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Pharmacology > L26: Tetracylclines/Macrolides - condensed > Flashcards

L26: Tetracylclines/Macrolides - condensed Flashcards

1
Q

Which class of drug does Erythromycin, Clarithromycin, and Azithromycin belong to?
A. Ketolides
B. Glycylcyclines
C. Tetracyclines
D. Macrolides

A

D. Macrolides

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2
Q

Which part of the bacterial 70S subunit is targeted by tetracyclines and aminoglycosides?
A. 50S
B. 30S

A

B. 30S

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3
Q

Which part of the bacterial 70S subunit is targeted by clindamycin and macrolides?
A. 50S
B. 30S

A

A. 50S

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4
Q

True or False: Tetracylines are considered to be bacteriocidal

A

False - bacteriostatic

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5
Q

True or False: Tetracylines enter bacteria via: passive diffusion and active transport, then reversibly bind 30S to block binding of next aminoacyl-tRNA to ribosome

A

True

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6
Q

Two main clinical uses of Tetracycline?
A. MRSA
B. Acne/Chlamydial Infections

A

B. Acne/Chlamydial Infections

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7
Q

Why are tetracyclines often not a drug of choice for gram (+) aerobic infections?

A

Resistance w/staph, strep, and pneumococci

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8
Q

Which gram (-) bacteria is resistant to tetracycline? anaerobe?

A

gram (-): Psuedomonas
anaerobe: B. fragilis

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9
Q

True or False: Tetracyclines can be used for periodontal disease (as in minocycline microspheres)

A

True

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10
Q

Which two conditions are primarily treated with Doxy?

A
  1. MRSA
  2. Chlamydia
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11
Q

True or False: Tetracyclines have limited use, since large number of bacterial strains are resistant

A

True

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12
Q

Proteus and Pseudomonas are resistant to…
A. Tetracycline
B. Tigecycline
C. Doxycycline

A

B. Tigecycline

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13
Q

True or False: Tetracyclines are time and concentration dependent killing

A

True

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14
Q

True or False: Tetracyclines do not cross placental barrier

A

False - they do

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15
Q

How are doxy and tigecycline excreted?

A

Non-renal mechanisms

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16
Q

3 AE’s associated with tetracyclines?

A

1) Nausea, vomiting
- can dose with food, but not dairy
2) Superinfections (C.dif)
3) Discoloration and enamel dysplasia

17
Q

True or False: Macrolides are associated with skin sensitivity to sun

A

False - tetracyclines

18
Q

Nephrotoxicity (Fanconi syndrome) can result from use of degraded ______
A. tetracyclines
B. macrolides
C. glycyclines

A

A. tetracyclines

19
Q

What are two reasons why drug resistance occurs in Tetracyclines?

A

1) Impaired drug influx or increased efflux via transporters
2) Expression of proteins that interfere w binding to 30S subunit

20
Q

Why is tigecycline effective for tetracycline resistant strains?

A

Efflux drug pumps are not effective in that case

21
Q

In gram (-) bacteria, older tetracyclines may be pumped out by ____ pump

In Staphylococci, tetracycline can be pumped out by the ____ efflux pump

In gram (+) bacteria, _____ protein causes the tetracyclines to “let go” of ribosome

A

Tet(AE) pump

Tet(K) efflux pump

Tet(M) ribosomal protection protein

22
Q

True or False: Chromosomal efflux pumps in Proteus and Pseudomonas a. can pump out all tetracyclines, even tigecycline

A

True

23
Q

True or False: Like tetracyclines, macrolides are bacteriostatic. However, unlike tetracyclines, they reversibly bind to the 50S ribosomal subunit

A

True

24
Q

True or False: Macrolides inhibit transcription step and use time-independent killing

A

False - translocation step; time-dependent

25
Q

____, the prototypical macrolide, acts against S. aureus to treat diptheria, pneumonia, and chlamydial infections.
A. Erythromycin
B. Clarithromycin
C. Azithromycin

A

A. Erythromycin

26
Q

True or False: Azithromycin is an alternative for penicillin-allergic patients for Streptococci and Staphylococci infections

A

False - Erythromycin

27
Q

Which macrolide has activity against Toxoplasma and M. leprae?
A. Erythromycin
B. Clarithromycin
C. Azithromycin

A

B. Clarithromycin

28
Q

True or False: Clarithromycin has better activity against H. influenzae than erythromycin does

A

True

29
Q

____, a 15 membered ring and macrolide, can treat urethritis and cervicitis due to N. gonorrhoeae and Chlyamydia

A

Azithromycin

30
Q

Uses of Azithromycin?

A

1) OM
2) Pharyngitis
3) COPD exacerbations
4) Community acquired pneumonia - H. influenze, Legionella

31
Q

Which macrolide is less active than other gram (+) or (-) staph/strep, but more active for H. Influenzae?

A

Azithromycin

32
Q

Which macrolide is given as enteric coated oral capsule, since stomach acid destroys free base + food interferes with absorption?

A

Erythromycin

33
Q

True or False: Azithromycin is taken up in the CNS

A

false - is not

34
Q

Which two macrolides inhibit P450?

A

Erythromycin + Clarithromycin

35
Q

True or False: Diarrhea is an AE associated with Erythromycin

A

True

36
Q

True or False: Prolonged QT intervals, hepatitis, and C. dif superinfections are AE associated with tetracyclines

A

False - macrolides

37
Q

Drug resistance can occur in ___ because there is modified ribosome drug binding site via: chromosomal mutation or ribosome methylation (ermA, B, etc.)
A. tetracyclines
B. macrolids

A

B. macrolides

38
Q

Mutations in ermA, B confer resistance to MLS-Type B, which means….

A

M: Macrolides
L: Lincosamides
D: Streptogramins

39
Q

_____ inhibit 30S ribosomal subunit. Diminishing use due to resistance, though dox still good for chlamydia and tigecycline may help overcome resistance.

______ inhibit 50S ribosomal subunit. Three drugs differ primarily in toxicities and 1/2 life. Resistance is an issue.

A

Tetracyclines

Macrolides

Pharmacology (53 decks)

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