Antibiotics- Bacterial Protein Synthesis Inhibitors

Question 1

Tetracycline agents

Answer 1

1. Tetracycline

2. Doxycycline

3. Minocycline
4. Tigecycline

Question 2

Activity spectrum of Tetracyclines

Answer 2

1. Anthrax
2. Chlamydial
3. Mycoplasma
4. Rickettsiae- RMSF, Typhus
5. Spirochetes- Lyme disease, relapsing fever; Syphilis
6. H pylori regimens

Question 3

Uses of Tetracyclines

Answer 3

1. Acne
2. CAP, bronchitis
3. Cellulitis (purulent) due to CA-MRSA
   
   • Off-label use
4. Lyme disease
5. Periodontitis
6. Acute bacterial rhinosinusitis (off-label use)

Question 4

ADEs of Tetracyclines

Answer 4

1. GI upset (mostly vomiting, can minimizing by taking with cola drink)
2. Interaction with di and trivalent ions (dont take with milk, tums or antacids)
3. Deposition in developing bones and teeth*** (It used to be recommended to not give in pregnancy or peds <8y/o but this guideline has now changed due to lack of evidence supporting)
4. Photosensitivity

Question 5

What ribosomal subunit do Tetracyclines attach to?

Answer 5

30S

Question 6

What ribosomal subunit do Macrolides bind to?

Answer 6

50S

Question 7

Macrolide agents

Answer 7

1. Erythromycin

2. Azithromycin

3. Clarithromycin

Question 8

ADEs of Macrolides

Answer 8

1. GI upset
2. Hepatic dysfunction
3. QT elongation (can lead to Torsades de pointes)
4. CYP450 inhibition
   
   • not azithromycin

Question 9

Activity spectrum of Macrolides

Answer 9

1. •CAP
2. Pertussis
3. Corynebacteria
   
   • Diphtheria
4. Chlamydial

Question 11

What ribosomal subunit do Lincosamides bind to?

Answer 11

50S

Question 12

Lincosamide agent

Answer 12

Clindamycin​-often given for dental infections in patients with true penicillin allergy

Question 13

Activity spectrum of Lincosamides

Answer 13

1. Skin, soft tissue infections
2. Anaerobic infections

Agent- Clindamycin

Question 14

ADE of Lincosamides

Answer 14

Can cause C difficile colitis

Question 15

What ribosomal subunit does Chloramphenicol bind to

Answer 15

50S

Question 16

Chloramphenicol agent

Answer 16

Chloramphenicol

Question 17

Activity spectrum of Chloramphenicol

Answer 17

1. Treatment of serious infections due to organisms resistant to less toxic antibiotics
2. Bacteroides
3. H. influenza
4. Neisseria meningitides
5. Salmonella
6. Rickettsia
7. Active against many vancomycin-resistant enterococci

Question 18

ADEs of Chloramphenicol

Answer 18

1. Dose-related anemia
2. Gray baby syndrome

Question 19

ADEs of Chloramphenicol- Dose-related anemia

Answer 19

Aplastic anemia

Requires frequent monitoring of CBC

Question 20

ADEs of Chloramphenicol- symptoms of Gray baby syndrome

Answer 20

1. Circulatory collapse
2. Cyanosis
3. Acidosis
4. Abdominal distention
5. Myocardial depression
6. Coma
7. Death

Question 21

ADEs of Chloramphenicol- Risks of Gray baby syndrome

Answer 21

1. Serum levels > 50mcg/ml
2. Patients with impaired hepatic or renal function

Question 23

What does Oxazolidinone bind to?

Answer 23

the 23S RNA of 50S subunit

Question 24

Oxazolidinone- Agent

Answer 24

Linezolid

Question 25

Activity spectrum of Oxazolidinone (agent- Linezolid)

Answer 25

1. MRSA 2. PRSP 3. VRE strains

Question 26

ADEs of Oxazolidinone (agent- Linezolid)

Answer 26

1. Dose-related anemia 2. Neuropathy 3. Optic neuritis 4. Serotonin syndrome with SSRIs

Question 27

What do Aminoglycosides bind to in order to inhibit protein synthesis?

Answer 27

30S ribosomal subunit

Question 28

Aminoglycoside agents

Answer 28

1. **Gentamicin** (prototype) 2. Tobramycin (More commonly prescribed) 3. Amikacin 4. Streptomycin (used for TB) 5. Neomycin (causes hypersensitivity rxns) \*1-3 are usually given

Question 29

Activity spectrum of Aminoglycosides

Answer 29

1. Aerobic gram-negative bacteria 2. H, influenza 3. M. catarrhalis 4. Shigella species 5. **Often used in combinations with beta-lactams**

Question 30

ADEs of Aminoglycosides

Answer 30

1. Nephrotoxicity (reversible), 2. Ototoxicity (irreversible), 3. Neuromuscular blockade