protein synthesis inhibitors Aminoglyco and macrolides Flashcards
What are the Aminoglycosides
Gentamycin Neomycin Amikacin Tobramycin Streptomycin Netilmicin
What are the Macrolides
Erythromycin
Clarithromycin
Azithromycin
Telithromycin
Which bind 30S
Aminogycosides
Tetracyclines
Glycylcyclines
Which inhibit 50S
Chloramphenicol Clindamycin Macrolides Linezolid Streptogramins
DOC plague
Streptomycin
Adjunct for hepatic encephalopathy
Oral Neomycin
Action of Oral Neomycin in hepatic encephalopathy
Reduce NH3 formation by gut bacteria
Only useful against aerobes
Aminogycosides
Main Aminoglycoside AE
Nephrotoxicity (ATN)
Ototoxicity
Good choice for Pts with PCN allergy
Macrolides
Empirit Tx community acuired PNA and pseudomonas
Macrolides
DOC pertussis
Erythromycin
What is contraindicated to give with MAcrolides
Statins
P450 inhibition
Which Macrolide doesn’t inhibit P450
Azithromycin
What is the Macrolide effect on the heart
QT prolongaion
Irreversible 30S inhibition
Aminoglycosides
Oral/Topical Aminoglycoside
Neomycin
Contraindicated in Myasthenia
Aminoglycosides (NMJ blockade)
Why are Aminoglycosides only good for Aerobes
O2 dependent transport into G-
Aminoglycoside excretion
Renal
Aminoglycoside Resistance mechanisms
Plasmid to modify/inactivate
Decreased accumulation
Altered/deleted receptor on 30S
How does Lactulose cause osmotic diarrhea
Acidify gut lumen trapping NH4+
Good for URTs
Macrolides
Bacteriostatic but cidal at high concentrations
Macrolides
What can Macrolides have cross-reactivity with
Clincamycin
Chloramphenicol
Can cause hepatotoxicity, MG exacerbation and visual disturbances
Telithromycin
Macrolide with worst oral absorption and f
Erythromycin
Macrolide with greatest tissue penetration
Azithroycin
Telithromycin
Additional Macrolide AE
GI effects (motilin) Cholestatic hepatitis
Macrolide Resistance
Decrease influx,
Increase efflux
Esterase hydrolyzes
Methylate binding site
What does Clindamycin cross react with
Macrolides
