)
chloramphenicol
tx neisseria meningitis, pen resistant strep pneumonia
oral - stopped in US, parenteral still available
which drug conjugates with glucoronic acid
chloramphenicol
to form chloramphenicol glocoronate
acetyl transferase is responsible for resistance in which drug?
chloramphenicol
it acetylates and inactivates chloramphenicol
bone marrow depression is in
chloramphenicol
which drug inhibits host’s protein synthesis in mito
chloramphenicol
gray baby syndrome (inadequate glucuronyl transferase activity in liver)
chloramphenicol
SE of tetracycline
- changes in normal flora
- bone and teeth depletion
- photosensitivity
which drug chelates with Ca, Fe, Al?
tetracycline
doxycycline and minocycline are long acting forms of
tetracyclines
tetracycline spectrum
broad:
G+/G-
02, 02-
MOA of tetracyclines
reversibly binds to 30S and can’t add AA -> STATIC
inh protein synthesis
DOC for vibrio/cholera
tetracyclines
DOC of mycoplasma pneumonia
tetra
DOC for chlamydia
Doxycycline (and erythro/arithromycin???????)
DOC for Rikettsial infection (Rocky Mnt)
Doxycycline
DOC for early lyme dz (Borrelia Burgdorferi)
tetracyclines
DOC for H.Pylori
tetra + metro + bismuth (all three together?)
CI in pregs, kids <8 yo, crosses placenta and breast milk
tetras
crosses placenta and breast milk
tetracyclines
Tigecycline (IV)
30s Static similar to tetracyclines but againt tetra res organisms MRSA MRSE (s epidermis) PRSP (pen res strep pneumoniae) VRE vanco res enterococci