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Antimicrobials > Protein Synthesis Inhibitors > Flashcards

Protein Synthesis Inhibitors Flashcards

1
Q

Gentamicin is used in combination with a _______ or _________ for treatment of serious enterococcus, staphylococcus, viridian group streptococcus

A

Penicillin or vancomycin

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2
Q

Azithromycin is administered ____hour(s) before or ____hour(s) after a meal

A

1 hour before; 2 hours after

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3
Q

Major way resistance is adapted to tetracyclines

A

Efflux pump

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4
Q

Aminoglycosides that cause misreading of mRNA

Bactericidal/Bacteriostatic?

A

Bactericidal

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5
Q

Action of Erythromycin

A

Binds to 50S r-RNA and prevents movement along m-RNA

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6
Q

Ototoxicity of aminoglycosides is enhanced by

A

Loop diuretics

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7
Q

Action of streptomycin

A

Changes shape of 30S r-RNA and causes m-RNA to be read incorrectly

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8
Q

This drug inhibits the activity of peptidyltransferase (static)

A

Chloramphenicol

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9
Q

Aminoglycosides, Tetracyclines, Spectinomycin, affect ___S component of ribosomes

A

30S

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10
Q

Aminoglycosides are composed of aminosugars linked through ____bonds

A

Glycosides

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11
Q

Aminoglycosides that interfere with the initiation complex of peptide formation.

Bactericidal/Bacteriostatic?

A

Bacteriostatic

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12
Q

3 mechanisms of resistance to aminoglycosides

A

Acetylation
Adenylation
Phosphorylation

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12
Q

2 aminoglycosides less vulnerable to inactivation enzymes

A

Netilmicin

Amikacin

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13
Q

Aminoglycosides pharmacokinetics

A

Water soluble, poor absorption in GIT, parenteral Administration requires

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14
Q

Amikacin has the same spectrum as

A

Gentamicin

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15
Q

Single daily dose of aminoglycosides is just as effective and less toxic due to

A

Ototoxicity and nephrotoxicity

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16
Q

Linezolid affects ____S component of ribosomes

A

50S

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17
Q

Spectinomycin can be used as an alternative treatment for _______. Single dose of __grams

A

Gonorrhea; 2g

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19
Q

Inhibits CYP450 enzymes (2)

A

Erythromycin and Clarithromycin

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20
Q

Azithromycin is acid _____(stable/Labile)

A

Stable

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21
Q

Tetracycline spectrum

S. N. HP. HD. B. V. C. R. M. BB. P. C&C

A

Streptococcus, Nesseria, H. Pylori, H. Ducrei, Brucella, V. Cholera, chlamydia, rickettsiae, mycoplasma, Borrelia burgdorferi, Protozoa, Anaerobes (C. Perfringens, C. Tetani)

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22
Q

Aminoglycosides exhibit ________dependent killing and a _______ effect where antibiotic activity persists beyond the time during which measurable drug is present

A
  • Concentration-dependent

- Post antibiotic effect

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23
Q

Inhibits translocation of peptidyl-tRNA from acceptor to donor site (static)

A

Macrolides and clindamycin

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24
Q

Streptomycin spectrum (3)

A

Yersinia pestis
Francisella tularensis
Mycobacterium tuberculosis

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25
Q

Transport of aminoglycosides across the cytoplasmic membrane is enhanced by _____ or _____

A

Penicillin or vancomycin

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26
Q

Tertiary question: By what mechanism in protein inhibition is best to treat plague, tularemia, tuberculosis?

A

Change shape of 30S r-RNA to be read incorrectly

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27
Q

Action of chloramphenicol

A

Binds to 50S r-RNA and inhibits formation of peptide bond

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28
Q

Oral use of ____ for hepatic encephalopathy and in preparation for elective bowel surgery along with _____

A

Neomycin………Erythromycin

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29
Q

Aminoglycosides spectrum

A

Aerobic Gram - bacilli

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30
Q

Gram - bacteria that are Gentamicin-resistant usually are susceptible to _____

A

Amikacin

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31
Q

Amikacin is more potent against _______ than gentamicin

A

P. Aeruginosa

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32
Q

Second line drug for multi-drug resistant mycobacterium tuberculosis

A

Amikacin

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33
Q

Synergistic combination used in pseudomonal infections

A

Tobramycin + Piperacillin/ticarcillin

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34
Q

Most potent drug for P aeruginosa

A

Tobramycin

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35
Q

Using streptomycin in pregnancy can cause ___ in the newborn

A

Deafness

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36
Q

Complication of the GIT such as ____ can occur with use of tetracyclines.

A

Pseudomembranous colitis

37
Q

Mechanism of Demeclocycline

A

Blocks ADH receptor in collecting ducts

38
Q

2 aminoglycosides with limited topical use for minor soft-tissue infections

A

Neomycin and kanamycin

39
Q

Neomycin and kanamycin often used in combo with _____ and _____

A

Bacitracin and polymyxin

40
Q

Side effect of Demeclocycline

A

Diabetes insipidus

41
Q

MG patients should take caution when taking _____ due to a _____

A

Aminoglycosides…..curare like effect

42
Q

1st line therapy for chlamydial urogenital infections during pregnancy

A

Erythromycin 500 mg 6 hours for 7 days or single dose Azithromycin

43
Q

Spectinomycin is a ______ antibiotic

A

Aminocyclitol antibiotic

44
Q

Antidotes for aminoglycosides overdose

A

Neostigmine and calcium gluconates

45
Q

Brucellosis treatment (2)

A

Gentamicin + doxycycline

46
Q

Paromomycin spectrum

E. C. L. T.

A

Entamoeba histolytica
Cryptosporidium Parvum
Leishmaniasis
Tapeworms

47
Q

Action of tetracycline

A

Interferes with the t-RNA anticodon reading of m-RNA codon by binding reversibly to 30S subunit

47
Q

Doxycycline and tigecycline are eliminated mainly by

A

The liver

48
Q

3 types of drugs that cause phototoxicity

A

Tetracyclines, sulfonamides, fluroquinolones

50
Q

Azithromycin is most commonly used in (3)

A

CAP
Pharyngitis/skin infections
Chlamydia infections

51
Q

Gentamicin spectrum

P. K. P. S. E. E.

A 
P. Aeruginosa
Klebsiella
Proteus 
Serratia
E. coli
Enterobacter sp.
52
Q 
Nephrotoxicity of aminoglycosides is enhanced by:
V
A
C
C
A

Vancomycin
Amphotericin B
Cisplatin
Cyclosporine

54
Q

Drug of choice for mycoplasma

A

Tetracycline

57
Q

What macrolide is highly active against chlamydia?

A

Azithromycin

59
Q

Endocarditis treatment using a protein synthesis inhibitor and_____

A

Streptomycin and penicillin

62
Q

Drug of choice for Rickettsiae, spirochete, chlamydia

A

Doxycycline

63
Q

Treatment of Chloroquine-resistant Malaria with_____

A

Tetracyclines

64
Q

Only tetracycline that is therapeutically efficient to enter CSF

A

Minocycline

65
Q

Result of tetracyclines on pregnant woman

A

Crosses placenta to cause bone deformities and tooth dysplasias

66
Q

Renal complications from tetracyclines (2)

A

Fanconi syndrome; diabetes insipidus with Demeclocycline

67
Q

What is the oral tetracycline of choice?

A

Doxycycline

68
Q

Minocycline & Doxycycline pharmokinetics

A

Completely absorbed, impaired by cations, dairy foods and antacids, extremes in bile & urine

68
Q

In renal disease, can doxycycline be administered? Why?

A

Yes- it is extremes in the bile

68
Q

Which ways to administer tetracyclines? (IV, IM, oral)

A

IV and oral (not IM)

68
Q

Administration and excretion of glycylcyclines: tigecycline?

A

Give slow IV infusion 30-60 min. Excreted in bile.

69
Q

A patient was bitten by a tick, within ____hours, you may administer a single,______mg dose of ______

A

72 hours; 200 mg; doxycycline

69
Q

Nausea, anorexia, diarrhea from tetracycline can be controlled by giving with food or _________.

A

Carboxymethylcellulose

70
Q

What form of erythromycin causes cholestatic jaundice?

A

Estolate

75
Q

Macrolides contain a ______ring to which ____________ are attached

A

Lactone ring; deoxy sugars

77
Q

Macrolides are mainly

Bacteriostatic/bacteriocidal?

A

Bacteriostatic

78
Q

Macrolides bind with _____________ in GIT and increases intestinal motility

A

Motilin receptors

79
Q

Name a ketolide

A

Telithromycin

80
Q

Name 4 macrolides

A

Erythromycin, Clarithromycin, Azithromycin, Roxithromycin

81
Q

Clarithromycin and Azithromycin are better than Erythromycin because Erythromycin….

A

Poor bioavailability
Short half life
Poor GI tolerability
Limited H. Influenzae coverage

82
Q

Adverse effects of macrolides (4)

A

Epigastric distress
GIT problems
Cholestatic jaundice
Prolong QT interval

83
Q

Mechanism of action of Macrolides

A

Protein synthesis inhibitors irreversibly bind to 50S subunit and inhibit translocation step

84
Q

Spectrum of macrolides

A

Gram +
Gram -
Atypical organisms
Spirochetes

85
Q

Azithromycin is more active in ______ infections than Erythromycin

A

Respiratory

86
Q

Erythromycin is acid _____(stable/labile) hence administered with ______

A

Labile; enteric coating

88
Q

Does Erythromycin enter CSF?

A

No

89
Q

Erythromycin and Clarithromycin inhibit metabolism of (5)

A 
Theophylline
Warfarin
Cyclosporine
Methylprednisolone
Digoxin
90
Q

Erythromycin is primarily excreted in ______

A

Bile

91
Q

Azithromycin is excreted by _____

and is _____(more/less) tolerated in pregnancy than other macrolides

A

The kidney; more

92
Q

Drug of choice for Diptheria

A

Erythromycin

93
Q

Whooping cough should be treated with

A

Erythromycin

94
Q

Azithromycin is more active against _______ than Clarithromycin and erythromycin

A

H. influenzae

95
Q

Oral erythromycin base is sometimes combined with _____ or ______ for preoperative preparation of the colon

A

Neomycin or kanamycin

96
Q

Clarithromycin is more active against _________(2) than erythromycin

A

Mycobacterium avian complex and H pylori

97
Q

Are erythromycin-resistant strep and staph also resistant to Clarithromycin?

A

Yes

Antimicrobials (6 decks)

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