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Tetracyclines, Macrolids, Aminoglycosides
pharm
80
Pharmacology
Graduate
07/13/2012

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Term
Ototoxicity
Definition
What Adverse Effect does Tetracylcine, Macrolids, and Aminoglycosidases all have in common
Term
blocks amino acyl charged tRNA for 30S ribosome inhibition
Definition
Tetracycline site of action
Term
Four 6 membered rings
Definition
Structure of tetracyclines
Term
Broad Specturm: Aerobic, Anearobic, G +, and G-
Can produce C. difficile superinfection
Definition
Tetracyclines activity
Term
H. pylori(GI ulcers) and Acne
Definition
Tetracycline DOC
Term
6-8 hours
Definition
Half Life of tetracycline
Term
12 Hours
Definition
Half Life of Demedocycline
Term
Tetracycline, Demedocycline, Doxycycline, Minocycline, Tigercycline
Definition
Tetracycline antibiotics (5)
Term
16-18 hours
Definition
Half life of doxycycline and minocycline
Term
Doxycycline
Definition
Most widely prescribed Tetracycline
Term
Rickettsia (RMSF and typhus)
Chlamydia psittao
Chlamydia trachomatis (lymphagranuloma venereum)
Ureaplasma urealyticum (urethritis)
M. Pneumonia - Atypical Pneumonia
Borrelia granulnatis - granuloma inguinale
Definition
DOC for Doxycycline
Term
Cholera
Brucellosis
Chlamydia pneumo
Definition
1st line for Doxycycline
Term
Legionella pneumo (Azithromycin)
H. dureyi - chancroid
C. tetani - tetanus(Vancomycin)
C. perfrin - Gas gangrene (PNCG)
syphilis (PNC G )
Definition
Back Ups for Doxycycline
Term
Nocardia (pulmonary)
Neisseria meningitis (carrier)- elimination in carrier state since its in saliva and tears
Acne
Definition
Minocycline used for:
Term
36 hours
Definition
Half Life of Tigercycline (Glycylcycline)
Term
MRSA
MRSE
VISA
VRSA
Pen resistant Strep Pneumo
VRE
Definition
Uses for Tigercycline
Term
Skin infections, complicated intra-abdominal, and community required pneumonia
Definition
Indications for Tigercycline
Term
Decreased accumulation-increased efflux
Alteration of target
Enzymatic inactivity
Definition
Resistant Mechanisms of Tetracyclines
Term
Doxycycline and Minocycline
Definition
oral available tetracyclines
Term
Dairy, Antacids, Ca 2+, Magnesium, aluminum, iron. Due to divalent and trivalent bonds decreasing absorption
Definition
What types of food should be avoided with tetracyclines
Term
Kidney, Liver, Spleen, Skin
Definition
Distribution of Tetracyclines
Term
Doxycycline
Definition
Tetracycline of choice for renal failure
Term
Accumulate in the liver
Secreted into bile
Reabsored by intestine and excreted into glomerular filtration
Definition
Metabolism of Tetracyclines
Term
Pregnant
Breast Feeding
Children less than 8 yo
Impaired Liver function
Definition
Contraindications of Tetracyclines
Term
Fanconi Syndrome
Definition
Outdated tetracyclines cause
Term
Children and Fetus- discoloration of teeth
Phototoxicity - everyone except minocycline
Vestibular Problems (minocycline)
Superinfection (C. difficil)
Fanconi
Pseudotumor cerebri
GI
Definition
Major Adverse Sides of tetracyclines
Term
Irreversible inhibition of 30S subunit (misreading of mRNA)
Definition
Amynoglycoside Action:
Term
Anearobes- need oxygen dependent system for transport across cell membrane
Definition
What can't Amynoglycosides kill
Term
beta lactams
Definition
Amynoglycosides are synergistic with
Term
Y. pestis and F. tularemsis
Definition
DOC for streptomycin
Term
Brucella
Streptobacillus
Myco tuberculosis
Definition
2nd line for streptomycin
Term
GNATS K
Gentamycin
Neomycin
Amikacin
Tobramycin
Streptomycin
Kanamycin
Definition
Types of Aminoglycosidases
Term
Gram negative
Severe: Bacteremia, Endocarditis (HACEK and Viridans Strep), Meningitis, Pneumonia, Chronic UTIs(Ecoli, Enterobacter, Pseudomonas, Proteus, Klesiella, Serratia)
Definition
Gentamycin and Tobramycin used for what physical conditions:
Term
Strep agalactiae
Lysteria
Campy fetus
Brucella
Definition
1st Line drug for Tobramycin and Gentamycin:
Term
Staph or strep epidermis infections
Definition
Gentamycin should not be used solely for
Term
Amikacin
Definition
Broadest Aminoglycosidase spectrum
Term
Amikacin
Definition
Aminoglycosidase which is resistant to inactive enzymes
Term
Nasocomial infections
Definition
Amikacin used for:
Term
Skin (Neosporin) which if there is a reaction it is from the Neomycin.
Bowel Surgery: Bowel sterilization and hepatic coma
Definition
Neomycin used for
Term
Serratia and P. aeriginosa
Definition
Kanamycin should not be used for
Term
Surgical prophylaxis via irragation
Definition
Kanamycin used for:
Term
Post antibiotic effect
Definition
Killing occurs below MIC in Aminoglycosidase
Term
Sterptococcus and Enterococcus
Definition
Aminoglycosidases are used with cell wall inhibitors (vancomycin and beta lactams) for:
Term
Parenterally
Definition
Administration of Aminoglycosidases
Term
renal cortex and Inner Ear
Traverse placental barrier - teratogenic
Definition
Distribution of Aminoglycosidases
Term
They are not metabolized but are rapidly excreted by Glomerular filtrate and accumulates in renal failure
Definition
Metabolism of Aminoglycosidases
Term
Ototoxic, Nephrotoxic (increased by loop diuretics), Neuromuscular Paralysis (neomycin), Allergies, Optic (streptomycin), Teratogen
Most problems are with Neomycin
Definition
Adverse Sides of Aminoglycosidases
Term
50S ribosome, inhibiting amino acyl tranlocation rxn of peptidyl RNA.
Definition
Macrolids Actions
Term
Both Low dose (Bacteriostatic)
High dose (Bactericidal)
Definition
Macrolids (Bactericidal or Bacteriostatic)?
Term
Erythromycin, Clarithromycin, Azithromycin
Definition
Types of Macrolids
Term
Corynebacterium diptheria
H. ducreyi
Definition
Ezythromycin 1st line
Term
beta lactams- treats similar microbes as penicillin G
Definition
Ezythromycin is an alternative for allergic rxns too
Term
MAI complex
Chlamydia pneumonia
Corynebacterium dipth
Definition
1st line of Clarithromycin
Term
Taxoplasma Gondii, Cryptosporidium, Plasmodium
Definition
Clarithromycin and Azythromycin can be used against what protozoa
Term
Azithromycin (Z-pak)
Definition
Most Widely prescribed Macrolid
Term
Chlamydia Trachomatis
Definition
DOC for Azythromycin
Term
Legionella and Chlamydia Pneumo
Corynebacterium diptheria
Definition
1st line for Azythromycin
Term
Azythromycin (also Morexella catarrhal)>Clarithromycin>Erythromycin
Definition
Best Macrolids against H. flu
Term
1. alter 50S subunit
2. Inactivation associated esterase
3. decrease permeabilty or increase efflux
4. cross resistance btw macrolids
5. methylation of 23s rRNA
Definition
Resistance against Macrolids
Term
Clarithromycin and Azithromycin stable in gastric acid, All can be taken Orally, Food decrease Azithromycin and Erythromycin but increases clarithromycin
Definition
Pharmokinetics-macrolids
Term
Hepatic excretion in bile and feces
Definition
Fate of Azythromycin
Term
Hepatic excretion in bile and feces, P450 system. Reabsorbed enterohepatic.
Definition
Fate of Erythromycin
Term
1st pass oxidation to 14-hydroxy metabolite
Excreted by both the kidney and liver
Definition
Fate of Clarithromycin
Term
Epigastric and GI, Ototoxic, Cardiotoxicity (Erythromycin)
Hepatic Damage (Erythromycin and Azithromycin)
Renal Damage (Clarithromycin)
Definition
Major Adverse Sides of Macrolids
Term
theophylline, warfarin, carbamyzepin, cyclosporine
Definition
Erythromycin and Clarithromycin Drug Interactions
Term
Azythromycin
Definition
Which drug does not inhibit CYP3A4 of the Macrolids
Term
Telithromycin
Definition
Only Ketolid
Term
Respiratory tract infections
staph aureus
Strep pyogenes/pneumonia (MDRSP)
H flu
Morexella catarhals
Legionella
Mycoplasma pneumonia
Chlamydia pneumonia
Definition
Telithromycin used for
Term
Oral with intracellular penetration
Definition
Administration of Telithromycin
Term
Hepatic, eliminated in kidney and some urine/bile
Definition
Metabolism of Telithromycin
Term
Cholestatic jaundice and hepatic failure
Definition
Adverse Sides of Telithromycin
Term
Patient less than 18
Hepatic problems
Patients with prolonged QT
Definition
Contraindication of Telithromycin
Term
Multidrug (2 of Penicillin, 2nd gen cyclosporines, macrolids, tetracyclines, bactrin (SMX-TAP)) resistant sterp Pneumo
Definition
MDRSP is:
Term
Inhibits protein synthesis by blocking translocation in 50S. It binds to 2 binding sites instead of 1 (5 and 2)
Definition
Telithromycin Action
Term
Tetracyclines
Definition
All Gram + cocci are resistant to...
Term
Tobramycin/cftazidime/cefepime
Definition
Combination treatment for P. aeruginosis
Term
Otitis Media due to it not covering H. flu
Definition
Ezythromycin not a good choice for
Term
Bacellis Anthrax, MRSA, L. monocytogenes, actinomyces israelli
Definition
Ezythromycin Back up
Term
H. flu
Strep and staph increased
Intracellular: Chlamydia, legionella, mycobacteria, ureaplasma
Definition
Clarithromycin is more effective against what when compared to Erythromycin
Term
Azithromycin
Definition
Best Macrolid for G- UTIs
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