Inhibitors of Protein Synthesis Flashcards
1
Q
What are the Tetracyclines
A
Doxycycline
Minocycline
Tetracycline
2
Q
What is the Glycylcycline
A
Tigecycline
3
Q
What are the Aminoglycosides
A
Gentamycin Neomycin Amikacin Tobramycin Streptomycin Netilmicin
4
Q
What are the Macrolides
A
Erythromycin
Clarithromycin
Azithromycin
Telithromycin
5
Q
What are the Misc Protein Synthesis Inhibitors
A
Chloramphenicol
Clindamycin
Linezolid
Fidaxomicin
6
Q
What are the Streptogramins
A
Quinupristin
Dafopristin
7
Q
Which bind 30S
A
Aminogycosides
Tetracyclines
Glycylcyclines
8
Q
Which inhibit 50S
A
Chloramphenicol Clindamycin Macrolides Linezolid Streptogramins
9
Q
Most common treatment of severe acne and rosacea
A
Tetracyclines
10
Q
Don’t take with milk/antacids
A
Tetracyclines
11
Q
Teratogenic
A
Tetracyclines (D)
Tigecycline
Aminoglycosides (D)
12
Q
Discoloration and hyperplasia of teeth
A
Tetracyclins
13
Q
Main AE is photosensitivity
A
Tetracyclins
14
Q
Last resort for MDR b/c increased risk of mortality
A
Tigecycline
15
Q
DOC empiric Tx infective endocarditis
A
Gentamycin
with Vanco or PCN
16
Q
DOC plague
A
Streptomycin
17
Q
Adjunct for hepatic encephalopathy
A
Oral Neomycin
18
Q
Action of Oral Neomycin in hepatic encephalopathy
A
Reduce NH3 formation by gut bacteria
19
Q
Only useful against aerobes
A
Aminogycosides
20
Q
Main Aminoglycoside AE
A
Nephrotoxicity (ATN)
Ototoxicity
21
Q
Good choice for Pts with PCN allergy
A
Macrolides
22
Q
Empiric Tx community acuired PNA and pseudomonas
A
Macrolides
23
Q
DOC pertussis
A
Erythromycin
24
Q
What is contraindicated to give with Macrolides
A
Statins
Due to P450 inhibition
25
Which Macrolide doesn't inhibit P450
Azithromycin
26
What is the Macrolide effect on the heart
QT prolongation
27
What is the effect of Chloramphenicol on the bone
BM toxicity leading to reversible or aplastic anemia
28
Gray Baby Syndrome
Chloramphenicol
| Cyanosis due to drug accumulation
29
What can you give for G+ anaerobes like bacteriodes
Cindamycin
30
Alternative Tx of PCP
Clindamycin with Primaquine
31
Can cause C. diff colitis
Clindamycin
32
Which organism is intrinsically resistant to Streptogramins
E. faecalis
33
Can penetrate macrophages and PMNs
Streptogramins
34
Inhibits 3A4
Streptogramins
35
Normally static but cidal against C. perfringes
Linezolid
36
Good for MDR G+, MRSA, VRE
Linezolid
37
Linezolid AE
Reversible myelosupression
Optic and peripheral neuropathy
Lactic acidosis
38
No cross resistance
Linezolid
39
Can give for C. diff after Metro and Vanco
Fidaxomicin
40
Inhibits RNAP
Fidaxomicin
41
100% f orally
Linezolid
42
What can you give to syphilis patients allergic to PCN
Tetracyclins
43
DOC Tetracyclins
Chlamydia, M. pneumoniae
Lyme disease w/o CNS, joints
Rickettsia
Cholera, Anthrax prophylaxis
44
Where is Tetracycline used as a combination therapy
H. pylori
Malaria prophylaxi
Plague, Tularemia, Brucellosis
45
Lipid soluble, IV for STIs and prostatitis
Doxycyclin
46
Reduce meningococcal carrier state
Minocycline
47
Where are Tetracyclines excreted
```
Urine
Except Doxycycline (bile)
```
48
Where to Tetracyclines concentrate
Kidney
Spleen
Skin
Liver
49
Stunting of growth
Tetracyclines
50
Other Tetracycline AE
Photosensitivity
Renal dysfunction
Hepatotoxicity
Dizziness/Vertigo
51
Mechanisms of Tetracycline Resistance
Increase efflux, decrease influx
Interfering with ribosome binding
Enzymatic inactivation
52
Military personnel taking Drug X for malaria prophylaxis and develops photosensitivity
Doxycyxline
53
What can expired Tetracycines cause
Fanconi's Syndrome
| Defective reabsorption in PCT
54
Broad spectrum use against MDR
Tigecycline
55
Given for complicated skin, soft-tissue and intra-abdominal infections
Tigecycline
56
DOC Hepatic encephalopathy
Lactulose
57
Tigecycline elimination
Bile/Fecal
58
Susceptible to Proteus and Pseudomonas efflux pumps
Tigecycline
59
Irreversible 30S inhibition
Aminoglycosides
60
Oral/Topical Aminoglycoside
Neomycin
61
Contraindicated in Myasthenia
Aminoglycosides (NMJ blockade)
62
Why are Aminoglycosides only good for Aerobes
O2 dependent transport into G-
63
Aminoglycoside excretion
Renal
64
Aminoglycoside Resistance mechanisms
Plasmid to modify/inactivate
Decreased accumulation
Altered/deleted receptor on 30S
65
How does Lactulose cause osmotic diarrhea
Acidify gut lumen trapping NH4+
66
Good for URTs
Macrolides
67
Bacteriostatic but cidal at high concentrations
Macrolides
68
What can Macrolides have cross-reactivity with
Clincamycin
| Chloramphenicol
69
Can cause hepatotoxicity, MG exacerbation and visual disturbances
Telithromycin
70
Macrolide with worst oral absorption and f
Erythromycin
71
Macrolide with greatest tissue penetration
Azithroycin
| Telithromycin
72
Additional Macrolide AE
```
GI effects (Inhibit motilin)
Cholestatic hepatitis
```
73
Macrolide Resistance
Decrease influx, Increase efflux
Esterase hydrolyzes
Methylate binding site
74
Actual uses of Chloramphenicol
VRE
| Topical eye infections
75
Inhibits 3A4 and 2C9
Chloramphenicol
76
Chloramphenicol Resistance
Acetyltransferase inactivates
| Altered permeability
77
What organisms can Chloramphenicol act on
```
Rickettsia
Anaerobes
N. meningitidis
H. influenzae
Salmonella
Bacteriodes
```
78
Toxoplasmosis Tx
Clindamycin with Pyrimethamine
79
Endocarditis prophylaxis for PCN allergy
Clindamycin
80
Most G- aerobes and enterococci are intrinsically resistant
Clindamycin
81
Can penetrate abscesses and bone
Clindamycin
82
Clindamycin AE
GI irritation
Skin rash
Neutropenia
Impaired liver
83
What does Clindamycin cross react with
Macrolides
84
Clindamycin resistance
Mutate receptor
| Enzymatic inactivation
85
Actually used to treat MDR and works on G+ cocci
Streptogramins
86
Always given in combination
Quinupristin
| Dalfopristin
87
Long Post-ABx effect
Streptogramins
88
Streptogramin AE
```
Venous irritation
Arthralgia
Myalgia
GI
HA/pain
```
89
Works on most G+ and TB
Linezolid (not actually given for TB)
90
How does Linezolid work
Inhibit formation of 70S by binding 23S of 50S
91
Weak reversible inhibitor of MAO
Linezolid
92
Linezolid Resistance
Decreased binding
93
Especially works on Clostridia
Fidaxomicin
94
Almost no systemic absorption so Oral
Fidaxomicin
95
May not be safe/effective <18
Fidaxomicin
96
Prevent C. diff recurrence
Fidaxomicin
