Term
| what are the two tetracyclins and one honorary (and its category) |
|
Definition
tetracyclin, doxycyclin
tigecyclin - glycyclin antibiotic |
|
|
Term
| what are the 5 aminoglycosides |
|
Definition
streptomycin
amikacin
gentamycin
tobramycin
neomycin |
|
|
Term
| what are the three macrolides and one honorary (and its category) |
|
Definition
azithromycin
erythromycin
clathromycin
trlithromycin - ketolide antibiotic |
|
|
Term
| what are the other 50S antibiotics (4) |
|
Definition
chloramphemicol
clindamycin
streptogramin
linezolid |
|
|
Term
| what protein inhibitors target the 50S subunit |
|
Definition
| macrolides and other 50S category |
|
|
Term
| what protein inhibitors target the 30S subunit |
|
Definition
| tetracyclins and aminoglycosides |
|
|
Term
| which tetracyclin is the drug of choice, why |
|
Definition
| doxycyclin- wider spectrum |
|
|
Term
| which protein inhibitors are bacteriocidial and which are bacteriostatic |
|
Definition
bacteriocidial: aminoglycocides
bacteriostatic; tetracyclins, macrolides, other 50S |
|
|
Term
| what is the main reason to use amikacin |
|
Definition
| stable against R plasmid resistance that occurs in gentamycin and tobramycin |
|
|
Term
| what is the most commonly used aminoglycocide, why |
|
Definition
| gentamycin- cheap, effective |
|
|
Term
| what is tobramycin used for |
|
Definition
|
|
Term
| what is neomycin used for |
|
Definition
|
|
Term
| which macrolides kill MAC |
|
Definition
| azithromycin, clathromycin |
|
|
Term
| how are macrolides absorbed |
|
Definition
azithromycin and clathromycin are absorbed well reducing GI upset
erythromycin is destoried by the GI tract and needs to be enteric coated |
|
|
Term
| what durgs penetrate prostatic fluid |
|
Definition
|
|
Term
| other than antibiotic, what is another use for erythromycin |
|
Definition
|
|
Term
| which protein inhibitors are ok to use in pregnacy |
|
Definition
|
|
Term
| which protein inhibitors are P450 inhibitors (3) |
|
Definition
| erythromycin, clathromycin, streptogramins |
|
|
Term
| what is streptogramin composed of |
|
Definition
30% quinuprostin
70% dalfopristin |
|
|
Term
| what are the three steps in protein production |
|
Definition
growtin chain goes to acceptor site to get new AA molecule (via peptidly transferase)
uncharged tRNA moves to donor site to make space for charged tRNA
charged tRNA comes to acceptor site |
|
|
Term
| which drugs stop peptidyl transferase, what does this stop from happening |
|
Definition
chloramphenicol
growing chain cannot get to the acceptor site to get a new AA |
|
|
Term
| which drugs stop tRNA from moving from acceptor site to donor site, what does this stop from happening |
|
Definition
macrlides, telithromycin, clindamclin, streptogramin
new charged tRNA cant get onto the acceptor site to provide more AA to the chain |
|
|
Term
| what drugs stop tRNA travel to the acceptor site |
|
Definition
|
|
Term
| what is the MOA of tetracyclins |
|
Definition
| bind 30S and block amino acyl (t)RNA binding |
|
|
Term
| what causes resistance in tetracyclins |
|
Definition
natural R factor makes it so Mg dependent TetA pumps turn on effluxing the drug from the cell
resistance to one = resistance to all |
|
|
Term
|
Definition
same as tetracycline except 5x more affinity for 30S
affects ribosomal protection proteins |
|
|
Term
| what causes resistance to tigecycline |
|
Definition
| minimal - no TegA concerns |
|
|
Term
| how does aminoglycides get into the cell (3) |
|
Definition
passive diffusion through the cell wall, O2 dependent transport through the cell membrane
helped by synergism with penicillin, ampicillin, or vancomycin to break the wall |
|
|
Term
| what are the 4 MOA of aminoglycocides |
|
Definition
interfere with initiation complex of peptide formation on 30S
induce misreading or mRnA making toxic or non functional AA
break polysomes into monomeres
post antibiotic effect |
|
|
Term
| what is the post-antibiotic effect |
|
Definition
| continue to supress growth at sub-inhibitory concentrations because it takes time for bacteria to make new ribosomes |
|
|
Term
| what is the MOA of macrolides |
|
Definition
stops amino acyl(tRNA) translocation
uncharged tRNA cannot move from acceptor to donor site to allow new charged rRNA in |
|
|
Term
| what are 4 ways to get resistance to macrolides |
|
Definition
decrease uptake of drug by microbe
binding site on 50S is methlyated
bacteria make esterase and cleave the macrolide
if there is penicillin resistance there is a 50% chance of macrolide resistance |
|
|
Term
| what do you use if a microbe is macrolide resistant because it is penicillin resistant |
|
Definition
|
|
Term
| what is the MOA of telithromycin |
|
Definition
| same as macrolides but bind to 50S 10x stronger |
|
|
Term
| how can a microbe become resistant to relithromycin |
|
Definition
| less of an issue - methylation of the 50S binding site isnt a problem |
|
|
Term
| why dont protein synthesis drugs stop out ribosomes |
|
Definition
| ours are different from bacterial, out mitochondrial ribosomes are like theirs but they are all safe and hidden |
|
|
Term
| what is the OA of chloramphenicol (2) |
|
Definition
inhibits peptidyl transferase
bacteriostatic |
|
|
Term
| what is the MOA of clindamycin |
|
Definition
| inhibits amino acyl transfer (tRNA) transfer |
|
|
Term
| what is the MOA of streptograims |
|
Definition
|
|
Term
| what are two contraindications to tetracyclines, why |
|
Definition
antacids and dairy: Ca, Mg, and Al chelate with the drug and form a non-absorbable product
less of an issue with doxycycline |
|
|
Term
| where do tetracyclines distribute to in the body (5) |
|
Definition
| liver, spleen, skin, CSF (not well), placenta |
|
|
Term
| what do tetracyclines bind in the body (not the GI) (4) |
|
Definition
| calcification (bone, teeth, tumors, gastric carcinomas) |
|
|
Term
| why cant you take tetracycline if you're pregnant |
|
Definition
| it accumulates in fetal bones and teeth |
|
|
Term
| how are tetracyclines eliminated |
|
Definition
release into bile, reabsorbed into intestines, release into glomerular filtrate
docycycline is not reabsorbed and is released in feces |
|
|
Term
| what are side effects of tetracyclines (4) |
|
Definition
discoloration of bone
discoloration of teeth
phototoxicity
stunts growth via hypoplasia of calcified tissue |
|
|
Term
| what type of antibiotic is tigecycline, how is it administered |
|
Definition
|
|
Term
| what are the side effects of tigecycline (2) |
|
Definition
| discolors teeth, teratogenic |
|
|
Term
| how does resistance develop to tigecycline |
|
Definition
| minimal, no TegA exporter issues |
|
|
Term
| how does tigecycline work (2) |
|
Definition
same as tetracycline except binds with 5x more affinity to 30S
affects ribosomal protection proteins |
|
|
Term
| how are aminoglycosides given, why |
|
Definition
| IV/IM because they are poorly absorbed |
|
|
Term
| how are amino glycosides metabolized and excreted |
|
Definition
not metabolized
excreted in urine |
|
|
Term
| where do aminoglycosides distribute to |
|
Definition
no CNS
dosent enter cells well because its polar
concentrate in renal cortex causing nephrotoxicity |
|
|
Term
| what are aminoglycosides synergistic with (3), why |
|
Definition
penicillin, vancomycin, ampicillin
the helper breaks through the cell wall and then the aminoglycosidestops protein synthesis |
|
|
Term
| what bugs does aminoglycosides use synergy with a cell wall drug to kill (4) |
|
Definition
| strep, enterococcus, endocarditis, listeria |
|
|
Term
| what are the three categories of side effects for aminoglycosides |
|
Definition
nephrotoxicity
ototoxicity
neuromuscular paralysis |
|
|
Term
| how can you tell if someone is getting nephrotoxicity from an aminoglycocide (2), why does this happen, what percautions are taken |
|
Definition
accumulates in cortex of nephron
disrupts ca transport
tubular necrosis
monitor plasma level if getting for >5d |
|
|
Term
| what are 5 signs of ototoxicity when on amino glycocides, what percautions are taken |
|
Definition
tinnitis, high frequency hearing loss, vertigo, ataxia, decreased balance
monitor plasma levels if taking for >5d |
|
|
Term
| why do you get neuromuscular paralysis on aminoglycocides, how does it happen, what is a concerning side effect of this |
|
Definition
occurs at high doses
blocks ACh receptors
can cause respiratory paralysis |
|
|
Term
| what is the antidote to neuromuscular paralysis on aminoglycocides (2) |
|
Definition
| cholinesterase inhibitor or Ca gluconate |
|
|
Term
| what two drugs interact with aminoglycocides, what is the outcome of each |
|
Definition
loop duruetics increase ototoxicity
cancer drugs increase nephrotoxicity |
|
|
Term
| where do macrolides distribute |
|
Definition
|
|
Term
| where are macrolides excreted |
|
Definition
| kidney but dont need to adjust in renal failure except for clathromycin which needs to be adjusted in severe renal failure |
|
|
Term
| which macrolides are teratogenic |
|
Definition
|
|
Term
| which macrolide is enteric coated, why. what are the others like |
|
Definition
| erythromycin is enteric coated because it is destoried by gastric acid. the others are stable and absorbed well. they decrease GI upset |
|
|
Term
| what drug pepentrates prostatic fluid |
|
Definition
|
|
Term
| explain the metabolism of the three macrolides |
|
Definition
erythromycin: metabolized a lot
azithromycin: not metabolized
clathromycin: metabolized to become active |
|
|
Term
| which macrolides are P450 inhibitors, what drugs do they mess up (3) |
|
Definition
erythromycin and clathromycin
theophyline and warfarin
they also kill the bacterial that inactivate digxin so sort of inhibiting for them too |
|
|
Term
| from lest to most, what is the p450 inhibition rank of the macrolides |
|
Definition
| azithromycin, clathromycin, erythromycin |
|
|
Term
| thlithromycin: type of antibiotic, MOA, resistance, administration |
|
Definition
ketolide antibiotic
MOA the same as macrolides but binds 10X stronger
less resistance - no methlyation issue
oral administration |
|
|
Term
| telithromycin: side effects (5) |
|
Definition
nausea, diarrhea, vomiting
headache, dizzy |
|
|
Term
| chloramphenicol: side effects (3) |
|
Definition
| anemia, marrow toxicity, gray baby (cannot glucorinate) |
|
|
Term
| why is chloramphenicol a bad cjoice |
|
Definition
| toxic, resistance, rare in pharmacy |
|
|
Term
| clindamycin: administration, metabolism, side effects (3) |
|
Definition
oral
cleared in liver
C. diff, fever, cramps |
|
|
Term
| what is the number one medicine that causes C. diff |
|
Definition
|
|
Term
|
Definition
|
|
Term
| streptogrraims: adeministration, side effects (2) |
|
Definition
IV
P450 inhibitor
phlebitis at injection site 10% |
|
|
Term
| inlesolid: administration (2), side effects (2) |
|
Definition
oral, IV
GI upset
tongue discoloration |
|
|
Term
| on a broad level, what do tetracyclines work on (3) |
|
Definition
gram negative and positive
atypicals |
|
|
Term
| what 4 conditions are tetracyclines the drug of choice for |
|
Definition
chlamydia
rickettsia- rocky mt. spotted fever
vrucella- lyme
coxiella- intracellular |
|
|
Term
| what 4 microbes are tetracyclines not the drug of choice for but its pretty good at it |
|
Definition
syphilis- alternative
acne
anthryx
vibro-cholerae |
|
|
Term
| on a broad level, what do tigecyclines work on (3) |
|
Definition
gram negative and positive
anaerobes: bacteroides, C non diff |
|
|
Term
| what specific microbes or types of infections is tigecycline good at (6) |
|
Definition
bacteroides, C non diff
MRSA, VREF
complicated skin infection
intra-abdominal infection |
|
|
Term
| on a broad level what do aminoglycosides work on (3) |
|
Definition
| aerobic gram negative rods |
|
|
Term
| what 3 specific microbes do aminoglycosides work on |
|
Definition
pseudomonas
mycobacterium (streptomycin)
moraxella |
|
|
Term
| on a general level, what does telithromycin kill (2) |
|
Definition
|
|
Term
| what 4 microbes does telithromycin kill |
|
Definition
| moraxella, chalmydia, mycoplasma, legionella |
|
|
Term
| on a general level, what do macrolides kill (4) |
|
Definition
| gram positive and negative rods and cocci |
|
|
Term
| what 5 microbes are important that marolides kill |
|
Definition
| hemophalus, legionella, chladymia pneumonia and STI, MAC |
|
|
Term
| what is an alternative to B-lactams in a non life threatening and life threatening infection |
|
Definition
non: macrolides
life threat: vancomycin |
|
|
Term
| what are the atypical bacteria that macrolides kills (4) |
|
Definition
mycoplasma pneumonia
legionella pneumonia |
|
|
Term
| what are 2 every day infections that macrolides kill |
|
Definition
|
|
Term
| what are 5 other microbes macrolides kill |
|
Definition
MRSI
listeria
clostridium
meningitidis
moraxella |
|
|
Term
| what is chloramphenicol an alternative to |
|
Definition
|
|
Term
| what does chloramphenicol kill (2) |
|
Definition
broad spectrum
rickettsia: typhys, rocky mt fever (when tetracycline resistant) |
|
|
Term
| what does clindamycin kill (5) |
|
Definition
bacteroides, actinomyces
CA-MRSA
strep, staph |
|
|
Term
| when do yo use streptograims (4) |
|
Definition
life threatening vancomycin resistant VREF, VRSA, MSSA
gram positive cocci |
|
|
Term
| what is streptograims not good at (4) |
|
Definition
| gonorrhea,legionella, C not diff |
|
|
Term
| what does linesolid kill (4) |
|
Definition
| c not diff, MRSA, VREF, VRSA, nosocomal pneumonia |
|
|
Term
| what is linesolid not good at |
|
Definition
|
|
