Chapter 73: Bacteriostatic Inhibitors of Protein Synthesis

Question 1

Tetracycline

Answer 1

Minocycline (Minocin)​

Doxycycline (Vibramycin)

Outpatient for resp infections ​

First drug of choice for Lyme disease ​

Avoid iron and calcium products –decrease absorption of Ab ​

Question 2

tetra uses

Answer 2

Broad spectrum of activity against gram + and gram -​

Acne ​

Tx of Atypical Infections , CAP​

CA-MRSA​

Tick born diseases*​

Part of triple therapy for H Pylori chronic gastritis​

Question 3

tetra ADR

Answer 3

Photosensitivity​
Can persist for days ​

Nephrotoxicity, hepatotoxicity​

Teeth Discoloration ​
Contraindications: Pregnancy and Lactation (); infants, Children < 8​

Food and Drug Interactions​
Take with full class of water and avoid divalent cations (Ca, Fe, etc)​
Take on empty stomach, absorption decreases with food ​

Question 4

lymes disease

Answer 4

300,000 new Lyme disease cases a year. From deer ticks. Bullseye rash and fever.

Question 5

Rocky Mountain ​Spotted Fever

Answer 5

RMSF from rickettsia -transferred in feces of lice.

Question 6

tetra therapeutic goals

Answer 6

Treatment of tetracycline sensitive infections, acne, and Lyme disease​

Question 7

identifying high risk pt for tetra

Answer 7

Contraindicated in pregnant women and children < 8​

Question 8

tetra evaluating therapeutic effects

Answer 8

Monitor for reduction in bacterial symptoms: fever edema, pain, inflammation​

Question 9

min ADR for tetra

Answer 9

GI distress can be reduced by taking tetracycline with meals. Avoid prolong exposure to light

If GI SE are s bad pt wants to d/c, can take with food.

Question 10

macrolide types

Answer 10

Azithromycin (Zithromax, Z Pac)​
Used for U/LRI, Chlamydia​
Tx for Mycoplasma or Legionaries’ Disease (Atypical CAP)​

Clarithromycin (Biaxin): Triple Tx for H. Pylori​
Clarithromycin, amoxicillin and omeprazole​

Erythromycin (E- Mycin) ​
Rarely used because of severe N/V/D​
Used as ophthalmic ointment in newborns for Gonococcal Conjunctivitis prevention (leading cause of infantile blindness)​

Very useful for atypical bacteria

Question 11

macrolide MOA

Answer 11

Binds with 50s subunit to prevent protein synthesis

Question 12

macrolide coverage

Answer 12

Effective against a wide range of gram positive bacteria. ​

Will cover everything a PCN can cover PLUS the atypicals.​

When you think atypical “walking” pneumonia, think azithromycin!!​

Go to drug in pts allergic to PCN

Given along with ceftriaxone for chlamydia and gonorrhea (respectively)

Question 13

macrolide ADR

Answer 13

Well tolerated, but causes prolonged QT interval​. n/v/d, abd pain. liver toxicity (estolate related), inhibit p450 system.

Question 14

macrolide therapeutic goal

Answer 14

Treatment of respiratory Infections, H Pylori infections, Atypical infections and a great alternative to a PCN allergy​

Question 15

macrolide identifying high risk pt

Answer 15

Use cautiously in patient with prolonged QT interval.​

Question 16

macrolide evaluating therapeutic effects

Answer 16

Monitor for reduction in bacterial symptoms: fever edema, pain, inflammation

Question 17

macrolide min ADR

Answer 17

GI distress can be reduced by taking with meals. Avoid us in patients with QT prolongation

Question 18

Clindamycin uses

Answer 18

Aerobic and Anaerobic coverage. ​
Acne: Topical prep​
Surgical prophylaxis for nasal, oral, sinus/ pharengeal operations​
Aspiration pneumonia​

Preferred over metronidazole for head, neck and lung anaerobic infections​

Some evidence suggests it has uses in necrotizing fasciitis and toxic shock syndrome as an antitoxin.​

Question 19

clinda MOA

Answer 19

Binds to 50s to inhibit protein synthesis

Question 20

clinda ADR

Answer 20

Classic drug associated with pseudomembranous colitis (c diff)​ Most common Ab to cause c diff –if diarrhea starts d/c drug.

Has metallic taste, erythema multiform,