Protein Synthesis Inhibitors

Question 1

Name the macrolides?

3

Answer 1

Erythromycin
Azithromycin (Zithromax)
Clarithromycin (Biaxin)

Question 2

What kind of bacteria does erythromycin work against?

2 with 3 and 2

Answer 2

Bacteria lacking cell walls
-Mycoplasma
-Legionella
-Chlamydia
Gram + and Gram -
-Strep pneumo
-GABH strep

Question 3

Specific diseases that erythromycin is typically prescribed for?
4

Answer 3

Strep throat (if allergic to penicillin)
CAP
Topically for acne
GOOD IN PREGNANCY

Question 4

Most common side effect of erythromycin?

Answer 4

POOR GI Tolerance

Question 5

As far as coverage goes what does Azithromycin (Zithromax) cover better than Erythromycin?
(name all that it covers though)
7

Two shared
Two only Z

Best coverage for?

Answer 5

-Strep pneumo
-GABH strep
Covers all that Erythromyscin covers except also:
-H. Flu
-Moraxella

The best atypical coverage

• Mycoplasma
• Legionella
• Chlamydia

Question 6

What specific diseases/infections is Azithromycin (Zithromax) typically used for?
3

Answer 6

CAP
ABECB
1 time dose for chlamydia
- more effective aganinst respiratory infections

Question 7

What is Clarithromycin used for?

Answer 7

Same as the other macrolides

Question 8

What diseases/infections is Clarithromycin typically used against?
6

Answer 8

CAP
Legionella
H. pylori
Sinusitis
Bronchitis
ABECB

Question 9

What is the MOA for macrolides?

Answer 9

BInd to 50s ribosomal subunit (bacteriostatic)

Question 10

S/E of macrolides?
(specifically erythromycin?)
3

Answer 10

GI distress
Many drug to drug interactions because of cytochrome P450
Increased instance of muscle toxicity

Question 11

What are the tetracyclines?

4

Answer 11

Tetracycline
***Doxycycline: by far the most important one you need to understand in this class!!

Minocycline
Demeclocycline

Question 12

What specific diseases/infections is Doxycycline used for typically?

Answer 12

drug of choice for

1. mycoplasma pneumoniae,
2. chlamydiae (which can be responsible for a variety of STIs), 3. rickettsiae (Rocky Mountain Spotted Fever), and excellent for 4. Lyme Disease
3. PID

Question 13

What is Minocycline used for commonly?

Answer 13

ance usually

Question 14

WHat is tetrcycline used for commonly?

Answer 14

acne

Question 15

What is Demecolcycline used for?

Answer 15

treatment of SIADH

Question 16

MOA for tetracyclines?

Answer 16

Binds to 30s ribsosomal subunit (bacteriostatic)

Question 17

What kind of bacteria is tetracylines good against?

Answer 17

gram + and Gram -

Question 18

Side effects to remmeber with tetracyclines?

4

Answer 18

Photosensivity
Dental staining
NOT used in children
Hepatotoxic

Doxy is safe in renal pts

Question 19

What does Clindamycin cover?

Answer 19

1. Gram + cocci

2. most anaerobes above the diaphragm

Question 20

What do we need to remember about clindamycin?

Answer 20

Clostridium difficile is ALWAYS resistant to clindamycin
Note: Clostridium difficile is a bug that hangs out in the gut and typically causes zero problems. However, with administration of Clindamycin you can potentially have overgrowth of Clostridium difficile which can lead to a potentially fatal disease referred to as pseudomembranous colitis

Question 21

What does chloramphenicol cover?

Answer 21

Broad spectrum
-high toxicity- only used for life thretening infections

GOOD CNS penetration

Question 22

Mechanism of action for chloramphenicol?

Answer 22

bind to 50s ribosomal subunit- inhibits protein synthesis

Question 23

Side effects to remember for chloramphenicol?

3

Answer 23

Bone marrow suppression
Grey baby syndrome
Anemias (reversible, hemolytic, aplastic)