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Host and Defense PMO > Antimicrobials 2 > Flashcards

Antimicrobials 2 Flashcards

1
Q

What is the difference between ribosome weight in prokaryotes vs. eukaryotes?

A

30S + 50s= 70s bacteria

40s + 60s= 80 s humans

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2
Q

Name two things that attack the 30s subunit

A

tetracyclines

aminoglycosides

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3
Q

Name 5 things that attack the 50s subunit

A 
Macrolides
Clindamycin
Linezolid
Chloramphenicol
Streptogramins
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4
Q

Name one thing that attacks the tRNA sythetase

A

mupirocin

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5
Q

Bacteria mRNA is ….while eukaryotic mRNA is….

A

polycistronic

monocistronic

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6
Q

What is the first amino acid in the polypeptide of prokaryotes?

A

fMet

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7
Q

What initiation factors are required for prokaryotes? Releasing factors?

A

IF1, IF2, IF3

RF1, RF2, RF3

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8
Q

How many initiation factors are required for eukaryotes? Releasing factors?

A

9, 1

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9
Q

What happens to the methionine when the translation is done?

A

Prokaryotes: the f is chopped off, met stays
Eukaryotes: the met is chopped off

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10
Q

What does chloramphenicol do?

A

Binds 50s part, inhibits formation of peptide bond

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11
Q

What does Erythromycin do?

A

Binds 50s part, prevents translocation

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12
Q

What do tetracyclines do?

A

Interfere with the tRNA and mRNA attachment

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13
Q

What does streptomycin do?

A

Changes the shape of the 30s portion, causing the mRNA code to be read incorrectly.

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14
Q

Streptomycin is an

A

aminoglycoside

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15
Q

Erythromycin is a

A

macrolide

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16
Q

What are the aminoglycosides?

A 
gentamicin
amikacin
tobramycin,
streptomycin
neomycin
(bind 30s and block initiation, prematurely terminate, and cause misreading)
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17
Q 
Aminoglycosides:
cidal or static?
concentration dependent or time?
what do they treat?
Example?
IV or oral?
metabolized?
Synergy with?
A 
cidal
concentration dependent
treat gram - aerobes
Streptomycin treats TB
IV or IM, NOT oral (but neomycin is topical)
not metabolized (polar, won't cross BBB)
Synergy with b lactase or vancomycin
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18
Q

Adverse effects of aminoglycosides

A 
ototoxicity
nephrotoxicity
neuromuscular paralysis
Contact dermatitis
(don't give to elderly, kidney patients)
19
Q

What is the oldest amino glycoside drug? How is it administered?

A

Streptomycin,
IM, IV
Has high level of bacterial resistance

20
Q

What is the most commonly used amino glycoside drug?

A

Gentamycin (IV)

21
Q

What is the broadest spectrum of all aminoglycosides?

A

Amikacin (IM, IV)

22
Q

What amino glycoside has excellent activity against Pseudomonas aeruginosa?

A

Tobramycin (IM, IV)

23
Q

What amino glycoside is only applied topically because of its toxicity? (Good for enemas too)

A

Neomycin

24
Q

What are the 4 tetracyclines?

A

Tetracycline, Doxycycline, minocycline, tigecycline

25
Q

What are Tetracyclines good against?

A

LOTS! G+, G-, and atypical weirdos like rickettsia, mycoplasma and chlamydia

26
Q

How do Tetracyclines work?

A

Bind to 30s blocking tRNA and mRNA. This is Type 3, time dependent killing. So you want to maximize amount of drug

27
Q

Tetracycline is the 1st drug of choice against

A

Rickettsia, mycoplasma, and chlamydial infections, brucellosis, cholera, and Lyme disease and plague

28
Q

Tetracycline is the 2nd dug of choice against

A

mixed infections of the respiratory tract and acne

29
Q

Which tetracycline is effective even when others are not?

A

Tigecycline

30
Q

What are the side effects of tetracycline

A

Every problem ever (liver, sun sensitive, tooth staining, itchy bottom, etc) and hairy tongue

31
Q

When is tetracycline contraindicated?

A

pregnant patients, kids under 8, liver and renal disease

32
Q

Is tigecycline effective against bacteremia?

A

No. (Bile/fecal excretion)

33
Q

What are the three macrolides?

A

Erythromycin, clarithromycin, azithromycin

34
Q 
Macrlolides: Mechanism?
Static or tidal?
What type of dependency?
Broad or narrow spectrum?
Safe or risky?
A 
Binds 50s and prevents translocation
Static
Type II (time dependent)
Broad spectrum, G+ and G- and atypical bacteria
One of the safest antibiotics
35
Q

How is Azithromycin better than Erythromycin?

A

Less active against staph and strep, but more active against respiratory infections like H. Influenzae, Moraxella, and Mycobacterium (Not TB).

36
Q

What is Azithromycin the drug of choice against?

A

urethritis caused by Chlamydia.

37
Q

How do macrocodes get taken in and where to they get distributed, metabolized, excreted etc?

A

Taken orally, (food hinders most but helps clarithro)
Goes to all body fluids except CSF
Metabolized in liver (can make other drugs concentrate because all but Az pack inhibit CYP450 enzymes.) Az has longest half life and volume distribution.
Excreted: Ery and az in bile. Clarithro: kidney and liver.

38
Q

Chloramphenicol: Mechanism, spectrum, Clinical use, PK, adverse effects

A

Mech: inhibits peptidyl transferase reaction to stop peptide bond and protein synthesis
Spectrum: Broad. G+,G-, anaerobes and rickettsia
Uses: ONLY life threatening H. Influenzae, bactericides, and meningitis when penicillin can’t be used (toxicity!!)
PK: IV or oral. Goes everywhere including CSF
Adverse effects: hemolytic anemia, aplastic anemia, gray baby syndrome, teratogen, serious drug interactions

39
Q

Clindamycin is a

A

LIncosamide

40
Q

Clindamycin mechanism, spectrum, PK, adverse effects, clinical uses

A

Mech: same as macrocodes
Spectrum: anaerobes, non-enterococcal G+, NO G-
PK: oral, IV, IM, doesn’t got to CSF
Adverse effects: pseudomembranous colitis. Treat that with vancomycin or metronidazole.
Clinical uses: good orally or parenterally

41
Q

Linezolid: mechanism, spectrum, PK, Clinical uses, Adverse effects

A

Binds 50s to prevent ribosomal complex formation
Good against all G +, aerobic or an. Not G-.
Bactericidal against streptococci, static against Enterococci and Staphylococci
Uses: VRE, nosocomial pneumonia (MRSA), CA Pneumonia, skin infections, staph strep and MRSA.
Side effects are very rare. Causes suppression of WBCs in some. Serotonin syndrome. Chronic use has reversible neurotoxicity (peripheral and optic)

42
Q

Quinuprostin/Dalfopristin are

A

Streptogramins

43
Q

Quinuprostin/Dalfopristin mechanism, spectrum, PK, Clinical uses, Adverse effects

A

Binds 50s, stops translocation.
Synergistic, bactericidal
Kills all G+, but no G- except moraxella and neisseria
PK: no dose adjustment needed in renal insufficiency
Reserve for serious infections by resistant G+
Adverse effects: pain at injection site, arthralgia and myalgia

44
Q

Mupirocin (Bactroban) mechanism, spectrum, PK, Clinical uses, Adverse effects

A 
Reversibly inhibits isoleucyl transfer-RNA synthetase enzyme.
Bactericidal against G+ and some G-
PK: topical
Clinical uses: skin infections
Avoid eyes

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