Tetracyclines and Macrolides

Question 1

Tetracyclines

Answer 1

Tetracycline, Doxycycline, Minocycline, Demeclocycline (structure is 4 rings)

Question 2

Tetracycline MOA

Answer 2

protein synthesis inhibitors, intracellular acting antibiotics, bind 30S ribosome, static

Question 3

Tetracycline Mechanism of Resistance

Answer 3

Efflux pump, ribosomal protection

Question 4

Tetracycline Kinetics

Answer 4

Doxy/Moncyc>tetra absorption, tetra on empty stomach, impaired by multivalent cations (Ca, Mg, Fe, Al), discoloration of teeth and deposition into bone

Question 5

Tetracycline Kinetics

Answer 5

widely to tissues, minimal CNS, cross placenta, metabolized, Tetra-renal and fecal, doxy/minocyc. non-renal but only doxycycline for renal impairment cases

Question 6

Tetracyclines ADR

Answer 6

N/V, photosensitivity, CNS (vertigo, HA), hepatotoxicity, skin pigmentation, esophagus ulcers, teratogenic not to be used in those 8 and younger

Question 7

Tigecyclilne-Tygacil (glycycline)

Answer 7

MOA like tetracycline, borader coverage b/c enhanced binding, protection against efflux

Question 8

Tigecycline Kinetics

Answer 8

minimal metabolism, eliminated in feces, protein bound, NVD,

Question 9

Macrolides

Answer 9

Erythromycin, Clarithromycin, Azithromycin, large ring with 2 sm. rings

Question 10

Macrolide MOA

Answer 10

protein synt. inhibitor, bind 50S, static

Question 11

Macrolide Resistance

Answer 11

Efflux pumps, decreased cell entry, target site mutations of 50S

Question 12

Macrolide Kinetics

Answer 12

Erythromycin on empty stomach, well distributed (clarith. azith.), no CNS, Eryth./Clarith. metabolized by Cyt P450

Question 13

Macrolide ADR

Answer 13

NVD, QT prolongation, ototoxicity, hepatits, metallic taste

Question 14

Clindamycin

Answer 14

binds 50S, well absorbed, no CSF, liver metabolism, no dose adjustment in renal impairment

Question 15

Clindamycin ADR

Answer 15

NVD, C. difficile infection, RASH

Question 16

Streptogramins

Answer 16

bind 50S, cidal, static w/ enterococci and staph, gram (+) only

Question 17

Streptogramin Kinetics

Answer 17

IV, metabolized, inhibit cytp450, ADR:phlebitis, myalgias, hyperbilirubinemia, GI

Question 18

linezolid-Zyvox (oxazolidinones) MOA

Answer 18

inhibit initiation of protein synthesis (70S and 30S),

Question 19

Linezolid

Answer 19

complete oral absorption, renal and non-renal, ADR: GI and anemia, is an MAOI

Question 20

Tedizolid (Sivextro)

Answer 20

bind 50S and 70S, staph (MRSA), strep, entero, well absorbed eliminated in feces, GI and anemia caused, is an MAOI