Term
| where is the resultant distribution of aminoglycosides due to their polarity? |
|
Definition
| in water, in edema, in renal cortices, in oto canal |
|
|
Term
| aminoglycosides are bacteriocidal/static? what do they target? |
|
Definition
|
|
Term
| what is the advantage of extended interval ABs over time-dependent? |
|
Definition
| the fewer times the concentration falls below the minimum inhibitory conc, the fewer times the bacteria can repopulate |
|
|
Term
|
Definition
gain access by passive diffusion and oxygen dependent transport system. This excludes gram pos and anaerobes
once there they:
-bind at start codon
-block addition at A site
-incorporate the wrong codon
***things like divalent cations (Ca2+ and Mg2+ from antacids block 02) |
|
|
Term
| explain synergy with respects to amino glycosides |
|
Definition
adding a cell wall inhibitor (B-lactam) so that the protein synthesis inhibitor can gain access
usually for bacterial endocarditis |
|
|
Term
| in the event of a community acquired pseudomona infection, what is the best course of action? |
|
Definition
| broad spectrum B-lactam instead of aminoglycoside because it will prob have poor penetration into inflammed tissue |
|
|
Term
| how might aminoglycocides affect the neuromuscular system? |
|
Definition
1.May inhibit prejunctional release of the neurotransmitter, acetylcholine
2.May ¯postjunctional sensitivity to acetylcholine
Respiratory paralysis is the big concern
BEWARE IN PATIENTS WITH MYASTHENIA GRAVIS |
|
|
Term
| should aminoglycides be used during pregnancy or while nursing? |
|
Definition
|
|
Term
| aminoglycocides against pseudo? |
|
Definition
|
|
Term
| why is neomycin not for systemic use? |
|
Definition
because of its high nephrotoxicity
however, it's good at killing off gut bugs which produce a lot of ammonia run the risk of causing hepatic encephalopathy |
|
|
Term
| subtype of disease that streptomycin is good for? |
|
Definition
| zoophilic diseases like rabbit fever, malta fever, and plauge |
|
|
Term
| streptomycin side effects |
|
Definition
| neurotoxicities to vestibular nerves, optic nerves, and peripheral neuritis |
|
|
Term
| group to definately not receive tetracycline or deriviates? |
|
Definition
| babies bc if can get into CSF, bone marrow, bone, dentine, enamel, unerupted teeth, can cross placenta, enter breast milk |
|
|
Term
| what impairs tetracyclines? |
|
Definition
di and trivalent cations (antacids), food, dairy, alkaline pH
and this is bad bc they wont be changed and those that stay in the gut can modify the local flora |
|
|
Term
| elimination commonality between doxyclyine, minocycline, and tigecycline |
|
Definition
non are renally excreted therefore renal function does not need to be considered
doxy is biliary
mino is hepatic
tige is biliary |
|
|
Term
| tetracycline/tigecycline MOA |
|
Definition
enter through porins, bind @ 30S A site, prevent binding
they are good for pretty much anything including caMRSA, but widespread resistance has limited their use
-tigecycline (not oral) has a few added bonuses against bacs which gained resistance to tetra or vanco |
|
|
Term
| species with intrinsic resistance to all tetracyclines? |
|
Definition
|
|
Term
what are tetracyclines(doxycline) first line for?
tigecycline? |
|
Definition
ricketsia, mycoplasma, chlyamidia, acne, spirochetes, caMRSA
complicated infections |
|
|
Term
what is Fanconi Syndrome linked to?
what are some other major SEs of tetracyclines/tigecylines? |
|
Definition
outdated tetracyclines
phototoxicity, c. diff, photosensitivity |
|
|
Term
unique adverse effects of:
minocycline
demclocycline
tigecycline |
|
Definition
-vestibular toxicity
-nephrogenic diabetes insipidus; water absorbed improperly especially during SIADH in which it is used for treatment
-acute pancreatitis; overall mortality |
|
|
Term
Erythromycin
àClarithromycin
àAzithromycin
àTelithromycin (Ketolide)
the macrolide/ketolide family. what are their absorption differences |
|
Definition
| erythromycin in acid labile and the rest are acid stabile, that is why the rest all have better oral absorption than erythro |
|
|
Term
|
Erythromycin, clarithromycin and telithromycin MOA, strong inhibitors of what?
|
|
Definition
| they block transpeptidyl translocation (strongest againsts gram pos) and inhibit CYP3A4 bc they are substrates |
|
|
Term
| what has intrinsic resistance against macrolides/ketolides? acquired resistance? |
|
Definition
enterococci have intrinsic resistance
acquired resistance is arrived at though efflux, the ability to methylate the ribo binding site so drug can't bind, |
|
|
Term
| Telithromucin adverse effects, but when to use |
|
Definition
GI, hepato, cardiac arrythmia, Myasth. Gravis exacerbation
***not approved for use in children
used co caPNEUMONIAS when benefits outweigh risks |
|
|
Term
|
Definition
-very lipophilic
-hepatic metabol but dependent on enzymes (hepatic tranferases) that neonates have fewer of,
therefore, contraindicated
***t1/2 is 3h in adults but very prolonged in kids
***can lead to GRAY BABY SYNDROME |
|
|
Term
| Chloroamphenicol uses and resistances: |
|
Definition
used for anything
EXCEPT: shigella, salmonella, P. aerug
***resistance confered by acetyltransferase which aceytlates chloro so it cannot bind to ribo
***only use for life-threatening diseases
***idiopathic bone marrow toxicities |
|
|
Term
|
Definition
same as erythros (macrolides, ketolides, AND CLINDAMYCIN); blocks transferase at 50S ribo
***however, chloro may also inhibit host prot syn in mitochondria |
|
|
Term
|
Definition
inhibits CYP3A4 and CYP2C9 thus can increase conc. of things like warfarin and phenytoin
**rifampin and phenobarbital can actually decrease Chloroamphenicol levels |
|
|
Term
| antimycrobial most associated with c. diff outbreaks? |
|
Definition
| clindamycin bc it depresses colonic flora for up to 2 weeks! |
|
|
Term
|
Definition
| constiutive ribo methylation; methylating the sites of binding |
|
|
Term
|
Definition
skin diseases for Pen allergic pts; caMRSA
parasites |
|
|
Term
| what is QUINUPRISITIN/DALFOPRSTIN a ratio of? |
|
Definition
| StreptograminB/Streptogramin A 30:70 |
|
|
Term
| QUINUPRISITIN/DALFOPRSTIN MOA: |
|
Definition
IV only
quinu binds to tranferase site on 50S and prohibts elongation while Dalflo also binds to quino and exacerbates its effects by causing a conformational change of the whole area
bacteriostatic alone,bacterioCIDAL together |
|
|
Term
| QUINUPRISITIN/DALFOPRSTIN interactions and cautions: |
|
Definition
c. diff
both inhibit CYP3A4, so don't give with other drugs with narrow TI |
|
|
Term
|
Definition
oral and 100% AVAILABILITY
hepatic meta |
|
|
Term
|
Definition
| binds 50S near 30S so neither can bind eachother. The initial tMet tRNA can bind to 30S, but can't go any further |
|
|
Term
LINEZOLID sensitive bacteria:
DI? |
|
Definition
g. pos aerobes and anaerobic cocci and bacilli.
|
|
|
Term
| hormones which LINEZOLID inhibits regulation of? |
|
Definition
it inhibits monoamine oxidase which results in an increase of:
dopamine
epinephrine
serotonin
norepi |
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