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PR3124 > Bacterial Protein Synthesis Inhibitors > Flashcards

Bacterial Protein Synthesis Inhibitors Flashcards

1
Q

How does macrolide resistance come about?

A

1) Ribosomal methylation & reduced binding of macrolides to the 50S ribosomal subunit
2) Increased expression of efflux pumps

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2
Q

What does Tetracyclines & Tigecyclines NOT cover?

A

Pseudomonas aeruginosa & Proteus

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3
Q

MOA of Aminoglycosides

A

Block formation of initiation complex by causing misreading of codon

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4
Q

Use of Aminoglycosides?

A

1) Empiric therapy for serious conditions
2) Aerobic Gram (-) & mycobacteria
3) 2nd line MDR tuberculosis

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5
Q

Use of Tobramycin

A

Pseudomonas aeruginosa

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6
Q

How are Aminoglycosides administered?

A

Parenterally (except Neomycin)

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7
Q

ADE of Aminoglycosides

A

1) Nephrotoxicity & Ototoxicity
2) Neuromuscular paralysis
3) Hypersensitivity

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8
Q

Use of Amikacin

A

WIDEST SPECTRUM
1) Proteus, P.aeruginosa, Enterobacter, E.coli,
Kebsiella (Gentamicin-resistant)
2) Mycobacterium TB

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9
Q

How are Macrolides administered?

A

Oral/IV (Clarithromycin: Oral only)

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10
Q

Coverage of Macrolides

A

Broad-spectrum, atypicals

Legionella, Chlamydia, Mycoplasma

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11
Q

Use of Erythromycin

A

1) Community acquired pneumonia

2) S. pneumoniae

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12
Q

Use of Clarithromycin

A

1) H.Pylori

2) Atypicals

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13
Q

Use of Azithromycin

A

1) Respiratory infections
(H.influenzae, Moraxella catarrhalis)
2) STD (Chlamydia trachomatis, Neisseria gonorrhoea)

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14
Q

Which of the bacterial protein synthesis inhibitors are safe for pregnancy?

A

Azithromycin, Erythromycin, Clindamycin

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15
Q

Use of Clindamycin

A

Anaerobic, Gram (+) bacteria

1) Severe anaerobic conidtion
2) Clostridium perfringen
3) MRSA, Streptococcus
4) Dental

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16
Q

Which agents can be used for MRSA?

A

1) Vancomycin
2) 5th gen cephalosporins (Ceftaroline, Ceftobiprole)
3) Doxycycline
4) Tigecycline
5) Clindamycin
6) Linezolid

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17
Q

How are Macrolides cleared?

A

Hepatic

18
Q

ADE of Clindamycin

A

1) CDAD
2) Esophageal irritation
3) Skin rashes

19
Q

Coverage of Linezolid

A 
Resistant Gram (+) strains
- MRSA, VRE, VRSA

Reserved for infections caused by multiple drug-resistant strains

20
Q

How is Tigecycline administered?

A

IV

21
Q

ADE of Linezolid

A

1) Bone marrow supression
2) GI effects
3) Serotonin syndrome
(avoid histamine & tyramine rich food)
4) Irreversible peripheral neuropathies

22
Q

Which agents can be used for community-acquired pneumonia?

A

1) Doxycycline
2) Tigecycline
3) Erythromycin

23
Q

What mechanisms of resistance were tigecycline designed to overcome?

A

1) Efflux pumps

2) Ribosomal protection

24
Q

How do bacteria gain macrolide resistance

A

1) ERM gene expression

2) Efflux pumps

25
Q

MOA of Tetracyclines

A
  • Prevents binding of tRNA to A site of mRNA-ribosome complex -> Inhibiting protein synthesis
26
Q

Coverage of Tetracyclines

A

Broad spectrum (Gram (+) & (-))

  • Atypical bacteria (Mycoplasma, Legionella, Chlamydia)
  • Spirochete bacteria
  • MRSA
27
Q

How should Tetracyclines be taken?

A

Oral (Empty stomach, avoid with dairy)

28
Q

ADE of Tetracyclines

A
  • GI Discomfort
  • Effects on calcified tissues
  • Hepatotoxicity & Phototoxicity
  • Vestibular dysfunction
  • Superinfection
29
Q

Contraindications for Tetracyclines/Tigecycline

A
  • Pregnancy
  • Breastfeeding
  • Child < 8yo
30
Q

How did resistance to Tetracyclines come about?

A

1) Efflux pumps

2) Ribosomal protection

31
Q

What is Tigecycline used for?

A
  • Broad-spectrum*
    1) MRSA
    2) MDR Enterococci
    3) VRE
    4) ESBL
    5) Community-acquired pneumonia
32
Q

What is Minocycline used for?

A

RTI caused by H.influenzae
Klebseilla spp
Plague due to Yernia Pestis

33
Q

How is Tigecycline administered?

A

IV

34
Q

Use of Streptomycin

A

1) Enterococcal carditis (Gentamicin-resistant)

2) M.TB/Other mycobacterial diseases

35
Q

Contraindications for Aminoglycosides

A
  • Pregnancy
  • Renal impairment
  • Myasthenia gravis
  • Hearing defects
36
Q

Use of Gentamicin

A 
More Gram (+)
(+) Penicillin: Enterococcal endocarditis, Proteus, Pseudomonas, Klebsiella
(+) Ceftriaxone: Staph endocarditis
37
Q

MOA of Macrolides

A

Binds reversibly to 50s subunit -> Inhibits protein synthesis (Bacteriostatic)

38
Q

Which of the bacterial protein synthesis inhibitors are cleared hepatically?

A

Macrolides, Clindamycin

39
Q

How is Clindamycin administered?

A

Oral/IV

40
Q

How is Linezolid administered?

A

Oral/IV

41
Q

Contraindications of Linezolid

A
  • Pregnancy
  • Catheter-related infections
  • Not to be used within 2 weeks of MAO inhibitors

PR3124 (16 decks)

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