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Infectious Disease > Overview of Exam 2 > Flashcards

Overview of Exam 2 Flashcards

1
Q

In transcription of DNA, what is the strand that is copied?

A

Noncoding (antisense) strand

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2
Q

Function of the 50S subunit of bacterial ribosomes

A

Biochemical tasks (does the actual synthesis of the new protein)

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3
Q

Function of the 30S subunit of bacterial ribosomes

A

Has to do with binding (and recognition of molecules and reading the code)

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4
Q

Peptidyl transferase

A

actual enzyme in the ribosome that has the catalytic activity to form the peptide bond

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5
Q

MOA of Aminoglycosides

A

1.) Interferes with initiation (where ribosome finds AUG start codon)
2.) Premature termination
3.) Causes wrong AA to be put in place
**Secondary action= might directly affect membrane permeability
BACTERIOCIDAL

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6
Q

Post-antibiotic effect

A

bacteria continue to die even after antibiotics have been stopped (residual antibiotic activity)

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7
Q

What’s special about doxycycline?

A

Only TC that can be dosed once/day (longer t1/2); is the only TC that covers CA-MRSA (not HA-MRSA)

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8
Q

What’s special about minocycline?

A

Can go over CSF since it is the most lipophilic of the tetracyclines; causes bluish-black pigmentation to skin in some pts; causes ototoxicity

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9
Q

MOA of tetracyclines

A

Bind to A site of 30S and blocks access of tRNA

BACTERIOSTATIC

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10
Q

What TC’s can you use in renal compromise?

A

Minocycline or Doxycycline

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11
Q

Important ADR’s of Tetracyclines

A

Teeth discoloration and bone effects!, Hepatotox, Nephrotox, Benign Intracranial hypertension (edema in the brain), Fanconi Syndrome (so don’t “save” you pills!)

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12
Q

MOA of Glycylcyclines

A

Blocks entry into A site of 30S (like TC’s) but are not affected by resistance mechanisms like TC’s are

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13
Q

Important ADR’s of Glycylcyclines

A

Teeth discoloration and bone effects (from chelation of metal); < elimination of Warfarin

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14
Q

MOA of Macrolides

A

Block the exit tunnel (DOES NOT INHIBIT RIBOZYME DIRECTLY)

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15
Q

Important ADR’s of Macrolides

A

Epidgastric distress, ototoxicity, cholestatic jaundice, metallic taste (only in Clarithro), Q-T prolongation/ torsades, 3A4 drug interactions

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16
Q

MOA of Telithromycin

A

Binds to 50S on 2 separate areas (exit tunnel like macrolides & other site nearby on 50S)

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17
Q

Important ADR’s of Telithromycin

A

Syncope (fainting), CYP interactions, Q-T prolongation, torsades

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18
Q

MOA of Lincosamides

A

Bind to exit tunnel of 50S and cause backlog

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19
Q

Important ADR’s of Clindamycin

A

Pseudomembranous Colitis (overgrowth of C. diff), > liver enzymes, < neurotransmission

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20
Q

MOA of Streptogramins

A

A binds to allosteric site on 50S and B binds to exit tunnel (same site as macrolides)

21
Q

Important ADR’s of Streptogramins

A

CYP 3A4 interactions, arthralgia/myalgia

22
Q

MOA of Chloramphenicol

A

Prodrug –> Inhibits peptidyl transferase (inhibits binding of tRNA to ribosome and prevents actual peptide bond from being made)

23
Q

Important ADR’s of Chloramphenicol

A

Mostly related to the fact that human protein synthesis in mitochondria can also be inhibited: Bone marrow suppression, aplastic anemia, Gray Baby Syndrome

24
Q

MOA of Oxazolidinones

A

Prevents initiation and not elongation!! (means no cross resistance with other abx) Binds to 50S and prevents 50S from coming into contact with 30S to form initiation complex

25
Q

Important ADR’s of Linezolid

A

Myelosuppression, Pseudomembranous Colitis,
** Linezolid is a weak inhibitor of MAO so can also have enhanced effects of adrenergic agents that use this enzyme: Serotonin Syndrome (when administered with SSRI’s), Cheese Reaction (avoid food or drink high in tyramine)

26
Q

MOA of Quinolones (Fluoroquinolones)

A 
Inhibit topoisomerases= allows them to break the DNA but then binds and prevents them from re-sealing the nick
DNA gyrase (Topoisomerase II)= Gram (-)
Topoisomerase IV= Gram (+)
27
Q

Important ADR’s of FQ’s

A

Achilles and Rotator Cuff Tendonitis and Rupture, Q-T prolongation/ torsades, CYP inhibition, chelation

28
Q

Which FQ can you use in renal failure?

A

Moxifloxacin (since it is most excreted by liver)

29
Q

MOA of Nitrofurantoin

A

Gets activated by having its NO2 group reduced by NADPH –> attacks sensitive enzymes

30
Q

Important ADR’s for Nitrofurantoin

A 
Hemolytic anemia (in pts with G6PD deficiency)
Acute pneumonitis (if drug achieves tx conc in blood)
31
Q

MOA for Metronidazole

A

PRODRUG –> activated when NO2 group is reduced by electron transport chain (ferrodoxins) –> attacks DNA

32
Q

Important ADR’s for Metronidazole

A

Furry tongue/ metallic taste, Steven-Johnson’s Syndrome, Disulfiram-like effect (if you drink you become ill)
NO PREGO!

33
Q

MOA of Rifamycins

A

Inhibit RNA Polymerase (transcription initiation)

34
Q

Important ADR’s of Rifamycins

A

Red-orange color to body fluids, induction of P450

35
Q

ADR’s specific to Rifabutin

A

Polymyalgia, pseudojaundice, Anterior uveitis (inflammation of undercoating of eye)

36
Q

MOA of Sulfonamides

A

Act like PABA and inhibit dihydropterate synthase –> inhibit synthesis of folic acid (used in DNA synthesis)

37
Q

Important ADR’s of sulfonamides

A

Crystalluria, hemolytic anemia (in pts with G6PD deficiency), SJS

38
Q

MOA of Trimethoprim

A

Inhibits dihydrofolate reductase (DHFR)

39
Q

Bactrim

A

Trimethoprim/ sulfamethoxazole 5:1 ratio

40
Q

Important ADR’s for Trimethoprim

A

Megaloblastic anemia, hemolytic anemia (in pts with G6PD deficiency), jaundice

41
Q

MOA of Fidaxomycin

A

same as Rifamycins, bind to RNA Pol and prevent initiation of transcription

42
Q

MOA of Daptomycin

A

Needs calcium as a cofactor!; forms channels that leak ions

43
Q

Can Daptomycin be used in Respiratory infections?

A

NO! b/c the surfactants in the lungs soak up the drug

44
Q

Important ADR’s with Daptomycin

A

Eosinophilic pneumonia, reversible myopathy, peripheral NS disorders

45
Q

MOA of polymixins

A

causes “leaks” in the membrane

46
Q

Important ADR’s with Polymixins

A

Neurotox, Nephrotox

47
Q

MOA of Glycopeptides

A

Inhibit polymerization of cell wall by binding directly to D-Ala/D-Ala and blocking addition of new NAG-NAM

48
Q

Important ADR’s of Glycopeptides

A

REDMAN’S SYNDROME, ototoxicity, nephrotoxicity, Q-T prolongation, NO PREGO

Infectious Disease (6 decks)

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