Quinolones, Macrolides, Vanc, Bacitracin, Clinda, Metro, and Polymyxins
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Created by:
birdsvsworms on June 1, 2011
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24 terms
Terms | Definitions |
|---|---|
 Vancomycin: indications | only serious g(+) infections--MRSA, staph meningitis, C.diff |
| Vancomycin: mechanism and side effects (four) | similar to pens--inhibits peptidoglycan construction-->bactericidal side effects: nephrotoxic, ototoxic, thrombophlebitis, "red man syndrome" |
| Bacitracin: indications and route of admin | gram (+) cocci eye and skin infections-->topical admin |
| Bacitracin: mechanism | similar to pens; interferes with regeneration of lipid carriers in peptidoglycan synthesis by blocking dephosphorylation |
| 3 members of quinolone family | ciprofloxacin, norfloxacin, and ofloxacin |
| Quinolones: mechanism, route of admin | inhibits DNA gyrase (topoisomerase II)-->bactericidal given PO |
| Quinolones: side effects (two) and contraindications (what type of pts) | side effects: n/v/d, can have suprainfections with streptococci and candida Contraindicated in pts < 18 yrs and > 60 yrs for cartilage damage (tendinitis and tendon rupture); also in preg and nursing mothers |
| Quinolones: 2 mechanisms for drug resistance | 1. gyrase mutation 2. decreased permeability of drug through porins |
| Quinolones: 8 indications | 1. UTI by multi-drug resistant bacteria 2. gastroenteritis (by shigella, salmonella, E.coli, helicobacter) 3. osteomyelitis and soft tissue infections (not routine) 4. intraabdominal and respiratory tract infections (not routine) 5. gonococcal infections 6. chlamydia 7. prophylaxis for traveler's diarrhea 8. pseudomonas |
| Which quinolone is particularly anti-pneumoncoccal? | ofloxacin--has closely related levofloxacin and moxifloxacin which are also "respiratory" quinolones |
| Macrolides: 4 members | erythromycin, azithromycin, clarithromycin, and spectinomycin |
| Macrolides: mechanism | binds to 50S ribosome to inhibit aminoacyl translocation-->bacteriostatic |
| Macrolides: drug resistance | plasmid-mediated gene encodes alternate protein on 50S ribosome |
| Erythromycin: indications (ten) | 1. DOC in community-acquired pneumonia (includes S. pneumoniae, Legionella, M. pneumoniae) 2. Treponema if pens allergy 3. Ureaplasma 4. Chlamydia (esp during preg) 5. Helicobacter 6. Listeria 7. Neisseria 8. Bordetella pertussis 9. Campylobacter 10. Gram pos: Pneumococci, Streptococci, Staphylococci, C. diphtheriae (eliminate carrier state) Similar spectrum as pen G |
| Azithromycin: indications (two) | 1. chlamydia 2. H. influenzae |
| Clarithromycin: indications (two) | 1. H. pylori (in combo with amoxicillin + PPI) 2. H. influenzae |
| Spectinomycin: indications | GU gonorrhea if pens allergy or if gonorrhea is pens-resistant |
| Clindamycin: indications | anaerobes B. fragilis infections, also Strep, Staph, and pneumococcal infx |
| Clindamycin: mechanism and route of admin | inhibits protein synthesis PO |
| Clindamycin: side-effects (two) | 1. suprainfection by C. difficile 2. hepatotoxicity |
| Metronidazole: indications (three) | Bacteriodes, Clostridia, and Pseudomembranous colitis |
| Metronidazole: mechanism and route of admin | inhibits DNA synthesis-->bactericidal oral; IV available |
| Metronidazole: side effects (two) | 1. minor GI and CNS disturbances 2. Interferes with EtOH metabolism--disulfram-like effect-->decreases activity of aldehyde dehydrogenase, so aldehyde toxicity |
| Polymyxins: indications and mechanism | topical for eye and ear with bacitracin or neomycin binds to phosphatidyl ethanolamine--detergent-like activity |
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