Walters -Tetracyclines

Question 1

____ are broad spectrum ____antibiotics, and help with some intracellular organisms. They undergo ____ recycling which means levels persist.

Answer 1

Tetracyclines; static; enterohepatic;

Question 2

what is tetracyclines mechanism

Answer 2

inhibits binding of aminoacyl tRNA to acceptor site of ribosome.

Question 3

tetracyclines are classified by their duration of ____

Answer 3

action

Question 4

What are the different durations of tetracyclins

Answer 4

1. short acting
2. intermediate acting
3. long acting

Question 5

what are the short acting tetracyclines

Answer 5

1. tetracyline; oral or topical for acne

2. oxytetracycline: ophthalmic with polymyxin B.

Question 6

what are the intermediate acting tetracyclines

Answer 6

demeclocycline: for dilutional hyponatremia with SIADH

Question 7

what is the mechanism in SIADH

Answer 7

inhibits a protein kinase in the kidneys CD on which ADH depends.

Question 8

what are the long acting tetracyclines

Answer 8

1. doxycycline: highly lipophilic

2. minocycline: used for acne;

Question 9

____ is associated with pulmonary lupus, hypersensitivity pneumonitis, pleural effusions

Answer 9

minocycline

Question 10

______ induces immunomodulatory and anti-inflammatory activity by blocking synthesis of _____ ____ and activating microglia which therefore decreases neuronal damage. It also improves stroke outcome and might be neuroprotective in Parkinsons, ALS or MS.

Answer 10

Minocycline

Question 11

what are other side affects of minocycline

Answer 11

1. SLE
2. pigmentation of nails, skin, sclera
3. black pigmentation of thyroid
4. blue black bone pigmentation of gums from bone pigmentation is permanent

Question 12

what are side effects of all tetracyclines

Answer 12

1. GI upset (take with food)
2. brown discoloration of teeth (chelates with calcium)
3. slowed growth
4. photosensitivity
   5.

Question 13

expired tetracyclines can cause:

Answer 13

1. fanconi like syndrome from nephrotoxic epianyhydrotetracycline –> N&V, polyuria, glycosuria, acidosis, et al.

Question 14

you want to avoid ___ products and antacids and magnesium salts because they will chelate with calcium phosphate and render antibiotic ineffective.

Answer 14

dairy

Question 15

_____ is structurally simialar to tetracyclines and is a long acting derivative of minocycline and have similar side effect and mechanism of action.

Answer 15

Tigecycline

Question 16

mechanism of tigecycline

Answer 16

same as tetracylines but tidal in some species and have greater activity vs tetracycline sensitive G+/G- and MRSA from greater steric hindrance

Question 17

what are uses of tigecyline

Answer 17

complicated skin and intraabdominal infections; community acquired bacterial pneumonia.

Question 18

You’re supposed to decrease dose in patients with severe ____ impairment or decrease clearance ; will increase half life and risk of toxicity

Answer 18

hepatic

Question 19

what is the FDA risk of tigecycline

Answer 19

increase risk of death in hospital acquired pneomonia particularly ventilator assisted pneumonia, complicated intra abdominal infections of complicated skin and skin structure infections