Protein Synthesis Inhibitors (Aminoglycosides and Tetracylines) Flashcards
The “S” in 30S and 50S means?
“Svedberg”
Aminoglycosides usually have this suffix on their names
-mycin
Aminoglycosides have the suffix “-mycin” except
amikacin
An aminoglycoside that is commonly used for PTB
Streptomycin
The abbreviation of the medication used to treat PTB
RIPES
What does “RIPES” mean?
Rifampicin Isoniazid Pyrazinamide Ethambutol Streptomycin
What does PTB mean?
Pulmonary Tuberculosis
True or False:
The RIPE medication are separated for PTB treatment.
FALSE. The RIPE medication is put into one tablet.
The RIPE drugs are what type of medication?
Antimycobacterial
Which RIPES drug is usually removed due to its adverse effects?
Streptomycin
Streptomycin is removed as a medication against PTB because?
It is usually removed because:
- of its adverse effects
- it is not compatible to all patients
The medication for PTB must continue for how many months?
3 to 6 months
After how many weeks of medication will a PTB patient become non-infective or non-virulent
2 weeks
The “DOTS” in TB-DOTS means?
Directly Observed Treatment, Short-course
An aminoglycoside used to treat neonates with sepsis.
Neonates means newborn
Gentamicin
An aminoglycoside used for eye treatment, usually for post-surgery cataract.
Tobramycin
Tobramycins used for eye treatment are in what form?
Ophthalmic drops
Tobramycin is usually associated with what drugs?
Dexamethasone
Dexamethasone, usually associated for tobramycin, is a what type of drug?
Dexamethasone is an anti-inflammatory steroid
Aminoglycosides’ antimicrobial action:
- across the membrane
- irreversibly trapped in cytoplasm
- binds to ribosome, miscoding the protein synthesis of the bacteria
It holds the organelles of the cell
Cytoplasm
Aminoglycosides are effective against:
- gram-negative bacteria
- pseudomonas
- brucella
- listeria
- streptococci
Aminoglycoside drugs are used against these bacteria because penicillins and cephalosporins are not effective.
Brucella and listeria
This bacteria causes cough
Streptococci
Aside from PTB, streptomycin is used against
Tularemia and plague
The plague comes from what animals?
Rats
True or False:
Aminoglycosides are usually used alone even in serious infections.
FALSE. Aminoglycosides are usually used in combination with beta-lactams in serious infections.
Aminoglycosides are usually in combination with?
beta-lactams
A time after the use of antibiotics when there is no growth of bacteria
Post-antibiotic effect
The post-antibiotic effect states that a patient can take the same drug again after how many months?
3 months
This is the amount of time the amount of drug lessens into half
Half-life
How many times in a day would a patient drink 75mg of ambroxol?
OD (once a day)
How many times in a day would a patient drink 30mg of ambroxol?
TID (thrice a day)
What toxicity can streptomycin cause?
Nephrotoxicity
This means an injury of renal proximal tubes
Nephrotoxicity
Nephrotoxicity can lead to the injury of?
Renal proximal tubes
Nephrotoxicity can increase the rate of?
It can increase the glomerular filtration rate
Ototoxicity is the damage of?
damage of cochlea and vestibular apparatus
It means the damage of cochlea and vestibular apparatus
Ototoxicity
Toxicity caused by aminoglycosides
Nephrotoxicity and ototoxicity
Neuromuscular blockade can cause:
- Weakness of respiratory musculature
- Flaccid paralysis
- Dilated pupils
True or False:
Neuromuscular blockade is rare but lethal
TRUE. It is rare but lethal.
True of False:
Ototoxicity only happens bilaterally.
FALSE. It can happen either unilaterally or bilaterally.
This helps lower the risk of nephrotoxicity and ototoxicity
Once-daily regimen
This is obtained to ensure efficacy
Peak serum level
This is obtained to reduce risk of toxicity
Serum level
Normal renal functions through levels can be obtained after how many hours?
18-24 hours
After 18-24 hours, how often is the serum creatinine level monitoring?
once or twice a week
What is the structure of tetracyclines?
“Four rings”
The types of tetracyclines are based on?
The duration of action
Examples of short-acting tetracycline
Oxytetracycline
Tetracycline
Example of intermediate tetracycline
Demeclocycline
Examples of long-acting tetracycline
Doxycycline
Minocycline
A long-acting tetracycline used for prophylaxis for leptospirosis
Doxycycline
Leptospirosis is caused by what bateria?
Leptospira
Leptospira can be found in flood and what body of water?
Lakes
Example of new cyclines
Tigecycline (Tygacil)
This is used when tetracyclines are not effective anymore.
Tigecycline
Tetracyclines must not be used with products containing?
Calcium
Tetracycline is not for what age group?
Children
Tetracycline competes with _____ and can lead to _____ malformation.
Tetracycline competes with [calcium] and can lead to [bone and teeth] malformation.
Mechanism of Action of Tetracycline
- passive diffusion through porins in bacterial cell
- binds to ribosomes, prevents addition of new amino acids into growing the peptide chains
Major Indications of Tetracycline
- Borrelia infections
- Brucellosis
- Chlamydia infections
- Rickettsia infections
- Cholera
- PID syndrome
An STD that usually infects females
Chlamydia
A protozoal infection that is treated with tetracycline
Rickettsia infections
Causative agent of cholera
What bacteria causes cholera
Vibrio cholera
Cause of cholera
Contaminated water
“Vibrio” in Vibrio cholera means?
It is kidney-bean shaped
Preclinical presentation of cholera
What does it look like
Rice water stool
Acne can be treated with what tetracycline?
Doxycycline
Anthrax is caused by what bacteria?
Bacillus anthracis
This infection was used as a biological weapon in 2001 in a form of letter
Anthrax
Anthrax can be found in?
Carcasses of sheep
Causes Legionnaire’s disease
Legionella
Legionella was found in what appliance?
Air conditioners
A pneumococcal infection that can be treated with tetracycline
Mycoplasma
Associated with the plague
Rat-bite fever
Always remember that the plague is caused by rats
An STD that can be treated with tetracyclines
Syphilis
Tetracycline toxicities occur as/in:
- Allergic reactions
- Teeth and bones
- GI (gastrointestinal) tract
Allergic reaction caused by tetracyclines
- rashes
- anaphylaxis
- lupus-like syndrome
- Vertigo, dizziness, tinnitus
A disease where the immune system or the antibodies attack your body
Lupus
Tetracycline toxicity to the teeth and bones
- becomes gray-brown; discolors into yellow for children under 8 yrs old
- depression of skeletal growth in preterms
(Remember that tetracyclines compete with calcium)
Tetracycline toxicity in the GI (gastrointestinal) tract
- esophageal ulceration
- vomiting
- epigastric distress
- hepatotoxicity in pregnant women and patients with renal failure
A semisynthetic derivative of tetracycline antibiotics
Glycylcycline
It maintains antibacterial effects but provides stability against mechanisms of tetracycline resistance
Tigecycline
Tigecycline inhibits protein translation by binding to the ______ and blocking entry of _____ into the _____ of the ribosome.
Tigecycline inhibits protein translation by binding to the [30S ribosomal subunit] and blocking entry of [amino-acyl tRNA molecules] into the [A site] of the ribosome.
Mnemonics:
Buy AT 30 means?
Buy
AT -> aminoglycoside, tetracycline
30 -> 30S
Mnemonics:
CEL at 50 means?
CEL -> clindamycin, erythromycin, lincosamides
at
50 -> 50S
Indications of Tigecycline
Adults with:
- skin complications (caused by staph. au. or strep.)
- intra-abdominal infections
Protein synthesis inhibitors are (bactericidal, bacteriostatic)
Protein synthesis inhibitors are [bacteriostatic]
An inhibitor drug usually misused to treat ulcer
Omeprazole
How many hours is the interval between drinking antibiotics and omeprazole?
2 to 3 hours
