Protein Synthesis inhibitors- Macrolides, tetracyclines Flashcards
List the Macrolides
Azithromycin
Clarithromycin
Erythromycin
Are macrolides bacteriostatic or Bacteriocidal?
Bacteriostatic, may be cidal in very high doses
Covers which gram pos cocci (this is an alternative for pen-allergic pt)
Strep pneumo, strep pyo (pneumonia, pharyngitis)
Covers which gram neg cocci
M. Catt (otitis media, community aquired pnuemonia)
Covers which gram neg bacilli
bordatella pertussis (ALL), H. Flu (Az and Cl), H. Pylori (Cl) Leigionella (Az)
Covers which gram pos bacilli
diptheria (e-mycin)
Macrolides are distributed into the brain and CSF (true or False)
False, widely distributed everywhere else. It even penetrates the placenta and enters the fetus
Erythromycin is metabolized via the _____
a. Kidneys
b. Liver
b. it is metabolized by the liver and excreted by bile. Would probably need to be dosed differently for those with liver disease
Clarithromycin is metabolized by_______
Kidneys
_______ is not metabolized at all. it has high tissue penetration.
Azithromycin
A serious side effect of macrolides is that they can
a. cause QT prolongation
b. can abort a fetus
c. cause poisoning
a. QT prolongation: DO NOT give with other meds that have this side effect as well.
A few medication known to have drug -drug intactions with macrolides (except azitrhomycin)
theophylline, warfarin, methylprednisolone, cyclosporine, SSRIs, benzodiazepines.
List the tetracyclines
Doxycycline, Minocylcine, Tetracycline
DMT
Are tetracyclines bacteriostatic or bacteriocidal?
Bacteriostatic
When resistance to tetracyclines occur what is an option?
Tigacycline, it is not affected by the same mechanisms of resistance as the others are.
What is the spectrum of tetracyclines
a. gram neg
b. gram pos
c. broad spectrum
These are broad spectrum but this has led to wide spread resistance due to over use
The gram pos cocci that are not resistant to tetracyclines
Staphylococcus aureus (MRSA): localized cutaneous infection, pneumonia, food poisoning (doxy, mino, tige)
The gram neg cocci that are not resistant to tetracyclines
Moraxella catarrhalis –> otitis media, community-acquired pneumonia [Doxycycline]
The gram pos bacillus that is not resistant to tetracyclines
Bacillus anthracis – anthrax [Doxycycline]
The gram neg bacilli that is effective against tetracyclines
H. influenzae – otitis media, community-acquired pneumonia [Doxycycline]
H. pylori – peptic ulcers [Tetracycline]
Vibrio cholerae – cholera [Doxycycline]
Anaerobes treated with tetracyclines
Propionobacterium acnes (gram + rod) – acne [Minocycline, Doxycycline]
Atypical organisms treated by tetra cyclines
Chlamydia -trachoma, community-acquired pneumonia, urethitis [Doxycycline]
Mycoplasma pneumoniae – community-acquired pneumonia [Doxycycline]
Richettsia – Rocky Mountain spotted fever, Q fever [Doxycycline]
Spirocetes treated with tetracyclines
Borrelia burgdorferi – Lyme disease (early) [Doxycycline]
Most of the tetracyclines are best absorbed on an______ stomach
empty
what dietary choice hinders the absorption of tetracyclines?
dairy products
Which tetracycline is the choice for patients with renal disease or are breast feeding?
Doxy
Most of them are excreted into the urine except for which two?
Doxy and mino
Tetracyclines are concentrated in the ________. For this reason you need to try to avoid for those with hepatic impairment
Liver
You have an 8 year old pateint you notice that his teeth are a gray color. You suspect that he was given a course of ________ when he was younger
Tetracyclines. for this reason they should not be given to children under 8 or to women in the second half of pregnancy.. They cause a temporary depression of bone growth
Some drug - drug interactions to consider with tetracyclines
Antacids / Iron Supplements
Phenytoin / Barbiturates / Carbamazepine
Oral Anticoagulants
