inhibitors of protein synthesis Flashcards
What is the mechanism of action for inhibitors of protein synthesis?
Suppress bacterial replication and growth.
Are tetracyclines and macrolides bactericidal or bacteriostatic?
Bacteriostatic.
Are aminoglycosides bactericidal or bacteriostatic?
Bactericidal.
What types of infections do inhibitors of protein synthesis treat?
Respiratory, GI, urinary, reproductive tract infections.
Name three tetracyclines.
Doxycycline, Minocycline, Demeclocycline.
Are tetracyclines broad or narrow spectrum?
Broad-spectrum.
Are tetracyclines bactericidal or bacteriostatic?
Bacteriostatic.
What has developed due to widespread tetracycline use?
Bacterial resistance.
How are tetracyclines used for acne?
Topically or orally.
What dental condition can tetracyclines be used for?
Periodontal disease (po, topical).
What respiratory infection is treated with tetracyclines?
Mycoplasma pneumonia.
What STI is treated with tetracyclines?
Chlamydia trachomatis.
What bacterial infection from ticks is treated with tetracyclines?
Rickettsia (Rocky Mountain spotted fever, Lyme disease).
What GI infection is treated with tetracyclines?
Helicobacter pylori (H. pylori).
What bioterrorism-related infection can tetracyclines treat?
Anthrax.
What type of urinary infection can tetracyclines treat?
UTIs.
What are common GI side effects of tetracyclines?
Cramping, nausea, vomiting, diarrhea, esophageal ulceration.
What permanent effect can tetracyclines have on teeth?
Tooth discoloration.
Who should avoid tetracyclines due to tooth discoloration?
Pregnant women and children <8 years old.
What major organ toxicity is associated with tetracyclines?
Hepatotoxicity.
How do tetracyclines affect sun exposure?
Photosensitivity—patients should wear sunscreen and protective clothing.
What type of secondary infection can tetracyclines cause?
Superinfection (C. diff, yeast infections).
Should tetracyclines be given to pregnant women?
No, they can cause permanent tooth damage.
How do tetracyclines affect birth control?
They decrease the efficacy of oral contraceptives.
What types of patients should use tetracyclines cautiously?
Pregnant/postpartum/lactating individuals, those with liver/kidney disease, children <8 years old.
What is chelation in relation to tetracyclines?
Binding of tetracyclines to certain substances, making them nonabsorbable.
What substances should NOT be taken with tetracyclines due to chelation?
Milk, calcium/iron supplements, magnesium laxatives, antacids.
What cardiac medication does doxycycline interact with?
Digoxin.
Name three macrolides.
Erythromycin, Azithromycin, Clarithromycin.
Are macrolides bacteriostatic or bactericidal?
Bacteriostatic (slow bacterial growth).
When are macrolides commonly used?
PCN allergy, Legionnaire’s disease, Bordetella pertussis, acute diphtheria, chlamydial infections, pneumonia, strep infections.
What are the common GI side effects of macrolides?
Nausea, vomiting, diarrhea.
How can macrolides affect heart function?
Prolonged QT interval.
What serious ear-related side effect is associated with high doses of macrolides?
Ototoxicity.
Should macrolides be used in pregnancy?
Use caution (risk vs. benefit).
What pre-existing conditions require caution with macrolides?
Liver disease, QT prolongation.
What enzyme system do macrolides inhibit, leading to drug interactions?
CYP450.
What common medications interact with macrolides?
Antihistamines, theophylline, carbamazepine, warfarin, digoxin.
What contraceptive precaution should patients take with macrolides?
Use backup contraception.
Name six aminoglycosides.
Gentamicin, Tobramycin, Neomycin, Streptomycin, Paromomycin, Amikacin.
Are aminoglycosides bacteriostatic or bactericidal?
Bactericidal (inhibit protein synthesis).
What type of bacteria do aminoglycosides primarily target?
Gram-negative bacilli.
Are aminoglycosides absorbed in the GI tract?
No.
What two forms of ototoxicity can aminoglycosides cause?
Vestibular (loss of balance) and cochlear (hearing loss).
What kidney-related toxicity can occur with aminoglycosides?
Nephrotoxicity (monitor I&O, BUN, creatinine, hematuria, cloudy urine).
How can aminoglycosides affect muscle function?
Neuromuscular blockade → respiratory depression & muscle weakness.
Which patient populations are at risk for neuromuscular blockade with aminoglycosides?
Patients with myasthenia gravis or those given anesthesia.
What neurologic side effect is unique to streptomycin?
Neurologic disorders.
Should aminoglycosides be used in pregnancy?
Use caution (risk of toxicity).
Which patients should use aminoglycosides cautiously?
Those with kidney impairment, hearing loss, or myasthenia gravis.
What other drugs increase nephrotoxicity risk when combined with aminoglycosides?
Amphotericin B, cephalosporins.
What drugs increase ototoxicity risk when combined with aminoglycosides?
Loop diuretics (furosemide), ethacrynic acid.
What neuromuscular blocking agents interact with aminoglycosides?
Tubocurarine, skeletal muscle relaxants.
Why should aminoglycosides and penicillins NOT be mixed in the same IV bag?
PCN inactivates aminoglycosides.
When should trough levels be measured for once-daily dosing of aminoglycosides?
Right before the next dose.
When should peak levels be measured for divided dosing of aminoglycosides?
30 min after IM injection or after IV infusion is complete.
When should trough levels be measured for divided dosing of aminoglycosides?
Right before the next dose.
