Protein Synthesis Inhibitors

Question 1

What are some aminoglycosides

Answer 1

Gentamicin, neomycin, amikacin, tobramycin, streptomycin

Question 2

What is the mechanism of aminoglycosides

Answer 2

Bactericidal
30S inhibitor
Inhibits initiation complex formation and causes misreading of mRNA
Blocks translocation

“A initiates the alphabet”

Question 3

What are aminoglycosides used for

Answer 3

Severe gram negative rod infections

Question 4

What are some toxicities of aminoglycosides

Answer 4

Nephrotoxicity
Neuromuscular blockade
Ototoxicity
Teratogen

Question 5

What is the mechanism of tetracyclines

Answer 5

Bind 30S and prevent attachment of aminoacyl-tRNA

Question 6

What should tetracyclines not be taken with

Answer 6

Milk, antacids, or iron preperations because divalent cations inhibit absorption

Question 7

What are tetracyclines used for

Answer 7

Borrelia burgdoferi, M pneumoniae, Rickettsia, Chlamydia

Question 8

What are some toxicities of tetracyclines

Answer 8

GI distress, discoloration of teeth
Inhibition of bone growth in children
Contraindicated in pregnancy

Question 9

What are some macrolides

Answer 9

Azithromycin
Clarithromycin
Erythromycin

Question 10

What is the mechanism of macrolides

Answer 10

Block translocation

Binds to the 23S rRNA

Question 11

What are macrolides used for

Answer 11

Atypical pneumonias (mycoplasma, chlamydia, legionella)
STD (chlamydia)
Gram positive cocci

Question 12

What are some toxicities to macrolides

Answer 12

Motility issues
Arrhythmia caused by QT prolongation
Cholestatic hepatitis
Rash
eOsinophilia

“MACRO”

Question 13

What is the mechanism of chloramphenicol

Answer 13

Blocks peptidyltransferase at 50S

Question 14

What is chloramphenicol used for

Answer 14

Meningitis (H. flu, Neisseria meningitidis, Strep. pneumo)

Question 15

What are toxicities to chloramphenicol

Answer 15

Anemia, aplastic anemia, gray baby syndrome

Question 16

What is the mechanism of clindamycin

Answer 16

Blocks peptide transfer (transpeptidation) at 50S

Question 17

What is clindamycin used for

Answer 17

Anaerobic infections in aspiration pneumonia or lung abscess
Oral infection with anaerobes

Anaerobes above the diaphragm (metronidazole treat below)

Question 18

What is the mechanism of sulfonamides

Answer 18

Inhibit dihydropteroate synthase

Bacteriostatic

Question 19

What are sulfonamides used for

Answer 19

Gram positive
Gram negative
Nocardia
Chlamydia

Question 20

What are toxicities to sulfonamides

Answer 20

Hypersensitivity reactions
Hemolysis if G6PD deficient
Nephrotoxicity, photosensitivity
Kernicterus in infants

Question 21

What is the mechanism of trimethoprim

Answer 21

Inhibit dihydrofolate reductase

Bacteriostatic

Question 22

What is the combination TMP-SMX used for

Answer 22

Block folate synthesis

UTI, Shigella, Salmonella, P. jirovecii pneumonia

Question 23

What are toxicities to TMP-SMX

Answer 23

Megaloblastic anemia
Leukopenia
Granulocytopenia

“TMP - treat marrow poorly”

Question 24

What is the suffix for fluoroquinolones

Answer 24

-oxacin

Ciprofloxacin, nofloxacin, levofloxacin

Question 25

What is the mechanism of fluoroquinolones

Answer 25

Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV

Question 26

What are fluoroquinolones used for

Answer 26

Gram negative rods of GI and urinary tracts | Neisseria and some gram positives

Question 27

What are toxicities to fluoroquinolones

Answer 27

Contraindicated in pregnancy and kids - cartilage damage GI upset, skin rashes, tendon issues

Question 28

What is the mechanism of metronidazole

Answer 28

Forms free radical toxic metabolites in bacterial cell that damage DNA

Question 29

What is metronidazole used for

Answer 29

Giardia, Entamoeba, Trichomonas (GET) Gardnerella, Anaerobes (bacteroides, C. difficile), with PPI and clarithromycin for triple therapy against H Pylori (GAP) GET GAP on the METRO