Drugs for infection: part 2

Question 1

Tetracyclines and Macrolides

Answer 1

Bacteriostatic inhibitors of protein synthesis (Inhibit binding transfer of tRNA to mRNA)

Question 2

Do tetracyclines cause outright death?

Answer 2

No

Question 3

Tetracyclines are _____ spectrum

Answer 3

Broad

Question 4

Tetracyclines are first-line drugs for…

Answer 4

Rocky Mountain Spotted Fever
Chlamydial infections
Acne treatment
Lyme’s disease

Question 5

Adverse effects of tetracyclines

Answer 5

GI irritation 
Effects on bones and teeth 
Suprainfecyion 
Hepatotoxicity 
Renal toxicity

Question 6

Tetracyclines form non absorbable molecules with certain metal ions so….

Answer 6

Do not take with milk products, antacids, calcium supplements, iron supplements

Question 7

Macrolides oldest (prototype)

Answer 7

Erythromycin

Question 8

Macrolides are _____ spectrum

Answer 8

Broad

Question 9

Members of macrolides

Answer 9

Azithromycin (Zithromax)
Clarithromycin (Biamax)
Dirithromycin (Dynabac)

Question 10

Macrolides are often used…

Answer 10

As an alternative to penicillins if the patient has a penicillin allergy

Question 11

Therapeutic uses of macrolides

Answer 11

Wooping cough
Legionnaire’s disease (pneumonia caused by Legionella pneumonphila)
Diptheria
Alternative to penicillin for respiratory tract infections by strep

Question 12

Can macrolides be pushed?

Answer 12

No

Question 13

Adverse effects of Macrolides

Answer 13

SIGNIFICANT GI effects
Liver injury
Sudden cardiac death (small risk, prolonged QT interval)

Question 14

Liver injury

Answer 14

Choelstatic hepatitis

Question 15

Aminoglycosides

Answer 15

Bactericidal inhibitors of protein synthesis

Question 16

Common aminoglycosides

Answer 16

Gentamycin
Tobramycin
Amikacin

Question 17

Aminoglycoside effects are limited to…

Answer 17

Gram negative bacilli

Question 18

Amino glycosides are very _______ and ______ spectrum

Answer 18

Potent

Broad

Question 19

Aminoglycosides have ______ therapeutic windows

Answer 19

Narrow

Question 20

Adverse effects of aminoglycosides

Answer 20

Ototoxicity
Nephrotoxicity
Neuromuscular blockade

Question 21

Neuromuscular blockade causes…

Answer 21

Flaccid paralysis - respiratory depression

Question 22

Monitoring drug serum levels: Peak levels

Answer 22

Draw 30 minutes after administration

To produce bacterial kill… must be sufficiently high

Question 23

Monitoring drug serum levels: trough levels

Answer 23

Divided doses - draw just prior to next dose
Once daily - draw 1 hour prior to next dose
To minimize ototoxicity must be sufficiently low

Question 24

Sulfonamides

Answer 24

Disrupt synthesis of Tetrahydrofolic acid

Question 25

Preferred use of sulfonamides

Answer 25

UTIs

Question 26

Sulfonamides adverse effects

Answer 26

Hypersensitivity reactions
-Stevens Johnsons
Hematologic effects
Kernicterus 
Renal damage

Question 27

Fluoroquinolones

Answer 27

Disrupt DNA
Inhibit DNA gyrase (enzyme needed for DNA supercoiling)
Rapidly bactericidal

Question 28

Fluoroquinolones are ______ spectrum

Answer 28

Broad

Question 29

Names of fluoroquinolone

Answer 29

Ciprofloxacin (Cipro) *prototype
Ofloxacin (Levaquin)
Lomefloxacin (Maxaquin)

Question 30

Uses for fluoroquinolones

Answer 30

Respiratory tract infections
UTIs
Skin / joint / soft tissue infections
-Facial cellulitis

Question 31

Oral administration of Cipro allows for….

Answer 31

Home treatment of infections that once would have forced a hospital admission for IV antibiotics

Question 32

Adverse effects of fluoroquinolones

Answer 32

MILD
GI problems 
-N/V/D
CNS effects 
-Dizziness, headache, confusion 
Tendon rupture 
May cause candida infections as a result of treatment