Protein Synthesis Inhibitors Flashcards
What are some aminoglycosides
Gentamicin, neomycin, amikacin, tobramycin, streptomycin
What is the mechanism of aminoglycosides
Bactericidal
30S inhibitor
Inhibits initiation complex formation and causes misreading of mRNA
Blocks translocation
“A initiates the alphabet”
What are aminoglycosides used for
Severe gram negative rod infections
What are some toxicities of aminoglycosides
Nephrotoxicity
Neuromuscular blockade
Ototoxicity
Teratogen
What is the mechanism of tetracyclines
Bind 30S and prevent attachment of aminoacyl-tRNA
What should tetracyclines not be taken with
Milk, antacids, or iron preperations because divalent cations inhibit absorption
What are tetracyclines used for
Borrelia burgdoferi, M pneumoniae, Rickettsia, Chlamydia
What are some toxicities of tetracyclines
GI distress, discoloration of teeth
Inhibition of bone growth in children
Contraindicated in pregnancy
What are some macrolides
Azithromycin
Clarithromycin
Erythromycin
What is the mechanism of macrolides
Block translocation
Binds to the 23S rRNA
What are macrolides used for
Atypical pneumonias (mycoplasma, chlamydia, legionella)
STD (chlamydia)
Gram positive cocci
What are some toxicities to macrolides
Motility issues Arrhythmia caused by QT prolongation Cholestatic hepatitis Rash eOsinophilia
“MACRO”
What is the mechanism of chloramphenicol
Blocks peptidyltransferase at 50S
What is chloramphenicol used for
Meningitis (H. flu, Neisseria meningitidis, Strep. pneumo)
What are toxicities to chloramphenicol
Anemia, aplastic anemia, gray baby syndrome
What is the mechanism of clindamycin
Blocks peptide transfer (transpeptidation) at 50S
What is clindamycin used for
Anaerobic infections in aspiration pneumonia or lung abscess
Oral infection with anaerobes
Anaerobes above the diaphragm (metronidazole treat below)
What is the mechanism of sulfonamides
Inhibit dihydropteroate synthase
Bacteriostatic
What are sulfonamides used for
Gram positive
Gram negative
Nocardia
Chlamydia
What are toxicities to sulfonamides
Hypersensitivity reactions
Hemolysis if G6PD deficient
Nephrotoxicity, photosensitivity
Kernicterus in infants
What is the mechanism of trimethoprim
Inhibit dihydrofolate reductase
Bacteriostatic
What is the combination TMP-SMX used for
Block folate synthesis
UTI, Shigella, Salmonella, P. jirovecii pneumonia
What are toxicities to TMP-SMX
Megaloblastic anemia
Leukopenia
Granulocytopenia
“TMP - treat marrow poorly”
What is the suffix for fluoroquinolones
-oxacin
Ciprofloxacin, nofloxacin, levofloxacin
What is the mechanism of fluoroquinolones
Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV
What are fluoroquinolones used for
Gram negative rods of GI and urinary tracts
Neisseria and some gram positives
What are toxicities to fluoroquinolones
Contraindicated in pregnancy and kids - cartilage damage
GI upset, skin rashes, tendon issues
What is the mechanism of metronidazole
Forms free radical toxic metabolites in bacterial cell that damage DNA
What is metronidazole used for
Giardia, Entamoeba, Trichomonas (GET)
Gardnerella, Anaerobes (bacteroides, C. difficile), with PPI and clarithromycin for triple therapy against H Pylori (GAP)
GET GAP on the METRO
