Term
| Which ribosome has the E, P, and A sites? |
|
Definition
|
|
Term
| Whata re the three ways antibiotics can inhibit bacterial ribosome function? |
|
Definition
| initiation, elongation, misreading |
|
|
Term
| Drugs that act on bacterial ribosomes often have what kind of effect on eukaryotic host? |
|
Definition
|
|
Term
| Describe the characteristics you must take into consideration when administering aminoglycosides. |
|
Definition
| concentration dependent killing, post antibiotic effect, follow drug levels, peak= effectiveness, trough = accumulation (renal excretion) |
|
|
Term
| What is the spectrum of aminoglycosides? |
|
Definition
gram - rods NOT anaerobes
gram + cocci in combination |
|
|
Term
| What is the spectrum of streptomycin? |
|
Definition
| M. tuberculosis, F. tularenis, Yersinis pestis combination for enterococcus |
|
|
Term
| What are the uses of streptomycin? |
|
Definition
| TB, Single agent, combination |
|
|
Term
| What is the spectrum of gentamycin and tobramycin? |
|
Definition
| GNR not anaerobes, pseudomonas, combination |
|
|
Term
| What is the spectrum of amikacin? |
|
Definition
|
|
Term
| What are the uses of gentamicin and tobramycin? |
|
Definition
| blood strem UT, combinations, NOT anaerobic |
|
|
Term
| How do bacteria develop resistance to aminoglycosides? |
|
Definition
| enzyme modification, altered ribosomal target, decreased permeability, efflux pump |
|
|
Term
| What are the otoxocity symptoms that can be caused by aminoglycosides? When do these symptoms occur? How? |
|
Definition
| auditory and vestibular, idiosyncratic and dose dependent, binds NMDA receptors, reactive oxygen species, mitochondrial toxicity (genetic predisposition--> necrosis or apoptosis |
|
|
Term
| At what doses do you get nephrotoxicity from aminoglycoside agents? |
|
Definition
| dose dependent and length dependent; sometimes idiosyncratic |
|
|
Term
| How do aminoglycosides cause nephrotoxicity? |
|
Definition
| filtered and binding to proximal tubules, binds megalin, alterations in calcium channels, necrosis or apoptosis due to cationic nature (calcium dependent) |
|
|
Term
| What is the spectrum of linezolid? |
|
Definition
| gram positive, especially resistant ones, good lung penetration |
|
|
Term
| Is resistance developing to linezolid? |
|
Definition
| ribosome target modification is seen with long-term use |
|
|
Term
| What are the mjoar side effects of linezolid? |
|
Definition
| hematologic, neuropathy, and serotonin syndrome |
|
|
Term
| What are the special characteristics of tetracyclines and glycocyclines? |
|
Definition
| long acting (doxycycline, minocycline, tigecycline), reversible binding to ribosome, binds metals (teeth, bones), captures photons, broad spectrum activity |
|
|
Term
| How do organisms become resistant to tetracycline? |
|
Definition
| efflux pump, ribosome protection (molecules taht have homology for ribosomal proteins, promotes dissociation), modification of molecule (oxidation Tet[x]), modification of ribosome target |
|
|
Term
| What is the spectrum of tetracycline? |
|
Definition
| broad spectrum, lots of resistance |
|
|
Term
| What are the characteristics of tetracycline dosing? |
|
Definition
|
|
Term
| What is the spectrum of doxycycline? |
|
Definition
| broad spectrum, intracellular bacteria |
|
|
Term
| How do you give tetracycline? |
|
Definition
|
|
Term
| How do you give doxycycline? |
|
Definition
|
|
Term
| What are the characteristics of doxycycline dosing? |
|
Definition
|
|
Term
| How do you give minocycline? |
|
Definition
|
|
Term
| What is the spectrum of minocycline? |
|
Definition
| intracellular bacteria and staphylococcus |
|
|
Term
| What are the dosing characteristics of minocycline? |
|
Definition
|
|
Term
| How do you give tigecycline? |
|
Definition
|
|
Term
| What is the spectrum of tigecycline? |
|
Definition
| broad spectrum, much less resistance, NOT pseudomonas |
|
|
Term
| What are the characteristics of tigecycline dosing? |
|
Definition
| BID dosing, binds ribosome more tightly |
|
|
Term
| How does chloramphenicol work? |
|
Definition
|
|
Term
| What is the spectrum of chloramphenicol? |
|
Definition
| broad spectrum, resistance growing |
|
|
Term
| What are the side effects of chloramphenicol? |
|
Definition
dose-dependent anemia (reversible), and aplastic anemia (irreversible)
** rarely used in this country but frequently in third world (cheap) |
|
|
Term
| How do bacteria become resistant to choloramphenicol? |
|
Definition
| chloramphenicol acetyl transferase |
|
|
Term
| How do macrolide/azalide/ketolides work? |
|
Definition
| reversible binding to ribosomes based on intracellular concentration |
|
|
Term
| What is the spectrum of macrolide/azalide/ketolide? |
|
Definition
| broad spectrum but resistance common among gram - organisms and increasing in gram + organisms |
|
|
Term
| Which antibiotic that targets bacterial protein synthesis is also anti inflammatory? |
|
Definition
| macrolide/azalide/ketolide |
|
|
Term
| What are the side effects of macrolide/azalide/ketolide? |
|
Definition
| GI, hearing loss (reversible) |
|
|
Term
| What are the mechanisms of resistance against macrolide/ketolide/azalide? |
|
Definition
| efflux pumps, altered binding sites (methylation= inducible or constitutive), alteration of tunnel morphology |
|
|
Term
| How do you give erythromycin? |
|
Definition
|
|
Term
| What is the spectrum of erythromycin? |
|
Definition
| respiratory gram +, helicobacter/campylobacter jejuni, mycoplasma, chlamydia, legionella |
|
|
Term
| What are the dosing characteristics of erythromycin? |
|
Definition
| QID dosing, GI upset frequent, motilin analogue, resistance increasing |
|
|
Term
| What is the spectrum of clarithromycin? |
|
Definition
| respiratory gram +, helicobacter/campy, mycoplasma, chlamydia, legionella + atypical mycobacteria (LESS RESISTANCE THAN ERYTHROMYCIN) |
|
|
Term
| What are the characteristics of clarithryomycin dosing? |
|
Definition
|
|
Term
| How do you give clarithrymycin? |
|
Definition
|
|
Term
| How do you give azithromycin? |
|
Definition
|
|
Term
| What is the spectrum of azithromycin? |
|
Definition
| respiratory gram +, helicobacter/campy, mycoplasma, chlamydia, legionella |
|
|
Term
| What are the characteristics of azithromycin dosing? |
|
Definition
| single dose STD perscription; daily dosing; long half-life |
|
|
Term
| How do you give telithromycin? |
|
Definition
|
|
Term
| What is the spectrum of telithromycin? |
|
Definition
| same as azithromycin (respiratory pathogens) |
|
|
Term
| What are the dosing characteristics of telithromycin? |
|
Definition
| daily dosing, resists efflux, does not induce erm |
|
|
Term
| How does clindamycin work? |
|
Definition
| binds in same area as macrolides on a ribosome and turns off toxin production |
|
|
Term
| What is the spectrum of clindamycin? |
|
Definition
| gram +, anaerobic (increasing resistance) |
|
|
Term
| How are bacteria resistant to clindamycin? |
|
Definition
| clindamycin is resistant to the bacterial efflux pump but NOT to the alteration of ribosome target (inducible erm) |
|
|
Term
| What are the possible side effects of clindamycin? |
|
Definition
|
|
Term
| Name a type of antibiotic used in animal feeds? |
|
Definition
|
|
Term
| Is there an IV formulation of streptogramins? |
|
Definition
|
|
Term
| What is the spectrum of streptogramins? |
|
Definition
| gram +, especially resistant ones (NOT E. faecalis) |
|
|
Term
| Describe resistance to streptogramins? |
|
Definition
| efflux, modification of drug, modification of ribosome |
|
|
Term
| What are the side effects of streptogramins? |
|
Definition
|
|
Term
| Ribosome modification of a bacteria can cause multiple resistance to which types of antibiotics? |
|
Definition
| macrolides, lincosamides, and streptogramins |
|
|
Term
|
Definition
| inhibit topoisomerase and gyrase |
|
|
Term
|
Definition
| inhibits the dissociation of RNA polymerase from sigma factor |
|
|
Term
| How do sulfa and trimethoprim work? |
|
Definition
| inhibit the synthesis of folic acid |
|
|
Term
| What must you take into account when giving flouroquinolones? |
|
Definition
| concentration dependent, spectrum and toxicity depends on side groups |
|
|
Term
| How do you give flouroquinolones? |
|
Definition
|
|
Term
| Why are flouroquinolones so popular? |
|
Definition
| inexpensive, good tissue penetration |
|
|
Term
| What are the major side effects of flouroquinolones? |
|
Definition
| tendon rupture, bone deformities (use care with children), QT prolongation |
|
|
Term
| How are bacteria able to become resistent to flouroquinolones? |
|
Definition
| mutations of target enzymes |
|
|
Term
| How do you give ciprofloxacin? |
|
Definition
|
|
Term
| What is teh spectrum of ciprofloxacin? |
|
Definition
gram neg organisms including pseudomonas
B. anthracis, STDs NOT syphilis |
|
|
Term
| What is the most potent antibiotic against GNR? |
|
Definition
|
|
Term
| How often do you give cipro? |
|
Definition
|
|
Term
| How is ciprofloxacin excreted from the body? |
|
Definition
|
|
Term
| How do you give Levofloxaxin? |
|
Definition
|
|
Term
| What is the spectrum of levofloxaxin? |
|
Definition
| gram negative > streptococcal, mycoplasma/chlamydia, legionella |
|
|
Term
| How is levovloxaxin excreted? |
|
Definition
|
|
Term
| How often do you give levofloxacin? |
|
Definition
|
|
Term
| How do you give moxifloxacin? |
|
Definition
|
|
Term
| What is the spectrum of moxifloxacin? |
|
Definition
| more potent against G+, less potent against G-, more anaerobes (oral) |
|
|
Term
| How often do you give moxifloxacin? |
|
Definition
|
|
Term
| Which flouroquinolone has less urinary excretion? |
|
Definition
|
|
Term
| How does trimethroprim-sulfa work? |
|
Definition
| two step inhibition: 1) inhibit generation of folinic acid 2) necessary for metabolism |
|
|
Term
| What is the spectrum of trimethoprim sulfa? |
|
Definition
| broad aerobic (not strep/not pseudomonas), pneumocystis jiroveci |
|
|
Term
| What are the side effects of trimethoprim-sulfa? |
|
Definition
| rash including phototoxicity, erythema multiforme to TEN, renal toxicity/hepatitis, hyperkalemia |
|
|
Term
| Which bacteria is exhibiting increasing resistance to trimethoprim-sulfa? |
|
Definition
|
|
Term
| What enzyme is inhibited by sulfa, PAS, and Dapsone? |
|
Definition
| dihydro-pterorate synthetase (converts PABA + Dihydro-Pteridine into Dihydropterorate) |
|
|
Term
| What enzyme is inhibited by trimethoprim? |
|
Definition
| dihydro-folic acid reductase (dihydrofolic acid into tetrahydro-folic acid) |
|
|
Term
| What is the spectrum of rifampin? |
|
Definition
| broad spectrum (staph and mycobacteria) |
|
|
Term
| How does resistance against rifampin occur? |
|
Definition
| occurs rapidly if used as a single agent due to enzyme mutation |
|
|
Term
| What are the side effects of rifampin? |
|
Definition
| hepatitis, orange secretions/urine, induction of P450 |
|
|
Term
| What is the spectrum of metronidazole? |
|
Definition
| anaerobes, C. difficile, amoebae (trichomonas, giardia, entamoeba) |
|
|
Term
| How do you give metronidazole? |
|
Definition
|
|
Term
| T/F Metronidazole has poor tissue penetration |
|
Definition
| false, has good penetration |
|
|
Term
| What are the side effects of metronidazole? |
|
Definition
| antabuse reaction, neuropathy, dysgeusia (metallic taste), black urine |
|
|
Term
| What is the mechanism of nitrofurantoin? |
|
Definition
| unclear; msut be reduced by an enzyme for activity |
|
|
Term
| What is the spectrum of nitrofurantoin? |
|
Definition
| (lower UTI infections), many gram -, (not proteus, not pseudomonas), enterococcus |
|
|
Term
| What are the side effects of nitrofurantoin? |
|
Definition
| pulmonary infiltrates/fibrosis, eosinophilia |
|
|
Term
| How do you give mupirocin? |
|
Definition
|
|
Term
| What is the spectrum of mupirocin? |
|
Definition
|
|
Term
|
Definition
|
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