Protein Synthesis

Question 1

Tetracycline and Tigecycline

MOA
ROA
ROE
Targets

Answer 1

Tetracycline - 30S bind; block tRNA
- Doxycycline, Minocycline, Tetracycline

Targets: Acne, STD, Atypical (chlamydia)
Oral, Renal
- note Minocycline is Hepatic metAb

glycylcyclines: Tigecycline

• Made from Minocycline
  IV, Hepatic
• can be for strong stuff, MRSA, VRE, ESBL gram negs
• Pseudomonas cannot

Question 2

Tetracycline, Tigecycline
AE
- note similarity to Fluoroquinolone
Contra-I

Learn CCCAPH
vs CCCAPPPT

Answer 2

CNS - dizziness, vertigo
CDAD - superinfection, fungus also
Cation problem

Accumulation in dentition - bones, teeth
- Contra I for Pregnant and kids < 8
Phototoxicity
Hepatotoxicity - only metab Minocycline, excrete tigecycline but Tetracyclines accumulate in liver well

Question 3

Whats the deal w Tigecycline

Answer 3

Overcome

• efflux pump
• ribosome protection

Question 4

Aminoglycosides

NOs

Answer 4

NO

• aerobic gram neg; less gram pos (unless pair w BM)
• nephrotoxicity
• ototoxicity
• No oral - IM IV except neomycin oral
• no pregnancy; NO CSF!!!
• NeurOmuscular paralysis!!!

Question 5

Aminoglycoside

• target and WHY
• MOA
• mode of killing

Answer 5

30S - block TIC, translocation

• Target is Aerobic GN - because need active transport ATP to enter cell
• active transport
• Concentration dependent killing w post antibiotic effect (VS time dependent effect >MIC)
• • is preventing cells from growing even below MIC, not due to residual amounts but due to prolonged effect of such AB, and time is needed for bacteria to recover;
• highly bactericidal

Question 6

Name 2 bacteria AG can go against

Note Gram Pos can

Answer 6

Pseudomonas

MTB;

Question 7

AG

- ROA, ROE

Answer 7

All IM/IV except Neomycin ORAL

Renal

Question 8

AG
AE
contra-I

Answer 8

NO - similar to vancomycin

• Nephrotoxicity
• Ototoxicity

Neuromuscular Paralysis
Hypersensitivity

No pregnant
No myasthenia gravis

Question 9

Note nephrotoxic drugs include

Amphotericin B
Vancomycin
AG
NSAIDs

Answer 9

okie

Question 10

Macrolide

MOA
Names
DDI

Answer 10

50S block translocation

Erythromycin
Clarithromycin
Azithromycin (oral + IM ceftriaxone for gonorrhea)

DDI

• CYP inhibitor; less so for azithromycin
• • tgt w FQ, Azole, and sadkjsadlkjdsa SSRI

Question 11

Macrolide
ROA
Use
ROE

Answer 11

Oral, IV - note enteric coating

Atypical
CAP - S. Pneumonia; HiB; LMCG for neonates;

note erythromycin substitute for penicillin allergy

LIVER EXCRETION

Question 12

Macrolide

AE

Answer 12

GI
Hepatotoxicity
QTc
Ototoxciity

Question 13

How is macrolide resistance gained

Answer 13

Erm gene gained
- ribosome methylation

efflux pumps

Question 14

Lincosamide

• MOA
• cross resistance
• Targets

Answer 14

Clindamycin - 50S

cross resistance if ERM gene at 50S
- otherwise if resistance to macrolide at efflux pump then ok;

Anaerobes GRAM POS = Opposite of AZTREONMA aerobic gram NEG + Opposite of Aminoglycosides

Question 15

Clindamycin

ROA
ROE
AE

Answer 15

Oral, IV, acne, HEPATIC metab

CDAD!!!
rashes

Question 16

Linezolid

MOA
Uses
ROA, ROE

Answer 16

Gram Pos ONLY
- 23S rRNA of 50S

MRSA, VRSA, VRE, listeria, enterococci, strep
LAST RESORT

Oral, IV, RENAL - similar to vancomycin

Question 17

Linezolid
AE

note linezolid not used for catheter-related infections in case gram negs

Answer 17

Think PBS;

Serotonin Syndrome
- careful for MAOI; St John Wart
Bone Marrow Suppression
- thrombocytopenia - need monitor blood;
Peripheral Neuropahty, optic neuritis

GI

Question 18

Cover and no cover

• cloxacillin
• aztreonam
• ertapenem
• vancomycin
• clindamycin
• ag
• macrolides
• TC
• linezolid

Answer 18

PRP, gram pos only

gram neg aerobes ONLY; pseudomonas can cos Aerobic GNR

ertapenum ESBL, except pseudomona

Gram Pos ONLY

clindamycin - anaerobes GRAM POS ONLY; Except CDAD which is also Anaerobic Gram Pos

ag - mostly gram neg

Macrolides - atypicals
TC - atypicals, STD

linezolid - gram pos only

Question 19

note streptomycin aminoglycoside for TB

Answer 19

okie

Question 20

ROE of Macrolide

Answer 20

Hepatic

Question 21

ROA

ROE of Lincosamide - Clindamycin

Answer 21

Oral, IV

• HEPATIC

Question 22

What are macrolide targets

Answer 22

Atypical

- think Tetracycline too but tetracycline contra I pregnancy

Question 23

Macrolide AEs

Answer 23

Hepatotoxicity
GI

Qtc, Ototoxicity - Can think as GOP

Question 24

Clindamycin targets

Answer 24

Anaerobe Gram POSITIVE

- except CDAD

Question 25

Aminoglycoside targets

Answer 25

Aerobic Gram Negs (gram pos can + BM)

- must be aerobic cos of Active transport needed

Question 26

Gimme AEs of FQ

Answer 26

CDAD
CNS: N&V,,,
Cation problem

Accumulate in tendon: Pregnant + <18 cannot

Prolong QTC: arrhythmia
Phototoxicity
Peripheral Neuropathy: myasthenia gravis cannot
Tendonitis

Question 27

Gimme AEs of TC

Answer 27

CDAD
CNS
Cation problem
Accumulate in dentitions, teeth discoloration
- pregnant + <8 cannot
Phototoxicity 

Hepatotoxicity

Question 28

FQ names
TC names
- gimme ROA, targets and ROE

Answer 28

Ciprofloxacin, Levofloxacin, Moxifloxacin
Tetracycline, Doxycycline, Minocycline

• Oral, IV
• Oral, (IV can)
• Gram Negs - Respi + Gram Pos
• STD; atypicals
• Renal (Moxifloxacin hepatic excretion)
• Renal (Minocycline hepatic metab)