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Pharmacology - Midterm 2 > Antimicrobials - Inhibitors of Protein Synthesis > Flashcards

Antimicrobials - Inhibitors of Protein Synthesis Flashcards

1
Q

True or False: Antimicrobial Inhibitors of Protein Synthesis are mainly Bacteriostatic.

A

True

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2
Q

MOA of Tetracylcines

A

Reversibly bind 30S subunit of ribosome, preventing attachment of aminoacyl tRNA; enter cell via passive diffusion and active transport and concentrate intracellularly

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3
Q

Tetracycline mechanisms of resistance

A

Enzymatic inactivation, production of proteins that interfere with binding to ribosome, impaired influx or increased efflux

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4
Q

Used to treat Syphilis in Penicillin allergic patients

A

Tetracyclines

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5
Q

Part of combination therapy for H.pylori, malaria prophylaxis and treatment, and treatment of plague, brucellosis, and tularemia

A

Tetracyclines

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6
Q

Absorption decreased by divalent cations and milk

A

Tetracyclines

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7
Q

Tetracycline that reaches high concentrations in all secretions

A

Minocycline

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8
Q

Lipid soluble Tetracycline for STDs and Prostatitis

A

Minocycline; give parenterally

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9
Q

AE of Tetracyclines

A

Hypoplasia and discoloration of teeth, stunting of growth, Photosensitivity

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10
Q

Contraindications of Tetracyclines

A

Category D, children under 8 yoa

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11
Q

Glycylcycline with Black Box warning –> last resort treatment

A

Tigecycline

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12
Q

Susceptible to Proteus and Pseudomonas efflux pumps

A

Tigecycline

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13
Q

MOA Tigecycline

A

Binds 30S ribosomal subunit

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14
Q

Contraindications of Tigecycline

A

Pregnancy, children under 8 yoa

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15
Q

Contraindications of Aminoglycosides

A

Teratogenic (Category D), Myasthenia Gravis

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16
Q

AE of Aminoglycosides

A

Nephrotoxic, Neuromuscular blockade, Ototoxic, and Teratogenic

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17
Q

Mechanisms of Resistance to Aminoglycosides

A

Modification/Inactivation of drug, decreased accumulation, modification of 30S binding site

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18
Q

How often are Aminoglycosides given, and why?

A

Once daily; Post-antibiotic effect + concentration- dependent killing

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19
Q

Which drugs do time-dependent killing?

A

Penicillins and Cephalosporins

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20
Q

Lactulose MOA

A

Nonabsorbable disaccharide degraded by intestinal bacteria to form Lactic Acid; favors NH4+ formation –> acidifying gut lumen and reducing plasma ammonium concentrations

21
Q

AE of Lactulose

A

Osmotic diarrhea, flatulence, abdominal cramping

22
Q

MOA of Macrolides

A

Reversibly bind 23S rRNA of 50S ribosomal subunit, inhibiting translocation

23
Q

Macrolide resistance mechanisms

A

Production of esterase to hydrolyze drugs (enterobacteriacea), modification of ribosomal binding site, decreased membrane permeability, increased efflux

24
Q

Similar binding site to Chloramphenicol and Clindamycin

A

Macrolides

25
Q

Macrolides with CYP450 inhibition

A

Erythromycin, Clarithromycin, Telithromycyin

26
Q

Causes Gray baby syndrome (cyanosis)

A

Chloramphenicol

27
Q

Inhibits CYP3A4 and CYP2C9

A

Chloramphenicol

28
Q

AE: inhibits mitochondrial ribosomes to cause reversible bone marrow suppression or Aplastic Anemia

A

Chloramphenicol

29
Q

Active against VRE and used topically for eye infections

A

Chloramphenicol

30
Q

Resistance mechanisms of Chloramphenicol

A

Chloramphenicol acetyltransferase inactivates the drug, altered permeability

31
Q

Treatment for Toxoplasmosis of the brain

A

Clindamycin + Pyrimethamine

32
Q

Alternative treatment for PCP

A

Clindamycin + Primaquine

33
Q

Endocarditis prophylaxis when allergic to Penicillin

A

Clindamycin

34
Q

AE: potentially fatal C. difficile infection (pseudomembranous colitis)

A

Clindamycin

35
Q

Good penetration into abscesses and bone

A

Clindamycin

36
Q

Has cross resistance with Macrolides

A

Clindamycin

37
Q

Resistance mechanisms of Clindamycin

A

Receptor modification or mutation, enzymatic inactivation of drug

38
Q

Acts a weak reversible MAOI

39
Q

Bacteriostatic, but bactericidal against Streptococcus and C. perfringens

40
Q

Long post-antibiotic effect

A

Streptogramins

41
Q

Inhibits CYP3A4 and penetrates macs and PMNs

A

Streptogramins

42
Q

Inhibits formation of 70S complex

43
Q

AE: mild bone marrow suppression, optic and peripheral neuropathy, lactic acidosis

44
Q

MOA: Binds and inhibits RNA polymerase

A

Fidaxomicin

45
Q

Indications of Fidaxomicin

A

C.difficile colitis in adults

46
Q

Contraindications of Fidaxomicin

A

Under 18 yoa

47
Q

What are the Streptogramins?

A

Dalfopristin and Quinupristin

48
Q

Alternative treatments for Hepatic Encephalopathy

A

Oral Vancomycin, Metronidazole, or Rifaximin

Pharmacology - Midterm 2 (16 decks)

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