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DD unit II > French Inhibitors of Protein Synth > Flashcards

French Inhibitors of Protein Synth Flashcards

1
Q

antibiotics that inhibiting protein synthesis?

A

Macrolides , Tetrocyclines, Lincomycins, Aminoglycosides, chloramphenicol, oxazolidinones, streptogamins

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2
Q

antibiotics that inhibiting INITIATION of protein synthesis?

A

AGs,TCNs

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3
Q

antibiotics that inhibiting ELONGATION of protein synthesis?

A

Chloramphenicol, MACs (Erythro), clindamycin

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4
Q

Mech of action of MACs (Azithromycin)?

A

static - inhibit protein synthesis at same site as Cindamycin

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5
Q

How do bacteria become resistant to MACs?

A

alter target (50S ribosome), efflux drug, inactivate drug

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6
Q

How to administer Azithromycin?

A

PO on empty stomach

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7
Q

MAC absorption?

A

good PO (some IV avilable)

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8
Q

MAC distribution?

A

wide - goes to fetu. Accumultes in macs, skin, lungs, tonsils, cervix, sputum

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9
Q

Azithromycin metabolism?

A

not metabolized - biliary excretion

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10
Q

Dosing for Azithromycin?

A

QD - high tissue penetration & slow release

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11
Q

MOST common clinical use for MACs?

A

G+ cocci (Strep & Staph), Atypicals (Chlamydia & mycoplasma)

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12
Q

Adverse reactions caused by MACs?

A

GI disturbance, hepatotoxicity, prolonged QT interval

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13
Q

DDI with MACs?

A

Erythromicin & clarithromycin can inhibit CYP450

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14
Q

How do MACs cause GI upset?

A

drug (especially erythro) binds motilin receptor

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15
Q

Do all MACs cause DDIs?

A

no! remember ACE (Azithro is A-ok, but Clarithro & Erythro Cause Effect)

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16
Q

Mech of action for TCNs?

A

static - binds 30S ribosome

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17
Q

How are TCNs selective?

A

host cells have efflux protein

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18
Q

resistance to TCNs?

A

MDR receptors (efflux), proteins that bind TCN

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19
Q

TCN absorption?

A

PO (impaired by milk products)

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20
Q

TCN distribution?

A

Fetus!

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21
Q

TCN elimination?

A

Doxy/mino = hepatic, other TCNs = renal

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22
Q

Spectrum of use for TCN?

A

Broad

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23
Q

common clinical use for TCNs?

A

MRSA, Atypicals (chlamydia, mycoplasma)

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24
Q

ADRs to TCNs?

A

Teeth & bones, Super infections (fungal), yeast overgrowth, photosensitivity, liver/kidney toxicity, GI disturbance

25
Q

DDIs with TCNs?

A

Antacids & Iron supplements (decrease bioavailability)

26
Q

Mechanism of action for Clindamycin (lincomycins)?

A

statos - binds 50S ribosome

27
Q

Route of absorption for Clindamycin?

A

PO (also IV)

28
Q

Clindamycin distribution?

A

especially into bone

29
Q

Clindamycin elimination?

A

heptaobiliary elimination & breast milk

30
Q

Spectrum for Clindamycin?

A

narrow (G+ cocci & Anaerobes) choice in MRSA

31
Q

ADRs to Clindamycin?

A

Superinfection (CDAD, pseudomembranous colitis), diarrhea

32
Q

Mechanism of action for Aminoglycosides?

A

CIDAL - irreversibly binds 30S, requires O2

33
Q

Resistance to AGs?

A

chemically modify AGs, decrease drug influx, change ribosomal target

34
Q

AGs absorption? Route?

A

poor oral absorption, route: IV/IM

35
Q

AGs distribution?

A

ECF, especially: renal cortex & inner ear

36
Q

AGs elimination?

A

renal

37
Q

AGs dosing?

A

once daily, narrow Therapeutic Index so requires Cp monitoring

38
Q

AGs spectrum?

A

narrow (G- aerobes: pseudomonas & E coli, M. tuberculosis, enterococci)

39
Q

ADR to AGs?

A

ototoxicity, nephrotoxicity (requires regular Cp monitoring)

40
Q

AGs DDI?

A

PCNs irreversibly binds and inhibits AGs

41
Q

Mech of action for Chloramphenicol?

A

statis - inhibits 50S ribosome (including mitochondrial ribosomes in bone marrow)

42
Q

Resistance to Chloramphenicols?

A

impermeability, inactivation by bacterial enzymes

43
Q

Chloramphenicol Absorption?

A

PO (also IV)

44
Q

Chloramphenicol distribution?

A

wide - including CSF

45
Q

Chloramphenicol elimination?

A

liver (glucouronidation) - neonates cannot process

46
Q

Chloramphenicol Spectrum?

A

broad (G+/- cocci, anaerobes including Bacteroides, Atypicals)

47
Q

ADR to chloramphenicol?

A

bone marrow toxicity (aplastic anemia), Gray baby syndrome (hepatotoxicity), GI

48
Q

Mech of action for Oxazolidinones?

A

static - binds 50S, inhibits formation of 70S complex

49
Q

Oxazolidinones absorption?

A

excellent PO (also IV)

50
Q

Oxazolidinones elimination?

A

nonenzymatic oxidation & renal

51
Q

Oxazolidinones Spectrum?

A

last resort - G+ (multi resistant)

52
Q

ADRs to Oxazolidinones?

A

thrombocytopenia

53
Q

DDI to Oxazolidinones?

A

inhibits MAO (hypertensive response, serotonin syndrome)

54
Q

Mech of action for Streptogamins?

A

CIDAL - binds 50S & inhibits elongation

55
Q

Streptogamin absorption?

A

IV only

56
Q

Streptogamin elimination?

A

hepatic conjugation, biliary excretion

57
Q

Streptogamin Spectrum?

A

last resort G+ & atypicals

58
Q

ADRs to Streptogamin?

A

infusion related, inhibits CYP3A4

DD unit II (8 decks)

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