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Bacteriostatic Inhibitors of Protein Synthesis Flashcards

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1
Q

what drug classes do Bacteriostatic Inhibitors of Protein Synthesis include

A 
Tetracyclines
Macrolides
Ketolides
Clindamycin
Chloramphenicol
Linezolid
Dalfoprisitine
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2
Q

what does bacteriostatic mean

A

suppress bacterial growth and replication but do NOT outright kill

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3
Q

are tetracyclines broad or narrow

A

broad

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4
Q

MOA of tetracylcines

A

inhibit protein synthesis

bind to 30s ribosomal subunit

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5
Q

are mammal cells affected by tetracyclines

A

no, they do not have an energy transport process that bacterial cells do (thats how they get into the cell and inhibit protein synthesis)

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6
Q

2 mechanisms for tetracyclines bacterial resistance

A

decrease drug uptake

acquisition of the ability to extrude tetras

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7
Q

some bacteria that tetracyclines are used against

A 
Rickettsia
spirochetes
brucella
chlamydia
mycoplasm
vibrio cholera
H. pylori
borrelia burgdorferi 
baccilus anthracis
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8
Q

are tetracyclines commonly used as 1st line drugs?

A

no

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9
Q

tetracyclines are 1st line for…

A

rickettsial dz (Rocky mountain spotted fever)
chlamydia trachamonis (cervicitis, trachoma,
lymphogranuloma venerum, urethritis)
brucellosis
cholera
pneumonia (caused by mycoplasma penumoniae)
lyme’s dz (caused by borrelia burgdorferi-multisystem
inflammatory disorder)
H.pylori (gastric infection)
antthrax

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10
Q

which tetracyclines is inhibited by foods

A

tetracyclines and demeclocycline

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11
Q

is minocycline inhibited by food

A

no

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12
Q

what prevents absorption of tetracylines

A 
Ca
Al
Mg
Fe
Zn

Must be taken 1 hr before or at leas 2-3 hrs after a meal

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13
Q

can tetracyclines penetrate the CSF

A

no

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14
Q

do tetracyclines cross the placenta

A

YES

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15
Q

elimination of tetracyclines

A

kidneys and liver

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16
Q

how are doxy/minocycline excreted vs tetracyclines and democycline

A

doxy/mino –> liver-preferred w/ pts w/ renal impairments

tetra/demo –> kidneys- not good for pts w/ renal impairments

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17
Q

major AR to tetracyclines and fetuses

A

staining of deciduous teeth

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18
Q

can tetracyclines be used in kids

A

should not be used in kids <8, permanent staining of teeth

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19
Q

tx for C. diff

A

PO vancomycin or metronidazole plus vigorous fluid and electrolyte replacement

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20
Q

what can happen if you take an expired tetracyclines

A

Fanconi Syndrome- renal tubular dysfunction (can lead to

renal failure)

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21
Q

SA of tetracyclines

A

GI, photosensitivity, renal/hepatic toxicity, suprainfection (c.
diff, candida), staining of bones and teeth

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22
Q

tetracyclines and digitoxin (warfarin) interactions

A

can increase digitoxin levels by increasing GI absorption and increase INR levels by decreasing vit K flora in gut

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23
Q

when should/can you take tetracyclines

A

on an empty stomach w/ glass of water

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24
Q

what are two long acting tetracyclines

A

doxy and minocycline

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25
doxycycline
vibramycin
26
demeclocycline (intermediate acting) stimulates.../uses
urine flow... use in SIADH
27
doxy is the first line for...
Lymes dz anthrax chlamydial infections
28
minocycline major SA
can damage vestibular apparatus (unsteady, dizzy)
29
demeclocycline
declomycin
30
minocycline
minocin
31
tetracycline examples
achromycin, sumycin
32
are macrolides broad or narrow spectrum
broad
33
MOA of macrolides
inhibits bacterial protein synthesis
34
what class is erythromycin part of
macrolides
35
what abx are structurally similar to tetracyclines (and are kinda considered tetras but not really...)
doxycycline, minocylcine, demeclocycline
36
erythromycin MOA
binds to 50s ribosomal subunit --> blocks new amino acid chain from being added
37
what is erythromycin similar to in terms of microbial spectrum
PCN
38
alternative to Pen G (allergic pts)
erythromycin
39
erythromycin is the DOC for...
``` bordetella pertussis (whooping cough) corynebacterium diphtheria ```
40
tetracyclines and erythromycin act well on...
chlamydial infections | pneumonia caused by mycoplasma pneumonia
41
erythromycin penetration of CSF
poor
42
does erythromycin cross the placenta and can it cause fetal harm
does cross the placenta but no evidence of fetal harm
43
elimination of erythromycin
liver
44
where does erythromycin concentrate in
liver
45
AR erythromycin
GI QT prolongation (increase torsades de pointe) sudden cardiac death
46
drug interactions of erythromycin (increase levels of...)
theophylline carbamazepine warfarin - inhibits liver metabolism of these drugs increasing plasma levels
47
erythromycin antagonizes effects of...
chloramphenicol and clindamycin
48
drugs that inhibit erythromycin metabolism
verapamil diltiazem azole antifungals HIV protease inhibitors
49
examples of macrolides
erythromycin azithromycin (zmax) clarithromycin (Biaxin)
50
clindamycin MOA
inhibits bacterial protein synthesis of 50S ribosomal subunits
51
does clindamycin cross CSF
no
52
where is clindamycin metabolized
liver
53
antimicrobial spectrum of clindamycin
G + including anaerobic streptococci
54
clindamycin is DOC for
bacteroides (esp. B fragilis)
55
chloramphenicol MOA
inhibits 50s ribosomal subunit
56
can chloramphenicol get intot he CSF
yes
57
where is chloramphenicol metabolized
liver
58
antimicrobial spectrum of chloramphenicol
``` G- anaerobic some strains of strep and staph rickettsia clostridium, chlamydia, mycoplasma ```
59
chloramphenicol DOC for
typhoid fever
60
chloramphenicol can be used for...(in conjunction w/ ampicillin)
bacterial meningitis
61
major adverse effects of chloramphenicol
bone marrow suppression resulting in pancytopenia
62
chloramphenicol with neonates
gray baby syndrome (cyanosis, respiratory distress, abdominal distension, vasomotor collapse, loose green stools, ashen grey look)
63
what class do dalfloprisitne /quinipristine belong to
streptogamins
64
MOA of dalfloprisitne /quinipristine separately vs together
``` separately = basteriostatic together = bacteriocidal ```
65
indications for streptogamins
principal indication: vancomycin resistant | others: MRSA, MRSE, drug resistant S. pneumonia
66
major adverse rxns of streptogamins
* hepatotoxicity (check LFTs and bilirubin levels twice weekly for 1st wk and then once a wk after) - thrombophlebitis
67
drug interactions of streptogamins
CYP3A4
68
what class does linezolid belong to
oxazolidinones
69
linezolid MOA
binds to 23s portion of 50 s ribosomal subunit
70
antimicrobial spectrum of oxazolidinones (e.g. linezolid)
significant activity against multidrug resistant pathogens including vanc resistant enterococci (VRE) and MRSA primarily effective against aerobic and facultative gram + bacteria
71
what do you use for VRE, health care associated pneumonia caused by staph aureus/strep pneumonia, CAP
linezolid
72
tigecycline (Tygacil) MOA
binds to 30s ribosomal subunits
73
what class is Tygacil part of
glycyclines
74
is Tygacil broad or narrow and what is it kinda like
broad, tetracyclines
75
what is tygacil specifically NOT active against
pseudomonas auroginosa or proteus species
76
what are the adverse effects similar to of tygacil
tetracyclines
77
what are retapamulan and mupirocin used for primarily
topical impetigo
78
retapamulan MOA
binds to 50s ribosomal subunit
79
is retapamulan bacteriostatics or bacteriocidal
bacteriostatic
80
what is mupirocin used for (2 things primarily)
impetigo caused by staph aureus/step pyogenes AND nasal colonization of MRSA
81
MOA of mupirocin
binds to isoleucyl transfer RNAsynthetase

Drugs (3 decks)

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