Antimicrobials dos

Question 1

Ribosome complex in bacteria

Answer 1

70s

Question 2

Why are protein synthesis inhibitors toxic to humans at higher doses

Answer 2

bc at higher doses there is reduce selectivity (doesn’t only focus on bacteria)

Question 3

Dose-dependent selectivity are major concerns for what 2 types of drugs?

Answer 3

Chloramphenicol

Tetracyclines

Question 4

what does chloramphenicol bind to during PSI

Answer 4

50S subunit

Question 5

What does Erythromycin bind to during PSI

Answer 5

50S

Question 6

What are the 5 Aminoglycosides

Answer 6

Gentamycin
Amikacin
Tobramycin
Streptomycin
Neomycin

Question 7

What mechanism do AMinoglycosides use?

Answer 7

Bind to 30S changin ts shape

Question 8

WHat effect on mechanism does AMinoglycosides have?

Answer 8

1) Block initiation
2) Early Termination
3) Misreading

Question 9

Whats the oldest aminoglycoside - so high level of resistance

Answer 9

Streptomycin

Question 10

How is Streptomycin administered

Answer 10

IM

IV

Question 11

What is the most commonly prescribed aminoglycoside?

Answer 11

gentamycin

Question 12

Gentamycin method of delivery?

Answer 12

IV

Question 13

What aminoglycoside has the broadest spectrum?

Answer 13

Amikacin

Question 14

Amikacin method of delivery

Answer 14

IM

IV

Question 15

What aminoglycoside is great against Pseudomonas aeruginosa?

Answer 15

Tobramycin

Question 16

Tobramycin method of Delivery

Answer 16

IM

IV

Question 17

What aminoglycoside is very toxic systemically?

Answer 17

Neomycin

Question 18

Neomycin mthods of delivery

2

Answer 18

Topical

Enema

Question 19

Clinical use for aminoglycosides

Answer 19

Gram Negative Aerobes

Question 20

Neomycin is toxic to what in body?

Answer 20

Kidney

Nephrotoxicity

Question 21

Risk of nephrotoxicity and ototoxicity with aminoglycosides is dependent on what?

Answer 21

COncentration

Question 22

WHat are the sites of accumulation for Aminoglycosides

Answer 22

Inner ear

Renal Cortex Proximal Tubule Cells

Question 23

WHat do aminogycosides synergize with and how?

Answer 23

Beta-Lactams
Vancomycin
Aminoglycosides are able to diffuse accross weakened bacterial cell wall more

Question 24

Adverse effects of Aminoglycosides

5

Answer 24

1) Ototoxicity
2) Nephrotoxicity
3) Neuromuscular paralysis
4) Teratogenic
Contact Dermatitis

Question 25

What patients are at highest risk of paralysis from Aminoglycosides

Answer 25

Patients with Myasthenia Gravis

Question 26

Additional at risk groups for AMinoglycosides

Answer 26

1) Elderly 2) Impaired Renal Function 3) Septic Pts 4) Recent exposure to other Aminoglycosides

Question 27

WHat are the 4 TTCs?

Answer 27

1) Tetracycline 2) Doxycycline 3) Minocycline 4) Tigecycline

Question 28

Mechanism of TTCs

Answer 28

Reversably binds to 30 S | Thus blocking access of the amino acyl-tRNA tothe mRNA

Question 29

Spectrum of TTCs

Answer 29

Gram + Gram - Atypical intracellular organisms

Question 30

Are TTCs cross resistant?

Answer 30

YES!!

Question 31

What TTC is effective when bacteria is cross resistant?

Answer 31

Tigecycline

Question 32

Oral absorption of TTCs is altered by what?

Answer 32

Dairy Iron supplements Antacids

Question 33

WHere does TTC concentrate?

Answer 33

Ca-hydroxyapatite of teeth and bones

Question 34

What antimicrobial is used for treatment of acne vulgaris

Answer 34

Tetracycline

Question 35

Should tetracycline be used during pregnancy?

Answer 35

NOOOOOO!!

Question 36

Adverse effects of TTCs

Answer 36

1) Disulfuram-like effet - avoid alcohol! | 2) Vestibular Problems

Question 37

What TTC gives the most vestibular problems?

Answer 37

Minocycline

Question 38

Oral adverse effects of TTC

Answer 38

hairy tongue | Deposition in bone and prmary dentition

Question 39

Tigecycline spectrum

Answer 39

Same as TTCs plus activity against MRSA, Multidrug resistant Strp. pneumonae, Vancomycin-resistant Enterococci

Question 40

Clinical use of Tigecycline

Answer 40

Developed to overcome TTC - resistance

Question 41

3 macrolides are

Answer 41

1) Erythromycin 2) Clarithromycin 3) Azithromycin

Question 42

Mechanism of Macrolides

Answer 42

Irreversibly binds to 50S | Thus inhibiting the translocation step

Question 43

Spectrum of Macrolides

Answer 43

broad. Gram + Gram - Atypical Bacteria

Question 44

Do Macrolides have cross resistance?

Answer 44

YES!!

Question 45

Clinical uses of macrolides

Answer 45

THey are very safe antimicrobials Upper respiratory infections COmmunity aquired pneumonia Pts allergic to penecillin

Question 46

_____ has been replaced by _______ and ______ for community aquired pneumonia bc of better activity and fewer adverse effects

Answer 46

- Erythromycin - Clarithromycin - Azithromycin

Question 47

What is known as z-pack

Answer 47

azithromycin

Question 48

WHat is the preferred therapy for urethritis due to CHalmydia

Answer 48

Azithromycin

Question 49

WHat has the longest half-life and volume distributon of the macrolides

Answer 49

azithromycin