Protein synthesis inhibitors - clindamycin, aminoglycosides

Question 1

Is clindamycin bacteriocidal or bacteriostatic?

Answer 1

static, but can be cidal at high concentrations on certain organisms

Question 2

clindamycin is used for what type of infection

a. mild
b. severe
c. skin only

Answer 2

b. clindamycin is used for severe infections (mainly severe anaerobic infections) - no gram neg cocci coverage

Question 3

What gram pos cocci are effectively treated by clindamycin

Answer 3

Strep. pneumoniae and S. pyogenes  -- pneumonia, pharyngitis (alternative if penicillin allergic)
Staphylococcus aureus (MSSA)--  osteomyelitis (alternative if penicillin allergic)
Staphylococcus aureus  (MRSA) --  localized cutaneous infection

Question 4

what anearobes are treated by clindamycin?

Answer 4

Clostridium perfringens (gram + rod)--  gas gangrene, food poisoning
Bacteroides fragilis  (gram – rod)  --  intraabdominal and brain abscess
Propionobacterium acnes  (gram + rod) -- acne  (topically)

Question 5

Clindamycins penetrate most tissues well but especially well into ______ but poorly into _____
A. lungs, GI
B. Skin, GU
C. Bone, CSF

Answer 5

C. Bone, CSF

Question 6

Clindamycin is metabolized in the______.

Answer 6

Liver. The biliary excretion. iT is also excreted in breast milk

Question 7

An adverse reaction that causes a c. diff infection

Answer 7

psuedomembrane colitis. (he mentions it is probably no worse than other broad spectrum agents

Question 8

Name the aminoglycosides

Answer 8

Streptomycin, Tobramycin, Gentamicin, Amikacin, Kanamycin, Neomycin

Question 9

Are the aminoglycosides bacteriocidal or bacteriostatic

Answer 9

clinically - cidal

but static in high concentrations

Question 10

are aminoglycosides effective against anaerobes?

Answer 10

Nope, they require O2 to get into the bacteria

Question 11

Aminoglycosides are not widely used because of?

Answer 11

toxicity

Question 12

Gram negative bacilli that aminoglycosides are effective on

Answer 12

Pseudomonas aeruginosa  infections in any organ or tissues (especially nosocomial)
E. coli, Klebsiella, Serratia, Proteus, Enterobacter (enteric gram negative)  urinary tract infections, lower respiratory infections, bacteremias
Mycobacterium tuberculosis  tuberculosis [Streptomycin plus multiple antitubercular drugs]

Question 13

gram pos cocci that aminoglycosides are effective on

Answer 13

Enterococci  bacteremia, endocarditis, intraabdominal infections [Gentamicin plus a penicillin or vancomycin]

Question 14

Aminoglycosides are poorly absorbed orally. They are rapidly abosorbed via _____

Answer 14

intramuscular injection.

Question 15

Aminoglycosides accumulate in the______ and the ______ causing ototoxicity and renal toxicity

Answer 15

renal cortex and inner ear

Question 16

Because they are not metabolized and they have a haf life of 2-3 hours aminoglycosides can be given how?

Answer 16

in single doses.