Exam 3 - Protein Synthesis Inhibitors

Question 0

Act on 50S subunit

Answer 0

Macrolides
Quinupristin-dalfopristin
Clindamycin

Question 1

Act on 30S subunit

Answer 1

Tetracyclines

Aminoglycosides

Question 2

Gram - , very little Gram +
Pseudomonas
NO ANAEROBIC/ATYPICAL antibacterial activity

Answer 2

Aminoglycosides

Question 3

Neuromuscular paralysis
Nephrotoxicity
Ototoxicity

Answer 3

Aminoglycosides

Question 4

Inhaled
IV
Most active against Enterobacteriaceae
P. auroginosa (cystic fibrosa)

Answer 4

Tobramycin

Question 5

Last resort
reserved against organisms resistant to other aminoglycosides
Works for TB

Answer 5

Amikacin

Question 6

can be topical; used in combo w/ ampicillin

Answer 6

Gentamcin

Question 7

Gram -
Gram +
CA-MRSA
S. pneumonia
ATYPICAL BACTERIA
Rickettsia
SPIROCHETES (B. BURGDORFERI, LYME DISEASE, H.PYLORI)

Answer 7

Tetracyclines

Question 8

H. pylori
Rocky Mountain Fever
Lymes Disease (tics)

Answer 8

Tetracyclines

Question 9

Deoxycycline does NOT need to be adjusted even w/ renal impairment

Answer 9

Tetracyclines

Question 10

Nephrotoxicity
PHOTOSENSITIVITY
DISCOLORATION OF TEETH (DON’T USE CHILDREN/PREGNANT)
PSEUDOMOTOR CEREBRI - brain swelling, intracranial pressure
Hepatoxicity
Vestibular/vertigo
Super Infections: Candida

Answer 10

Tetracyclines

Question 11

Bind w/ calcium, aluminum, and iron (reduced bioavailability)
DO NOT TAKE W/ ANTACIDS OR IRON

Answer 11

Tetracyclines

Question 12

Does not need to be adjusted in renal impairment (tetracycline)

Answer 12

Doxycycline

Question 13

causes vertigo and dizziness

Answer 13

Minocycline

Question 14

Bioavailability reduced by minerals and dairy products

Answer 14

Tetracycline

Question 15

Avoid in patients on anti-arrthmics (can prolong QTC, esp w/ Erythromycin, increase ventricular arrhythmias)

Answer 15

Macrolides

Question 16

Macrolides that inhibit 3A4

Answer 16

Erythromycin and Clarithromycin

Question 17

Gram +
Gram - H. influenzae, H. pylori, M. catrrhalis
Atypical bacteria
Inhibit 3A4

Answer 17

Clarithromycin

Question 18

Same spectrum as Clarithromycin
Little effect on CYP
Doesn’t cause as many side effects

Answer 18

Azythromycin

Question 19

For adults, treatment of C. diff - associated bacteria
not DOC since it’s more expensive, Vancomycin works just as well
- only use for infection or strongly suspected to be caused by C. diff; do not use for systemic infections

Answer 19

Fidaxomicin

Question 20

Higher levels of adverse effects to Vancomycin

• N&V
• abdominal pain
• GI hemorrhage
• anemia
• neutropenia

Answer 20

Fidaxomicin

Question 21

Used for CA-MRSA

Answer 21

Clindamycin

TMP-SMX

Question 22

Adverse effects:
severe diarrhea (can develop w/o having C. diff)
C. diff
Pseudomonas colitis

Answer 22

Clindamycin

Question 23

D-test: isolated strains of S. aureus show susceptibility to ______ but resistant to Erythromycin. D-test is done to ensure that resistance to ______ cannot be induced/occur.

Answer 23

Clindamycin

Question 24

Vancomycin-resisistant Enterococcus faecium (VRE)

Answer 24

Linezolid

Quinupristin-Dalfopristin

Question 25

Used IV, potent 3A4 inhibitor

Answer 25

Quinipristin-Dalfopristin

Question 26

Interacts w/:
lovastatin and simvastatin - watch for rhabdo and muscle pain
Carbamezepine - anti-epileptic

Answer 26

Quinipristin-Dalfopristin

Question 27

MOA: inhibits bacteria protein synthesis by binding/inhibiting 23S, 50S, 70S

Answer 27

Linezolid

Question 28

Oral bioavailability almost 100%

Answer 28

Linezolid

Question 29

Bone marrow suppression (thrombocytopenia, anemia, leukopenia - monitor CBC)

Answer 29

Linezolid

Question 30

Serotonin syndrome in conjuction w/ SSRIs

Answer 30

Linezolid

Question 31

Indicated for IMPETIGO (common skin infection, topical), eradicate nasal colonization of MRSA

Answer 31

Mupirocin