CH3 | Protein Synthesis Inhibitors (Tetracyclines) Flashcards

1
Q

List the tetracyclines.

A
  • Tetracycline (prototype).
  • Minocycline.
  • Doxycycline (newer agent).
  • Demeclocycline (newer agent).
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2
Q

What is the mechanism of action of tetracyclines?

A

Tetracyclines bind reversibly to the 30S subunit of the bacterial ribosome; exhibiting a bacteriostatic effect.

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3
Q

How do tetracyclines enter bacterial cells?

A

In part by passive diffusion and an energy-dependent active transport (inner cytoplasmic membrane).

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4
Q

What is the antibacterial spectrum of tetracyclines?

A

Considered to be broad-spectrum bacteriostatic antibiotics for:
- Gram-positive bacteria.
- Gram-negative bacteria.
- Protozoa.
- Spirochetes.
- Mycobacteria.

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5
Q

What conditions are tetracyclines used to treat?

A
  • Acne.
  • Chlamydia.
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6
Q

What are the bacterial resistance mechanisms to tetracyclines?

A
  • Increased drug efflux or decreased drug influx.
  • Production of tetracycline-blocking proteins.
  • Enzymatic inactivation.
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7
Q

How are tetracyclines absorbed?

A

Adequately after oral administration.

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8
Q

How are doxycycline and minocycline administered?

A

Orally and IV.

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9
Q

How should tetracyclines be taken?

A

On an empty stomach. Dairy products or divalent/trivalent cations should be avoided.

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10
Q

Where do tetracyclines concentrate?

A
  • Most body fluids.
  • Bile.
  • Liver.
  • Kidney.
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11
Q

Why should tetracyclines be avoided in pediatrics and children?

A

Tetracyclines bind to tissues undergoing calficiation.

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12
Q

How do tetracycline use relate to pregnant women?

A

Tetracyclines cross the placental barrier and concentrate in fetal bones and dentition.

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13
Q

Which tetracyclines achieve therapeutic CSF levels?

A
  • Minocycline.
  • Doxycycline.
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14
Q

How is tetracycline (drug) eliminated?

A

Unchanged in the urine.

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15
Q

How is minocycline eliminated?

A

Undergoes hepatic metabolism and renal metabolism (to a lesser extent).

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16
Q

How is doxycycline eliminated?

A

Via the bile, into the feces.

17
Q

What are the adverse effects of tetracyclines?

A
  • GIT disturbances.
  • Drug deposition in bones and teeth; dangerous to children.
  • Hepatotoxicity.
  • Phototoxicity (sunburn).
  • Vestibular dysfunction.
  • Benign intracranial HTN (headaches; blurred vision) (rare).
  • Contraindicated in: Pregnant and breastfeeding women, and children less than 8 years of age.
18
Q

Which tetracyclines have a higher risk of phototoxicity?

A
  • Tetracycline.
  • Demeclocycline.
    Wear adequate sun protection.
19
Q

Which tetracyclines have a higher risk of vestibular dysfunction?

A

Minocycline.