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Immunology Pharm Lecture 2 Antimicrobials Fall 2018
Terms in this set (72)
Protein synthesis inhibitors?
Inhibitors of the 30S Ribosomal Subunit?
Which drugs are classified as aminoglycosides?
Which drugs are classified as tetracyclines?
Which drugs are Inhibitors of the 50S Ribosomal Subunit?
Which drugs are classified as Macrolides?
Drugs classified as Other ABX?
What do protein synthesis inhibitors do?
inhibit either 30s or 50s subunits
Bacterial protein synthesis & sites of drug action
What do you need to remember about aminoglycosides?
They bind to 30S ribosomal subunit
Have multiple mechanisms of resistance
Adverse Effects for Aminoglycosides?
**—commonly occurs in elderly b/c physicians dodn't dose-adjust the drug to pts reduced glomerular filtration rate that normally occurs in the aging process.
***-neuromuscular junction blockade
Aminoglycosides is given by?
Given by IM or IV injection (poorly absorbed from the GI tract)
dosage monitoring using plasma levels
-often used for once-a-day dosing
-eliminated by glomerular filtration
MOA of aminoglycosides ?
Undergo active transport across cell membrane via an *
** process after crossing the outer membrane via a porin channel
not effective against anaerobes
Bactericidal inhibitor of protein synthesis
If you have a patient that has an aerobic gram (-) bacteria what drugs can you give?
Pt has either:
Which 3 drugs are reserved for gram (-) and often combined w/penicillins or cephalosporins?
Which drug class has a narrow therapeutic index & you have to monitor closely once given? They also have which BBW?
** (acute tubular necrosis)
Neuromuscular junction blockade (high doses)
Tetracyclines are Bacteriostatic or bacteriocidal?
Tetracyclines have reversible inhibition of protein synthesis of which inhibitor?
30s ribosomal subunit
Tetracyclines are know for?
Being both gram (+) & (-), they have broad spectrum of action
-they also have multiple drug resistance
AE for tetracyclines?
-GI toxicity (nausea)
Bone Growth Retardation
Inhibits bone growth (fetuses, infants & children)
—don't give to children <8 YOA or some physicians say under 14 YOA
If you have a pt that is eating food or medicines that contain calcium, or antacid / iron—containing meds can you give Tetracyclines????
Relative CI for Tetracyclines?
Can cross placenta & is excreated in milk
Pt who has the following DX's can be given which Drug class?
Rocky Mountain spotted fever (rickettsia)
Gram (-) & (+) bacteria includes?
Rocky Mountain spotted fever (rickettsia)
MOA of Macrolides?
Binds reversibly to the 50S ribosomal subunit
Macrolides are often used in which situation?
Used in pts who are allergic to PCN.
What is DOC in macrolides for pt resistant. to PCN?
Which 2 drugs in the macrolides have a broader spectrum?
If a pt has an anaphylactic rxn to PCN. What drug class is CI??
Use for Azithromycin?
Mycobacterium Adium complex prophylaxis in pts w/advanced HIV
Sinusitis & otitis media (H. Influenza, M. Catarrhalis)
Use for Clarithromycin ?
Infection caused by H.pylori
Also for infections TX'ed w/azithromycin
Use for Erythromycin?
Neonatal genital or ocular infections
AE for Macrolides??
Erythromycin (cytochrome P450 system inhibitor) increased effects with certain drugs (e.i. Carbamazepine , cyclosporine, Digoxin, midazolam, quinidine)
The MOA for Chloramphenicol is?
Inhibition of 50S peptidyl transferase, Bacteriostatic
AE for chloramphenicol?
Aplastic anemia (idiosyncratic w/oral admin)
Dose dependent inhibition of erythropoiesis
Gray baby syndrome
deficiency of glucuronyl transferase @ birth (inhibits cytochrome P-450s)
MOA for Clindamycin?
Inhibits protein synthesis @ the 50s ribosome ***
** but can be Bactericidal depending on susceptibility
Use of clindamycin?
Severe gram (+) anaerobic infections
Bacterial (Gardnerella, mycoplasma, prevotella) vaginosis (vaginal cream, vaginal suppository)
Pelvic inflammatory disease (IV)
Topically in TX of severe acne
AE of clindamycin????
pseudomembranous colitis (c.difficile)
Linezolid (oral, IV) main use?
Reserved for treatment of vancomycin-resistant enterococcus
AE for Linezolid?
GI- (diarrhea, N&V)
Thrombocytopenia & neutropenia
Inhibits monomania oxidase (MAO)
*Avoid consuming tyramine-containing foods (aged cheese, red wine)
Use of quinupristin-dalfopristin?
TX of serious or life-threatening infections associated w/VRE bacteremia
TX of complicated skin infections caused by MRSA or Strepococcus Pyogenes
AE of quinupristin-dalfopristin?
drug-drug interactions for quinupristin-dalfopristin?
Potent inhibitors of CYP34A4
Increased plasma levels of—(cyclosporine, Diazepam, nucleoside reverse transcriptase inhibitors, warfarin)
Intranasal—eradication of nasal colonization w/MRSA
Topical —TX of impetigo or secondary infected traumatic skin lesions due to s.aurerus & s. Pyogenes
Which of the following drugs are considered antimetabolites?
dihydrofolate Reductase inhibitors
Drugs classified as sulfonamides?
Drugs that are classified as dihydrofolate reductase inhibitors?
Antimetabolites used for for microorganism interfere w/ metabolism of?
-competitive inhibition of PABA
Synergistic action w/trimethoprim
Adjective TX in toxoplasmosis
Uncomplicated attack of malaria
All sulfonamides are used for?
Prevention & treatment of infection in 2nd&3rd degree burns
AE of sulfacetamide?
-aplastic anemia (rare)
-methemoglobinemia & hemolysis in G6PD deficient pts
-folate deficiency w/macrocyclic anemia
Crystalluria & hematuria
Kerinecterus in infants
Sulfacetamide CI's ?
-preexisting bone marrow suppression
-megalobastic anemia 2ndary to folate deficiency
OM & bronchitis (in combo w/sulfonamide)
Trimethoprim/Sulfamethoxazole (TMP/SMX) also known as?
Use : Trimethoprim/Sulfamethoxazole?
PO— UTIs, acute OM in children, **
TX & prophylaxis of (PCP)
)****, traveler's diarrhea (due to e.coli)
DOC for adult UTI Treatment??
MOA of nitrofurantoin?
Inhibition of protein synthesis, aerobic energy metabolism DNA, RNA & cell wall synthesis
Can be bacterialcial in urine @ therapeutic doses
AE for nitrofurantoin?
Common—GI (LOA, N&V)
**- cholestatic jaundice syndrome, hepatic necrosis, hepatitis
***- Hypersensitivity rxn
**-peripheral neuropathy, pseudotumor cerebri
**-interstitial pneumonia, pneumonia, Pulmonary fibrosis, pulmonary hypersensitivity
Anuria, oliguria, or significant impairment of renal function***
Drugs classified as messing with DNA replication/ DNA gyrase inhibitors?
Drugs classified as fluoroquinolones?
1st gen fluoroquinolones?
2nd gen fluoroquinolones?
2nd gen fluoroquinolones use?
Gram (-) bacteria including gonoccus also many gram (+) cocci (mycobacteria & M.pneumoniae)
3rd gen fluoroquinolones?
3rd gen fluoroquinolones use?
Less activity against gram (-) bacteria but greater against some gram (+) cocci (s.pneumoniae, enterococci, MRSA)
4th gen fluoroquinolones?
4th gen fluoroquinolones use?
Broadest spectrum of the fluoroquinolones good activity against anaerobes & pneumococci, good CNS penetration
AE of fluoroquinolones???
Interactions w/other drugs ***
avoid taking calcium-containing medications, theophylline, caffeine
Interference w/collagen synthesis—causes tendon rupture
ALL QUINOLONES PROLONG QT interval****
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