lecture 2- protein synthesis inhibitors

Question 1

mechanism of action for protein synthesis inhibitors

Answer 1

block protein synthesis from occurring –> inhibit bacteria from propagating
-Bacteriastatic

Question 2

Protein synthesis inhibitors

Answer 2

macrolides
clindamycin
choramphenicol
streptogrammins
amminoglycosides
tetracyclines

Question 3

what do macrolides cover (light stop sign)

Answer 3

gram pos, gram neg, not anaerobes

Question 4

can protein synthesis inhibitors inhibit human ribosomes too?

Answer 4

only if its high enough trough there is cross selectivity

Question 5

what group of abx covers atypical bacteria like legionella sp, mycoplasma pneumonia, chlamydophilia pneumonia, chlamydia trachomatis

Answer 5

macrolides

Question 6

whats a good treatment for mycobacterium avium complex and what is MAC?

Answer 6

macrolides treat it

– opportunistic infxn like HIV can aquire this infxn

Question 7

what does h pylori and NSAIDs cause and how can it be treated

Answer 7

peptic ulcers; treated by macrolides

Question 8

what stimulates motolin receptors and what does it cause

Answer 8

macrolides; causing stomach cramps, motility aka diarrhea

Question 9

adverse effects of macrolides how?

Answer 9

cramps, diarrhea, n/v, bc of motolin receptors in GI tract

• transient hearing loss
• renal insufficiency
• qt prolongation

Question 10

treatment for QT prolongation/torsades

Answer 10

magnesium sulfate

Question 11

how can torsades be caused

Answer 11

with mutltiple medications given like macrolides or history of qt prolong

Question 12

what do macrolides inhibit?

Answer 12

CYP3A4

Question 13

How does macrolides have an effect on other drugs that increase their levels?

Answer 13

cyp3a4 inhibition— drugs are metobalozied through here so levels of drugs increase bc enzyme is being inhibited

Question 14

which ACE is stronger in affecting cyp3a4

Answer 14

ECA

Question 15

main coverage for tetracycline

Answer 15

broad spectrum

• atypicals
• animal born illnesses (Yersinia Pestists plague)
• MRSA

Question 16

what is tetracycline given to treat

Answer 16

acne* and atypical pneumonia

Question 17

what medication can you not take with a glass of milk and why

Answer 17

tetracycline because it chelates with cations

Question 18

what medication causes discoloration in teeth

Answer 18

tetracycline probably because it binds to the calcium

Question 19

which medication side effect is photosensitivity

Answer 19

tetracycline, use sunscreen

Question 20

what should be monitored for tetracycline

Answer 20

renal adjustment

Question 21

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

Answer 21

glycylcycline- tigecycline

Question 22

what is a cousin to tetracycline and used more for critically ill pts

Answer 22

glycylcycline- tigecycline TYGA

Question 23

what does aminoglycosides cover against

Answer 23

(gram neg) pseudomonas and has enterococcal synergy

Question 24

aminoglycosides are ___ dependent killers. Monitor ____ index to make sure they are not ___ to develop toxicity.
Compare to vancomycin

Answer 24

vanco is time dependent and have to therapeutic drug monitor too but to make sure it’s efficacious enough >MIC levels

Question 25

aminoglycosides like gentamicin causes toxicity where

Answer 25

ototoxicity and renal

Question 26

oxazolinodine --> linezolid (zyvox) is like vancomycin except

Answer 26

oxazolinodine is a backup because it covers for VRE so like to hold back --- both cover MRSA MDR

Question 27

what is serotonin syndrome and where do you see it

Answer 27

taking medications such as linezolid (zyvox) | block the metabolism of serotonin so increase in levels

Question 28

tyramine foods like lobster can cause

Answer 28

precursor to serotonin syndrome

Question 29

what drug depolarizes causing inhibition of DNA RNA and protein synthesis (bacteriacidal)

Answer 29

daptomycin

Question 30

which drug is covers VRE but does not cover pneumonias

Answer 30

Daptomycin

Question 31

pt with VRSE pneumonia treatment - daptomycin - vancomycin - linezolid (zyvox) - gentamicin

Answer 31

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

Question 32

what drugs inhibit the bacterial DNA gyrase (topoisomerase II and IV)

Answer 32

FQ

Question 33

FQ and macrolides are similar in that they both can cause

Answer 33

QT prolongation

Question 34

tetracycline and FQ are similar in that they both

Answer 34

have food interactions like with iron and calcium inhibiting absorption of drug

Question 35

what medication can put 14 yo pt at risk for tendonitits/achilles rupture

Answer 35

FQ

Question 36

what medication is the worst culprit when it comes to causing C. diff or diarrhea and what does can it lead to?

Answer 36

Clindamycin which can further lead to pseudonomembraneous colitis