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Micro Pharm Flashcards

0
Q

What is MOA of bacitracin and vancomycin

A

Block peptidoglycan synthesis

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1
Q

What is MOA of penicillins, cephalosporins, aztreonam and imipenem?

A

Block cell wall synthesis by inhibiting crossing linking of peptidoglycan (binding transpeptidases)

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2
Q

What is MOA of sulfonamides/trimethoprim?

A

Block nucleotide synthesis by inhibiting folic acid synthesis

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3
Q

What is th MOA of fluoroquinolnes?

A

Block DNA topoisomerases

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4
Q

What is the MOA of rifampin?

A

Blocks mRNA synthesis

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5
Q

What is th MOA of metronidazole?

A

Damages DNA

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6
Q

What is the MOA of chloramphenicol , macrolides, clindamycin, streptogramins, linezolid?

A

Inhibits protein synthesis at 50S subunit

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7
Q

What is the MOA of amino glycosides and tetracyclines?

A

Block protein synthesis at 30S ribosomal unit

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8
Q

What is the MOA of penicillin?

A

Bind penicillin binding proteins, transpeptidases, and inhibits cross-linking of the peptidoglycan wall
Activates autolytic enzymes

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9
Q

What is the penicillin used for?

A

Gram positive orgs: s. pneumo, s.pyogenes, actinomyces

Neisseria meningitidis, syphilis

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10
Q

Is penicillin bacteriacidal or bacteriostatic?

A

Cidal

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11
Q

What are the side effects of penicillin?

A

Hypersensitivity reactions

Hemolytic anemia

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12
Q

What is the mechanism of resistance to penicillin?

A

Production of B-lactamases

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13
Q

What are the penicillinase-resistant penicillins?

A

Oxacillin, nafcillin, dicloxacillin

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14
Q

What organism are the penicillinase-resistant penicillins used for?

A

S. aureus

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15
Q

What are the side effects of oxacillin, dicloxacillin, nafcillin?

A

Hypersensitivity

Interstitial nephritis

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16
Q

What are the amino penicillins?

A

Ampicillin

Amoxicillin

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17
Q

What are the uses for amino penicillins?

A

Broader spectrum: H. Flu, Listeria, Proteus, E. coli, Salmonella, Shigella, enterococcus

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18
Q

What is the mneumonic for the amino penicillins?

A 
HELPSS:
H.flu
E.coli
Listeria
Proteus
Salmonella
Shigella
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19
Q

What are the side effects of amino penicillins?

A

Hypersensitivity
Rash
Pseudo membranous colitis

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20
Q

What is the mech of resistance to amino penicillins?

A

Production of beta lactamases

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21
Q

What is in amoxicillin?

A

Clavulanic acid - prevents from beta-lactamases

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22
Q

What are the anti pseudomonal penicillins?

A

Ticarcillim, piperacillin

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23
Q

What are the anti pseudomonals used for?

A

Pseudomonas

Gram negative rods

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24
Q

What is the side effect of anti-pseudomonals?

A

Hypersensitivity

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25
Q

What are the B-lactamase inhibitors?

A

CAST:
Clavulanic Acid
Sulfabtam
Tazobactam

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26
Q

Why can’t you use penicillinase-resistant penicillins against MRSA?

A

MRSA is resistant because it has an altered penicillin-binding site

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27
Q

What are the organisms that are not covered by cephalosporins?

A 
LAME:
Listeria
Atypicals: chlamydia, mycoplasma
MRSA
Enterococci
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28
Q

Which cephalosporin can be used for MRSA ?

A

Ceftaroline

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29
Q

What is the advantage of cephalosporin over penicillin?

A

Less susceptible to b-lactamase

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30
Q

Are cephalosporins bacteriostatic or cidal?

A

Cidal

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31
Q

What are the first generation cephalosporins?

A

Cefazolin

Cephalexin

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32
Q

What are the first generation cephalosporins used for?

A

Gram positives
Proteus
E. coli
Klebsiella

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33
Q

What is cefazolin used for?

A

Used prior to surgery to prevent staph wound infections

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34
Q

What are the second generation cephs?

A

Cefoxitin
Cefaclor
Cefuroxime

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35
Q

What are the second generation cephs used for?

A 
Gram positive cocci
HEN PEKS:
H. Flu
Enterobacter
Neisseria
Proteus
E.coli
Klebsiella
Serratia
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36
Q

What are the third generation cephalosporins?

A

Ceftriaxone
Cefoxatime
Ceftazidime

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37
Q

What are the third gen cephs used for?

A

Serious gram negatives that are resistant to other beta-lactams
Neisseria
Pseudomonas

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38
Q

What is the 4th gen ceph?

A

Cefepime

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39
Q

What is the 4th gene ceph used for?

A

Pseudomonas and gram positives.

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40
Q

What is the mech of resistance of cephalosporins?

A

Change in protein structure of the penicillin binding sites

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41
Q

What are the side effects of cephalosporins?

A

Hypersensitivity

Vit K def

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42
Q

What is the MOA for aztreonam?

A

Prevents peptidoglycan cross-linking by binding to PBP3

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43
Q

What is aztreonam used for?

A

Only gram negative rods

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44
Q

When is aztreonam used?

A

When a patient is allergic to penicillin

When a patient has renal insufficiency and can’t tolerate amino glycosides

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45
Q

What are the side effects of aztreonam?

A

Well tolerated - occasional GI upset

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46
Q

What is imipenem?

A

Broad spectrum, b-lactamase resistant carbapenem - inhibits cell wall synthesis

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47
Q

What is imipenem inactivated by?

A

Dihydropeptidases in the renal tubules

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48
Q

What is cilastatin?

A

Inhibits dihydropeptidases in renal tubules

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49
Q

What is imipenem the DOC for?

A

Enterobacter

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50
Q

What are the other clinical uses of imipenem?

A

Gram positive cocci
Gram negative rods
Anaerobes

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51
Q

What is the advantage or meropenem?

A

Reduced risk of seizures

Stables in dihydropeptidases

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52
Q

What are the side effects of imipenem?

A

GI
Skin rash
CNS tox - seizures

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53
Q

When is imipenem used and why?

A

In life threatening situations when nothing else has worked because of its side effects

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54
Q

What is the MOA of vancomycin?

A

Inhibits bac wall synthesis by binding to the d-ALA, d-ALA portion of the cell wall precursors

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55
Q

Is vancomycin bacteriocidal or bacteriostatic?

A

Cidal

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56
Q

What is vancomycin used for?

A

Gram positive only: serious multi-drug resistant orgs:
MRSA
enterococcus
C. Difficile

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57
Q

What are the side effects of vanc?

A

Nephrotoxicity
Ototoxicity
Thrombophlebitis
Red man syndrome - prevented with antihistamines and slow infusion rate

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58
Q

What is the mech of resistance to vanc?

A

Change of D-ALA D-ALA to D-ALA D-LAC

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59
Q

What are the amino glycosides?

A 
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
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60
Q

Are aminoglycosides bacteriocidal or bacteriostatic?

A

Cidal

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61
Q

What’s the MOA of aminoglycosides?

A

Inhibit formation of the initiation complex causing misreading of mRNA
Block translocation

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62
Q

What is required for aminoglycoside uptake?

A

O2

So not effective against anaerobes

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63
Q

What are aminoglycosides used for?

A

Severe gram negative rod infections:
Chronic UTI
P. aeroginosa
Enterococcus endocarditis

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64
Q

What aminoglycoside is used for bowel surgery?

A

Neomycin

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65
Q

What drugs are aminoglycosides synergistic with

A

B-lactams

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66
Q

What is the toxicity of aminoglycosides?

A

Nephrotoxicity
Ototoxicity
Teratogenicity
Neuromuscular blockade

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67
Q

What is the mech of resistance?

A

Plasmid dependent - carries enzymes that inactivate the aminoglycosides by acetylation, phosphorylation, adenylation

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68
Q

Are tetracyclines bacteriocidal or static?

A

Static

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69
Q

What is the MOA of tetracyclines?

A

Bind to 30s and prevent attachment of aminoacyl-tRNA - inhibits addition of amino acids to growing chains

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70
Q

What are tetracyclines used for?

A

Borrelia
Mycobacterium
Rickettsia
Chlamydia

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71
Q

What are the side effects of TC?

A 
GI 
Discoloration of teeth
Inhibition of bone growth
Photosensitivity
Teratogenicity
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72
Q

What is the mech of resistance against a TC?

A

Decreased uptake

Or increased efflux by plasmid-encoded transport pumps

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73
Q

What is the MOA of macrolides?

A

Inhibits protein synthesis by blocking translocations

Bind to 23S rRNA and 50S ribsosomal subunit

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74
Q

What are the macrolides?

A

Azithromycin
Clarithromycin
Erythromycin

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75
Q

Are macrolides cidal or static?

A

Static

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76
Q

What are the uses of macrolides?

A

Atypical pneumonia
Chlamydia
Gram positive cocci

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77
Q

What are the side effects of macrolides?

A 
Motility issues
Arrhythmia - prolonged QT
Acute cholestatic hepatitis
Rash
Eosinophilia
Increased conc. of theophylline, anticoagulants
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78
Q

What is the mech of resistance to a macrolides?

A

Methylation of 23S rRNA binding site

Transmembranous efflux pumps

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79
Q

What is the MOA of chloramphenicol?

A

Blocks peptidyltransferase at 50S ribosomal subunit

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80
Q

Is chloramphenicol bacteriocidal or static?

A

Static

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81
Q

What is chloramphenicol used for?

A

Meningitis

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82
Q

What are the side effects of chloramphenicol?

A

Anemia
Aplastic anemia
Gray baby syndrome

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83
Q

Why do babies get gray baby syndrome?

A

Because they lack UDP-glucuronyl transferase

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84
Q

What is the mech of resistance of chloramphenicol?

A

Plasmid-encoded acetyl transferase that inactivates it

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85
Q

What is the MOA of clindamycin?

A

Blocks peptide transfer at 50S subunit

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86
Q

Is clindamycin bacteriocidal or static?

A

Static

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87
Q

What is clindamycin used for?

A

Anaerobic infections:
B. gracilis in abscesses
C. Perfringens
Treats anaerobics ABOVE the diaphragm

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88
Q

What is the toxicity of clindamycin?

A

Fever, diarrhea, pseudo membranous colitis

89
Q

What is the MOA of sulfonamides?

A

Inhibit dihydroteroate reductase

90
Q

Are sulfonamides cidal or static?

A

Static

91
Q

What are sulfonamides used for?

A

Gram pos
Gram neg
Chlamydia
Nocardia

92
Q

What are the side effects of sulfonamides?

A 
Hypersensitivity
Hemolysis in g6PD def
Nephrotoxicity 
Photosensitivity
Kernicterus
Displaces drugs from albumin - warfarin
93
Q

What is the mech of resistance of sulfonamides?

A

Altered dihydropteroate synthase
Decreased uptake
Increased PABA

94
Q

What is the MOA of trimethoprim?

A

Inhibits dihydrofolate reductase

95
Q

What is the MOA of TMP-SMX?

A

Blockade of folic acid synthesis

96
Q

What is TMP-SMX used for?

A

UTIs

Pneumocystis

97
Q

What are the side effects of TMP?

A

Megaloblastic anemia
Leukopenia
Granulocytopenia

98
Q

What is the MOA of fluoroquinolones?

A

Blocks DNA gyrase (topo II) and topo IV

99
Q

Are quinolones cidal or static?

A

Cidal

100
Q

What are quinolones used for?

A

Gram neg rods of GU and GI tract

Some gram positives

101
Q

What are the toxicities of fluoroquinolones?

A 
GI
Dizziness
Super infections (c. Difficile)
Headache
Skin rash
Tendinitis
Tendon rupture
Cartilage damage (teratogen)
Prolonged QT
102
Q

What is the mech of resistance to fluoroquinolones?

A

Mutation in DNA gyrase
Plasmid resistance
Efflux pumps

103
Q

What decreases the absorption of fluoroquinolones

A

Antacids

104
Q

What decreases the absorption of TCs?

A

Milk, antacids, iron containing preps

Divalent cations

105
Q

What is the MOA of metronidazole?

A

Forms free radical toxic metabolites that damage the bac cell DNA

106
Q

Is metro cidal or static?

A

Cidal and antiprotozoal

107
Q

What is metro used for?

A 
GET GAP
Giardia
Entamoeba 
Trichomonas 
Gardnerella
Anaerobes (below diaphragm)
H. Pylori
108
Q

What is the tox?

A

Disulfiram like reaction with alcohol
Headache
Metallic taste

109
Q

What is the tx for mycobacterium TB?

A 
RIPE
Rifampin 
Isoniazid
Pyrazinamide
Ethambutol
110
Q

What is the prophylaxis for mycobacterium TB?

A

Isoniazid

111
Q

What is the prophylaxis for M. Avium-intracellulare?

A

Azithromycin

112
Q

What is the tx for m.avium TB?

A 
EARS:
Ethambutol
Azithromycin
Rifampin
Streptomycin
113
Q

What is the tx for M. Leprae?

A

Long- term tx with dapsone and rifampin for tuberculoid form

Dapsone+rifampin+clofazimine for lepromatous form

114
Q

What is the MOA of isoniazid?

A

Decreases synthesis of mycolic acid

115
Q

What is needed for isoniazid to be converted to active metabolite?

A

Bacterial catalase peroxidase

116
Q

What is the toxicity of isoniazid?

A

Neurotoxicity

Hepatotoxicity

117
Q

What can be used for prevent neurotoxicity caused by isoniazid?

A

Vit b6

118
Q

What is the MOA of rifampin?

A

Inhibits DNA-dependent RNA pol

119
Q

What is rifampin used for?

A

Prophylaxis for meningococcal meningitis
Chemoprophylaxis in children exposed to H. Flu type B
Delays resistance to dapsone
M. TB

120
Q

What are the side effects?

A

Red/orange body fluids
Minor hepatotoxicity
Induces P450
Rapid resistance if used alone

121
Q

What is the MOA of pyrazinamide?

A

Acidify intracellular environment via conversion to pyrazinoic acid,

122
Q

What are the side effects of pyrazinamide?

A

Hyperuricemia

Hepatotoxicity

123
Q

What is the MOA of ethambutol?

A

Decreased carb polymerization of mycobacterium cell wall by blocking arabinosyltransferase

124
Q

What is the side effect of ethambutol?

A

Optic neuropathy - red/green color blindness

125
Q

What do you use to treat VRE?

A

Linezolid and streptogramins

126
Q

What is the MOA of amphotericin B and nystatin?

A

Binds ergosterol and forms pores in the membrane

127
Q

What are the side effects of amphotericin B?

A 
Fever
Chills
Hypotension
Nephrotoxicity 
Arrythmia anemia
IV phlebitis
128
Q

What are the uses of amphotericin B?

A

Cryptococcal meningitis

Systemic fungal infections: histo, blasts, coccidiosis. Candida

129
Q

What needs to be supplemented when giving amphotericin B?

A

K and Mg because of altered renal tubule permeability

130
Q

What are the uses of nystatin?

A

Only topical
Swish and swallow for oral thrush
Topical for diaper rash, vaginal candidiasis

131
Q

What is MOA of Azoles?

A

Inhibit P450 enzymes - no ergosterol synthesis

132
Q

What are Azoles used for?

A

Local less serious systemic mycoses

133
Q

What is fluconazole used for?

A

Chronic suppression of cryptococcal meningitis in AIDS

Candidiasis infection

134
Q

What is intraconazole used for?

A

Blasto
Histo
Coccidiosis

135
Q

What is clotrimazole and miconazole used for?

A

Topical fungal infections

136
Q

What are the side effects of Azoles?

A

Testosterone synthesis inhibition - gynecomastia

Liver dysfunction

137
Q

What is the MOA of flucytosine?

A

Inhibits DNA and RNA synthesis by converting to 5-fluorouracil by cytosine deaminase

138
Q

What is the clinical use of of flucytosine?

A

Systemic fungal infections - meningitis by cryptococcal in combo with amphotericin B

139
Q

What is the toxicity of flucytosine?

A

Bone marrow suppression

140
Q

What is the MOA of caspofungin, mica fungin?

A

Inhibiting cell wall synthesis by inhibiting synthesis of beta-glucan

141
Q

What are the fungins used for?

A

Invasive aspergillosis and candida

142
Q

What is the toxicity of the fungins?

A

GI upset

Flushing

143
Q

What is the MOA of terbinafine?

A

Inhibits fungal enzyme squalene epoxidase

144
Q

What is terbinafine used for?

A

Dermatophytoses - onycho

145
Q

What are the side effects of terbinafine?

A

Abnormals LFTs

Visual disturbances

146
Q

What is the MOA of griseofulvin?

A

Interferes with MT function - disrupts mitosis

147
Q

What is griseofulvin used for?

A

Oral tx of superficial infections

Inhibits growth of dermatophytes

148
Q

What is the tox of griseofulvin?

A 
Teratogenic
Carcinogenic
Confusion
Headaches
Induces P450 and warfarin metabolism
149
Q

What is the MOA for chloroquine?

A

Blocks detox of heme into hemozoin –> heme builds up and is toxic to plasmodia

150
Q

What is chloroquine uses for?

A

Plasmodia except falciparum

151
Q

What is the toxicity of chloroquine?

A

Retinopathy

152
Q

What is the mech of resistance employed by falciparum?

A

Efflux pump

153
Q

What do you tx falciparum with?

A

Artemether/lumifantrine

Atorvaquone/proguanil

154
Q

What do you use for life threatening malaria?

A

Quinidine or artisunate

155
Q

What are the antiprotozoal therapies?

A

Pyrimethamine - toxoplasmosis
Suramin and melarsopol - T. Brucei
Nifurtimox - T. Cruzi
Sodium stibogluconate- leishmaniasis

156
Q

What are the antihelminthic therapies?

A 
Mebendazole
Pyrantel pamoate
Ivermectin
Diethylcarbamazine
Praziquantel - flukes
157
Q

What is the MOA of zanamivir, oseltamivir?

A

Inhibit neuroaminidase - decrease release of progeny

158
Q

What is zanamivir used for?

A

Tx and prevention of flu A and B

159
Q

What is the MOA of ribavirin?

A

Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase

160
Q

What is ribavirin used for?

A

RSV

HEP C

161
Q

What is the toxicity of ribavirin?

A

Hemolytic anemia

Severe teratogen

162
Q

What is the MOA of acyclovir and ganciclovir?

A

Guanosine analog - inhibits viral DNA pol by chain termination

163
Q

What is acyclovir used for?

A

HSV
VZV
Genital and mucho cutaneous lesions and encephalitis

164
Q

What is acyclovir ineffective against?

A

Weak for EBV

No effect on CMV or latent infection of HSV/VZV

165
Q

Which cyclovir has better bioavailability?

A

Valacyclovir and valganciclovir

166
Q

What do you use for VZV?

A

Famiciclovir

167
Q

What is the mech of resistance to cyclovir?

A

Mutated viral thymidine kinase

Normal thymidine kinase monophosphorylates the acyclovir for incorporation into DNA

168
Q

What is ganciclovir used for?

A

CMV

169
Q

What is the toxicity of ganciclovir?

A

Pancytopenia

Renal toxicity

170
Q

What is the mech of resistance to ganciclovir?

A

Mutated CMV DNA pol

Lack of viral kinase

171
Q

What is the MOA of foscarnet and cidofovir?

A

Bind to pyro phosphate binding site of viral DNA pol

Inhibits viral DNA pol

172
Q

What Are foscarnet and cidofovir used for?

A

CMV retinitis

Acyclovir resistant HSV

173
Q

What is the toxicity of foscarnet and cidofovir?

A

Nephrotoxicity

174
Q

What is the mech of resistance to foscarnet?

A

Mutated DNA pol

175
Q

What does HAART include?

A

2 nucleoside reverse transcriptase inhibitors
1 non-nucleoside reverse transcriptase inhibitors OR
1 protease inhibitors OR 1 integrate inhibitor

176
Q

What is the MOA of protease inhibitors?

A

Prevent maturation of new viruses by preventing HIV protease from cleaving HIV mRNA into new products.

177
Q

What are the protease inhibitors?

A

The -inavirs

178
Q

What is the toxicity of protease inhibitors?

A 
Hyperglycemia 
GI 
Lipodystrophy
Nephropathy
Hematuria (indinavir)
179
Q

Which protease Inhibitor inhibits P450?

A

Ritonavir

180
Q

What is the MOA of NRTIs?

A

Nucleoside analogs that competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain because they lack the 3’ OH group

All must be activated by phosphorylation except tenofovir

181
Q

What are the NRTIs?

A 
-vudine
Tenofovir
Emtricitabine
Abacivir
Didanosine
182
Q

Which NRTIs are used for prophylaxis and to reduce transmission during pregnancy?

A

Zidovudine

183
Q

What are the toxicities of NRTIs?

A 
Bone marrow suppression (reverse with G-CSF and EPO)
Peripheral neuropathy
Lactic acidosis
Rash
Anemia (ZDZ)
184
Q

What are the NNRTIs?

A

Nevirapine
Efavirenz
Delaverdine

185
Q

What is the MOA of NNRTIs?

A

Bind the reverse transcriptase at a different site than NRTI

Don’t require phosphorylation

186
Q

What are the side effects of NNRTIs?

A 
Bone marrow suppression (reverse with G-CSF and EPO)
Peripheral neuropathy
Lactic acidosis
Rash
Anemia
187
Q

What is the integrate inhibitor?

A

Raltegravir

188
Q

What is the MOA of raltegravir?

A

Inhibits HIV genome integration into host cell

189
Q

What is the toxicity of raltegravir?

A

Hypercholesterolemia

190
Q

What is the MOA of INFs?

A

Block replication of RNA and DNA viruses

191
Q

What are INFs used for?

A

Alpha - chronic hep B and C, Kaposi’s
Beta- multiple sclerosis
Gamma - chronic granulomatous disease

192
Q

What is the toxicity of IFN?

A

Neutropenia

Myopathy

193
Q

What are the antibiotics to avoid in pregnancy?

A 
SAFe Children Take Really Good Care
Sulfonamides
Aminoglycosides
Fluoroquinolones
Clarithromycin
Tetracyclines
Ribavirin 
Griseofulvin 
Chloramphenicol
194
Q

What is the mech of resistance to isoniazid?

A

Decreased levels of catalase peroxidase

195
Q

What is needed for isoniazid to become active?

A

Catalase peroxidase in the mycobacterium

196
Q

What is the mech of resistance to streptomycin?

A

Altered 30S ribosomal protein structure so antibiotic cant bind

197
Q

What is needed for pyrazinamide to work?

A

Bacterial pyrazinamidase

198
Q

What is the tx of choice for malaria?

A

Chloroquine

199
Q

What is the tx for life threatening malaria?

A

IV quinidine

200
Q

What is added for tx of plasmodium vivax and ovale?

A

Primaquine to kill the hypnozoite in the liver

201
Q

What is used to treat African sleeping sickness?

A

Pentamidine

202
Q

What is the tx for leishmaniasis?

A

Pentamidine

203
Q

What is the tx for p. jirovecii?

A

Pentamidine

TMP

204
Q

What is used to tx Chaga’s?

A

Nifurtimox

205
Q

What is the MOA of isopropanol as a disinfectant?

A

Disruption of cell membranes

Degradation of proteins

206
Q

What is the MOA of chlorhexidine as an disinfectant?

A

Disruption of cell membranes

Coagulation of cytoplasm

207
Q

What is the MOA of hydrogen peroxide as a disinfectant?

A

Produces destructive free radicals that oxidize cellular components
Also sporicidal

208
Q

What is MOA of iodine as an disnfectant?

A

Halogenation of proteins and nucleic acids

Sporicidal

209
Q

When is chlorhexidine used?

A

Surgeries and percutaneous procedures

210
Q

What surgeries is chlorhexidine contraindicated in?

A

Neurologic, otologic, and ophthalmic procedures

211
Q

What is the MOA of formaldehyde as a disinfectant?

A

Alkylation and cross-linking of DNA and proteins

212
Q

What is formaldehyde used for?

A

Cleaning hospital instruments that cannot withstand autoclaving

213
Q

What is the MOA of daptomycin?

A

Depol of cell membrane used in MRSA

214
Q

What are the side effects of daptomycin?

A

Myopathy and CPK elevation

215
Q

What is daptomycin inhibited by?

A

Pulmonary surfactant

216
Q

What is the MOA of linezolid?

A

Inhibits bac synthesis by binding to 50S subunit

217
Q

What are the side effects of linezolid?

A

TCP
Optic neuritis
Serotonin syndrome

218
Q

What is daptomycin used for?

A

Treating skin infections

Bacteremia due to S. aureus

219
Q

What is daptomycin ineffective against?

A

Gram negatives

220
Q

Which drugs are well known for inhibiting warfarin metabolism?

A

TMP
Metronidazole
Macrolides
Azoles

221
Q

What is ricin?

A

A potent toxin for the castor oil plant that inhibits protein synthesis by cleaving the rRNA component of the eukaryotic 60S subunit

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