What do ribosomes do?
they synthesize proteins inside cells
if ribosomes don’t work, you can’t make proteins and cell will die
What is the MOA of Protein Synthesis Inhibitors?
They bind to ribosomes in bacteria and prevent them from working
Which Protein Synthesis Inhibitors are Bacteriostatic?
- Tetracyclines (-cycline)
- Macrolides
- Clindamycin
- Linezolid
Which Protein Synthesis Inhibitors are Bacteriocidal?
Aminoglycosides
don’t mix w/ furosemide or ASA b/c ototoxic
What are common uses for Tetracyclines (-cycline)?
- Unique infections (Rocky Mountain Spotted Fever, Cholera, Lime Disease, Anthrax)
- Acne
- Peptic Ulcer Disease (H. pylori)
- Periodontal Disease
Tetracyclines have interactions with foods rich in what?
CAMIZ
- Calcium
- Aluminum
- Magnesium
- Iron
- Zinc
Calcium supplements, Iron supplements, Milk of Magnesia, & Antacids w/ calcium and aluminum and zinc would be bad with which antibiotic?
Tetracylcine
Who should not take tetracycline due to their effect on teeth discoloration?
Tetracycline bind to calcium and prevent it’s absorption, causing teeth and bones to look grey
it is contraindicated for children
Adverse effects of tetracycline?
- Teeth discoloration
- Esophageal irritation
- Photosensitivity
Erythromycin is which class of Protein Synthesis Inhibitors? What is it given to clients who do not have an infection?
Erythromycin is a Macrolide
It will increase gastric motility for those w/ gastroparesis
Common uses for Macrolides?
- Upper respiratory tract infections
- Lower respiratory tract infections (pneumonia)
- Increasing gastric motility (erythromycin)
Adverse effects of Macrolides?
- GI upset
- Distorted (Metallic) taste [Mac computer is metal]
- CYP interactions
Which Macrolide is especially a concern for metallic taste and CYP interactions?
clarithromycin
Which Protein Synthesis Inhibitor is extremely common and has a strong gram+ activity?
Clindamycin
Which Protein Synthesis Inhibitor absorbs very well and is useful for joint and tendon infection?
Clindamycin
aCL pain w/ CLindamycin
Does Clindamycin cross the BBB?
NO
Not good for meningitis
Major adverse effect of Clindamycin?
C. diff
CLaustridium difficult w/ CLindamycin
Which Protein Synthesis Inhibitor kills resistant organisms like MRSA & Vancomycin Resistant Enterococcus (VRE)?
Linezolid
- gram+ activity
- expensive ($100/pill)
Which Protein Synthesis Inhibitor is a MAOI?
Linezolid
Avoid Tyramine
What foods are rich in Tyramine?
Aged foods
- Aged cheese
- Aged meats
- Fava beans
- Chianti wine
- Banana bread
What should we avoid w/ Linezolid?
Tyramine foods SSRI SNRI TCA MAOI OTC cold meds sumatriptan
When using Linezolid long term, what could happen?
- Lactic acidosis
- Optic neurotics, peripheral neuropathy
- Bone marrow suppression
Aminoglycosides are —–
bactericidal
- they are also nephrotoxic and ototoxic
Aminoglycosides synergize well w/ ——.
Beta-Lactams
BL’s break down the cross links allowing aminoglycosides to go in and bind to ribosomes
Is the ototoxic effects of Aminoglycosides reversible?
NO
Why take an Aminoglycoside Qday instead of Q4hr or Q6hr?
It is safer b/c more of the drug is in the ‘washout zone’ which gives ears a break
Which two meds can treat C. diff?
metronidazole
vancomycin
Why can Linezolid be both expensive and a good value?
expense b/c it costs $100/pill
Good value b/c if it works like it should, it will decrease your hospital stay (which costs much more than $100)
Which two particular difficult infections are effectively treated by Linezolid?
VRE (Vancomycin Resistant Enterococcus)
MRSA (Methicillin Resistant Staphylococcus Aureus)
Why can you not infuse Penicillin (-cillin) and Aminoglycosides together?
Penicillin will deactivate the Aminoglycosides
They can be taken at the same time, but not through same IV
When is the best time to draw a drug trough level for Aminoglycosides?
30 minutes before the next dose b/c you want to confirm it is in the washout zone
Early signs of ototoxicity w/ Aminoglycosides?
Tinnitus
Early signs of nephrotoxicity w/ Aminoglycosides?
proteinuria
dilute urine
Elevated BUN
Elevated Serum Creatinine
