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PHRM 865 Therapeutics > Lec 6 Clindamycin/Tetracyclines/Chloramphenicol/Quinolones Cushman > Flashcards

Lec 6 Clindamycin/Tetracyclines/Chloramphenicol/Quinolones Cushman Flashcards

(61 cards)

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1
Q

clindamycin MOA

A

inhibits protein synthesis by binding to the bacterial 50S ribosome

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2
Q

clindamycin is most effective against (2 things)

A

1) Aerobic Gram-(+) cocci, including some members of the Staphylococcus and Streptococcus genera.
2) Anaerobic Gram-(–) bacilli, including some members of the Bacteroides and Fusobacterium genera

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3
Q

Clindamycin may be used systemically to treat bone infections with _______ _______ (bacteria), or topically to treat severe acne

A

staphylococcus aureus

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4
Q

Clindamycin is administered IV with _______ and _______ to treat AIDS patients with _______ caused by Toxoplasma gondii.

A

pyrimethamine
leucovorin
encephalitis

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5
Q

potentially lethal condition commonly assoc with clindamcyin (2-10% of pts)

A

pseudomembranous colitis

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6
Q

tx for pseudomembranous colitis assoc with clindamycin (2)

A

metronidazole or vancomycin

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7
Q

tetracycline is a broad spectrum antibiotic that was found in ____ of Egyptians and Nubians

A

beer

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8
Q

tetracyclines form stable chelates with polyvalent metal ions such as (4 of them listed)

A

Ca, Al, Cu, Mg

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9
Q

tetracycline should not be given with what two things (2 examples)

A

high calcium (milk)
heavy metals (TUMS)

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10
Q

When concomitant therapy with tetracyclines and multivalent metals cannot be avoided, the metals should be administered ___-___ hours after the tetracycline.

A

1-2

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11
Q

why should children not be given tetracyclines?

A

teeth discoloration due to chelating calcium

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12
Q

Tetracyclines should be avoided after the ___ month of pregnancy in order to avoid undesirable effects on fetal bones and teeth

A

4th

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13
Q

Tetracyclines undergo ___ ___ ___ at pH values of 8.5 or above. The _______ product in inactive.

A

cleavage in base; lactone

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14
Q

tetracyclines MOA (2 things)

A

-binds to 30S ribosome subunit, blocks attachement of aminoacyl-tRNA to A site of ribosome
-inhibitors of codon-anticodon interaction

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15
Q

tetracyclines most common use

a. gynecomastia
b. acne
c. fever
d. vertigo

A

b. acne

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16
Q

tetracyclines remain the treatment of choice for infections caused by all of the following EXCEPT:

a. chlamydia
b. Rickettsia
c. brucellosis
d. salmonella
e. spirochetal infections

A

d. salmonella

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17
Q

tetracycline is produced by fermentation of _______ _______

A

streptomyces aureofaciens

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18
Q

tetracycline C-6

a. secondary hydroxyl
b. tertiary hydroxyl
c. no hydroxyl

A

b. tertiary hydroxyl

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19
Q

demeclocycline C-6

a. secondary hydroxyl
b. tertiary hydroxyl
c. no hydroxyl

A

a. secondary hydroxyl

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20
Q

T or F: tetracycline and demeclocycline absorption is lowered with food and milk

A

T (take without)

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21
Q

minocycline, doxycycline, tigecycline C-6

a. secondary hydroxyl
b. tertiary hydroxyl
c. no hydroxyl

A

c. no hydroxyl

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22
Q

what is the significance of the secondary hydroxyl on demeclocycline?

A

it dehydrates more slowly than tetracycline bc the secondary cation intermed formed is less stable (higher nrg) than the tertiary cation intermed formed from tetracycline

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23
Q

which drug has vestibular toxicities such as vertigo, ataxia, and nausea?

a. tetracycline
b. demeclocycline
c. minocycline
d. doxycycline
e. tigecycline
f. sarecycline

A

c. minocycline

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24
Q

half-life of 18-22 hours permits once a day dosing

a. tetracycline
b. demeclocycline
c. minocycline
d. doxycycline
e. tigecycline
f. sarecycline

A

d. doxycycline

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25
what is the significance of the tetracyclines lacking a C-6 hydroxyl?
therefore does not undergo acid-catalyzed dehydration, therefore has no potential for 4-epi...mediated toxicity
26
T or F: tigecycline is active against gram-positive only
F (both pos and neg)
27
T or F: tigecycline is available PO and IV
F (IV only)
28
protected from resistance development due to efflux pump induction and also due to to ribosomal protection proteins a. tetracycline b. demeclocycline c. minocycline d. doxycycline e. tigecycline f. sarecycline
e. tigecycline
29
weight adjusted dosing a. tetracycline b. demeclocycline c. minocycline d. doxycycline e. tigecycline f. sarecycline
f. sarecycline
30
interaction with penicillin and tetracyclines
tetracyclines are bacteriostatic and penicillins work on dividing bacteria; don't give together
31
sarecycline use
acne
32
T or F: dose inc is recommended for sarecycline with anticoagulants and Pgp substrates (digoxin)
F (dec)
33
sarecycline most common SE
nausea
34
chloramphenicol MOA: binds reversibly to the ___ ribosomal subunit, inhibits ______ ______ activity of the ribosome and blocks peptide bond formation between the P site and the A site
50S; peptidyl transferase
35
which of the following is FALSE about chloramphenicol? a. prodrug is chloramphenicol sodium succinate b. lipid soluble c. relatively bound to plasma proteins d. does not cross BBB e. indicated for bacterial meningitis and typhoid fever
d. does not cross BBB
36
which is NOT a resistance mechanism for chloramphenicol? a. reduced membrane permeability b. mutation of the 50S ribosomal subunit c. increased efflux pumps d. elaboration of chloramphenicol acetyltransferase
c. increased efflux pumps
37
-most serious toxicity is aplastic anemia -bone marrow suppression is common a. omadacycline b. chloramphenicol c. levofloxacin d. clindamycin
b. chloramphenicol
38
inc risk of childhood leukemia a. tetracycline b. chloramphenicol c. levofloxacin d. clindamycin
b. chloramphenicol
39
first gen quinolones have activity against gram _____ bacteria
negative
40
second gen quinolones have a _______ substituent at C-6 and a heterocyclic ring (usually ________) at C-7
fluorine piperazine
41
_________ is the most potent fluoroquinolone showing MIC = 0.01 to 1 µg/mL for Gram-(–) organisms a. ciprofloxacin b. levofloxacin c. moxifloxacin d. oxolinic acid
a. ciprofloxacin
42
T or F: second gen quinolones have less activity against gram positive organisms and mycoplasma compared to first gen
F (extended activity)
43
two discontinued first gen quinolones
oxolinic acid nalidixic acid
44
"drug of last resort" due to severe SE a. ciprofloxacin b. levofloxacin c. moxifloxacin d. ozenoxacin
c. moxifloxacin
45
third gen a. ciprofloxacin b. levofloxacin c. moxifloxacin d. ozenoxacin
b. levofloxacin
46
second gen a. ciprofloxacin b. levofloxacin c. moxifloxacin d. ozenoxacin
a. ciprofloxacin
47
fourth gen a. ciprofloxacin b. levofloxacin c. moxifloxacin d. ozenoxacin
c. moxifloxacin
48
used topically to treat impetigo due to staph aureus or strep pyogenes a. ciprofloxacin b. levofloxacin c. moxifloxacin d. ozenoxacin
d. ozenoxacin
49
oral or IV use for tx of skin infections a. moxifloxacin b. ozenoxacin c. delafloxacin
c. delafloxacin
50
DNA _______ is blocked by the quinolones a. folding b. religation c. cleavage d. binding
b. religation
51
increasing resistance to quinolones has led to which drug being first line for neisseria gonorrhoeae? a. cefipime b. cefdinir c. ceftriaxone d. cephalexin
c. ceftriaxone
52
effective against chlamydia trachomatis a. ciprofloxacin b. levofloxacin c. moxifloxacin d. ozenoxacin
b. levofloxacin
53
__________ as a sole therapy is effective in 50% of diabetic foot infections.
ciprofloxacin
54
effective against haemophilus ducreyi a. ciprofloxacin b. levofloxacin c. moxifloxacin d. ozenoxacin
a. ciprofloxacin
55
resistance to fluroquinolones (3 things)
1. decreased cellular permeability 2. efflux pumps 3. point mutations of enzymes
56
fluoroquinolone resistance: which is more common, point mutations in the A or B subunit of the DNA gyrase?
A
57
T or F: if you are resistant to one fluoroquinolone, you can switch to another of the same class
F (cross resistance, but not with other classes of antibiotics)
58
T or F: fluoroquinolones and tetracyclines should NOT be given with foods and drugs containing heavy metals
T
59
__________ has been associated with hyperglycemia and hypoglycemia in diabetic patients a. ciprofloxacin b. levofloxacin c. moxifloxacin d. ozenoxacin e. gatifloxacin
e. gatifloxacin
60
T or F: tetracyclines can cause damage growing cartilage and cause tendon rupture
F (fluoroquinolones)
61
can be used to treat pseudomonal infections with children with cystic fibrosis a. clindamycin b. tetracyclines c. chloramphenicol d. fluoroquinolones
d. fluoroquinolones

PHRM 865 Therapeutics (32 decks)

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