Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pharmacology > Ribosomal and DNA Abx > Flashcards

Ribosomal and DNA Abx Flashcards

1
Q

Tetracyclines

A
  • Tetracycline
  • Minocycline
  • Doxycycline***
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tetracycline MOA/MOR

A

MOA: 30S bacterial ribosome inhibition

MOR: Ribosomal binding site alterations, efflux pumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tetracycline pharm/interactions

A
  • May increase INR
  • Can’t combine isotretinoin –> Causes pseudotumor cerebri
  • Multivalent cations may decrease absorption

-Split excretion (60% hepatic/40% renal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tetracycline Pearls

A
  • Doxy can come in many different “salts” that drastically vary in price
  • Use generic doxycycline hyclate
  • These drugs seem protective against C diff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tetracycline ADRs

A
  • Nausea
  • Photosensitivity
  • Contraindicated pregnant women
  • Hyperpigmentation (minocycline)
  • Black hairy tongue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Doxycycline microbial coverage

A
  • CAP typicals
  • CAP atypicals
  • Rickettsia, Ehrlichia/Anaplasma, B burger
  • Pasteurella
  • Staph aureus
  • Chlamydia trachomatis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Common indications for Doxycycline

A
  • URTI*
  • CAP
  • NGU
  • Tick-borne disease (cutaneous manifestations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Extended-spectrum Tetracyclines

A
  • Tigecycline
  • Omadacycline
  • Eravacycline

MOA: 30S ribosome inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Extended-spectrum Tetracyclines pharmacology

A
  • Drug interactions
  • Split excretion
  • Bacteriostatic
  • Higher mortality, don’t use unless we have to!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Extended-spectrum tetracyclines

A
  • Broad-spectrum of activity that includes G=, G-, atypical, & anaerobic pathogens
  • Does NOT get pseudomonas
  • Used mostly for nosocomial infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Macrolides

A
  • Erythromycin
  • Azithromycin***
  • Clarithromycin

MOA: 50S ribosome
MOR: Binding site alterations, efflux pumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Macrolide interactions/pharm

A
  • All agents known to increase INR
  • Clarith/erythromycin: potent inhibitor of CYP3A4
  • All agents should not be used with other QT prolongers

-Hepatic excretion, bacteriostatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Macrolide class ADRs

A

-All associated with prolonged QTc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Erythromycin ADRs

A
  • Activate motilin receptors causing uncoordinated peristalsis and N/V/D
  • Used off-label as an agent in gastroparesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clarithromycin ADRs

A

-Metallic taste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Azithromycin ADRs

A
  • Generally well tolerated

- high dose can cause N/V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Macrolide coverage

A

Azithromycin: S pyogenes, S pneumo, Hib, M catarrhalis, chlamydial, legionella, mycoplasma, Bordetella pertussis (resistance to S pneumo + Hib limits use)

Clarithromycin: mostly used for H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Macrolide indications

A
  • URTIs ID hates em tho
  • CAP*
  • NGU*
  • Enteritis
  • H pylori (Clarithromycin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fidaxomicin pearls

A

MOA: Macrolide inhibits RNA polymerase

-BACTERICIDAL against C diff

Little to no activity against anything else other than clostridia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lincosamides

A

-Clindamycin

MOA: 50S ribosomal inhibition

MOR: Efflux pump, ribosomal target modification

21
Q

Lincosamides coverage

A
  • Covers most anaerobes
  • best above the diaphragm with oropharyngeal microbes
  • Often used to cover SA, S pyogenes, viridans strep in those with serious PCN allergies
22
Q

Lincosamide indications

A
  • Substitute for B lactam allergy in SSTI, strep pharyngitis
  • Anaerobic infections/abscesses
23
Q

Oxazolidinones, drug and MOA and MOR

A
  • Linezolid
  • Tedizolid
  • MOA: binds ribosomal 50s subunit
  • MOR: multiple mutations, slow to develop
24
Q

Drug interactions with oxazolidinones

A
  • MAOI -> levodopa

- Concomitant serotonergic drugs -> serotonin syndrome

25
Q

Oxazolidinones ADRs

A
  • Reversible thrombocytopenia (monitor platelets x2 weeks)
  • Watch dietary tyramine due to MAOI
  • Peripheral neuropathy
  • Serotonin syndrome
26
Q

Oxazolidinones uses

A

-MRSA and VRE infections (has broad gram + activity)

27
Q

Aminoglycosides, main drugs and MOA and MOR

A
  • Gentamicin
  • Tobramicin
  • Amikacin
  • MOA: inhibits 30s ribosome
  • MOR: ribosomal binding site alterations, efflux pumps, AGases
28
Q

Aminoglycoside pharmacology

A
  • Additive nephrotoxicity
  • Renal excretion
  • Bactericidal
  • Measure trough conc 30 min before next dose
  • Narrow spectrum abx, only covers aerobic gram negative**
29
Q

Aminoglycosides ADRs

A
  • Nephrotoxicity

- Ototoxicity (genta>tobra)

30
Q

Aminoglycosides clinical indications

A
  • Genta: aerobic GNBs (severe infections), endocarditis

- Tobra: most GNBs including pseudomonas

31
Q

Aminoglycosides claim to fame on the small drugs including: amikacin, streptomycin, neomycin, kanamycin, paromomycin, and spectinomycin

A
  • Amikacin: MDR GNBs
  • Streptomycin: TB
  • Neomycin: bowel cleansing
  • Kanamycin: surgical irrigation
  • Paromomycin: parasite and tapeworm infections
  • Spectinomycin: gonorrhea tx for allergic pts
32
Q

Pleuromutilins drug and MOA

A
  • Lefamulin

- MOA: binds peptidyl transferase center of 50s subunit of bacterial ribosome, inhibits bacterial protein synthesis

33
Q

Pleuromutilins pharmacology and ADRs

A
  • Pharm: hepatic excretion and bacteriostatic

- ADRs: N/D, QT prolongation

34
Q

Pleuromutilins microbial coverage:

A
  • Respiratory microbes
  • STI microbes
  • Tx indications: CAP
35
Q

FQs, drug MOA and MOR

A
  • Non respiratory: cipro
  • Respiratory: levo, moxi
  • Anti-MRSA: delafloxacin
  • MOA: inhibits DNA topoisomerases (unwinds), prevents replication
  • MOR: alterations in DNA topo, efflux pumps
36
Q

FQ interactions

A
  • Multivalent cations decrease absorption
  • Not with QT-prolonging agents
  • Clinically may raise INR
37
Q

FQ split excretion for levo, moxi, and cipro

A
  • Levo: 100% renal
  • Moxi: 90% hepatic
  • Cipro: 50/50
38
Q

FQ ADRs

A
  • Tendinopathy
  • Arthropathy (CI in kids <18, okay in CF kids)
  • Anaphylaxis and AIN
  • CNS toxicities (HA, anxiety; peripheral neuropathies)
39
Q

FQ Robert’s Nail in the Coffin ADRs

A
  • Photosensitivity (exaggerated sunburn)
  • QT prolongation
  • Dysglycemia*
  • HTX/liver failure
40
Q

You should not use FQ in these 3 diagnoses

A
  • Sinusitis
  • Bronchitis
  • Uncomplicated UTIs (cystitis)
  • HTN
  • Connective tissue disorders
  • Do not use under 18 yo
41
Q

Non-respiratory FQ coverage and tx indications

A
  • Coverage: aerobic GNBs

- Indications: diaphragm to pelvis (upper and lower UTI, tx of enteric infections/travelers diarrhea)

42
Q

Respiratory FQ coverage and tx indications

A
  • Coverage: increase activity for Strep pneumo and atypical respiratory/genital pathogens
  • Indications: upper and lower UTI (not moxi), enteric infections, URI/LRTIs
43
Q

Anti-MRSA FQ coverage and tx indications

A
  • Coverage: Kills MRSA, drug-resistant gono

- Indications: SSTIs and CAP (last resort)

44
Q

When should you use FQs?

A

When you are desperate

45
Q

Nitroimidazoles

A

-Metronidazole

46
Q

Nitroimidazole drug interactions (CYP)

A

-3A4 and 2C9 inhibitor (massive issues with Warfarin)

47
Q

Nitroimidazole ADRs

A
  • Metallic taste
  • Disulfuram-like rxn (avoid ETOH)
  • Fetotoxic in first trimester
  • Neurotox with several 2 week pulses
48
Q

Nitroimidazole coverage and tx indications

A
  • Coverage: most anaerobes (best below diaphragm), + C. diff, various protozoa (trich, giardia, entamoeba)
  • Indications: bacterial vaginosis, CDI, giardiasis and trichomoniasis, intrabd abscess

Clinical Pharmacology (54 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions