MOA of tetracyclines; cidal or static? MOR?
Prevent elongation via binding "a" site at 30S (no tRNA can bind) static; channel formations that pumps tetracycline out (contirbutes to MDR)
Toxicity of tetracyclines that contraindicates its use in pregnancy or children?
bone and teeth dysplasia (via ca chelation)
Only tetracycline secreted in liver? what about the rest?
DOC for protatitis (chlamydial or gonorrheal infection)?
Use of tetracyclines? spectrum resembles what other antibiotic?
broad spectrum like macrolides; atypicals (intracellulars, mycoplasma, chlamydia, rickettsia, borriela) H. pylori
tetracycline for atypical meningitis? what other drug can be used for this?
Drug for SIADH? what is its toxicity?
democycline; diabetes insipidis and reversible vestibular function
Aside from bone/ joint issues what are other toxicities of tetracycline? What should you tell your patient about taking tetracyclines
don't take with food; chelators (Mg, Ca Fe); photosensitivity, vestibular balance issues, GI distress
Important toxicity of cloramphenicol? metabolism? how does it cause this?
liver; grey baby syndrome bc need to be conjugated in liver to be activated (glucorindation immature in babies) bone marrow supression dosage dependent
Use of chloramphenicol?
Serious rickettsial infections; pts allergic to PCN in meningococcal meningitis
bind 50S binds peptidyl transferase blocking peptide bond formation; bacteriostatic
MOA and MOR macrolides?
Bind 50S rRNA preventing translocation; rRNA becomes methylated (via methyl transferase)
Which macrolides are lipid soluble? how about water soluble?
Erythromycin, clarithromycin; azithromycin
Use of macrolides?
broad spectrum (like chloramphenicol) atypicals, gram positives and negatives; legionella
DOC for legionella pneumonia?
Drug used for MAC; which one also is effective against gastric ulcers>
azithromycin (water soluble) clarithromycin (lipid); clarithromycin
Contraindications of macrolides?
Toxicity of macrolides?
deafness, GI distress with motillin, erythro salt biliary obstruction, CYP interactions
spectrum of clindomycin? MOA/ MOR?
(like macrolide) binds 30S prevents translocation of rRNA (static) anaerobes and gram positives (osteomyelitis post S. aureus)
Typical use of clindomycin? toxicity?
osteomyelitis (s. aureus) pseudomembranous collitis
Linolizid MOA/ MOR; use?
(like aminoglycoside) bind 50S and prevents formation of initiation complex (static); conjugating enzymes that increase solubility and excretion; VRE VRSA
Toxicity of linolizid?
Use streptogramins? common ones? MOR/MOA?
VRE/ VRSA; quinupristine, dalfopristine; (same as tetracycline) bind A site blocking tRNA with aa inhibiting elongation; pumped out of cell