BIIC Pharmacology Lecture 7_Antimicrobials 3 Pharmacology of bacterial infections

Question 1

What are the 7 classes of Protein Synthesis Inhibitors?

Answer 1

Aminoglycosides
Tetracyclines
Lincosamides
Macrolides
Streptogramins
Oxazolidinones
Amphenicols

Question 2

What are the 5 Aminoglycosides

Answer 2

amikacin (IV/IM), neomycin (topical), gentamicin(IV/IM), streptomycin(IV/IM), tobramycin(IV/IM)

Question 3

What are the main uses of the Aminoglycosides?

Answer 3

gram (-) bacilli including E. coli, Klebsiella pneumoniae and Pseudomonas aeruginosa

Question 4

What are the main ADRs of Aminoglycosides?

Answer 4

Ototoxicity and Neurotoxicity

Question 5

What are the 4 tetracyclines?

Answer 5

doxycycline, tigecycline (IV), minocycline, tetracycline

Question 6

What are the main uses of the tetracyclines?

Answer 6

Broad spectrum but most effective against gram positive bacteria

Question 7

What is the effect of food on the absobtion of tetracyclines?

Answer 7

Tetracyclines will chelate with many foods and should therefore be taken on an empty stomach

Question 8

What are the main ADRs of tetracyclines?

Answer 8

Phototoxicity, teeth discoloration and bone malformation (contraindicated in children under 8) and GI discomfort (this often leads to patients trying to take with food.

Question 9

What are the three Macrolides?

Answer 9

azithromycin (PO, IV, Zithromax®), clarithromycin (PO, Biaxin®), erythromycin (PO, IV)

Question 10

Can Macrolides be used in patients with penicillen hypersensativity?

Answer 10

Yes, they are often the considered the primary alternative for these patients.

Question 11

What are the two main ADRs of Macrolides?

Answer 11

Ototoxicity (similar to aminoglicosides) and Prolonged QT interval (this is a probable test question)

Question 12

What is the clinically used streptogramin combination?

Answer 12

quinupristin/dalfopristin

Question 13

What is quinupristin/dalfopristin used to treat

Answer 13

Gram positive cocci and Vancomycin-resistant enterococci (VRE)

Question 14

What is the main Oxazolidinone?

Answer 14

linezolid (PO, IV)

Question 15

What is the main use of linezolid?

Answer 15

Drug resistant aerobic gram positive bacteria includeing VRE

Question 16

What is the main ADR of linezolid (an Oxazolidinone)

Answer 16

irreversible peripheral neuropathies and optic neuritis causing blindness

Question 17

What is the main DDI of linezolid (an Oxazolidinone)?

Answer 17

serotonin syndrome with large quantities of tyramine-containing foods, selective serotonin reuptake
inhibitors, or monoamine oxidase inhibitors

Question 18

What is the effective spectrum of Chloramphenicol?

Answer 18

Broad-spectrum antibiotic, effective against most aerobic and anaerobic bacteria, except Pseudomonas aeruginosa

Question 19

What is Chloramphenicol used to treat?

Answer 19

It is reserved for life threatening infections

Question 20

What are the two main ADRs of Chloramphenicol?

Answer 20

1) Fatal bone marrow depression and aplastic anemia (1 in 40,000)
2) Gray baby syndrome

Question 21

What is Gray baby syndrome (probable test question)

Answer 21

It is an often fatal ADR of Chloramphenicol that results from decreased ability to conjugate drug in infants. It presents with gray coloration, abdominal distention, vomiting, flaccidity, cyanosis, hypothermia, decreased respiration, and vasomotor collapse

Question 22

What is the Lincosamide?

Answer 22

clindamycin (PO, IV, IM, topical)

Question 23

What is clindamycin (a Lincosamide) used to treat?

Answer 23

MRSA and other Gram positive bacteria

Question 24

What ARD does clindamycin carry an especially high risk of?

Answer 24

Clostridium Defficile superinfection

Question 25

What are the 3 Fluoroquinolones?

Answer 25

ciprofloxacin, levofloxacin, moxifloxacin

Question 26

What is the MOA of Fluoroquinolones

Answer 26

these agents inhibit DNA gyrase and topoisomerases resulting in inhibition of DNA replication

Question 27

What are Fluoroquinolones used to treat?

Answer 27

Bacillus anthracis, UTIs, and URIs

Question 28

Should Fluoroquinolones be taken with food?

Answer 28

No, Like tetracyclines they should be taken on an empty stomach.

Question 29

What are the ADRs for Fluoroquinolones?

Answer 29

Phototoxixity (like tetracyclines) and prolonged QT interval (like macrolides)

Question 30

What is cotrimoxazole (PO, IV)

Answer 30

it is a combination of sulfamethoxazole and trimethoprim, which together are synergisitc folic acid inhibitors.

Question 31

What is cotrimoxazole most often used to treat?

Answer 31

Gram Positive cocci and Gram Negative Bacilli, and in UTIs and as a prophylactic treatment in AIDs