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Drugs > Bacteriostatic Inhibitors of Protein Synthesis > Flashcards

Bacteriostatic Inhibitors of Protein Synthesis Flashcards

1
Q

what drug classes do Bacteriostatic Inhibitors of Protein Synthesis include

A 
Tetracyclines
Macrolides
Ketolides
Clindamycin
Chloramphenicol
Linezolid
Dalfoprisitine
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2
Q

what does bacteriostatic mean

A

suppress bacterial growth and replication but do NOT outright kill

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3
Q

are tetracyclines broad or narrow

A

broad

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4
Q

MOA of tetracylcines

A

inhibit protein synthesis

bind to 30s ribosomal subunit

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5
Q

are mammal cells affected by tetracyclines

A

no, they do not have an energy transport process that bacterial cells do (thats how they get into the cell and inhibit protein synthesis)

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6
Q

2 mechanisms for tetracyclines bacterial resistance

A

decrease drug uptake

acquisition of the ability to extrude tetras

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7
Q

some bacteria that tetracyclines are used against

A 
Rickettsia
spirochetes
brucella
chlamydia
mycoplasm
vibrio cholera
H. pylori
borrelia burgdorferi 
baccilus anthracis
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8
Q

are tetracyclines commonly used as 1st line drugs?

A

no

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9
Q

tetracyclines are 1st line for…

A

rickettsial dz (Rocky mountain spotted fever)
chlamydia trachamonis (cervicitis, trachoma,
lymphogranuloma venerum, urethritis)
brucellosis
cholera
pneumonia (caused by mycoplasma penumoniae)
lyme’s dz (caused by borrelia burgdorferi-multisystem
inflammatory disorder)
H.pylori (gastric infection)
antthrax

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10
Q

which tetracyclines is inhibited by foods

A

tetracyclines and demeclocycline

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11
Q

is minocycline inhibited by food

A

no

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12
Q

what prevents absorption of tetracylines

A 
Ca
Al
Mg
Fe
Zn

Must be taken 1 hr before or at leas 2-3 hrs after a meal

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13
Q

can tetracyclines penetrate the CSF

A

no

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14
Q

do tetracyclines cross the placenta

A

YES

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15
Q

elimination of tetracyclines

A

kidneys and liver

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16
Q

how are doxy/minocycline excreted vs tetracyclines and democycline

A

doxy/mino –> liver-preferred w/ pts w/ renal impairments

tetra/demo –> kidneys- not good for pts w/ renal impairments

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17
Q

major AR to tetracyclines and fetuses

A

staining of deciduous teeth

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18
Q

can tetracyclines be used in kids

A

should not be used in kids <8, permanent staining of teeth

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19
Q

tx for C. diff

A

PO vancomycin or metronidazole plus vigorous fluid and electrolyte replacement

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20
Q

what can happen if you take an expired tetracyclines

A

Fanconi Syndrome- renal tubular dysfunction (can lead to

renal failure)

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21
Q

SA of tetracyclines

A

GI, photosensitivity, renal/hepatic toxicity, suprainfection (c.
diff, candida), staining of bones and teeth

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22
Q

tetracyclines and digitoxin (warfarin) interactions

A

can increase digitoxin levels by increasing GI absorption and increase INR levels by decreasing vit K flora in gut

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23
Q

when should/can you take tetracyclines

A

on an empty stomach w/ glass of water

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24
Q

what are two long acting tetracyclines

A

doxy and minocycline

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25
Q

doxycycline

A

vibramycin

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26
Q

demeclocycline (intermediate acting) stimulates…/uses

A

urine flow… use in SIADH

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27
Q

doxy is the first line for…

A

Lymes dz
anthrax
chlamydial infections

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28
Q

minocycline major SA

A

can damage vestibular apparatus (unsteady, dizzy)

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29
Q

demeclocycline

A

declomycin

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30
Q

minocycline

A

minocin

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31
Q

tetracycline examples

A

achromycin, sumycin

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32
Q

are macrolides broad or narrow spectrum

A

broad

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33
Q

MOA of macrolides

A

inhibits bacterial protein synthesis

34
Q

what class is erythromycin part of

A

macrolides

35
Q

what abx are structurally similar to tetracyclines (and are kinda considered tetras but not really…)

A

doxycycline, minocylcine, demeclocycline

36
Q

erythromycin MOA

A

binds to 50s ribosomal subunit –> blocks new amino acid chain from being added

37
Q

what is erythromycin similar to in terms of microbial spectrum

A

PCN

38
Q

alternative to Pen G (allergic pts)

A

erythromycin

39
Q

erythromycin is the DOC for…

A 
bordetella pertussis (whooping cough)
corynebacterium diphtheria
40
Q

tetracyclines and erythromycin act well on…

A

chlamydial infections

pneumonia caused by mycoplasma pneumonia

41
Q

erythromycin penetration of CSF

A

poor

42
Q

does erythromycin cross the placenta and can it cause fetal harm

A

does cross the placenta but no evidence of fetal harm

43
Q

elimination of erythromycin

A

liver

44
Q

where does erythromycin concentrate in

A

liver

45
Q

AR erythromycin

A

GI
QT prolongation (increase torsades de pointe)
sudden cardiac death

46
Q

drug interactions of erythromycin (increase levels of…)

A

theophylline
carbamazepine
warfarin

  • inhibits liver metabolism of these drugs increasing plasma levels
47
Q

erythromycin antagonizes effects of…

A

chloramphenicol and clindamycin

48
Q

drugs that inhibit erythromycin metabolism

A

verapamil
diltiazem
azole antifungals
HIV protease inhibitors

49
Q

examples of macrolides

A

erythromycin
azithromycin (zmax)
clarithromycin (Biaxin)

50
Q

clindamycin MOA

A

inhibits bacterial protein synthesis of 50S ribosomal subunits

51
Q

does clindamycin cross CSF

A

no

52
Q

where is clindamycin metabolized

A

liver

53
Q

antimicrobial spectrum of clindamycin

A

G + including anaerobic streptococci

54
Q

clindamycin is DOC for

A

bacteroides (esp. B fragilis)

55
Q

chloramphenicol MOA

A

inhibits 50s ribosomal subunit

56
Q

can chloramphenicol get intot he CSF

A

yes

57
Q

where is chloramphenicol metabolized

A

liver

58
Q

antimicrobial spectrum of chloramphenicol

A 
G-
anaerobic 
some strains of strep and staph
rickettsia 
clostridium, chlamydia, mycoplasma
59
Q

chloramphenicol DOC for

A

typhoid fever

60
Q

chloramphenicol can be used for…(in conjunction w/ ampicillin)

A

bacterial meningitis

61
Q

major adverse effects of chloramphenicol

A

bone marrow suppression resulting in pancytopenia

62
Q

chloramphenicol with neonates

A

gray baby syndrome (cyanosis, respiratory distress, abdominal distension, vasomotor collapse, loose green stools, ashen grey look)

63
Q

what class do dalfloprisitne /quinipristine belong to

A

streptogamins

64
Q

MOA of dalfloprisitne /quinipristine separately vs together

A 
separately = basteriostatic
together = bacteriocidal
65
Q

indications for streptogamins

A

principal indication: vancomycin resistant

others: MRSA, MRSE, drug resistant S. pneumonia

66
Q

major adverse rxns of streptogamins

A
  • hepatotoxicity (check LFTs and bilirubin levels twice weekly for 1st wk and then once a wk after)
  • thrombophlebitis
67
Q

drug interactions of streptogamins

A

CYP3A4

68
Q

what class does linezolid belong to

A

oxazolidinones

69
Q

linezolid MOA

A

binds to 23s portion of 50 s ribosomal subunit

70
Q

antimicrobial spectrum of oxazolidinones (e.g. linezolid)

A

significant activity against multidrug resistant pathogens including vanc resistant enterococci (VRE) and MRSA

primarily effective against aerobic and facultative gram + bacteria

71
Q

what do you use for VRE, health care associated pneumonia caused by staph aureus/strep pneumonia, CAP

A

linezolid

72
Q

tigecycline (Tygacil) MOA

A

binds to 30s ribosomal subunits

73
Q

what class is Tygacil part of

A

glycyclines

74
Q

is Tygacil broad or narrow and what is it kinda like

A

broad, tetracyclines

75
Q

what is tygacil specifically NOT active against

A

pseudomonas auroginosa or proteus species

76
Q

what are the adverse effects similar to of tygacil

A

tetracyclines

77
Q

what are retapamulan and mupirocin used for primarily

A

topical impetigo

78
Q

retapamulan MOA

A

binds to 50s ribosomal subunit

79
Q

is retapamulan bacteriostatics or bacteriocidal

A

bacteriostatic

80
Q

what is mupirocin used for (2 things primarily)

A

impetigo caused by staph aureus/step pyogenes AND nasal colonization of MRSA

81
Q

MOA of mupirocin

A

binds to isoleucyl transfer RNAsynthetase

Drugs (3 decks)

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