chemptherapy part 1 (3) Flashcards
protein synthesis inhibitors
- erythmromycin, azithromycin, clarithromycin, clindamycin, tetracyclines, chloramphenicol, aminoglycosides
- referred to as ‘_____’
- greater affinity for microbial ribosomal subunits _____, _____, and _____
- protein synthesis occurs at a much faster rate in _____ cells and therefore _____ activity is strong
broad spectrum antibiotics 30S 50S 70S microbial antibacterial
tetracyclines
- _____ spectrum, gram _____ and gram _____
- also _____, rickettsia, chlamidya and some protozoans (amoeba)
- tetracycline, doxycycline, minocycline
- block _____ synthesis by penetrating through the bacterial _____ by _____ and binding to _____ subunit
- prevent binding of _____ to _____ ribosome complex
- prevent addition of amino acids to chain
broad positive negative anaerobes protein cell wall passive diffusion 30S tRNA mRNA
tetracyclines
- erratic absorption and remains in _____ and kills _____
- absorption impaired by food, _____, _____ (AL+++, Mg++, Fe++)
- reaches fetus thus damaging developing _____ and _____
- -_____ of papilla
- –_____ or discolored _____
- –_____ syndrome (ARF)
-clinical uses: _____, PUD, periodontal diseases, cholera, chlamydia, and other STDs, plague, _____, skin infections
GIT flora Ca++ milk antacids bones teeth hypertrophy darkened tongue fanconi's acne Lyme Ds
macrolides: erythromycin
- azithromycin, clarithromycin
- _____ spectrum (newer classified as broad spectrum)
- gram _____ (pneumococci, strep, staph, chlamydia, legionella)
- gram _____ (treponema pallidum and campylobacter)
- alternative for patients allergic to _____
- binds to the _____ subunit of ribosomes
- -blocks addition of new _____ to the growing _____ (blocks protein synthesis)
-_____ at normal or _____ at larger concentrations
narrow positive negative penicillins 50S amino acids peptide bacteriostatic bactericidal
newer macrolides
- _____
- FDA approved 2004 semi-synthetic derivative known as ketolide
- high affinity for 50S ribosomal binding
- bind to an additional site on the _____ ribosome
- may be used where _____ to macrolides has developed in bacterial strains
- large number of drug interactions
- rare cases of fulminant hepatic necrosis
telithromycin
23S
resistance
chloramphenicol
- bacteriostatic: _____/_____/_____/_____
- H influenza, N meningitis, bacteriosides
- salmonella: typhoid fever, bacterial meningitis
- rickettsia
- binds to _____ ribosomal subunit
- resistance: plasmid encoded _____ that inactivate the drug
- toxicity: inhibition of mitochondrial protein synthesis. _____ syndrome
- lack of _____: vomiting, flaccidity, hypothermia, respiratory distress, gray color
aerobic anaerobic gram positive gram negative 50S acetyltransferases gray baby conjugation
clindamycin (cleocin)
- derivative of lincomycin
- _____
- binds to _____ subunit of bacteria ribosome
- _____ for strep, staph, and pneumo
- spectrum
- -anaerobes (gram _____ and _____)
- aerobes (gram _____)
- used for skin and soft tissue
- penetrating wound of abdomen
- septic abortion
- prophylaxis of infective _____
lincosamide 50S bacteriostatic positive negative positive endocarditis
pseudomembranous colitis risk factors: -antibiotics --\_\_\_\_\_ --\_\_\_\_\_ --\_\_\_\_\_ --\_\_\_\_\_ --\_\_\_\_\_
- elderly
- females with _____ diseases
clindamycin cephalosporins ampicillin amoxicillin erythromycin genitourinary
pseudomembranous colitis
- clinical features
- -crampy abdominal pain
- -lower quadrant abdominal tenderness
- -watery diarrhea
- -fever
- -leukocytosis
treatment
- stop all antibiotics
- hydration
- _____ (oral 500 mg QID for first 2 days or 125 mg QID, 10-14 days)
- metronidazole (500 mg TID, 7-14 days)
vancomycin
tiacumicins: fidoxamin
- _____
- _____ spectrum _____ antibiotic drugs called tiacumicans
- fermentation product obtained from an actinomycete
- fidaxomicin is _____ absorbed into the bloodstream, is _____, and selectively eradicates _____
- little disruption to the multiple species of bacteria that make up the normal, healthy intestinal flora
- fidoxamicin binds to and prevents movement of the “switch regions” of bacterial RNA polymerase
- _____ motion occurs during the opening and closing of the _____
fidaxomicin narrow macrocyclic minimally bactericidal c diff switch DNA:RNA clamp
