MicroB Antimicrobials 3. Bacteria Protein Synthesis Inhibitors Flashcards
All amiNOglycosides are given […] and cleared […] except for […]
All amiNOglycosides are given **IV/IM **and cleared renally except for Neomycin (oral + eliminated unexchanged in feaces)
“NO” Oral
Neomycin: It is contraindicated in the presence of intestinal obstruction, history of hypersensitivity to neomycin or other aminoglycosides, in patients with ulcerative gastrointestinal disease.
Not given parenterally due to severe nephrotoxicity
All tetracyclines cross the […] barrier and concentrate in fetal […] and […]
hence all tetracyclines are contraindicated in […]/[…]/[…]
All tetracyclines cross the placental barrier and concentrate in fetal bones and dentition
hence all tetracyclines are contraindicated in pregnancies (Cat D)/breast-feeding woman/children less than 8 years of age
Aminoglycoside Resistance
- Increased […] pumps
- inhibition of the aminoglycoside […]
- Production of aminoglycoside […] enzymes (works by e.g. acetylation of aminoglycosides) by Gram negative bacteria
- 30S subunit […]
Aminoglycoside Resistance
- Increased efflux pumps
- inhibition of the aminoglycoside uptake
- Production of aminoglycoside inactivating enzymes (works by e.g. acetylation of aminoglycosides) by Gram negative bacteria
- 30S subunit alteration
- and 4. can deduce. The concept is quite common.
bacterial ribosome consists of a […]S subunit and a […]S subunit, whereas in the mammalian ribosome the subunits are 60S and 40S
Protein synthesis inhibitors affect […] stage
Name the 30S inhibitors:
1. […]
2. […]
3. […]
Name the 50S inhibitors:
1. […]
2. […]
3. […]
bacterial ribosome consists of a 50S subunit and a 30S subunit, whereas in the mammalian ribosome the subunits are 60S and 40S
Protein synthesis inhibitors affect translation stage
Name the 30S inhibitors:
1. Tetracycline
2. Glycylcycline (Tigecycline)
3. Aminoglycosides
Name the 50S inhibitors:
1. Macrolides
2. Clindamycin
3. Linezolid
Clindamycin use is closely associated with […], and is contraindicated in patients with pseudomembranous colitis or ulcerative colitis.
Clindamycin use is closely associated with CDAD, and is contraindicated in patients with pseudomembranous colitis or ulcerative colitis
Clostridium difficile associated diarrhoea (CDAD); diarrhoea, caused by overgrowth of C. difficile.
C. difficile is always resistant to clindamycin
Clindamycins are used to treat […] infections
Clindamycins are used to treat anaerobic infections
Exclusively for those bugs wearing gas masks (in sketchy microb) such as Clostridium perfringen
Glycylcyclines (tigecycline) were designed to overcome two common mechanisms of tetracycline resistance
- Resistance mediated by acquired […] and/or
- […]
Glycylcyclines (tigecycline) were designed to overcome two common mechanisms of tetracycline resistance
- Resistance mediated by acquired efflux pumps and/or
- Ribosomal protection
Tigecycline = tetracycline on steroids (TIGER cycline)
linezolid binds the bacterial […] ribosomal RNA of the 50S subunit and prevents the formation of a functional 70S initiation complex.
- Used against Gram-[…] organisms including staphylococci, streptococci, enterococci, Listeria monocytogenes
- Because of its unique mechanism of action, linezolid is active against […], […],[…], […] & […]
linezolid binds the bacterial 23S ribosomal RNA of the 50S subunit and prevents the formation of a functional 70S initiation complex.
- Used against Gram-positive organisms including staphylococci, streptococci, enterococci, Listeria monocytogenes
- Because of its unique mechanism of action, linezolid is active against** MRSA, ESBL,Carbapenemase, VRE **& VRSA
Not indicated for Gram-negative infections. Gram-negative pathogenic bacteria are intrinsically resistant due to efflux pumps that force linezolid out of the cell faster than it can accumulate.
The study group like to call it THE BOSS OF GRAM POSITIVE ANTIBIOTICS. THE APEX PREDATOR. Vancomycin is a close contender, but too bad there are VREs.
Tim will strangle you if u use it carelessly. #antibioticsstwardship
Macrolide Contraindications: Patients with […] dysfunction should be treated cautiously with erythromycin, or azithromycin, because these drugs accumulate in the […].
Macrolide Contraindications: Patients with hepatic dysfunction should be treated cautiously with erythromycin, or azithromycin, because these drugs accumulate in the liver.
Macrolide antibiotics are widely used for a variety of bacterial infections in pregnancy (cat B and cat C)
Isnt crows associated with eating liver in some greek mythology? Prometheus?
Macrolides are effective against the […] microbes like Legionella pneumophilia, Mycoplasma and Chlamydia.
Used in respiratory tract infections (CAP), Chlamydial infections, Diphtheria, H.pylori (Clarithromycin/Azithromycin + […] +[…]), Mycobacterial infections.
Macrolides are effective against the atypical microbes like Legionella pneumophilia, Mycoplasma and Chlamydia.
Used in respiratory tract infections (CAP), Chlamydial infections, Diphtheria, H.pylori (Clarithromycin/Azithromycin + omeprazole +amoxicillin), Mycobacterial infections.
“Crows for the atypical boys”
Similar to Fluroquinolones, Tetracyclines should NOT be administered with […] or other substances that contain […] as it decreases […] due to the formation of non absorbable chelates.
Similar to Fluroquinolones, Tetracyclines should NOT be administered with dairy products (contains calcium) or other substances that contain divalent and trivalent cations (magnesium and aluminium antacids or iron supplements) as it decreases absorption due to the formation of non absorbable chelates.
TLDR, wheels and flowers dont go well with milk nor antacid nor iron supplements lol….
Tetracyclines have activity against a broad spectrum of bacteria (Gram-positive,Gram- negative, atypical, spirochete)
but are useless against […] and […]
Tetracyclines have activity against a broad spectrum of bacteria (Gram-positive,Gram- negative, atypical, spirochete)
but are useless against Pseudomonas aeruginosa (PAE) and Proteus
Tetracyclines are referred to “wheels” in my cards cuz of sketchy microb HAHAHHAA
The 6 NOs of AmiNOglyosides
- Spectrum: Mainly aerobic gram […]
- Mechanism: […]
- Toxicity: […]
- NO to use during […]
- NO to […] administration (except Neomycin)
- NO to […]
The 6 NOs of AmiNOglyosides
- Spectrum: Mainly aerobic gram Negative Organisms
- Mechanism: NO to protein synthesis (30s)
- Toxicity: Nephro- and Oto- toxocities
- NO to use during pregnancy
- NO to oral administration (except Neomycin)
- NO to CSF penetration
Avoid/limit usage with other nephrotoxic drugs such as Amphotericin B, Vancomycin, NSAIDs and neuromuscular blocking agent
Precautionary measures/avoid use if it needs to be used in patients with renal impairment, hearing defects and/or myasthenia gravis
The macrolides (Erythromycin, Clarithromycin, Azithromycin) are a group of bacterio[…] antibiotics.
- Erythromycin is an alternative to […] in individuals with an allergy to β- lactam antibiotics.
- Compared to erythromycin, clarithromycin and azithromycin has improve acid stability, tissue penetration and broaden spectrum of activity.
- Azithromycin has less […]
The macrolides (Erythromycin, Clarithromycin, Azithromycin) are a group of bacteriostatic antibiotics.
- Erythromycin is an alternative to penicillin in individuals with an allergy to β- lactam antibiotics.
- Compared to erythromycin, clarithromycin and azithromycin has improve acid stability, tissue penetration and broaden spectrum of activity.
- Azithromycin has less DDI
The most frequent use of aminoglycosides is […] therapy for serious infections such as septicemia, complicated urinary tract infections, and nosocomial respiratory tract infections.
Aminoglycosides are often used in combination with a cell wall–active agent ([…]) for the therapy of serious proven or suspected bacterial infections. Rationales for this approach:
1. To expand the empiric […] of activity of the antimicrobial regimen to ensure the presence of at least one drug active against a suspected pathogen.
2. To provide […] bacterial killing.
3. To prevent the emergence of […] to the individual agents.
The most frequent use of aminoglycosides is empiric therapy for serious infections such as septicemia, complicated urinary tract infections, and nosocomial respiratory tract infections.
Aminoglycosides are often used in combination with a cell wall–active agent (Beta-Lactam) for the therapy of serious proven or suspected bacterial infections. Rationales for this approach:
1. To expand the empiric spectrum of activity of the antimicrobial regimen to ensure the presence of at least one drug active against a suspected pathogen.
2. To provide synergistic bacterial killing.
3. To prevent the emergence of resistance to the individual agents.
Prolonged use of aminoglycosides should be restricted to the therapy of life-threatening infections
These 3 reasons are synonymous for the rational behind antibiotic combinations!!! Very important to know.
