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Pharm Midterm 2 > Inhibitors of Protein Synthesis > Flashcards

Inhibitors of Protein Synthesis Flashcards

1
Q

What are the Tetracyclines

A

Doxycycline
Minocycline
Tetracycline

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2
Q

What is the Glycylcycline

A

Tigecycline

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3
Q

What are the Aminoglycosides

A 
Gentamycin
Neomycin
Amikacin
Tobramycin
Streptomycin
Netilmicin
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4
Q

What are the Macrolides

A

Erythromycin
Clarithromycin
Azithromycin
Telithromycin

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5
Q

What are the Misc Protein Synthesis Inhibitors

A

Chloramphenicol
Clindamycin
Linezolid
Fidaxomicin

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6
Q

What are the Streptogramins

A

Quinupristin

Dafopristin

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7
Q

Which bind 30S

A

Aminogycosides
Tetracyclines
Glycylcyclines

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8
Q

Which inhibit 50S

A 
Chloramphenicol
Clindamycin
Macrolides
Linezolid
Streptogramins
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9
Q

Most common treatment of severe acne and rosacea

A

Tetracyclines

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10
Q

Don’t take with milk/antacids

A

Tetracyclines

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11
Q

Teratogenic

A

Tetracyclines (D)
Tigecycline
Aminoglycosides (D)

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12
Q

Discoloration and hyperplasia of teeth

A

Tetracyclins

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13
Q

Main AE is photosensitivity

A

Tetracyclins

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14
Q

Last resort for MDR b/c increased risk of mortality

A

Tigecycline

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15
Q

DOC empiric Tx infective endocarditis

A

Gentamycin

with Vanco or PCN

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16
Q

DOC plague

A

Streptomycin

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17
Q

Adjunct for hepatic encephalopathy

A

Oral Neomycin

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18
Q

Action of Oral Neomycin in hepatic encephalopathy

A

Reduce NH3 formation by gut bacteria

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19
Q

Only useful against aerobes

A

Aminogycosides

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20
Q

Main Aminoglycoside AE

A

Nephrotoxicity (ATN)

Ototoxicity

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21
Q

Good choice for Pts with PCN allergy

A

Macrolides

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22
Q

Empiric Tx community acuired PNA and pseudomonas

A

Macrolides

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23
Q

DOC pertussis

A

Erythromycin

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24
Q

What is contraindicated to give with Macrolides

A

Statins

Due to P450 inhibition

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25
Q

Which Macrolide doesn’t inhibit P450

A

Azithromycin

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26
Q

What is the Macrolide effect on the heart

A

QT prolongation

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27
Q

What is the effect of Chloramphenicol on the bone

A

BM toxicity leading to reversible or aplastic anemia

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28
Q

Gray Baby Syndrome

A

Chloramphenicol

Cyanosis due to drug accumulation

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29
Q

What can you give for G+ anaerobes like bacteriodes

A

Cindamycin

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30
Q

Alternative Tx of PCP

A

Clindamycin with Primaquine

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31
Q

Can cause C. diff colitis

A

Clindamycin

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32
Q

Which organism is intrinsically resistant to Streptogramins

A

E. faecalis

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33
Q

Can penetrate macrophages and PMNs

A

Streptogramins

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34
Q

Inhibits 3A4

A

Streptogramins

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35
Q

Normally static but cidal against C. perfringes

A

Linezolid

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36
Q

Good for MDR G+, MRSA, VRE

A

Linezolid

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37
Q

Linezolid AE

A

Reversible myelosupression
Optic and peripheral neuropathy
Lactic acidosis

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38
Q

No cross resistance

A

Linezolid

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39
Q

Can give for C. diff after Metro and Vanco

A

Fidaxomicin

40
Q

Inhibits RNAP

A

Fidaxomicin

41
Q

100% f orally

A

Linezolid

42
Q

What can you give to syphilis patients allergic to PCN

A

Tetracyclins

43
Q

DOC Tetracyclins

A

Chlamydia, M. pneumoniae
Lyme disease w/o CNS, joints
Rickettsia
Cholera, Anthrax prophylaxis

44
Q

Where is Tetracycline used as a combination therapy

A

H. pylori
Malaria prophylaxi
Plague, Tularemia, Brucellosis

45
Q

Lipid soluble, IV for STIs and prostatitis

A

Doxycyclin

46
Q

Reduce meningococcal carrier state

A

Minocycline

47
Q

Where are Tetracyclines excreted

A 
Urine
Except Doxycycline (bile)
48
Q

Where to Tetracyclines concentrate

A

Kidney
Spleen
Skin
Liver

49
Q

Stunting of growth

A

Tetracyclines

50
Q

Other Tetracycline AE

A

Photosensitivity
Renal dysfunction
Hepatotoxicity
Dizziness/Vertigo

51
Q

Mechanisms of Tetracycline Resistance

A

Increase efflux, decrease influx
Interfering with ribosome binding
Enzymatic inactivation

52
Q

Military personnel taking Drug X for malaria prophylaxis and develops photosensitivity

A

Doxycyxline

53
Q

What can expired Tetracycines cause

A

Fanconi’s Syndrome

Defective reabsorption in PCT

54
Q

Broad spectrum use against MDR

A

Tigecycline

55
Q

Given for complicated skin, soft-tissue and intra-abdominal infections

A

Tigecycline

56
Q

DOC Hepatic encephalopathy

A

Lactulose

57
Q

Tigecycline elimination

A

Bile/Fecal

58
Q

Susceptible to Proteus and Pseudomonas efflux pumps

A

Tigecycline

59
Q

Irreversible 30S inhibition

A

Aminoglycosides

60
Q

Oral/Topical Aminoglycoside

A

Neomycin

61
Q

Contraindicated in Myasthenia

A

Aminoglycosides (NMJ blockade)

62
Q

Why are Aminoglycosides only good for Aerobes

A

O2 dependent transport into G-

63
Q

Aminoglycoside excretion

A

Renal

64
Q

Aminoglycoside Resistance mechanisms

A

Plasmid to modify/inactivate
Decreased accumulation
Altered/deleted receptor on 30S

65
Q

How does Lactulose cause osmotic diarrhea

A

Acidify gut lumen trapping NH4+

66
Q

Good for URTs

A

Macrolides

67
Q

Bacteriostatic but cidal at high concentrations

A

Macrolides

68
Q

What can Macrolides have cross-reactivity with

A

Clincamycin

Chloramphenicol

69
Q

Can cause hepatotoxicity, MG exacerbation and visual disturbances

A

Telithromycin

70
Q

Macrolide with worst oral absorption and f

A

Erythromycin

71
Q

Macrolide with greatest tissue penetration

A

Azithroycin

Telithromycin

72
Q

Additional Macrolide AE

A 
GI effects (Inhibit motilin)
Cholestatic hepatitis
73
Q

Macrolide Resistance

A

Decrease influx, Increase efflux
Esterase hydrolyzes
Methylate binding site

74
Q

Actual uses of Chloramphenicol

A

VRE

Topical eye infections

75
Q

Inhibits 3A4 and 2C9

A

Chloramphenicol

76
Q

Chloramphenicol Resistance

A

Acetyltransferase inactivates

Altered permeability

77
Q

What organisms can Chloramphenicol act on

A 
Rickettsia
Anaerobes
N. meningitidis
H. influenzae
Salmonella
Bacteriodes
78
Q

Toxoplasmosis Tx

A

Clindamycin with Pyrimethamine

79
Q

Endocarditis prophylaxis for PCN allergy

A

Clindamycin

80
Q

Most G- aerobes and enterococci are intrinsically resistant

A

Clindamycin

81
Q

Can penetrate abscesses and bone

A

Clindamycin

82
Q

Clindamycin AE

A

GI irritation
Skin rash
Neutropenia
Impaired liver

83
Q

What does Clindamycin cross react with

A

Macrolides

84
Q

Clindamycin resistance

A

Mutate receptor

Enzymatic inactivation

85
Q

Actually used to treat MDR and works on G+ cocci

A

Streptogramins

86
Q

Always given in combination

A

Quinupristin

Dalfopristin

87
Q

Long Post-ABx effect

A

Streptogramins

88
Q

Streptogramin AE

A 
Venous irritation
Arthralgia
Myalgia
GI
HA/pain
89
Q

Works on most G+ and TB

A

Linezolid (not actually given for TB)

90
Q

How does Linezolid work

A

Inhibit formation of 70S by binding 23S of 50S

91
Q

Weak reversible inhibitor of MAO

A

Linezolid

92
Q

Linezolid Resistance

A

Decreased binding

93
Q

Especially works on Clostridia

A

Fidaxomicin

94
Q

Almost no systemic absorption so Oral

A

Fidaxomicin

95
Q

May not be safe/effective <18

A

Fidaxomicin

96
Q

Prevent C. diff recurrence

A

Fidaxomicin

Pharm Midterm 2 (52 decks)

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