L34 - Drugs Flashcards Preview

HDID Block 2 > L34 - Drugs > Flashcards

Flashcards in L34 - Drugs Deck (41)
Loading flashcards...
1

Adverse effect for aminoglycosides

Oto/nephrotoxicity
*Irreversible*
Neuromuscular blockade - avoid for MG patients

2

Adverse event for tetracyclines

Bone/teeth
Photo-sensitivity (sunburn easily)

3

Adverse events for ery/azithromycin

GI
QT prolongation

4

Adverse events for clindamycin

C.diff infection

5

Adverse events for linezolid

BM suppression
Serotonin syndrome

6

What drugs are your first choice for anaerobes (3)

Clindamycin
Metronidazole
Tigecycline

7

GP only protein synthesis inhibitors (2)

Linezolid
Mupirocin

8

Bacterial ribosome structure

30S + 50S = 70S
vs humans: 40S + 60S = 80S

9

Are most protein synthesis inhibitors cidal or static

STATIC

10

Common aminoglycosides (2)

Gentamicin
Amikacin

(Streptomycin)

11

Mechanism of action for aminoglycosides

Binds 30S - X protein synthesis
Cidal or static - depends on [ ]

12

Spectrum of action aminoglycosides

GN w/ pseudo
GP only w/ B-lactams b/c can't penetrate cell wall on own
No anaerobic

13

When to give/not to give aminoglycosides

IV only - hospital use for systemic GN infections
High [ ] in ear and kidney - use for complex UTIs
AVOID with:
- Pneumonia - inactivated pH
- Abscesses

14

Tetracycline other name & mechanism

Doxycycline
Reversible 30S binding
STATIC
Lipophilic = GN & P entry

15

2 resistance mechanisms vs tetracycline

Active efflux
Ribosomal protection proteins!!
Resistance to tetra = common, major limiting factor for clinical use

16

Tetracycline spectrum of activity

Broad GN (limited by resistance)
GP (some CA-MRSA)
Some anaerobic
Chlamydia
Mycoplasma

17

When are you going to give tetracycline? When are you going to avoid it?

Bronchitis
CA pneumonia
Chlamydia
AVOID: (bone growth side effect concerns)
- Kids
- Pregnant women

18

What's the other name for glycylcycline? Mechanism

= Tigecycline
Synthetic tetracycline
Broader coverage & works for tetracycline resistant bugs

19

Spectrum of activity glycylcycline

VERY BROAD
GN w/o proteus or pseudo
- *Rapid resistance may develop*
GP w/ MRSA & VRE
Most anaerobes

20

When are you going to use glycylcycline? Avoid?

IV only:
Complicated skin/ST or intra-ab infections
CA pneumonia
- Careful about increased mortality risk

21

3 macrolides

Azithromycin
Erythromycin
Clarithromycin

22

Macrolide mechanism

50S binding
Static
Azithro - long 1/2 life
Erythro - Cp450 metabolism therefore many drug interactions

23

Macrolide spectrum of activity

GN
GP
Some GN anaerobes
Chlamydia
Legionella
Mycoplasma

24

When are you using each of the 3 microlide options?

Azithro: CA pneumo/bronchitis, atypical pneumo, chlamydia
Erythro: gut motility
Clarithro: mycobacterium avium complex disease, vs. H. pylori

25

Mechanism of lincosamide/clindamycin

Binds 50S
Static - cidal at high doses

26

Which drug might induce clindamycin resistance

Erythromycin

27

Clindamycin spectrum of activity

GP only w/ CA MRSA
Anaerobes:
- Above the diaphragm
- Bacteroides fragillis

28

When are you using clindamycin

Community aspiration pneumo
Oral/ENT infections
Human bite wounds
Abscesses
S/ST due to CA MRSA

29

2 names for oxazolidinones

Linezolid
Tedizolid - overcomes resistance to other forms of this drug

30

Oxazolidinone mechanism of action

Binds 50S
Increased potency b/c additional target site @ binding region of rRNA
Static
100% bioavailability
PO or IV