Ribosomal Antibiotics Flashcards

1
Q

Ribosomal Antibiotics

A

SAT C MLS L

Sprectinomycin

Aminoglycosides

Tetracyclines

Chloramphenocol

Macrolides

Lincomides

Stregogramins

Linezolid

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2
Q

Spectinomycin- MOA

A

binds to 30s subunit and prevents the formation of the initation complex

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3
Q

Spectinomycin- MOR

A
  1. Change in Binding Site
  2. Produce innactivating enzyme
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4
Q

Spectinomycin- admin

A

Parenteral

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5
Q

Spectinomycin- t 1/2

A

1-2 hours, 50 hrs in kidney failure

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6
Q

Spectinomycin- Use

A
  1. Single Dose Antibiotic tx for Gonorhea when resistant organisms are present and want to use a parenteral form
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7
Q

Aminoglycosides- MOA

A

Binds to 30s subunit –>

  1. inhibits 70s formation
  2. inhibits polyribosome formation
  3. misreading mRNA
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8
Q

Amigoclycosides- MOR

A
  1. Group transferases which innactivate the drug- Amino acetyl/aldenyl/Phospho- trasferases
  2. Normal inhibitory mechs
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9
Q

Aminoglycosides- Transport into cells

A
  1. passive diffusion through porins
  2. active transport across the cell membrane via O2 DEPENDENT MECHANISM, with energy from the E/C gradient, coupled to a protein pump

Therefore it only works on aerobes and is better with a cell wall destroying agent ie beta lactams

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10
Q

Aminoglycosides- AE

A
  1. Neprhotoxic
  2. Ototoxic- cochlear and vestibular
  3. Neurotoxic
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11
Q

What organ failure requires dose change of aminoglycosides

A

Renal

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12
Q

Aminoglycosides wide or narrow therapeutic range?

A

Narrow

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13
Q

Aminoglycosides- how is it dosed, what properties of aminoglycosides allow it to be dosed that way

A

dosed once a day for 3 reasons

  1. concentration dependent killing
  2. long post antibiotic effect
  3. nephrotoxicity is based on amount of time it spends at the trough, longer trough= more nephrotox, as does any dec RBF or underlying renal failure
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14
Q

Aminoglycosides- spectrum

A

Gram negative aerobes

  1. PSEUDOMONAS
  2. E.Coli
  3. Proteus
  4. klebsiella
  5. Enterobacter
  6. Serratia
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15
Q

Aminoglycosides- ROA

A

IV

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16
Q

Aminoglycosides- excretion

A

renal

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17
Q

Aminoglycosides- Drugs

A
  1. Streptomycin
  2. Gentomycin
  3. Tobramycin
  4. Neomycin
  5. Actinomycin
  6. Netilmicin
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18
Q

Streptomycin

A
  • ROA: IV
  • renal failure: huge t1/2 inc in renal failure
  • use: in Tb
  • AE: very nephrotoxic and vestibular toxic with minimal GI
19
Q

Neomycin

A
  1. Admin- Topical (neosporin), Oral
  2. AE- highly nephroand choleartoxic-
  3. Absorption- not absorbed in bowel UNLESS there is damage
  4. Uses- bowel prep before surgery, with another drug for Gram +’s
20
Q

Amikacin

A
  1. Resistance- resistance to most group transferases
  2. Use- use in the hospital if something is resistant to Gentimycin or Tobramycin
21
Q

Tetracylines- MOA

A
  1. binds to 30s subunit–> blocks aminoacyl tRNA from binding to mRNA and the ribosome complex
22
Q

Tetracyclines- MOR

A
  1. MOR- plasmid mediated efflux pump
23
Q

Tetracycline- Specturm

A
  1. Staph/ Strep/ Enteric Anaerobes
  2. Resp infxn- H.Flu, penumococcus
  3. Pneumoia- Mycoplasma Pneumonia, Chlamydophila, Legionella (DOC in atypical penumonia)
24
Q

Tetracyline- DOC

A
  1. atypical pneumonia
  2. STD- chalidmyia, PID, urea plasma, chancre
  3. Ricketsia
  4. Acne
  5. Lyme dz
25
Q

Tetracycline- absorption

A

Oral absorption

Interfered with by any food with metal (Ca, Fe, Mg) or multivitamin b/c the metal will chelate the drug

26
Q

Tetracyline- Drugs

A
  1. Tetracyline
  2. Doxycyline
  3. Minocyline
  4. Tigecycline
  5. Demeclocycline
27
Q

Tetracyline- Length of action

A

Short acting

28
Q

Doxycycline

excretion, AE, use

A
  1. Excretion- GI via bile
  2. AE= photosensitivity
  3. use= acne
29
Q

Minocyline- AE, why?

A

AE= vertigo from CNS infiltration

30
Q

Tigacycline- admin, spectum, clearance, t1/2, AE/ CI

A
  1. Admin= IV
  2. spectrum- very broad- PRSP, MRSA, NOT Pseudomonas or Proteus
  3. clearance- liver
  4. t1/2= 36 hr
  5. AE= N/V
  6. CI- during pregnancy through age 10
31
Q

Demeclocylcline- AE

A

Causes nephrogenic Diabetes insipidus

32
Q

Tetracyclines- AE

A
  1. Teeth and bone discoloration (CI during preg- age 8)
  2. hepatotoxicity
  3. photosensitivity- esp Doxycycline
33
Q

Tetracycline- exceretion

A

All are renal except doxycycline

34
Q

Macrolides- MOA

A

bind to 50s subunit and prevent translocation down the RNA

35
Q

Macrolides- MOR

A

Plasmid mediated receptor site methylation

36
Q

Marolides- absorption

A

Oral

37
Q

Do Macrolides concentrate intra or extracellularly

A

Intra

38
Q

Macrolies- Use and spectrum

A

Broad specturm

Used in Respiratory infxns

39
Q

Macrolides- Drugs

A

Erythromycin

Clarithromycin

Azithromycin

Telithromycin

40
Q

Erythromycin

  1. P450?
  2. Spectrum is similar to?
  3. Uses
A
  1. P450 inhitibor
  2. spectrum is similar to Penicillin
  3. Uses- gastroporesis b/c stimulates motilin receptor, SBE prophylaxis in dental surgery for those with a penicillin allergy
41
Q

Calrithromycin

  1. Spectrum
  2. AE
  3. CI
A
  1. MAC, H.Pylori
  2. funny tasete in mouth but less GI tox than erythromycin
  3. CI in pregnancy
42
Q

Azithromycin

  1. relative length of t1/2
  2. spectrum
  3. AE
  4. DOC
  5. common name
A
  1. long
  2. H.flu, Moraxella
  3. AE- tinnitus
  4. DOC in chalmydia
  5. Z-pack
43
Q

Telithromycin- what charecteristics does it have that make it an important drug

A

Many Macrolide Resistant drugs are not resistant to this

  1. Binds more tightly to RNA
  2. poor substrate for efflux pump