Erdman - Tetracyclines Flashcards
Mechanism of action
-Reversibly binds to the 30S ribosomal subunit
-Displays bacteriostatic activity
Tetracycline mechanisms of resistance
-Decreased permeability
-Efflux
-Ribosomal protection proteins
-Enzymatic inactivation
Does tetracycline exhibit cross-resistance within its class?
Yes besides minocycline and the tetracycline analogs
What are the tetracyclines?
-Doxycycline
-Minocycline
-Tetracycline
-Demeclocycline
What are the tetracycline analogs?
-Tigecycline
-Eravacycline
-Omadacycline
Tetracycline gram positive spectrum of activity
-PSSP (doxycycline)
-MSSA (not really considered for use)
Which tetracyclines have the best activity against gram-positive aerobes?
-Minocycline
-Doxycycline
Tetracycline atypical spectrum of activity
-Legionella
-Chlamydophila
-Chlamydia
-Mycoplasma
-Ureaplasma
Tetracycline analog gram positive spectrum of activity
-MSSA
-MRSA
Tetracycline analog gram negative spectrum of activity
-Enhanced activity compared to original tetracyclines
-EEACKSS
-Stenotrophomonas maltophilia
-NOT proteus or pseudomonas
What impairs absorption of tetracyclines?
Di and trivalent cations
Tetracycline distribution
Has good distribution and can distribute into prostate
Do tetracyclines need to be adjusted for renal insufficiency?
No
Which tetracyclines need to be adjusted for hepatic insufficiency?
-Tigecycline
-Eravacycline
Clinical uses of tetracyclines/analogs
-Outpatient community acquired pneumonia (doxy)
-Chlamydia infections - nongonococcal urethritis
-Acinetobacter
-Polymicrobial infections such as complicated skin and intrabdominal infections (analogs)
Tetracycline/tigecycline adverse effects
-Nausea/vomiting (especially with tigecycline)
-Photosensitivity
-Pregnancy category D: discoloration of permanent teeth and decreased bone growth in children
