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Session 3 Pharm- 9

Pharm -9- protein synthesis inhibitors

What type of drug is erythromycin (E-mycin) Macrolide (50s)
What type of drug is azithromycin (Zithromax) Macrolide (50S)
What type of drug is Clarithromycin (Biaxin) Macrolide (50s)
What type of drug is Dirithromycin (Dynabac) Macrolide (50s)
Why would you probably avoid prescribing erythromycin Many drug interactions (CYP450-3A4), Poor Half life, GI effects, No H. Flu coverage and poor S. Pneumoniae
What would you prescribe Azithromycin and Clarithromycin for good for Gram + (not MRSA), some gram neg, good for atypicals like Legionella sp., mycoplasma pneumoniae, and chlamydia pneumonia
Which of the macrolides requires adjustment in renal impairment Clarithromycin
How do the macrolides work inhibit translocation steps by binding 50s subunit
What are the major s/e of using macrolides GI s/e, Hepatitis (mostly with erythromycin) cholestatic hepatitis, QTc prolongation, allergic reactions
What resistance mechanisms have bacteria developed to macrolides altered target site, antibiotic efflux pump,
What type of drug is Telithromycin (Ketek) Ketolide
What is the advantage of the ketolide telithromycin less resistance than macrolides but still has drug interactions (3A4)
What are the major s/e of using telithromycin the ketolide diarrhea, visual changes (blurry, difficulty focusing), QTc Prolongation, Hepatotoxicity,
Is a ketolide a first-line therapy no only approved for CAP not used first line
What place in therapy does clindamycin have covers CA-MRSA but not HA-MRSA, covers anaerobes. Mostly used for its coverage of anaerobes. Commonly used in pts with PCN allergy
What are the s/e of clindamycin diarrhea, (C. Difficile), hepatotoxicity, Rash
What type of drug is linezolid (Zyvox) Oxazolidinones
What is the clinical use for linezolid (Zyvox) used against gram + bacteria and HA- MRSA, Enterococcus faecalis and Faecium including VRE. Becoming first line DOC for MRSA
Why is Linezolid (Zyvox) becoming the drug of choice for MRSA PO formulation with 100% bioavailability doesn't need adjustment in renal or hepatic failure
What are the s/e of Linezolid (Zyvox) Myelosuppression (thrombocytopenia), Peripheral/optic neuropathy, lactic acidosis, serotonin syndrome (inhibits MAOI)
Pt is taking an MAOI for depression and has come down with a MRSA infection would you prescribe them Linezolid (Zyvox) if so why if not why Though it is considered first line therapy for MRSA you would avoid using it in this case because Zyvox inhibits MAOI as well and can cause serotonin syndrome if combined with MAOI drugs
What is the DOC when switching from IV vancomycin Linezolid (Zyvox)
What type of drug is Quinupristin-dalfopristin (Synercid) Streptogramin
What is the place in therapy for Quinupristin-dalfopristin (Synercid) Good against Gram +, enterococcus faecium (VRE)a and MRSA (not approved though). ITS MAIN ROLE IT TO TX VRE
What are the major s/e of Quinupristin-dalfopristin (Synercid) Infusion related reactions, elevation of conjugated bilirubin, arthralgias/myalgias
What type of drug is doxycycline tetracycline
What type of drug is minocycline tetracycline
What type of drug is demecyclocycline tetracycline
What type of drug is Oxytetracycline tetracycline
What is the DOC for rickettsial infections (Lyme disease, Q fever, Rocky Mt spotted fever, Ehrlichiosis) Doxycycline
What is the 2nd line agent for CAP, COPD exacerbation and can be used to tx Acne and Chlamydia Doxycycline
What is the primary use of Demeclocycline used in SIADH, blocks ADH induced water resorption
What drug of the tetracycline family is prescribed for Rheumatoid arthritis and can be used for Staph infections including CA-MRSA but is limited due to is s/e profile Minocycline
What are the major s/e of using minocycline deposition in calcified tissue= tooth discoloration, deformation of bone/growth inhibition. Avoid giving with calcium, causes photosensitivity, GI upset, Vestibular rxn, hepatotoxicity
Why should you counsel pt to throw away old tetracycline meds they decompose into toxic compounds
What type of med is Tigecycline (Tygacil) Glycylcyclines
What is the probably future use for Tigecycline (Tygacil) broad spectrum of activity covers MRSA, enterococcus faecalis, gram negatives except Pseudomonas and some of the anaerobes. Currently approved for cSSSI, intra-abdominal infections and Acinetobacter
Tigecycline works at the exact same site as the tetracycline why is it more effective it overcomes all the resistance mechanisms bacteria have to tetracycline like the efflux pumps and ribosomal modifications
What are the major s/e of Tigecycline GI disturbances, photosensitivity, Pseudotumor cerebri
What is the use for chloramphenicol Last resort for tx of rickettsial infections in children
What drug can cause gray baby syndrome Chloramphenicol
What drug can cause aplastic anemia chloramphenicol
What type of drug is Gentamicin Aminoglycoside
What type of drug is Tobramycin Aminoglycoside
What type of drug is Amikacin Aminoglycoside
What type of drug is streptomycin Aminoglycoside
What type of drug is Netilmicin Aminoglycoside
What type of drug is Kanamycin Aminoglycoside
What type of drug is Neomycin Aminoglycoside
What is the primary use for the aminoglycosides lesser and greater gram neg coverage IE Pseudomonas A., Serratia Marcescens, Acinetobacter
What do you usually prescribe with an aminoglycoside and why a beta lactam because they have synergy working together
What types of resistance are there to aminoglycosides altered ribosomes, altered uptake
Why don't aminoglycosides cover the anaerobes require oxygen to get across the cell membrane to exert their action
What concerns do you need to be aware of when prescribing an aminoglycoside it is cleared renally and has a narrow therapeutic index monitor peaks and troughs and caution in renally impaired pt
What are the major s/e of the aminoglycosides Nephrotoxicity (tubular necrosis), Ototoxicity/vestibulotoxicity (often permanent careful with high doses)
Created by: smaxsmith