Protein synthesis inhibitors

Question 1

name the protein synthesis inhibitor groups

Answer 1

Tetracyclines, Glycyclines, Aminoglycosides, Macrolides/Ketolides, Others..

Question 2

Tetracycline group

Answer 2

Demeclocyline, Doxycycline, Minocycline, Tetracycline

Question 3

Glycycline group

Answer 3

Tigecycline

Question 4

Aminoglycoside group

Answer 4

Amikacin, Gentamicin, Neomycin, Streptomycin,Tobramycin

Question 5

Macrolide/Ketolide group

Answer 5

Azithromycin, Clarithromycin, Erythromycin, Telithromycin

Question 6

Others group

Answer 6

Cloraphenicol, clindamycin, Linezolid, Quinupristin/Dalfopristin

Question 7

Tetracycline site of action

Answer 7

Reversibly bind to 30S ribosomal subunits

Question 8

Tetracycline spectrum

Answer 8

Broad spectrum bacteriostatic, gram+ bacilli and gram- rods, and organisms other than bacteria

Question 9

Organisms effected by tetracyclines

Answer 9

All cocci, Bacillus anthracis+, Vibrio cholerae-, Yersinia prestis-, Clostridium prfringens/tetani, Borelia burgdoferi , Leptospira, Mycoplasma pneumoniae, Chlamydia, Rickettsia rickettsi

Question 10

Tetracycline distribution

Answer 10

Liver, kidney, spleen and skin, bind to tissue undergoing calcifications,

Question 11

Tetracycline elimination

Answer 11

Both bile and glomerular filtration (breast milk)

Question 12

Doxycycline elimination

Answer 12

preferably through bile

Question 13

Tetracycline Adverse effects

Answer 13

Gastric discomfort, discoloration of teeth and hypoplasia of bone during development, hepatotoxicity in pregnant women with pyelonephritis, phototoxicity, Vestibular problems, Superinfections

Question 14

Tetracycline Absorption

Answer 14

adequately absorbed after oral ingestion, Do not ingest together with diary products or divalent/trivalent cations because of decreased absorption.

Question 15

Tetracycline contraindications

Answer 15

Renally impaired patients (except doxycycline) Not use in pregnant women or children under 8 years

Question 16

Glycylcyclines (Tigecycline) Spectrum

Answer 16

MRSA, Multi resistant Strep pneumo, VRE, B-lactamase producing gram- bacteria, Acinetobacter baumannii

Question 17

Tigecycline distribution

Answer 17

Distributes rapidly to body tissues, and sould never be used against bacteremia

Question 18

tigecycline elimination

Answer 18

primarily through bile.

Question 19

Tigecycline adverse effects

Answer 19

Significant nausea and vomiting, otherwise same as other tetracyclines

Question 20

Tigecycline interactions

Answer 20

No P450 interaction, Inhibits clearance of Warfarin, diminishes effectiveness of contraceptives.

Question 21

Tigecycline site of action

Answer 21

Bacteriostatic, reversibly binding to 30S subunit inhibits translation

Question 22

Aminoglycosides action

Answer 22

Gram- bacilli, diffuse through porin channels, bactericidal bind to 30S

Question 23

Aminoglycosides spectrum

Answer 23

gram- bacilli, pseudomonas aeruginosa, Only aererobic organisms (unless used together with a B-lactam/Vancomycin)

Question 24

Clinical use monotherapy

Answer 24

Only UTI

Question 25

Aminoglycosides adminisration

Answer 25

only parenterally (except neomycin, but is so nephrotoxic that it is only used topically)

Question 26

Dose calculation (aminoglycosides)

Answer 26

Lean body mass, since aminoglycosides don’t distribute to fat.

Question 27

aminoglycoside metabolism

Answer 27

is not metabolizes in the body, quickly excreted to urine NB patients with renal impairment

Question 28

Patient with myasthenia gravis is given an aminoglycoside abx, what would reverse the neuromuscular paralysis?

Answer 28

Calcium gluconate or neostigmine

Question 29

aminoglycoside acumulation

Answer 29

accumulates in perilymph, endolymph and renal cortex, hence oto- and nephrotoxixcity

Question 30

aminoglycoside ototoxicity

Answer 30

may lead to deafness, known to affect fetuses in utero

Question 31

aminoglycoside nephrotoxicity

Answer 31

affects proximal tubular cells, can range from mild renal impairment to ATN

Question 32

Ketolide

Answer 32

telithromycin

Question 33

Macrolides site of action

Answer 33

Bids to the 50S subunit inhibits translocation, is bacteriostatic, but can act bacteriocidal in high doses

Question 34

Erythromycin spectrum

Answer 34

acts on many of the same organisms as Penicillin G, is used in patients with penicillin sensitivity

Question 35

Clarithromycin spectrum

Answer 35

similar to erythromycin, but additional H. Influenza, Chlamydia, Legionella, Moraxella, Ureaplasma, H. Pylori.

Question 36

Azithromycin spectrum

Answer 36

Better action against, H. influenza, Moraxella, Chlamydia, Mycobacterium avium.

Question 37

Telithromycin spectrum

Answer 37

A ketolide, acts on same organisms same as azithromycin, but more effective on resistant strains.

Question 38

cross-resistance of macrolides

Answer 38

all… erythromycin, azithromycin, clarithromycin , except for the ketolide, telithromycin..

Question 39

Erythromycin distribution

Answer 39

all body fluids and tissues especially liver, even prostatic fluid, except CSF,

Question 40

erythromycin accumulation

Answer 40

accumulates in macrophages

Question 41

Tetracyclines primary use

Answer 41

Mycoplasma pneumo, Chlamydia, Rickettsia, Vibrio.

Question 42

Tetracyclines secondary use

Answer 42

acne and resp infections for susceptible organisms

Question 43

Tetracycline specific use

Answer 43

H pylori

Question 44

Doxycycline spec use

Answer 44

lyme disease, malaria prophylaxis, amebiasis

Question 45

minocycline spec use

Answer 45

meningococal carrier state

Question 46

Demeclocycline specific use

Answer 46

inhibits ADH action on kidneys.. used for patients with ADH secreting tumors.