Bacteriostatic

Question 1

What is the prototype for bacteriostatic medications?

Answer 1

Tetracycline

Question 2

Therapeutic use of Tetracycline?

Answer 2

mycoplasma (PNA), chlamydia and rickettsia, acne vulgaris, PCN allergy substitute, H pylori

Question 3

MOA of Tetracyclines?

Answer 3

Binds with 3OS ribosomes and inhibits microbial protein synthesis

Question 4

Adverse effects of TtracycliNE?

Answer 4

N/V/D, photosensitivity, esophagitis/ulceration, hepatotoxicity, pancreatitis, blood dyscrasia, hypersensitivity, superinfection

Question 5

Why shouldn’t children be given Tetracycline?

Answer 5

d/t discoloration of the teeth and enamel hypoplasia in children < 8, as well as interference with bone growth

Question 6

Contraindications for Tetracycline?

Answer 6

hypersensitivity, pregnancy/lactation

Question 7

Tetracycline precautions?

Answer 7

renal failure

Question 8

Route, absorption, metabolism, and excretion of Tetracycline?

Answer 8

Route: PO; rapid
Absorption: 75% stomach
Metabolism: liver
Excretion: active form via renal

Question 9

Should tetracycline be taken on an empty stomach or with food?

Answer 9

on an empty stomach (1hr AC or 2 hours PC); 2 hours between use of tetracycline and chelators

Question 10

How to minimize GI adverse effects of Tetracycline?

Answer 10

Take with food but note that it can reduce absorption

Question 11

Why should ultraviolet light be avoided with tetracycline?

Answer 11

It can cause a sunburn; photosensitivity

Question 12

What symptoms should the pt notify the provider that may indicate a superinfection with the use of Tetracyclines?

Answer 12

diarrhea (c diff) or vaginal/anal itching (yeast)

Question 13

Interactions with Tetracyclines?

Answer 13

milk products, calcium and iron supplements, laxatives containing Mg, and antacids causes formation of nonabsorbable chelators → reducing absorption

Question 14

What should patients avoid to prevent esophagitis with tetracycline use?

Answer 14

taking med just before lying down

Question 15

What is the prototype for macrolides?

Answer 15

Erythromycin

Question 16

Therapeutic use of Erythromycin?

Answer 16

PCN allergy substitute, STI, pertussis

Question 17

MOA of Erythromycin?

Answer 17

suppresses protein synthesis at the level of the 50S bacterial ribosome

Question 18

Adverse effects of ErytRhrOmyCiN?

Answer 18

N/V, phlebitis, ototoxicity, rash, superinfection, prolonged QT interval, Torsades de pointes, pseudomembranous colitis

Question 19

Contraindications for Erythromycin?

Answer 19

hypersensitivity, hx of prolonged QT, concurrent use of pimozide, ergotamine, dihydroergotamine, procainamide, quinidine, dofetilide, amiodarone, or sotalol

Question 20

Erythromycin precautions?

Answer 20

liver/renal disease

Geriatric population → increased risk of ototoxicity and prolonged QT interval

Question 21

Route, metabolism, and excretion of Erythromycin?

Answer 21

Route: PO, IV; rapid onset
Metabolism: partially by liver by cytochrome P450
Excretion: mainly in bile, small amount of urine

Question 22

Can Erythromycin be taken with meals?

Answer 22

Should be on empty stomach 1h AC and 2h PC

If GI upset take with meals

Question 23

How should the Erythromycin IV infusion be administered?

Answer 23

Slow infusion

Question 24

T/F. Patients should not drink grapefruit juice with Erythromycin

Answer 24

True

Question 25

Interactions with Erythromycin?

Answer 25

can increase half-lives and plasma level of several drugs