Infectious Disease: Protein Synthesis Inhibitors

Question 1

What is the MOA of Aminoglycosides

Answer 1

Block protein synthesis at 30s

Question 2

What do aminoglycosides require to work

Answer 2

O2 for transport into cells
-no effective against anaerobes or intracellular organisms

Question 3

What is the major use of aminoglycosides

Answer 3

Aerobic Gram (-) Bacteria

Question 4

What are common aminoglycoside drugs

Answer 4

Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin

Question 5

What major bacteria do Aminoglycosides cover

Answer 5

Enterobacteriaceae
-Salmonella
-E. Coli
-Klebsiella
-Shigella

Question 6

What is Vancomycin-Gentamicin used for

Answer 6

Sepsis

Question 7

What is Ampicillin-Gentamicin used for

Answer 7

Endocarditis

Question 8

What are common adverse effects of Aminoglycoside use

Answer 8

Nephrotoxicity

Ototoxicity

Neuromuscular blockade

Question 9

What patient population are Aminoglycosides avoided in

Answer 9

Myasthenia Gravis

Pregnant

Question 10

What pregnancy class are aminoglycosides

Answer 10

D
-reports of fetal renal and ototoxicity

Question 11

Why are aminoglycosides avoided in patients with Myasthenia Gravis

Answer 11

block/limit release of ACh at neuromuscular junctions

Question 12

What is the MOA of Macrolides

Answer 12

Block protein synthesis at 50S

concentrate inside macrophages and other cells

Question 13

What are macrolides effective against

Answer 13

Intracellular Pathogens
-Chlamydia
-Legionella

S. Pneumoniae

Question 14

Can macrolides be used in patients with a penicillin allergy

Answer 14

yes

Question 15

What respiratory pathogens do Macrolides offer good coverage for

Answer 15

CAP

S. Pneumonia
H. Influenzae
Moraxella

Legionella
Chlamydia
Mycoplasma

Question 16

What STI are Macrolides used for

Answer 16

Chlamydia
-intracellular bacteria

Question 17

What macrolide is used for Chlamydia

Answer 17

Azithromycin

Question 18

What drug class is the preferred treatment of Bordetella Pertussis

Answer 18

Macrolides

Question 19

What is a special use of Clarithromycin

Answer 19

triple therapy for H. Pylori

Question 20

What is a special use of Erythromycin

Answer 20

Binds motilin-R in GI tract

stimulates smooth muscle contraction

used in GI motility disorders

Eye ointment for newborns

Question 21

What are adverse effects of Macrolides

Answer 21

N/D, abdominal pain

Prolonged QT

Acute Cholestatic Hepatitis

P450 Enzyme Inhibition

Infantile Pyloric Stenosis

Question 22

What is a contraindication to Macrolides

Answer 22

Prior Cholestatic Jaundice or liver dysfunction

Question 23

What pattern of LFTs are seen in Acute Cholestatis hepatitis

Answer 23

Increased
-AST
-ALT
-Alk Phos
-Bilirubin

Question 24

What age group are macrolides avoided in

Answer 24

Children <2 weeks old

Question 25

What macrolides are associated with infantile Pyloric Stenosis

Answer 25

Erythromycin Azithromycin

Question 26

What is the MOA of Tetracyclines

Answer 26

inhibit protein synthesis at 30s

Question 27

what are common Tetracycline drugs

Answer 27

Doxycycline Tetracycline Minocycline

Question 28

What are tetracyclines effective against

Answer 28

Atypical pathogens -tick borne -zoonotic

Question 29

What affects the intestinal absorption of Tetracyclines

Answer 29

Minerals/antacids -Ca -Mg -Milk -Fe PO reduced with food

Question 30

What tetracycline is not affected by food

Answer 30

Doxycycline

Question 31

What are the common adverse effects of Tetracyclines

Answer 31

GI distress Photosensitivity Discoloration of teeth Inhibition of bone growth in children

Question 32

What patient population are Tetracyclines contraindicated in

Answer 32

Pregnancy -cross placenta -accumulate in fetal bone and teeth

Question 33

What is the MOA of Clindamycin

Answer 33

Blocks proteins synthesis at 50s

Question 34

What does Clindamycin cover

Answer 34

Some gram (+) many anaerobes

Question 35

What common gram (+) bacteria does Clindamycin cover

Answer 35

Staph Viridans Strep Strep Pyogenes S. Pneumoniae

Question 36

What common anaerobes does Clindamycin cover

Answer 36

Clostridium Perfringens Mouth anaerobes -Fusobacterium -Prevotella -Peptostreptococcus "anaerobes above the diaphragm: aspiration pneumonia"

Question 37

What line drug is Clindamycin typically

Answer 37

2nd line agent

Question 38

What are 2 common uses of Clindamycin

Answer 38

Post-partum Endometritis GBS infection in pregnancy

Question 39

What Clindamycin based regiment is used in Post-partum Endometritis

Answer 39

Gentamycin + Clindamycin

Question 40

What Clindamycin based regiment is used in GBS infection in pregnancy

Answer 40

Clindamycin for patient with severe penicillin allergy

Question 41

What adverse effect is commonly associated with Clindamycin

Answer 41

C. Difficile -Pseudomembranous colitis -massive watery diarrhea

Question 42

What is the MOA of Linezolid

Answer 42

Blocks protein synthesis at 50s

Question 43

What are the major uses of Linezolid

Answer 43

Vancomycin-resistant enterococcus (VRE) Methicillin-resistant S. Aureus (MRSA)

Question 44

What are the common adverse effects of Linezolid

Answer 44

Myelosuppression Peripheral and optic Neuropathy Serotonin Syndrome -high risk with SSRI