Antibiotics: Inhibitors of Protein Synthesis

Question 1

Macrolides MOA

Answer 1

Bind the 50 s subunit irreversibly.

Question 2

Macrolides spectrum

Answer 2

Gram positives. Bacteriostatic.

Question 3

Macrolides elimination

Answer 3

fecal.

Question 4

Macrolides resistance

Answer 4

efflux pumps and methylation of the drug binding site.

Question 5

Macrolides toxicity

Answer 5

Diarrhea (erythro), QT pronlongation, hepatotoxicity and drug interactions (CYP 3A4)

Question 6

Erythromycin

Answer 6

Macrolide. Oral/IV. Has immense GI effects and drug interactions.

Question 7

Clarithromycin (biaxin)

Answer 7

Macrolide. Oral. Least GI disturbance but still has drug interactions.

Question 8

Azithromycin (zithromax)

Answer 8

Macrolide. Oral/IV. Has some GI disturbances but has the least drug interactions.

Question 9

Chlamydia DOC

Answer 9

Azithromycin or tetracycline

Question 10

Ketolides: Telithromycin (ketek) MOA

Answer 10

Binds the 50S subunit with great affinity.

Question 11

Telithromycin (ketek) spectrum

Answer 11

broad spectrum. Bacteriostatic. Good for erythromycin/penicillin resistant respiratory pathogens like pneumococci.

Question 12

Telithromycin (ketek)

Answer 12

Ketolide. Oral.

Question 13

Telithromycin (ketek) toxicity

Answer 13

Diarrhea, hepatotoxicity, drug interactions (CYP3A4).

Question 14

Clindamycin (cleocin) MOA

Answer 14

Reversibly binds the 50S subunit.

Question 15

Clindamycin spectrum

Answer 15

Aerobic gram positives and some anaerobic gram negative and positive organisms. Can be used for strep and staph infections (MRSA). Static or cidal depending on the concentration.

Question 16

Osteomyelitis DOC

Answer 16

Clindamycin

Question 17

Toxic Shock DOC

Answer 17

Clindamycin

Question 18

Toxoplasma encephalitis DOC

Answer 18

Clindamycin

Question 19

Clindamycin toxicity

Answer 19

pseudomembranous colitis (C-Diff). Hepatotoxicity. Crosses the placenta and breast milk.

Question 20

Streptogramins

Answer 20

Dalfopristin;Quinupristin (synercid)

Question 21

Synercid MOA

Answer 21

Blocks ribosome function. Dalfo in the early phase and Quin in the late phase. Bactericidal.

Question 22

Synercid

Answer 22

Streptogramin. Dalfopristin;Quinupristin. IV.

Question 23

Synercid toxicity

Answer 23

GI disturbance and drug interactions (CYP3A4)

Question 24

Oxazolidinone

Answer 24

Linezolid (zyvox)

Question 25

Linezolid MOA

Answer 25

prevents formation of a functional 70S ribosome.

Question 26

Linezolid spectrum

Answer 26

Aerobic gram positive. Reserved as an alternate to prevent resistance.

Question 27

Synercid Spectrum

Answer 27

Aerobic Gram positive. MSSA, MRSA, VRE.

Question 28

Linezolid (zyvox)

Answer 28

Oxazolidinone. IV/Oral.

Question 29

Linezolid toxicity

Answer 29

Reversible, nonselective inhibitor of monoamine oxidase (MAO) causing an increase in serotonin and NE.

Question 30

Aminoglycosides MOA

Answer 30

Irreversibly inhibit protein synthesis by binding the 30S subunit. Bactericidal. Extremely polar so has to be actively transported into the baceteria using oxygen so limited to aerobes. Concentration dependent killing. With a long PAE.

Question 31

Aminoglycosides spectrum

Answer 31

Aerobic gram negative enteric bacterial rods. Often combined with beta lactam antibiotics.

Question 32

Streptomycin

Answer 32

Aminoglycoside. Second line TB drug. IV/IM.

Question 33

Gentamicin

Answer 33

Aminoglycoside. IV/IM, topical.

Question 34

Tobramycin

Answer 34

Aminoglycoside. IV/IM, topical.

Question 35

Amikacin

Answer 35

Aminoglycoside. IV/IM.

Question 36

Neomycin

Answer 36

Aminoglycoside. Oral, topical.

Question 37

Enterococcus infection DOC

Answer 37

Aminoglycoside and a penicillin.

Question 38

Pseudomonas aerginosa DOC

Answer 38

tobramycin with an antipsuedomonal penicillin

Question 39

Tuleremia DOC

Answer 39

Gentamycin

Question 40

Aminoglycoside toxicity

Answer 40

ototoxicity and nephrotoxicity.

Question 41

Broad spectrum antibiotics (3)

Answer 41

Chloramphenicol (chloromycetin), tetracyclines and glycylcyclines.

Question 42

Chloramphenicol (choloromycetin) MOA

Answer 42

Binds the 50s subunit and prevents attachment of tRNA. Bacteriostatic. Can have effects on mammalian mitochondria.

Question 43

Chloramphenicol spectrum

Answer 43

reserved for life threatening infections. Broad spectrum. Best CNS penetration.

Question 44

Chloramphenicol treats:

Answer 44

typhoid fever, meningitis (H. influ, N. meningitides (pen resistant), S. pneumoniae), rickettsia, brucellosis, rocky mountain spotted fever, meliodosis, bacterial conjunctivitis (topical).

Question 45

Chloramphenicol toxicity

Answer 45

bone marrow suppression, fatal aplastic anemia, gray baby syndrome.

Question 46

Chloramphenicol elimination

Answer 46

Conjugated with glucuronic acid in the liver.

Question 47

Chloramphenicol Resistance

Answer 47

acetyl transferase can be produced which acetylates the chloramphenicol and inactivates it.

Question 48

Tetracyclines MOA

Answer 48

inhibit protein synthesis by binding the 30S subunit to block tRNA binding. bacteriostatic.

Question 49

Tetracycline spectrum

Answer 49

broad spectrum. Chelation with calcium and iron.

Question 50

Tetracycline contraindications

Answer 50

pregnant women and kids younger than 8.

Question 51

Tetracycline toxicity

Answer 51

Inhibits bone growth and teeth discoloration, photosensitivity, GI, superinfection, hepatotoxicity.

Question 52

Aminoglycoside elimination

Answer 52

excreted rapidly by the kidneys.

Question 53

Tetracycline

Answer 53

Oral.

Question 54

doxycycline

Answer 54

tetracycline. oral.

Question 55

minocycline

Answer 55

tetracyclne. oral.

Question 56

Cholera DOC

Answer 56

Tetracycline

Question 57

Mycoplasma Pneumonia

Answer 57

Tetracycline

Question 58

Lyme disease (early)

Answer 58

Tetracycline

Question 59

Vibrio

Answer 59

Tetracycline

Question 60

Rocky mountain spotted fever

Answer 60

Tetracycline (doxycycline)

Question 61

Glycylcycline MOA

Answer 61

Similar to tetracycline but active against tetracycline resistant organisms.

Question 62

Glycylcycline treats

Answer 62

MRSA, MRSE (S. epidermis), PRSP (pen resistant strep. pneumoniae), VRE.