- suprainfection - QT prolongation and sudden cardiac death (torsades de pointes)

- Very few - Potential QT prolongation

- Cannot be taken with food - Increased risk of heart arrhythmias

Drugs two last time Flashcards by Amitav Rahman

Bacteriostatic Inhibitors of protein synthesis function, and 8 classes included

Inhibit growth and replication, do not kill bacteria, include

tetracyclines
macrolides
clindamycin
chloramphenicol
dalfopristin/quinipristin
Linezolid
Retamulin/mupirocin
Tigecycline

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Tetracyclines spectrum (including 9 specific ones)

Broad speectrum including

1) rickettsia
2) spirochettes
3) brucella
4) chlamydia
5) mycoplasma
6) vibrio cholerae
7) helicobacter pylori
8) borrelia burgdorferi
9) bacillus anthracu

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3 common uses of tetracyclines

1) acne
2) peptic ulcers
3) peridontal disease

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3Tetracycline ADRs

Photosensitivty, bone and teeth discoloration, suprainfection

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Tetracycline mech of action

Bind 30s ribosome preventing protein synthesis, actively transported into cell via energy dependent process only present in bacterial cells

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Tetracycline resistance

Decreased uptake, increased exclusion of tetracyclines

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Tetracycline absorption

GI absorption limited because of chelates (with any metal ion), topical use too

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4 tetracyclines available

1) tetracycline (short acting, no food)
2) denecocycline (medium acting, no food)
3) doxyxcline(long acting, no food)
4) minocycline (long acting, food okay)

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Fanconi syndrome

Ingestion of outdated tetracycline can cause renal tubular dysfunction leading to renal failure

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Macrolides spectrum

Broad spectrum

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Macrolides include 3 drugs

1) erythromycin
2) azithromycin
3) clarithromycin

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Macrolides resistance

Pumping out macrolides or modifying target ribosomes

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Macrolide mechanism of action

Bind 50S ribosome subunit to prevent protein synthesis

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Erythromycin spectrum

Most gram + and few gram -, first choice for bordatella pertussis and cornybacterium diptheria

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Erythromycin is often seen as an alternative for ____ in those with an allergy

PCN G

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Erythromycin ADRs

suprainfection

- QT prolongation and sudden cardiac death (torsades de pointes)

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Clarithromycin spectrum

Most gram + and few gram -, more active than erythromycin in certain situations

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Clarithromycin ADRs

Very few

- Potential QT prolongation

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Clarithromycin and azithromycin are often prescribed over erythromcyin because of one distinct advantage

They do not typically cause nausea and diarrhea

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Azithromycin spectrum

Less active than erythromycin on strep/staph, more active on gram - bacterium

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Azithromycin ADR’s

Cannot be taken with food

- Increased risk of heart arrhythmias

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Clindamycin mechanism of action

Inhibition of the 50S ribosome to prevent protein synthesis

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Clindamycin absorption

-Parenterally/IV, topical, oral

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Clindamycin excretion

Mostly hepatic metabolism

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Clindamycin treats

Gram + and -, DOC for Bacteroides

Clindamycin ADR

Can cause psudomembranous colitis from Cdiff

Chloramphenicol mechanism of action

Inhibit protein synthesis through binding the 50s ribosomal subunit

Chloramphenicol spectrum

Broad spectrum but often last resort, DOC for typhoid fever and effective against bacterial meningitis

Chloramphenicol absorption

GI route

Chloramphenicol ADRs

- Pancytopenia (aplastic anemia) | - Gray baby syndrome

Dalflopristin/Quinipristin mechanism of action

Streptogamins, together become bactericidal

Dalflopristin/Quinipristin treats...

VRE and MRSA

Dalfopristin/Qunipristin ADR's

- Hepatotoxicity | - Thrombophlebitis

Linezolid mechanism of action

Binds 23s portion of 50s subuinit of ribosome, cross resistance therefore unlikely

Linezolid treats

VRE and MRSA

Linezolid ADR

Myelosuppression

Tigecycline spectrum

Gram + and -, drug resistant strains, no pseudomonas

Tigecycline mechanism of action

Binds to 30s ribosome

Tigecycline absorption

IV antibiotic

Tigecycline ADRs

Stained teeth in children and photosensitivity

Retapamulin/mupirocin function

Topical antibiotics indicated for impetigo

Fluoroquinolones are designated not to be used...

...in simple and acute infections

Fluoroquinolones spectrum

Broad spectrum, most gram neg and some gram pos including MRSA

Fluorquinolones abosrption

PO administration

Fluoroquinolones ADRs

Tendon rupture/peripheral neuropathy/hypogllycemia/mental illness

Fluoroquinolones include these 8

1) ciprofloxacin 2) norfloxacin 3) ofloxacin 4) Levofloxacin 5) Moxifloxacin 6) gemifloxacin 7) gatifloxacin 8) delafloxacin

Fluoroquinolones mech of action

Enter bacterium by passive diffusion and inhibit replication of baterial DNA by inhibiting bacterial DNA gyrase and toposiomerase IV

Fluorquinolones have a poor activity against....

...anaerobes

Fluorquinolone resistance (2)

1) alterations in DNA gyrase | 2) reduced ability of drug to cross bacterial membranes

Cipro is often given prophylactically for patients exposed to these 2 pathogens

1) anthrax exposure | 2) meningococcal disease

Cipro ADR

Phototoxicity

Cipro absorption

Gut, must be taken apart from food to prevent chelate formation

Norfloxacin indication

UTI caused by P aeruginosa

Ofloxacin indication

Less effective against P. aeruginosa

Levofloxacin

More effective against gram +

Moxifloxacin

CAP

Gemifloxacin

CAP

Gatifloxacin

Topical use only

Delafloxacin

Acute bacterial skin infection from MRSA

Metronidazole spectrum

Protozoa or anaerobic bacteria, DOC for Cdiff, amoeba, and trichomonas vaginalis

Metronidazole mechanism of action

Taken up passively, converted to active form in anaerobic bacteria, break up DNA helical structure

Metronidazole ADRs

Neurologic effect, urine darkening

Rifampin spectrum

Broad, often for myobacterial infection

Rifampin mech of action

Inhibit RNA poly

Rifampin ADR

Hepatotoxicity, body fluid discoloration

Bacitracin absorption

Topical only (unless life threatening)

Bacitracin mech of action

Inhibit synthesis of cell wall

Bacitracin spectrum

Gram pos

Sulfonamides mech of action

Inhibition of synthesis of folic acid by binding where PABA does to be bacteriostatic

Sulfonamide resistance (3 methods)

R factor 1) Increase synthesis of PABA 2) Prevent sulfonamide binding 3) Reduce uptake of sulfonamide

Sulfonamide spectrum

Broad, gram + including MRSA and some gram neg, DOC for acute UTI

Sulfonamide ADRs

- Photosensitivity - drug fever - Steven Johnson syndrome (widespread lesions) - acute hemolytic anemia - Kernicterus (bilirubin buildup in newborn brain

Trimethoprim spectrum

Gram - bacilli, some gram +, some protozoa, DOC for uncomplicated UTI

Trimethoprim-Sulfamethoxazole (bactrim) spectrum

UTI, pneumocytis pneumonia, others

Drugs two last time Flashcards

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