Ch 39 Bacterial Protein Synthesis Inhibitor

Question 1

aminoglycosides

Answer 1

• AE: ototoxicity, nephrotoxicity
• end with “cin”
• used IV only
• use gentamicin then tobramycin, then amikacin
• aerobic gram (-)

Question 2

aminoglycoside TDM

Answer 2

• want peak 30 minutes after infusion and trough just prior to next dose
• peak = dose dependent
• trough = interval dependent

Question 3

peak = too high
trough = too high

Answer 3

decrease dose and extend interval

Question 4

peak = too high
trough = adequate

Answer 4

decrease dose

Question 5

peak = too low
trough = too high

Answer 5

increase dose and extend interval

Question 6

peak = too low
trough = adequate

Answer 6

increase dose

Question 7

tetracycline

Answer 7

• DOC for rocky mountain spotted fever, lyme, chlamydia

- AE: tooth discolor, avoid in kids under 8, photosensitivity

Question 8

tigecycline

Answer 8

• has decreased vulnerability to resistance with use reserved
• CAP, intraabdominal infection
• skin/soft tissue infection

Question 9

macrolides

Answer 9

• end with mycin
• MAI in AIDS pts
• erythromycin increase gastric motility
• atypical coverage
• azithromycin as 1 dose alternative to chlamydia

Question 10

clindamycin

Answer 10

• DOC for anaerobe and active against gram (+)

- increases incidence of C. diff superinfections

Question 11

chloramphenicol

Answer 11

• rarely used due to safety profile
• can be bacteriostatic or bactericidal
• has risk of gray baby syndrome
• broad spectrum against meningitis pathogens

Question 12

quinupristin-dalfopristin (synercid)

Answer 12

-only streptogramin antibiotic available (Tx vancomycin resistant)

Question 13

linezolid

Answer 13

• indicated for VRE, MSSA, MRSA
• thrombocytopenia possible
• can cause serotonin syndrome with SSRI
• very expensive but oral alternative to vancomycin

Question 14

mupirocin (bactrobran)

Answer 14

• lacks cross resistance with other drugs
• topical for impetigo
• MRSA nasal colonization