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Perio 1 > Antimicrobials dos > Flashcards

Antimicrobials dos Flashcards

1
Q

Ribosome complex in bacteria

A

70s

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2
Q

Why are protein synthesis inhibitors toxic to humans at higher doses

A

bc at higher doses there is reduce selectivity (doesn’t only focus on bacteria)

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3
Q

Dose-dependent selectivity are major concerns for what 2 types of drugs?

A

Chloramphenicol

Tetracyclines

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4
Q

what does chloramphenicol bind to during PSI

A

50S subunit

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5
Q

What does Erythromycin bind to during PSI

A

50S

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6
Q

What are the 5 Aminoglycosides

A 
Gentamycin
Amikacin
Tobramycin
Streptomycin
Neomycin
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7
Q

What mechanism do AMinoglycosides use?

A

Bind to 30S changin ts shape

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8
Q

WHat effect on mechanism does AMinoglycosides have?

A

1) Block initiation
2) Early Termination
3) Misreading

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9
Q

Whats the oldest aminoglycoside - so high level of resistance

A

Streptomycin

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10
Q

How is Streptomycin administered

A

IM

IV

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11
Q

What is the most commonly prescribed aminoglycoside?

A

gentamycin

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12
Q

Gentamycin method of delivery?

A

IV

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13
Q

What aminoglycoside has the broadest spectrum?

A

Amikacin

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14
Q

Amikacin method of delivery

A

IM

IV

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15
Q

What aminoglycoside is great against Pseudomonas aeruginosa?

A

Tobramycin

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16
Q

Tobramycin method of Delivery

A

IM

IV

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17
Q

What aminoglycoside is very toxic systemically?

A

Neomycin

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18
Q

Neomycin mthods of delivery

2

A

Topical

Enema

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19
Q

Clinical use for aminoglycosides

A

Gram Negative Aerobes

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20
Q

Neomycin is toxic to what in body?

A

Kidney

Nephrotoxicity

21
Q

Risk of nephrotoxicity and ototoxicity with aminoglycosides is dependent on what?

A

COncentration

22
Q

WHat are the sites of accumulation for Aminoglycosides

A

Inner ear

Renal Cortex Proximal Tubule Cells

23
Q

WHat do aminogycosides synergize with and how?

A

Beta-Lactams
Vancomycin
Aminoglycosides are able to diffuse accross weakened bacterial cell wall more

24
Q

Adverse effects of Aminoglycosides

5

A

1) Ototoxicity
2) Nephrotoxicity
3) Neuromuscular paralysis
4) Teratogenic
Contact Dermatitis

25
Q

What patients are at highest risk of paralysis from Aminoglycosides

A

Patients with Myasthenia Gravis

26
Q

Additional at risk groups for AMinoglycosides

A

1) Elderly
2) Impaired Renal Function
3) Septic Pts
4) Recent exposure to other Aminoglycosides

27
Q

WHat are the 4 TTCs?

A

1) Tetracycline
2) Doxycycline
3) Minocycline
4) Tigecycline

28
Q

Mechanism of TTCs

A

Reversably binds to 30 S

Thus blocking access of the amino acyl-tRNA tothe mRNA

29
Q

Spectrum of TTCs

A

Gram +
Gram -
Atypical intracellular organisms

30
Q

Are TTCs cross resistant?

A

YES!!

31
Q

What TTC is effective when bacteria is cross resistant?

A

Tigecycline

32
Q

Oral absorption of TTCs is altered by what?

A

Dairy
Iron supplements
Antacids

33
Q

WHere does TTC concentrate?

A

Ca-hydroxyapatite of teeth and bones

34
Q

What antimicrobial is used for treatment of acne vulgaris

A

Tetracycline

35
Q

Should tetracycline be used during pregnancy?

A

NOOOOOO!!

36
Q

Adverse effects of TTCs

A

1) Disulfuram-like effet - avoid alcohol!

2) Vestibular Problems

37
Q

What TTC gives the most vestibular problems?

A

Minocycline

38
Q

Oral adverse effects of TTC

A

hairy tongue

Deposition in bone and prmary dentition

39
Q

Tigecycline spectrum

A

Same as TTCs plus activity against MRSA, Multidrug resistant Strp. pneumonae, Vancomycin-resistant Enterococci

40
Q

Clinical use of Tigecycline

A

Developed to overcome TTC - resistance

41
Q

3 macrolides are

A

1) Erythromycin
2) Clarithromycin
3) Azithromycin

42
Q

Mechanism of Macrolides

A

Irreversibly binds to 50S

Thus inhibiting the translocation step

43
Q

Spectrum of Macrolides

A

broad.
Gram +
Gram -
Atypical Bacteria

44
Q

Do Macrolides have cross resistance?

A

YES!!

45
Q

Clinical uses of macrolides

A

THey are very safe antimicrobials
Upper respiratory infections
COmmunity aquired pneumonia
Pts allergic to penecillin

46
Q

_____ has been replaced by _______ and ______ for community aquired pneumonia bc of better activity and fewer adverse effects

A
  • Erythromycin
  • Clarithromycin
  • Azithromycin
47
Q

What is known as z-pack

A

azithromycin

48
Q

WHat is the preferred therapy for urethritis due to CHalmydia

A

Azithromycin

49
Q

WHat has the longest half-life and volume distributon of the macrolides

A

azithromycin

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