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Pharmacology > Misc. antibiotics > Flashcards

Misc. antibiotics Flashcards

1
Q

What is the MOA of tetracyclines?

A

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

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2
Q

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

A

REVERSIBLY

IRREVERSIBLY

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3
Q

Are tetracyclines bacteriocidal or static?

A

STATIC (cidal at high concentrations against susceptible organisms)

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4
Q

What are 3 big MOR for tetracyclines?

A

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

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5
Q

Do you see cross-resistance at all for tetracyclines?

A

YES but not for minocycline

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6
Q

Which tetracycline is resistant to the MORs?

A

tigecycline

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7
Q

Describe the spectrum of activity for tetracyclines

A

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

GRAM NEG: burkholderia pseudomallei, neisseria, H. flu

Aerobes: actinomyces, proprionibacterium

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

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8
Q

What are the miscellaneous bacteria covered by tetracylcine

A 
legionella 
chlamydophila
chlamydia
mycoplasma
ureaplasma
rickettsia
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9
Q

What is a special inclusion and exemption of tigecycline?

A

INCLUDED: bacteroides

OMISSION: proteus and pseudomonas

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10
Q

True or false: tigecycline has pseudomonas activity

A

FALSE (big hole in activity)

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11
Q

Why can you not use tigecycline for bacteremias or UTIs?

A

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

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12
Q

What is the route of admin for tigecycline?

A

IV

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13
Q

What impairs absorption of tetracyclines?

A

di and trivalent cations

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14
Q

Where is a big site of distribution of tet?

A

prostate

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15
Q

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

A

renal: tetracycline, demeclocycline

non renal: doxy, mino, tige

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16
Q

what do you use tet/glycylcyclines for?

A

RMSF, CA pneumo, STDs

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17
Q

What is demeclocycline particularly useful for?

A

SIADH

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18
Q

Name 5 adverse effects of tetracyclines

A

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

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19
Q

What can you get with expired tet?

A

fanconi like syndrome (renal failure)

20
Q

What effects do tetracylcines have on pregnancy?

A

discoloration of teeth and decreased bone growth

21
Q

What is the MOA of sulfonamides?

A

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

22
Q

Are sulfonamides bacteriocidal or static?

A

STATIC

23
Q

What is the most common short acting sulfonamide?

A

sulfamethoxazole

24
Q

What does Trimethoprim do?

A

inhibits dihydrofolate reductase

25
Q

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

A

sulfamethoxazole

trimethoprim

(both result in no purines produced)

26
Q

Is resistance common to sulfonamides?

A

YES (structural change of enzyme)

27
Q

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

A 
\+ = staph aureus
- = stenotrophomonas maltophilia
28
Q

TMP-SMX is prophylaxis of choice for what bug?

A

pneumocystis carinii

29
Q

Where do TMP-SMX get good distribution?

A

prostate

30
Q

Where are TMP-SMX eliminated?

A

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

31
Q

Name 5 clinical uses for TMP-SMX

A

1) acute, chronic, or recurrent infections of the urinary tract
2) acute/chronic bacterial prostatitis
3) skin infections due to CA MRSA
4) bacterial sinusitis
5) NOCARDIA

32
Q

Name 4 adverse effects associated with TMP-SMX

A

1) leukopenia
2) thrombocytopenia
3) hypersensitivity (rash)
4) crystalluria

also get tubular necrosis and interstitial nephritis

33
Q

Name 3 drug interactions common of TMP-SMX

A

1) phenytoin
2) warfarin
3) methotrexate

34
Q

How is TMP-SMX administered?

A

oral (single or double strength) or IV

35
Q

What is the MOA of chloramphenicol?

A

binds to 50S subunit of 70s ribosome

36
Q

For which 3 bugs is chloramphenicol bacterioCIDAL (not static) for?

A

1) H. flu
2) strep pneumo
3) N. meningitidis

37
Q

What are 3 resistance mechanisms for chloramphenicol?

A

1) reduced permeability/uptake
2) ribosomal mutation
3) acetyltransferase inactivation

38
Q

You should decrease chloramphicol dose in what kind of failure?

A

liver (adjustment not required in renal failure)

39
Q

Is chloramphenicol used for pseudomonas?

A

NO

40
Q

What 4 bugs does chloramphenicol treat?

A

Ricketssiae
Spirochetes
Chlamydia
Mycoplasma

IN DEVELOPING WORLD

41
Q

What are the 2 main adverse effects of chloramphenicol?

A

1) Aplastic anemia

2) Gray baby syndrome

42
Q

What are the 2 UTI agents?

A

Nitrofurantoin

Methenamine

43
Q

Which UTI agent is converted to formaldehyde in acidic pH?

A

Methenamine

44
Q

Which UTI agent is used to suppress UTIs and which to treat?

A

Methenamine –> suppress

Nitrofurantoin –> treat

45
Q

How are the UTI agents administered?

A

orally

46
Q

What are some adverse effects of nitrofurantoin?

A

GI intolerance

rashes

Pharmacology (21 decks)

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