inhibitors of protein synthesis

Question 1

What is the mechanism of action for inhibitors of protein synthesis?

Answer 1

Suppress bacterial replication and growth.

Question 2

Are tetracyclines and macrolides bactericidal or bacteriostatic?

Answer 2

Bacteriostatic.

Question 3

Are aminoglycosides bactericidal or bacteriostatic?

Answer 3

Bactericidal.

Question 4

What types of infections do inhibitors of protein synthesis treat?

Answer 4

Respiratory, GI, urinary, reproductive tract infections.

Question 5

Name three tetracyclines.

Answer 5

Doxycycline, Minocycline, Demeclocycline.

Question 6

Are tetracyclines broad or narrow spectrum?

Answer 6

Broad-spectrum.

Question 7

Are tetracyclines bactericidal or bacteriostatic?

Answer 7

Bacteriostatic.

Question 8

What has developed due to widespread tetracycline use?

Answer 8

Bacterial resistance.

Question 9

How are tetracyclines used for acne?

Answer 9

Topically or orally.

Question 10

What dental condition can tetracyclines be used for?

Answer 10

Periodontal disease (po, topical).

Question 11

What respiratory infection is treated with tetracyclines?

Answer 11

Mycoplasma pneumonia.

Question 12

What STI is treated with tetracyclines?

Answer 12

Chlamydia trachomatis.

Question 13

What bacterial infection from ticks is treated with tetracyclines?

Answer 13

Rickettsia (Rocky Mountain spotted fever, Lyme disease).

Question 14

What GI infection is treated with tetracyclines?

Answer 14

Helicobacter pylori (H. pylori).

Question 15

What bioterrorism-related infection can tetracyclines treat?

Answer 15

Anthrax.

Question 16

What type of urinary infection can tetracyclines treat?

Answer 16

UTIs.

Question 17

What are common GI side effects of tetracyclines?

Answer 17

Cramping, nausea, vomiting, diarrhea, esophageal ulceration.

Question 18

What permanent effect can tetracyclines have on teeth?

Answer 18

Tooth discoloration.

Question 19

Who should avoid tetracyclines due to tooth discoloration?

Answer 19

Pregnant women and children <8 years old.

Question 20

What major organ toxicity is associated with tetracyclines?

Answer 20

Hepatotoxicity.

Question 21

How do tetracyclines affect sun exposure?

Answer 21

Photosensitivity—patients should wear sunscreen and protective clothing.

Question 22

What type of secondary infection can tetracyclines cause?

Answer 22

Superinfection (C. diff, yeast infections).

Question 23

Should tetracyclines be given to pregnant women?

Answer 23

No, they can cause permanent tooth damage.

Question 24

How do tetracyclines affect birth control?

Answer 24

They decrease the efficacy of oral contraceptives.

Question 25

What types of patients should use tetracyclines cautiously?

Answer 25

Pregnant/postpartum/lactating individuals, those with liver/kidney disease, children <8 years old.

Question 26

What is chelation in relation to tetracyclines?

Answer 26

Binding of tetracyclines to certain substances, making them nonabsorbable.

Question 27

What substances should NOT be taken with tetracyclines due to chelation?

Answer 27

Milk, calcium/iron supplements, magnesium laxatives, antacids.

Question 28

What cardiac medication does doxycycline interact with?

Answer 28

Digoxin.

Question 29

Name three macrolides.

Answer 29

Erythromycin, Azithromycin, Clarithromycin.

Question 30

Are macrolides bacteriostatic or bactericidal?

Answer 30

Bacteriostatic (slow bacterial growth).

Question 31

When are macrolides commonly used?

Answer 31

PCN allergy, Legionnaire’s disease, Bordetella pertussis, acute diphtheria, chlamydial infections, pneumonia, strep infections.

Question 32

What are the common GI side effects of macrolides?

Answer 32

Nausea, vomiting, diarrhea.

Question 33

How can macrolides affect heart function?

Answer 33

Prolonged QT interval.

Question 34

What serious ear-related side effect is associated with high doses of macrolides?

Answer 34

Ototoxicity.

Question 35

Should macrolides be used in pregnancy?

Answer 35

Use caution (risk vs. benefit).

Question 36

What pre-existing conditions require caution with macrolides?

Answer 36

Liver disease, QT prolongation.

Question 37

What enzyme system do macrolides inhibit, leading to drug interactions?

Answer 37

CYP450.

Question 38

What common medications interact with macrolides?

Answer 38

Antihistamines, theophylline, carbamazepine, warfarin, digoxin.

Question 39

What contraceptive precaution should patients take with macrolides?

Answer 39

Use backup contraception.

Question 40

Name six aminoglycosides.

Answer 40

Gentamicin, Tobramycin, Neomycin, Streptomycin, Paromomycin, Amikacin.

Question 41

Are aminoglycosides bacteriostatic or bactericidal?

Answer 41

Bactericidal (inhibit protein synthesis).

Question 42

What type of bacteria do aminoglycosides primarily target?

Answer 42

Gram-negative bacilli.

Question 43

Are aminoglycosides absorbed in the GI tract?

Answer 43

No.

Question 44

What two forms of ototoxicity can aminoglycosides cause?

Answer 44

Vestibular (loss of balance) and cochlear (hearing loss).

Question 45

What kidney-related toxicity can occur with aminoglycosides?

Answer 45

Nephrotoxicity (monitor I&O, BUN, creatinine, hematuria, cloudy urine).

Question 46

How can aminoglycosides affect muscle function?

Answer 46

Neuromuscular blockade → respiratory depression & muscle weakness.

Question 47

Which patient populations are at risk for neuromuscular blockade with aminoglycosides?

Answer 47

Patients with myasthenia gravis or those given anesthesia.

Question 48

What neurologic side effect is unique to streptomycin?

Answer 48

Neurologic disorders.

Question 49

Should aminoglycosides be used in pregnancy?

Answer 49

Use caution (risk of toxicity).

Question 50

Which patients should use aminoglycosides cautiously?

Answer 50

Those with kidney impairment, hearing loss, or myasthenia gravis.

Question 51

What other drugs increase nephrotoxicity risk when combined with aminoglycosides?

Answer 51

Amphotericin B, cephalosporins.

Question 52

What drugs increase ototoxicity risk when combined with aminoglycosides?

Answer 52

Loop diuretics (furosemide), ethacrynic acid.

Question 53

What neuromuscular blocking agents interact with aminoglycosides?

Answer 53

Tubocurarine, skeletal muscle relaxants.

Question 54

Why should aminoglycosides and penicillins NOT be mixed in the same IV bag?

Answer 54

PCN inactivates aminoglycosides.

Question 55

When should trough levels be measured for once-daily dosing of aminoglycosides?

Answer 55

Right before the next dose.

Question 56

When should peak levels be measured for divided dosing of aminoglycosides?

Answer 56

30 min after IM injection or after IV infusion is complete.

Question 57

When should trough levels be measured for divided dosing of aminoglycosides?

Answer 57

Right before the next dose.