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Flashcards in Misc. antibiotics Deck (46)
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1

What is the MOA of tetracyclines?

REVERSIBLY binds to the 30S ribosomal subunit (inhibits protein synthesis - no binding of tRNA to acceptor site)

2

Tetracyclines ____________ bind to the 30S subunit while aminoglycosides _______________ bind to the 30S subunit

REVERSIBLY

IRREVERSIBLY

3

Are tetracyclines bacteriocidal or static?

STATIC (cidal at high concentrations against susceptible organisms)

4

What are 3 big MOR for tetracyclines?

1) efflux pumps
2) ribosomal protection proteins
3) enzymatic inactivation

5

Do you see cross-resistance at all for tetracyclines?

YES but not for minocycline

6

Which tetracycline is resistant to the MORs?

tigecycline

7

Describe the spectrum of activity for tetracyclines

GRAM POS: MSSA, PSSP, bacillus, listeria, nocardia

GRAM NEG: burkholderia pseudomallei, neisseria, H. flu

Aerobes: actinomyces, proprionibacterium

MISC: legionella, chlamydophila, chlamydia, mycoplasma, ureaplasma, rickettsia

8

What are the miscellaneous bacteria covered by tetracylcine

legionella
chlamydophila
chlamydia
mycoplasma
ureaplasma
rickettsia

9

What is a special inclusion and exemption of tigecycline?

INCLUDED: bacteroides

OMISSION: proteus and pseudomonas

10

True or false: tigecycline has pseudomonas activity

FALSE (big hole in activity)

11

Why can you not use tigecycline for bacteremias or UTIs?

cannot maintain good levels in the blood and does not concentrate in the bladder

12

What is the route of admin for tigecycline?

IV

13

What impairs absorption of tetracyclines?

di and trivalent cations

14

Where is a big site of distribution of tet?

prostate

15

What 3 drugs are not eliminated via the kidney? andwhat 2 are?

renal: tetracycline, demeclocycline

non renal: doxy, mino, tige

16

what do you use tet/glycylcyclines for?

RMSF, CA pneumo, STDs

17

What is demeclocycline particularly useful for?

SIADH

18

Name 5 adverse effects of tetracyclines

1) GI (nausea and vomiting)
2) hypersensitivity
3) PHOTOSENSITIVITY (exaggerated sunburn)
4) renal (fanconi-like syndrome with expired tets)
5) PREGNANCY CAT D

19

What can you get with expired tet?

fanconi like syndrome (renal failure)

20

What effects do tetracylcines have on pregnancy?

discoloration of teeth and decreased bone growth

21

What is the MOA of sulfonamides?

INHIBITS dihydropteroate synthetase (so PABA cannot be incorporated into tetrahydropteroic acid)

22

Are sulfonamides bacteriocidal or static?

STATIC

23

What is the most common short acting sulfonamide?

sulfamethoxazole

24

What does Trimethoprim do?

inhibits dihydrofolate reductase

25

____________ blocks conversion of PABA ---> dihydrofolic acid while __________ blocks dihydrofolic acid ----> tetrahydrofolic acid

sulfamethoxazole

trimethoprim

(both result in no purines produced)

26

Is resistance common to sulfonamides?

YES (structural change of enzyme)

27

What is the big gram positive and big gram negative bug TMP-SMX targets?

+ = staph aureus
- = stenotrophomonas maltophilia

28

TMP-SMX is prophylaxis of choice for what bug?

pneumocystis carinii

29

Where do TMP-SMX get good distribution?

prostate

30

Where are TMP-SMX eliminated?

liver and kidney - need to adjust dose in patients with CrCl