Bacterial Protein Synthesis Inhibitors Flashcards
Moderate spectrum BPSI
Macrolides
Ketolide
Narrow spectrum BPSI
Lincosamides
Streptogramins
Linezolid
BUY AT 30, CELLS at 50
Aminoglycosides Tetracycline Chloramphenicol Erythromycin Lincosamides Linezolid Streptogramins
Causes aplastic anemia and gray baby syndrome
Chloramphenicol
Used for SIADH
Demeclocycline
Causes tooth enamel dysplasia/discoloration
Tetracycline
Do not take tetracycline with?
Milk (decreases absorption)
Indications of macrolides
CAP
Pertussis
Diphtheria
Chlamydial infections
All macrolides inhibit CYP450 except
Azithromycin
Macrolide with the highest Vd and slowest elimination
Azithromycin
Used for macrolide resistance
Telithromycin
Used for endocarditis prophylaxis (penicillin-allergy)
Clindamycin
Causes pseudomembranous colitis (C. difficile)
Clindamycin
Used for anaerobic infections above the diaphragm
Clindamycin
Used for anaerobic infections below the diaphragm
Metronidazole
Indication of quinupristin-dalfopristin
(Streptogramin) and Linezolid/Oxazolidinone
Infections caused by drug-resistant gram positive cocci (MRSA, VRSA, VRE)
Causes arthralgia-myalgia syndrome
Streptogramins
Causes serotonin syndrome
Linezolid
Mode of antibacterial action of aminoglycosides
Concentration-dependent killing action
Mode of antibacterial action of penicillins and cephalosporins
Time-dependent killing action
What is the basis for once-daily dosing of aminoglycosides?
Post-antibiotic effect
Least resistance but has the narrowest therapeutic window among aminoglycosides
Amikacin
Aminoglycosides
GNATS canNOT kill anaerobes Gentamycin Neomycin Amikacin Tobramycin Streptomycin Nephrotoxicity Ototoxicity Teratogen
Most vestibulotoxic and nephrotoxic aminoglycosides
Gentamicin
Tobramycin
2nd line drug for MDRTB
Amikacin
Teratogen (causes congenital deafness); administered IM
Streptomycin
Used as bowel prep for elective surgery and for hepatic encephalopathy
Neomycin (topical and oral)
Used for the treatment of visceral leishmaniasis
Paromomycin
Most ototoxic aminoglycosides
Kanamycin
How do you reverse the neuromuscular blockade caused by neomycin?
Give calcium gluconate and neostigmime
Cumulative ototoxicity occurs when aminoglycosides are given with?
Loop diuretics
Broad spectrum BPSI
Chloramphenicol
Tetracyclines
Tetracycline which has the the broadest spectrum (less resistance)
Tigecycline
Toxicities of tetracycline
Deposition in developing bones and teeth, photosensitivity, superinfection
The only bacterial protein synthesis inhibitor which is bactericidal
Streptogramins
Causes QT prolongation
Macrolides
MOA of doxycyline
Interference with binding of aminoacyl-tRNA to bacterial ribosomes
Clarithromycin vs Erythromycin
Clarithromycin is more active than erythromycin against M. avium complex, T. gondii, and H. pylori
Primary mechanism of resistance of gram-positive organisms to erythromycin
Methylation of binding sites on the 50s ribosomal subunit
DOC of Chlamydial infection (non compliant patient)
Single oral dose of azithromycin
DOC for prophylaxis in high-risk penicillin-allergic patients undergoing genitourinary and lower GI surgical procedures
IV vancomycin
DOC of CAP
Monotherapy:
Macrolides
Doxycycline
Respiratory quinolone
Macrolides should not be taken with?
Methylxanthines (caffeine)
Causes dose-related anemia
Chloramphenicol Oxazolidinone (Linezolid)
Causes Fanconi’s syndrome
Tetracycline
