FA glycylcycline/fluoroquinolones/daptomycin Flashcards
glycylcycline group agent?
tigecycline
tigecycline is derivate of what?
tetracycline
tigecycline binds to what?
Bind to 30S subunit → blockage of entry of amino-acyl tRNA into ribosomal A site → inhibition of protein synthesis (bacteriostatic effect)
tigecycline cidal or static?
static
tigecycline spectrum?
broad
tigecycline cover gram what?
Broad spectrum anaerobic, gram -, gram +.
Anaerobes (broad spectrum)
Gram-positive aerobes (not effective against S. viridans or Enterococci; limited efficacy against MSSA)
Partially effective against gram-negative aerobes (no effect against Proteus species)
Multidrug-resistant organisms (MRSA, VRE)
Gram-intermediate bacteria: Borrelia, Mycoplasma, Rickettsia, Chlamydia
tigecycline CNS penetration?
poor
tigecycline route of ellimination?
oute of elimination: mostly biliary
tigecycline should not be taken with what?
Glycylcyclines should not be taken with milk, antacids, or iron supplements because divalent cations inhibit the absorption of glycylcyclines in the intestines.
special use of tigecycline?
Good soft tissue penetration: effective for treating deep tissue infections
tigecycline adverse?
GI upset (nausea, vomiting)
Hepatotoxicity
Deposition in bones and teeth
Photosensitivity
tigecycline contraindications?
Children < 8 years of age
Pregnant women
Breastfeeding women
Cautious use in patients with hepatic dysfunction
lipopeptide group agent?
daptomycin
daptomycin mechanism?
incorporate K+ channels into the cell membrane of gram-positive bacteria → rapid membrane depolarization → loss of membrane potential → inhibition of synthesis of DNA, RNA, and proteins → cell death (bactericidal effect)
daptomycin cidal or static?
cidal
daptomycin what gram?
gram +
daptomycin route of ellimination?
renal
daptomycin use?
Gram-positive bacteria
!!S. aureus, especially MRSA (complicated skin infection)
Mainly used in skin and skin structure infections, bacteremia, and endocarditis
Vancomycin-resistant Enterococci (VRE)
Not used in pneumonia (daptomycin is bound and inactivated by surfactant)
why do not prescribe daptomycin for pneumonia?
daptomycin is bound and inactivated by surfactant
daptomycin adverse?
Reversible myopathy
Rhabdomyolysis
Allergic pneumonitis
daptomycin contraindications?
hypersensitivity
daptomycin resistance?
Mechanisms of resistance: repulsion of daptomycin molecules due to the change in the bacterial surface charge
