ABs- inhibitors of Protein synthesis

Question 1

what are the 7 ABs that act by protein synthesis inhibition?

Answer 1

Aminoglycosides, Tetracyclines, Chloramphenicol, Clindamycin, Erythromycin (macrolides), Quinupristin/ dalfopristin, and Linezolid

Question 2

what is the only AB that binds to the 30s part of the ribosome

Answer 2

Tetrecyclines, but some Aminoglycosides bind to 30s too!

Question 3

Aminoglycoside MoA cidal or static

Answer 3

bind to 30s or 50s, inhibit tRNA attachment, and polysome breakdown
cidal

Question 4

Tetracylcline MoA, static or CIdal

Answer 4

Tetracycline bind to 30s blocking tRNA binding to mRNA

static

Question 5

Aminoglycoside spectrum?

Answer 5

Aminoglycosides are effective against GRAM NEG only! especially pseudomonas

Question 6

How can Aminoglycosides be used to treat Gram pos?

Answer 6

Aminoglycoside + B lactam= effective against Gram +

Question 7

the 6 aminoglycoside drugs

Answer 7

streptomycin, kanamycin, gentamicin, tobramycin, amikacin, neomycin

Question 8

Clinical use of streptomycin

Answer 8

Streptomycin = drug resistant TB.

Use penicillin + streptomycin to treat endocarditis (outdated)

Question 9

Kanamycin clinical use

Answer 9

Kanamycin NOT used in the US

Question 10

Gentamicin, Tobramycin, and Amikacin uses?

Answer 10

Gram neg infections, septicemia, meningitis, endocarditis, pneumonia
possible use against gram + w B lactams

Question 11

Neomycin uses?

Answer 11

Neomycin effective for topical tx of burns, wounds, infected dermatoses and oral use for prep for bowl surgery

Question 12

Aminoglycoside absorption, distrib, metabolism/ excretion

Answer 12

Aminoglycosides are given IV and IM. Poor distribution, don’t enter CNS, renal excretion

Question 13

Aminoglycoside Toxicity

Answer 13

Aminoglycosides are DOSE RELATED!!

Question 14

Aminoglycoside toxicities

Answer 14

Aminoglycosides cause ototoxicity (cochlear hair death), Nephrotoxicity and Neuromuscular blockage

Question 15

What is important for treat pts with myaesthenia Gravis

Answer 15

Aminoglycosides cause neuromuscular blockage- muscle weakness and respiratory depression

Question 16

What are the 3 concentration dependent drugs

Answer 16

Aminoglycosides, quinolones, and daptomycin

Question 17

what are the 3 Time dependent drugs

Answer 17

B lactams, Vancomycin, and quinolones (quinolones also Time dependent)

Question 18

what do ahminoglycosides exhibit

Answer 18

aminoglycosides exhibit a post antibiotic effect- actions occur long after the drugs have cleared the blood

Question 19

tetracylines bind to what part of the ribosome? are static or cidal?

Answer 19

tetracyclines bind to 30s part of ribosome and are STATIC

Question 20

what is the specificity of tetracyclines

Answer 20

tetracyclines accumulate preferentially in bacteria through an energy dependent transporter lacking in mammalian cells

Question 21

What are tetracyclines effective against

Answer 21

rickettsiae, mycoplasma, chlamydia and protozoa

GRAM - and GRAM + . 1st BROAD spectrum AB

Question 22

tetracyclines are now considered a what due to resistance and toxicities

Answer 22

tetracyclines are 2nd line of defense for acne, outpatient mycoplasma, urethritis

Question 23

resistance to tetracyclines are due to what

Answer 23

tetracyclines resistance are due dec influx, INC efflux, DEC binding to ribosomes

Question 24

what don’t you use Tetracyclines with

Answer 24

dont admin tetracyclines with MILK or antacids

Question 25

what is a concern with the distribution of Tetracyclines

Answer 25

Tetracylines are sequestered in the bone with some penetration into CNS

Question 26

Tetracyclines are what concern for the mouth

Answer 26

Tetracyclines causes yellowing browning of the teeth, don't admin in the pregnant or young!

Question 27

are tetracyclines photosensitive? | whats a special toxicity of tetracyclines?

Answer 27

YES tetracyclines are photosensitive! | tetracyclines= fanconi syndrome: renal tubular dysfunction after admin outdated tetracyclines

Question 28

What is a newer Tetracycline agent that is static and binds to 30s part of ribosome

Answer 28

Tigecycline: monocycline and Glycylcycline

Question 29

Tigecycline spectrum? and what is the difference between tigecycline and tetracyclines?

Answer 29

Tigecycline is BROAD spectrum effective against gram - and gram + including anaerobes. Tigecycline is not effected by the same resistance mechanisms as tetracycline

Question 30

Tigecycline is used against what bacteria

Answer 30

Tigecycline used against bacteria resistant to B lactams, vancomycin, and tetracyclines

Question 31

what is a limiting toxicity of Tigecycline

Answer 31

Tigecycline causes nausea

Question 32

what is the clinical use of Tigecycline

Answer 32

Tigecycline is used for complicated intra abdominal and skin and skin structure infections

Question 33

What is a nitrobenzene analog that has very limited clinical use

Answer 33

Chloramphenicol

Question 34

Chloramphenicol is very limited clinically why?

Answer 34

Chloramphenicol causes a fatal side effect: aplastic anemia

Question 35

What is chloramphenicol's spectrum

Answer 35

Chloramphenicol is BROAD spectrum effective against Gram - and Gram +

Question 36

What is Chloramphenicol used for when tetracyclines are ineffective

Answer 36

Chloramphenicol is used to treat rikettsial infections when tetracyclines are ineffective

Question 37

What is the resistance of chloramphenicol

Answer 37

Chloramphenicol resistance develops due to acetylation of the drug, dec uptake, change in ribosome structure

Question 38

what is the fatal toxicity of chloramphenicol

Answer 38

Aplastic anemia!

Question 39

What is the other serious toxicity of chloramphenicol

Answer 39

Chloramphenicol is responsible for Gray Baby syndrome- bc neonates can't glucoronidate chloramphenicol which accumulates inhibition of mitochondrial protein synthesis- abdominal destination, cyanosis = high mortality

Question 40

what are the 3 macrolides

Answer 40

erytrhomycin, azithromycin, clarithromycin

Question 41

Spectrum of macrolides? | macrolides are effective against what?

Answer 41

Static some cidal against gram + Macrolides effective against Mycoplasma pneumonia, Legionnaires, Chlamydial infections, other respiratory infections, pneumoniae middle ear and sinus infections in children

Question 42

What are the resistance to Macrolides

Answer 42

Macrolide resistance from methylation of 50s ribosome, enhanced efflux pump, chromosome mutations of 50s, macrolide hydrolysis by esterases

Question 43

What is used the least out of the 3 macrolides

Answer 43

Erythromycin is the least used bc has the shortest half life, narrowest spectrum and least desirable effects

Question 44

What is a semisynthetic Erythromycin analog that binds to the 50s ribosomal subunit

Answer 44

Ketolide - Telithromycin

Question 45

Ketolide- Telithromycin spectrum: What infection specifically?

Answer 45

Broad spectrum. TX of RTI, community acquired pneumonia | and effective against Macrolide resistant strains

Question 46

What is the toxicity warning of Telithromycin

Answer 46

Liver Toxicity= Ketolide

Question 47

Clindamycin spectrum

Answer 47

Clindamycin effective against Gram + bacteria and anaerobes: S pyogenes

Question 48

What two drugs are for anaerobic infections

Answer 48

Clindamycin and Metronidazole

Question 49

What is Clindamycin used to treat specifically?

Answer 49

Clindamycin used to treat Penicillin resistant infections and gram + anaerobes

Question 50

what is the specific toxicity that comes with Clindamycin use, making it a rarely used AB

Answer 50

Clindamycin causes pseudomembraneous colitis by toxin form from C difficile. C difficile is resistant to Clindamycin

Question 51

If a pseudomembraneous colitis develops from use of Clindamycin then what do you treat this C difficile infection with?

Answer 51

Metronidazole

Question 52

The combo of what two drugs is effective against mainly gram + organisms and is bactericidal

Answer 52

Quinopristin/ dalfopristin

Question 53

Quinopristin/ dalfopristin is used specifically to treat what infections

Answer 53

VRE and MRSA type infections

Question 54

What AB is Broad spectrum against gram + (staph, strep, enterococcus) and has poor activity against gram - and anaerobes

Answer 54

Linezolid

Question 55

What is Linezolid specifically used to treat?

Answer 55

VRE and MRSA infections

Question 56

What inhibits isoleucyl tRNA synthetase and is bacteriocidal

Answer 56

Mupirocin

Question 57

What is Mupirocin effective against

Answer 57

Gram + and some gram -. Skin infections including MRSA