Protein Synthesis Flashcards
Tetracycline and Tigecycline
MOA
ROA
ROE
Targets
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
Tetracycline, Tigecycline
AE
- note similarity to Fluoroquinolone
Contra-I
Learn CCCAPH
vs CCCAPPPT
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
Whats the deal w Tigecycline
Overcome
- efflux pump
- ribosome protection
Aminoglycosides
NOs
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!!!
Aminoglycoside
- target and WHY
- MOA
- mode of killing
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
Name 2 bacteria AG can go against
Note Gram Pos can
Pseudomonas
MTB;
AG
- ROA, ROE
All IM/IV except Neomycin ORAL
Renal
AG
AE
contra-I
NO - similar to vancomycin
- Nephrotoxicity
- Ototoxicity
Neuromuscular Paralysis
Hypersensitivity
No pregnant
No myasthenia gravis
Note nephrotoxic drugs include
Amphotericin B
Vancomycin
AG
NSAIDs
okie
Macrolide
MOA
Names
DDI
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
Macrolide
ROA
Use
ROE
Oral, IV - note enteric coating
Atypical
CAP - S. Pneumonia; HiB; LMCG for neonates;
note erythromycin substitute for penicillin allergy
LIVER EXCRETION
Macrolide
AE
GI
Hepatotoxicity
QTc
Ototoxciity
How is macrolide resistance gained
Erm gene gained
- ribosome methylation
efflux pumps
Lincosamide
- MOA
- cross resistance
- Targets
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
Clindamycin
ROA
ROE
AE
Oral, IV, acne, HEPATIC metab
CDAD!!!
rashes
Linezolid
MOA
Uses
ROA, ROE
Gram Pos ONLY
- 23S rRNA of 50S
MRSA, VRSA, VRE, listeria, enterococci, strep
LAST RESORT
Oral, IV, RENAL - similar to vancomycin
Linezolid
AE
note linezolid not used for catheter-related infections in case gram negs
Think PBS;
Serotonin Syndrome - careful for MAOI; St John Wart Bone Marrow Suppression - thrombocytopenia - need monitor blood; Peripheral Neuropahty, optic neuritis
GI
Cover and no cover
- cloxacillin
- aztreonam
- ertapenem
- vancomycin
- clindamycin
- ag
- macrolides
- TC
- linezolid
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
note streptomycin aminoglycoside for TB
okie
ROE of Macrolide
Hepatic
ROA
ROE of Lincosamide - Clindamycin
Oral, IV
- HEPATIC
What are macrolide targets
Atypical
- think Tetracycline too but tetracycline contra I pregnancy
Macrolide AEs
Hepatotoxicity
GI
Qtc, Ototoxicity - Can think as GOP
Clindamycin targets
Anaerobe Gram POSITIVE
- except CDAD
Aminoglycoside targets
Aerobic Gram Negs (gram pos can + BM)
- must be aerobic cos of Active transport needed
Gimme AEs of FQ
CDAD
CNS: N&V,,,
Cation problem
Accumulate in tendon: Pregnant + <18 cannot
Prolong QTC: arrhythmia
Phototoxicity
Peripheral Neuropathy: myasthenia gravis cannot
Tendonitis
Gimme AEs of TC
CDAD CNS Cation problem Accumulate in dentitions, teeth discoloration - pregnant + <8 cannot Phototoxicity
Hepatotoxicity
FQ names
TC names
- gimme ROA, targets and ROE
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)