1. 50 large ribosomal unit joins with 30s ribosomal unit

2. Initiation- tRNA goes onto P site with a Met group attached

3. Amino acid incorporation- tRNA w/ specific AA sits onto the A-site

4. Elongation: Petide bond forms via peptidyl transferase between AA groups

5. A site tRNA moves over to P site to move over for another tRNA to repeat the process

6. Termination

1. Aminoglycosides (30s), Oxazoladinones (linezolid) (50s): blocks initiation complex
2. Tetracyclines/glycylcycline (30s), dalfopristin/quinupristin (50s): blocks AA incorporation
3. Cloramphenicol (50s): blocks peptide bond formation
4. Macrolides/Clindamycin (lincosamides) (50s), type B streptogramins, ketolide: blocks elongation

Bacteria: 70s

Humans: 80s

A=Aminoglycosides

T= Tetracyclines

Chloramphenicol, clindamycin

Erythromycin

Lincomycin

Linezolid

"Buy AT 30, CCELL (sell) at 50" 

What does this mean?

30s inhibitors:

Aminoglycosides

Tetracyclines

50s inhibitors:

Chloramphenicol, Clindamycin

Erythromycin

Lincomycin

Linezolid

"Mean" GNATS can NOT kill anaerobes

Gentamicin

Neomycin

Amikacin

Tobramycin

Streptomycin

Blocks initiation of complex, causes misreading of codes upon tRNA trying to come in and bind to subunit and f***s it up

Requires O₂ for uptake

G- aerobic rods

Used in conjnction w/ cell wall inhibitors (β-lactams)

 Neomycin for bowel surgery

Also for enterococci & P. aeruginosa

"Mean" GNATS canNOT kill anaerobes

Nephrotoicity (esp. w/ cephalosporins)

Ototoxicity (especially w/ loop diuretics)

Teratogen 

Neuromuscular blockade, blocks acetylcholine release

What is the most common drug associated w/ contact dermatitis?

What other agents can you find in neomycin/sporin?

Neomycin (neosporin)

Can find polymixin and bacitracin

*Boards love this question*

Botulism toxin or aminoglycoside SE

If botulin is not one of the answers, then look for a -mycin drug :)

Also a common board question

Broad spectrum, but good with atypical bacteria like H. pylori, M. pneumonia, vibrio,

Rickettsia (typhus/spotted fever), Lyme disease, Chlamydia

• doxacycline
• minocycline
• democlocycline (Blocks ADH receptors, use for SIADH)

• Tooth enamel dysplasia (discoloration)
• Dec bone growth in children
• Phototoxicity
• GI distress
• Vestibular dysfunction
• DO NOT give to children or pregnant women

• Production of conjugating enzymes (transferase)
• Inactivate drugs by acetylation (of own ribosomes to prevent recognition by drug), phosphorylation, or adenylation

• Blocks transpeptidation, 50s inhibitor

• Meningitis (H. influenzae, N. miningitidis, S. pneumoniae)
• Conservative in states, used a lot still in developing countries

• Bone marrow suppression
• "Gray baby"-> toxicity+lack UDP glucuronyl transferase= kernicterus
• Anemia (dose dependent
• aplastic anemia (dose independent)

What is the MOA of macrolides?

Blocks translocation:

Binds to 23S rRNA of 50s ribosomal subunit

• Erythromycin
• Azithromycin
• Clarithromycin

• Atypical pneumonias (mycoplasma, chlamydia, legionella)
• URIs
• STDs
• G+ cocci
• Neisseria

• Prolonged QT interval (esp erythromycin)
• GI discomfort (most common cause of noncompliance) by stimulating motilin
• Reversible deafness (ototoxic)
• Acute cholestatic hepatitis
• eosinophilia, skin rashes
• increases serum conc. of theophyllines

Anaerobic infections (G+, S. aureus: osteomyelitis)

in aspiration pneumonia/lung abscesses 

"Treats anaerobes above the diaphragm vs. metronidazole anaerobic infections below diaphragm"

• Pseudomembranous colitis (C. dif)
• fever
• diarrhea

1. metronidazole
2. Vancomycin

VRSA/VRE

drug resistant pneumococci