lecture 2- protein synthesis inhibitors Flashcards
mechanism of action for protein synthesis inhibitors
block protein synthesis from occurring –> inhibit bacteria from propagating
-Bacteriastatic
Protein synthesis inhibitors
macrolides clindamycin choramphenicol streptogrammins amminoglycosides tetracyclines
what do macrolides cover (light stop sign)
gram pos, gram neg, not anaerobes
can protein synthesis inhibitors inhibit human ribosomes too?
only if its high enough trough there is cross selectivity
what group of abx covers atypical bacteria like legionella sp, mycoplasma pneumonia, chlamydophilia pneumonia, chlamydia trachomatis
macrolides
whats a good treatment for mycobacterium avium complex and what is MAC?
macrolides treat it
– opportunistic infxn like HIV can aquire this infxn
what does h pylori and NSAIDs cause and how can it be treated
peptic ulcers; treated by macrolides
what stimulates motolin receptors and what does it cause
macrolides; causing stomach cramps, motility aka diarrhea
adverse effects of macrolides how?
cramps, diarrhea, n/v, bc of motolin receptors in GI tract
- transient hearing loss
- renal insufficiency
- qt prolongation
treatment for QT prolongation/torsades
magnesium sulfate
how can torsades be caused
with mutltiple medications given like macrolides or history of qt prolong
what do macrolides inhibit?
CYP3A4
How does macrolides have an effect on other drugs that increase their levels?
cyp3a4 inhibition— drugs are metobalozied through here so levels of drugs increase bc enzyme is being inhibited
which ACE is stronger in affecting cyp3a4
ECA
main coverage for tetracycline
broad spectrum
- atypicals
- animal born illnesses (Yersinia Pestists plague)
- MRSA
what is tetracycline given to treat
acne* and atypical pneumonia
what medication can you not take with a glass of milk and why
tetracycline because it chelates with cations
what medication causes discoloration in teeth
tetracycline probably because it binds to the calcium
which medication side effect is photosensitivity
tetracycline, use sunscreen
what should be monitored for tetracycline
renal adjustment
what is a medication that can be given to a critically ill patients with resistant bacteria such as E.coli, Entercocci, or MRSA and is bacteriostatic
glycylcycline- tigecycline
what is a cousin to tetracycline and used more for critically ill pts
glycylcycline- tigecycline TYGA
what does aminoglycosides cover against
(gram neg) pseudomonas and has enterococcal synergy
aminoglycosides are ___ dependent killers. Monitor ____ index to make sure they are not ___ to develop toxicity.
Compare to vancomycin
vanco is time dependent and have to therapeutic drug monitor too but to make sure it’s efficacious enough >MIC levels
aminoglycosides like gentamicin causes toxicity where
ototoxicity and renal
oxazolinodine –> linezolid (zyvox) is like vancomycin except
both cover MRSA MDR
what is serotonin syndrome and where do you see it
taking medications such as linezolid (zyvox)
block the metabolism of serotonin so increase in levels
tyramine foods like lobster can cause
precursor to serotonin syndrome
what drug depolarizes causing inhibition of DNA RNA and protein synthesis (bacteriacidal)
daptomycin
which drug is covers VRE but does not cover pneumonias
Daptomycin
pt with VRSE pneumonia treatment
- daptomycin
- vancomycin
- linezolid (zyvox)
- gentamicin
linezolid
- not dapto bc it cant cover pneumonia
- not vanco bc VR is vanco resistant
- not genta bc thats gram neg only covering against pseudomonas
what drugs inhibit the bacterial DNA gyrase (topoisomerase II and IV)
FQ
FQ and macrolides are similar in that they both can cause
QT prolongation
tetracycline and FQ are similar in that they both
have food interactions like with iron and calcium inhibiting absorption of drug
what medication can put 14 yo pt at risk for tendonitits/achilles rupture
FQ
what medication is the worst culprit when it comes to causing C. diff or diarrhea and what does can it lead to?
Clindamycin which can further lead to pseudonomembraneous colitis
