Term
| which type of PSIs block initiation? transpeptidation? translocation? |
|
Definition
tetracyclines
chloramphenicol
Erythromycin and Clindamycin |
|
|
Term
| which PSIs bind to 50s subunit? 30S? |
|
Definition
Buy AT 30, CELL at 50
30 - Aminoglycosides and Tetracyclines
50 - Chloramphenicol, Erythromycin, Linezolid cLindamycin |
|
|
Term
| which PSIs are orally administered? |
|
Definition
Oral - Chloramphenicol, Erythromycin, Tetracycline
Not oral - Aminoglycosides
**remember picture of cake with AG missing*** |
|
|
Term
| how are most PSIs excreted? exceptions? |
|
Definition
renal - most
Bile - Erythromycin, Azithromycin, Doxycycline
"Exit At Dumper" |
|
|
Term
| name 4 tetracyclines and whether they are short are long acting |
|
Definition
Tetracycline - SA, 6-8h
Oxytetracycline - SA, 6-8h
Doxycycline - LA, >16h
Minocycline - LA >16h |
|
|
Term
| mechanism of resistance to tetracyclines |
|
Definition
1. active efflux of the drug
2. Acquisition of a protein that binds to same site in ribosome but doesn't inhibit synthesis |
|
|
Term
| Tetracyclines main indication |
|
Definition
|
|
Term
|
Definition
permanent discoloration of teeth
decreased bone growth and development from loss of Ca
Phototoxicity |
|
|
Term
| Demeclocycline off-label use? ADRs? |
|
Definition
Syndrome of Inappropriate Secretion of ADH (SIADH)
interferes w/ ADH receptors -> nephrogenic diabetes insibpidus |
|
|
Term
|
Definition
Gentamacin, Netilmicin, NEomycin, Amikacin,Tobramycin, Streptomycin,
"A mean guy likes GNNATS" |
|
|
Term
| are PSIs bactericidal or bacteriostatic? |
|
Definition
bacteriostatic
EXCEPT: Aminoglycosides |
|
|
Term
| what type of bacteria do AMinoglycosides work for? |
|
Definition
aerobic Gram+ rods
-they require O2 for uptake |
|
|
Term
| what antibiotics snergize with Aminoglycosides |
|
Definition
|
|
Term
| mechanism of reistance to Aminoglycosides |
|
Definition
| synthesis of conjugation enzymes (acetyl-, nucleotidyl-, phospho- transferases) which bind to and inactivate aminoglycosides |
|
|
Term
| What are the components to Neosporin (triple antibiotic ointment)? |
|
Definition
bacitracin
neomycin
Polymyxin B |
|
|
Term
|
Definition
Nephrotoxicity
Ototoxicity - vestibular and chochlear, lose high frequency hearing first. Can also affect fetus in utero
Paralysis - decrease in Ach release leading to neuromuscular blockade
Not given in pregnancy (class D)
*toxicity is dose related |
|
|
Term
|
Definition
| Azithromycin, clarithromycin, erythromycin, telithromycin |
|
|
Term
| Mechanism of resistance to Macrolides? which is not sensitive to this? |
|
Definition
methylation-induced decreased affinity for binding to 50S subunit
Telithromycin not sensitive to methylation |
|
|
Term
| which macrolides are excreted hepatically? renally? CYP inhibitors? |
|
Definition
Hepatic - Erythromycin and Azithromycin
Renal - Clarithromycin
CYP inhibitors - Erythromycin, Clarithromycin, telithromycin |
|
|
Term
| which are among the safest antibiotics and can be administered during pregnancy? |
|
Definition
|
|
Term
|
Definition
GI distress - motilin receptor agonists
Ototoxicity (reversible) - hearing |
|
|
Term
| what type bacteria is Clindamycin used for? |
|
Definition
| anaerobic, e.g. Bacteroides fragilis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| pseudomembranous colitis from overgrowth of C. difficile |
|
|
Term
|
Definition
| life-threatening infections for which there are no alternatives |
|
|
Term
|
Definition
Anemia
Bone marrow toxicity
Gray Baby Syndrome
CYP450 inhibition
Contraindicated in pregnancy (Class D)and children |
|
|
Term
| which drug causes Gray Baby syndrome? what is the cause? Syx? |
|
Definition
Chloramphenicol
babies have less glucoronyl transferase -> increased chloramphenicol
Syx: depressed respiration and circulation, cyanosis, hypotension, hypothermia, hypotonus |
|
|
Term
| what is the difference between the mechanism of action of Linezolid and Streptogramins? |
|
Definition
Linezolid- binds to 50s subunit, preventing it from attaching to 30S/mRNA complex
Streptogramins - bind to 50S subunit on initiation complex, preventing aminoacyl transferase |
|
|
Term
| what are the streptogramins? |
|
Definition
| Quinupristin/Dalfopristin combination |
|
|
Term
| use of Linezolid and Streptogramins |
|
Definition
VRE and VRSA
Vancomycin Resistant Enterococi and Vancomycin Resistant Staphalococus aureus |
|
|
Term
| What are the types folic acid synthesis inhibitors |
|
Definition
| Sulfonamides (sulfamethoxazole) and Trimethoprim |
|
|
Term
| what drugs block Dihydrofolate reductase? |
|
Definition
Trimethoprim, Methotrexate, and Pyrimethamine
*all have "meth" in name |
|
|
Term
| what drugs block dihydropteroate synthase? |
|
Definition
|
|
Term
| steps of folic acid synthesis? |
|
Definition
| Pteridine + PABA --DHP synthase--> Dihydropteroic acid + glutamate -> DHF --DHF reductase--> THF (folic acid) |
|
|
Term
|
Definition
Crystalluria, hypersensitivity(Steven-Johnson syndrome/skin rash) and phototoxicity
Kernicterus - bilirubin encephalopathy from displacement of bilirubin from albumin
Tolbutamide displacement -> hypoglycemic effect
Warfarin displacement -> anticoagulant effect
Hemolytic anemia in G6PD deficiency
Not used in newborns >2mo or pregnant women |
|
|
Term
|
Definition
| Folate deficiency -> megaloblastic anemia |
|
|
Term
| how can folate deficiency/anemia be prevented when giving Trimethoprim? |
|
Definition
| give with folinic acid (leucovorin) which is converted to THF and independent of the enzymes inhibited |
|
|
Term
|
Definition
|
|
Term
| what type of bacteria are fluoroquinolones used for? main indications? |
|
Definition
gram- bacteria
use: UTI, STD, GI, skin, soft tissue and bone infections by gram- |
|
|
Term
| Mode of action of Fluoroquinolones |
|
Definition
DNA gyrase inhibitors "Topple the Queen"
bind to and interfere w/ DNA gyrase (Topoisomerase II) and Topoisomerase IV, which normally cut and re-aneal supercoiled bacterial DNA so it can replicate. These drugs allow it to be cut but not re-anealed |
|
|
Term
| what type of bactera is Topoisomerase II mainly found in? IV? |
|
Definition
II- mainly Gram-
IV- mainly Gram+ |
|
|
Term
| mechanism of resistance to fluoroquinolones |
|
Definition
altered topoisomerase that prevents fluoroquinolone binding
modified porin channels and less access to fluoroquinolones |
|
|
Term
|
Definition
decreased absorption w/ cations
Headach, diarrhea and nausea
Photosensitivity
Adults: tendon rupture
Not used in pregnancy, nursing mothers and children <18yrs b/c of cartilage erosion
Not used in pts w/ arrhythmia b/c increases QT interval
CYP450 inhibition |
|
|
Term
|
Definition
long acting, tetracycline
excreted in bile |
|
|
Term
|
Definition
long acting, tetracycline
renal excretion |
|
|
Term
|
Definition
tetracycline
renal excretion
interferes w/ ADH receptors, used off-label for SIADH |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Macrolide
hepatic excretion |
|
|
Term
|
Definition
Macrolide
renal excretion
CYP inhibitor |
|
|
Term
|
Definition
Macrolide
Hepatic excretion
CYP inhibitor |
|
|
Term
|
Definition
|
|
Term
| which antibacterial drugs are contraindicated in pregnancy |
|
Definition
Fluoroquinolones (cartilage damage); aminoglycosides (ototoxicity); chloramphenicol (Gray Baby); tetracyclines (bone growth inhibition); sulfonamides (kernicterus)
***know your FACTS before taking drugs when pregnant |
|
|
