Tetracyclines Flashcards

1
Q

What are the first gen and second gen tetracyclines?

A

First gen: Tetracycline

Second gen: Doxycycline, Minocycline

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2
Q

What is a glycylcycline?

A

Tigecycline is a minocycline derivative with better spectrum of activity and more ability to overcome bacterial resistance

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3
Q

Tetracyclines

Mechanism of Action

A

Reversibly bind bacterial 30S subunit

Prevent aminoacyl tRNA from binding and adding another AA to the chain

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4
Q

Tetracyclines are static or cidal?

A

Bacteriostatic

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5
Q

Tetracyclines

Mechanisms of Resistance

A

Efflux Pumps
Ribosomal Protection Proteins
Enzymatic Inactivation

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6
Q

Tetracycline
Spectrum of Activity
Gram Positive Aerobes

A
MSSA
PSSP
Bacillus
Listeria
Nocardia
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7
Q

Tetracycline
Spectrum of Activity
Gram Negative Aerobes

A
Burkholderia pseudomallei
Neisseria
Haemophilus
Campylobacter
Helicobacter
Vibrio
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8
Q

Tetracycline
Spectrum of Activity
Anaerobes and Miscellaneous Bacteria

A
Actinomyces
Legionella
Chlamydia
Mycoplasma
Ureaplasma
Rickettsia
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9
Q

Tigecycline
Spectrum of Activity
Gram Positive Aerobes

A

MRSA, MSSA

VRE, VSE

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10
Q

What conditions is tigecycline never used for?

A

Bacteremias and UTIs because it has a high distribution and can therefore not reach high blood concentrations

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11
Q

What bacteria does tigecycline not have activity against?

A

Pseudomonas and Proteus

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12
Q

Tigecycline
Spectrum of Activity
Gram Negative Aerobes

A
Acinetobacter baumannii
Citrobacter
E coli
Klebsiella
Serratia
Stenotrophomonas
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13
Q

How are most tetracyclines administered?

A

IV
Only doxycycline can be given oral or IV.
Absorbed best on an empty stomach

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14
Q

What drugs impair absorption of tetracyclines?

A

Divalent and trivalent cations

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15
Q

Tetracyclines

Distribution

A

Very broad distribution. Not well concentrated in the blood or bladder

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16
Q

Tetracyclines Elimination

A

Tetracycline is renally eliminated.

Doxycycline and Tigecycline are excreted by mainly non-renal routes. Adjust tigecycline dosage in liver disease.

17
Q

Tetracycline Clinical Uses

A
Respiratory Infections
STDs- Chlamydia, Syphilis, gonorrhea
Prophylaxis of malaria
Rocky Mountain Spotted Fever
Polymicrobial Infections (tigecycline)
Acne
SIADH
18
Q

Tetracycline

Adverse Effects

A

Nausea, vomiting
PHOTOSENSITIVITY
Reversible diabetes insipidus with outdated meds
Hepatic enzyme elevation

19
Q

Should tetracycline be used in pregnant women?

A

Never!

It is a Category D teratogen. Causes discoloration of permanent teeth and decreased bone growth in children.