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Melissa's Pharm 2 > T3-Protein Synthesis Inhibitors > Flashcards

T3-Protein Synthesis Inhibitors Flashcards

1
Q

What is the MOA of protein synthesis inhibitors?

A

These drugs bind to bacterial ribosomes and make them no longer work, so bacteria are unable to make proteins. Bacteria need proteins to live.

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2
Q

What are the 5 drug classes we are talking about with protein synthesis inhibitors?

A
  1. Tetracyclines
  2. Macrolides
  3. Clindamycin
  4. Linezolid
  5. Aminoglycosides
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3
Q

Bacteriostatic or bactericidal: Tetracycliens

A

Bacteriostatic

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4
Q

Bacteriostatic or bactericidal: Macrolides

A

Bacteriostatic

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5
Q

Bacteriostatic or bactericidal: Aminoglycosides

A

Bactericidal

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6
Q

Bacteriostatic or bactericidal: Clindamycin

A

Bacteriostatic

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7
Q

Bacteriostatic or bactericidal: Linezolid

A

Bacteriostatic

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8
Q

What are the 4 common uses for tetracyclines?

A
  1. Unique infections
  2. Acne
  3. Peptic ulcer disease (H. Pylori)
  4. Periodontal disease
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9
Q

Tetracycline are given for unique infections. What are 4 examples of unique infections?

A

Rocky Mtn. Spotten Fever
Cholera
Lyme Disease
Anthrax

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10
Q

What are the four tetracyclines?

A

Demeclocycline
Doxycycline
Minocycline
Tetracycline

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11
Q

What tetracycline is the most common?

A

Doxycycline

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12
Q

Tetracyclines bind to cations that are divalent or trivalent (chelating) and that deactivates the tetra’s and they can’t be absorbed. What are some examples of these divalent or trivalent interactions?

A 
Ca2+
Fe3+
Mg2+
Al3+
Zn2+
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13
Q

Tetracyclines should be administered __ before or __ after ingestion of chelating agents.

A

1 hour before

2 hours after

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14
Q

What are the 3 most common adverse effects seen with tetracyclines?

A
  1. Teeth discoloration
  2. Esophageal irritation
  3. Photosensitivity

Think of a buck-toothed kid who plays tetras all the time and never gets any sun so is super pale and then is weird and swallows a tetras and it gets stuck in his esophagus.

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15
Q

Tetracyclines: Teeth discoloration. When is this seen and who should avoid tetracyclines because of it!?

A

Tetracycline binds to calcium and prevents its absorption. This is only in developing bones and teeth. Children under age 8 should avoid tetracyclines. Pregnant women should avoid too because the fetus is less than 8 years old. (breastfeeding should avoid as well)

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16
Q

There are only three Macrolides. What are they?

A

Erythromycin
Clarithromycin
Azithromycin

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17
Q

What are the common uses of all macroclides?

A
  • URI (otitis media, strep)
  • LRI (pneumonia)
  • Increase gastric motility (erythromycin only)
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18
Q

Why is erythromycin sometimes given to clients who do not have an infection?

A

It will increase gastric motility for those with gastroparesis (delayed stomach emptying)

*Gastroparesis is a long term effect of diabetes!

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19
Q

What are the adverse effects of Macrolides?

A

GI upset
Distorted taste
CYP interactions

20
Q

All Macrolides have those adverse effects of GI upset, distorted taste, and CYP interactions. What drug is especially known for the distorted taste and CYP interactions?

A

Clarithromycin

21
Q

Clarithromycin is especially known for having an adverse effect of distorted taste. What taste do patients present with?

A

Metallic taste

22
Q

Clindamycin is extremely ____. It has strong gram ___ activity.

A

Common; gram+

23
Q

Clindamycin can absorb and distribute well. What does this mean?

A

It can distribute so well it can get into the bone. It is able to treat infections in the bone!

24
Q

Clindamycin can cross into bone. Can it cross the BBB?

A

No

25
Q

Do clients like the taste of clindamycin?

A

No!

26
Q

What is the adverse effect associated with Clindamycin?

A

C. diff

27
Q

What do you do if there is a patient taking Clindamycin and signs of C. diff are showing?

A
  • STOP the Clindamycin
  • Swap the method of washing your hands. DO NOT USE the alcohol, use SOAP AND WATER
  • Give Metronidazole (or vancomycin)
28
Q

Linezold has gram __ activity.

A

Gram-

29
Q

Which two primarily difficult infections is linezolid good at defeating?

A

VRE

MRSA

30
Q

Is Lizezold cheap or expensive?

A

EXPENSIVE!!! $100/pill

31
Q

Explain why linezolid can be considered both expensive and a good value.

A

You can save money by not going to the hospital, but it still costs $100 a pill

32
Q

Linezolid is a ____.

A

MAOI

33
Q

Since linezolid is a MAOI. What food and drugs should be avoided?

A

Fava beans, chianti wine, old cheese, aged alcohol, banana bread

SSRI, SNRI, TCA, MAOI, OTC cold meds, Mepadril, Triptans

34
Q

What are the adverse effects (long-term use) of Linezolid?

A
  • Lactic acidosis (signs of hyperventilation, solmnance, myopathy, malise)
  • Optic neuritis, peripheral neuropathy
  • Bone marrow suppression (anemia)
35
Q

What are the two Aminoglycosides?

A

Amikacin

Gentamicin

36
Q

Aminoglycosides synergize with beta-lactams. What does this mean?

A

So beta lactams weaken bacterial cell walls, they weaken the cross links that make them strong. Aminoglycosides are able to get into the cell easier (they must reach the ribosome to damage it so it can’t make proteins). It is much easier to get into the cell when the wall is weak from the beta lactams!

37
Q

Aminoglycosides have a ____ therapeutic index.

A

Narrow

38
Q

Should ahminoglycosides be taken once daily or q8h?

A

ONCE DAILY

39
Q

What are the adverse effects of aminoglycosides?

A

Neprotoxic

Ototoxic

40
Q

What are the early signs of aminoglycoside induced ototoxicity?

A

Ringing (tinnitus), dizziness, prolonged headache

41
Q

If permanent injury of ototoxicity is to be avoided, aminoglycides should be withdrawn at the ___ sign of damage.

A

FIRST

42
Q

What are the sings of nephrotoxicity?

A

Proteinuria
Casts in urine
Production of dilute urine
Elevations in serum creatine and BUN

43
Q

If you are taking an aminoglycide, what levels must be monitored?

A

BUN

Serum creatinine levels

44
Q

Explain why penicillins and aminoglycosides must not be mixed or infused together?

A

Penicillin with deactivate the aminoglycide. Don’t let them touch! They can’t physically touch, but they still can be given at the same time (just don’t mix or infuse them together)

45
Q

What is the correct time to draw a drug trough level for an aminoglycide?

A

30 minutes before the next dose of Aminoglycoside. You want to know that it is in the wash out zone. (this prevents the ototoxicity)

Melissa's Pharm 2 (32 decks)

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