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Pharm Module 3 antibiotics > Protein synthesis inhibitors > Flashcards

Protein synthesis inhibitors Flashcards

1
Q

What are the main categories of protein synthesis inhibitors

A

Aminoglycosides
lincosamides
oxazolidinone
Macrolides
Streptogramins
tetracyclines

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2
Q

What drugs are considered aminoglycosides

A

Gentamicin
Amikacin
Tobramycin

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3
Q

What type of drugs are considered lincosamides

A

Clindamycin

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4
Q

What type of drugs are considered oxazolidinones

A

Linezolid

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5
Q

What type of drugs are considered Macrolides

A

Azithromycin
Clarithromycin
Erythromycin

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6
Q

What type of drugs are considered tetracyclines

A

Doxycycline
Minocycline
Tetracycline

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7
Q

What are the ribosomal subunits of protein synthesis that antibiotics can effect

A

30S
50S
tRNA

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8
Q

Which antibiotics effect 50s protein synthesis

A

Erythromycin
Chloramphenicol
Clindamycin

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9
Q

Which antibiotics effect 30s protein synthesis

A

tetracycline
gentamycin
tobramycin
amikacin

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10
Q

60% of classes of antibiotics target which part of the cell

A

Ribosomes / ribosomal RNA

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11
Q

Where on the ribosome do antibiotics bind

A

at moving parts

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12
Q

Aminoglycosides target which ribosomal subunit and are considered bactericidal or static

A

30s
bactericidal

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13
Q

Tetracyclines target which ribosomal subunit and are considered cidal or static

A

30s
bacteriostatic

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14
Q

Which bacteriostatic antibiotics target the 50s ribosomal subunit

A

Chloramphenicol
Clindamycin
Macrolides

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15
Q

which antibiotics are both bactericidal AND bacteriostatic and target the 50s ribosomal subunit

A

Linezolid
Streptogramins

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16
Q

What is the main target for aminoglycosides

A

Pseudomonas

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17
Q

What kind of interaction do aminoglycosides have when paired with B-lactams and vancomycin

A

synergistic

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18
Q

Do aminoglycosides have CNS penetration or GI absorption

A

No

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19
Q

What are the major side effects of aminoglycosides

A

Ototoxicity (Permanent)
vestibular toxicity (permanent)
renal toxicity (Reversible)

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20
Q

What drugs do you not combine with aminoglycosides

A

Loop diuretics

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21
Q

What is a complete contraindication for using aminoglycosides

A

M. Gravis

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22
Q

What type of drug is gentamicin and how is it administered

A

Aminoglycosides
IM / IV

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23
Q

What is gentamicin used for

A

Serious gram neg infections
-pseudomonas
-Enterobacter
-proteus

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24
Q

If a patient who has CF contracts pseudomonas or enterobacter… what would be the first line of treatment

A

gentamicin

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25
Q

When is Amikacin used

A

For gentamicin resistant bacteria

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26
Q

Would you administer a patient neomycin via IV

A

No, oral only because of toxicity

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27
Q

What is neomycin generally given for

A

Bowel surgery prophylaxis

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28
Q

What is the most widely used tetracycline

A

Doxycycline

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29
Q

Which type of tetracycline is best for someone with a CNS infection and why

A

Minocycline because its more hydrophobic

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30
Q

If a patient has chlamydia, rickettsia, or mycoplasma, what is the drug of choice to treat

A

Tetracycline

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31
Q

What is the number 1 Lyme treatment in the country

A

Doxycycline

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32
Q

What do you recommend to your patient who you are prescribing tetracycline to avoid GI distress

A

Take with food

DO NOT take with dairy or antacids

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33
Q

Which form of tetracycline is safe for renal impaired patients

A

Doxycycline

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34
Q

What are the adverse effects of tetracycline

A

Photosensitivity
Superinfections
Calcified tissue growth inhibitor in kids
Causes yellowing of teeth in kids

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35
Q

What is a new class of antibiotics derived from minocycline

A

Glycylcycines

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36
Q

When are tigecyclines used (glycylcycines)

A

As a last resort for MRSA, VRE and enterobacteria

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37
Q

What is the mechanism of action for chloramphenicol

A

Binds 50s subunit which blocks aminoacyl binding to acceptor site which inhibits peptidyl transferase and thus translation

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38
Q

What is unique about chloramphenicol

A

crosses the blood brain barrier

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39
Q

Where is chloramphenicol generally used

A

Mostly outside the US for Rocky Mountain spotted fever

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40
Q

What is the major adverse effect of chloramphenicol

A

grey baby syndrome (incomplete hepatic development)

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41
Q

What is erythromycin useful for

A

an alternative to penicillin for gram positive infections

42
Q

How do clarithromycin and erythromycin differ

A

Clarithromycin has better activity against H. influenza, chlamydia, legionella, moraxella and helicobacter pylori

43
Q

What is a generic name for azithromycin

A

Z pack

44
Q

What is azithromycin typically used for

A

respiratory tract infections

Strep pharyngitis in PCN allergic patients

45
Q

What is the drug of choice for Chlamydial STI

A

Azithromycin

46
Q

Why is Erythromycin not administered via IV

A

It is associated with high incidence of thrombophlebitis

47
Q

Why is azithromycin not given with food

A

food inhibits absorption

48
Q

What is unique of azithromycin as a macrolide

A

Has the longest half life (68 hours)

49
Q

Which patients would you not prescribe a macrolide

A

patients with hepatic dysfunction

50
Q

What drug to drug interaction do you have to be aware of with macrolides

A

They cause CYP inhibition, so drugs like Digoxin will not be metabolized by the liver correctly and increase the levels in the body

51
Q

What is the mechanism of action for clindamycin

A

Inhibits peptidyl transferase by binding to the 50s ribosomal subunit

52
Q

How can clindamycin be administered

A

IV or PO

53
Q

Is clindamycin narrow or broad spectrum

A

Narrow spectrum for gram + cocci

54
Q

What is the primary use of clindamycin

A

Anaerobic bacterial infections
MRSA

55
Q

If someone comes in with an abscess, what would you treat them with and why

A

Clindamycin because it is able to penetrate an abscess

56
Q

What are major causes of C.Diff or pseudomonas colitis

A

Doxycycline
Clindamycin

57
Q

What is the MOA for Linezolid

A

Binds to the 50s ribosomal subunit to inhibit protein synthesis

58
Q

Is Linezolid bactericidal or bacteriostatic

A

Mostly bacteriostatic

59
Q

What is linezolid bactericidal against

A

Streptococci and C. perfringens

60
Q

What is the most common use for Linezolid

A

MRSA and VRE but is NOT the first line agent

61
Q

What are the adverse effects of Linezolid

A

Serotonin syndrome when used in combo with anti-depressants

Dose dependent Thrombocytopenia

62
Q

What are the main categories of antimetabolites / DNA gyrase inhibitors

A

Fluoroquinolones
Nitroimidazole
Rifamycins
Nitrofurantoin

63
Q

What are the drugs that are involved with folate synthesis inhibitors

A

TMP-SMX
Co-trimoxazole

64
Q

Which antibiotics are dihydrofolate reductase inhibitors

A

Trimethoprim

65
Q

What is the MOA for fluoroquinalones

A

They inhibit type 2 topoisomerase (inhibit DNA duplication)

66
Q

What antibiotics make up fluoroquinalones

A

Ciprofloxacin
Levofloxacin
Ofloxacin
Moxifloxacin

67
Q

What is Moxifloxacin

A

4th gen fluoroquinolone that is safe for those with renal disease

68
Q

What is second generation fluoroquinolone and what is it useful against

A

Ciprofloxacin
Psuedamonas aeruginosa*
*Think staph coverage

69
Q

What is third generation fluoroquinolone and what is it useful against

A

Levofloxacin
Strep pneumoniae
*Think for respiratory infections

70
Q

What is 4th generation fluoroquinalones

A

Moxifloxacin -> not for pseudomonas aeruginosa

71
Q

If a patient comes in after taking antibiotics with tendinopathy or an achilles tendon rupture, what antibiotic were they most likely on

A

Cipro or other fluoroquinalones

72
Q

What other adverse effects happen with fluoroquinalones

A

QT prolongation
articular cartilage erosion during development (avoid in children and pregnancy)

73
Q

Patient presents with bacterial sinusitis caused by S. pneumoniae, H.influenza, or M.catarrhalis, what is the first line agent for treatment

A

Amoxicillin or amoxicillin+calvulanate

74
Q

Patient presents with bacterial sinusitis caused by S. pneumoniae, H.influenza, or M.catarrhalis, what is the first line agent for treatment if they are allergic to penicillin

A

Doxycycline

75
Q

What is a last resort alternative for penicillin allergic patients with bacterial sinusitis

A

Respiratory fluoroquinolone (levo or moxifloxacin)

76
Q

A patient with severe sinusitis presents with bacterial bronchitis (most likely cause by pseudomonas). What are you going to treat them with first

A

IV antipsuedamonal such as cefepime

77
Q

What are the most common cause of a UTI

A

E.Coli
staph
K. pneumoniae

78
Q

A patient presents with a UTI, what are you going to treat them with

A

Nitrofurantoin
Amoxicillin
Cephalosporin
Trimethoprim/sulfamethoxazole (if not pregnant)

79
Q

What is the brand name of Nitrofurantoin

A

Macrobid

80
Q

When is Nitrofurantoin used

A

UTIs

81
Q

What is the most common species targeted by metronidazole

A

Bacteroides

82
Q

A patient presents with Helicobacter Pylori infection, what might you give them as a treatment

A

Metronidazole

83
Q

What is the most common side effect of metronidazole

A

GI upset

84
Q

What are you going to advise your patient that is taking metronidazole

A

Avoid alcohol

85
Q

What is the MOA for sulfonamides

A

They inhibit folate metabolism

86
Q

What is the MOA for Trimethoprim

A

Inhibit dihydrofolate reductase

87
Q

Which antibiotics make up Bactrim and why

A

Sulfamethoxazole and trimethoprim

They are bacteriostatic alone but when combined turn bactericidal

88
Q

What is the dosing ratio of sulfamethoxazole trimethoprim

A

5:1

89
Q

What are the common side effects of Bactrim

A

Rash (common)
SJS (rare)
Neonatal kernicterus

90
Q

What is neonatal kernicterus

A

Bilirubin encephalopathy caused by sulfa

91
Q

What is Bactrim most useful against

A

UTI
Biliary tree infections
PJP
Toxoplasmosis
Salmonella

92
Q

What is the MOA of Rifampin

A

Inhibit RNA polymerase
Bactericidal

93
Q

When is rifampin used

A

Mycobacterium tuberculosis (cannot use alone)

94
Q

Why do you have to be careful when giving rifampin

A

There is a large capacity for drug-drug interactions

95
Q

What is an adverse effect of rifampin

A

Orange-red tears, saliva, urine & sweat

96
Q

What is the MOA of Isoniazid

A

Inhibits the synthesis of mycolic acids (Essential component of mycobacterial cell wall)

97
Q

What combo of drugs treats most strains of TB

A

Isoniazid and Rifampin

98
Q

What are the phases of treating TB

A

Intensive phase: 4 drug combo (2 months)

The last 7 months: Isoniazid and rifampin

99
Q

What is ethambutol MOA

A

Inhibits mycobacterial arabinosyl transferase

100
Q

How is ethambutol given and why

A

With other anti-TB drugs to prevent resistance

Pharm Module 3 antibiotics (2 decks)

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