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Pharm - Ch. 85

Bacteriostatic Inhibitors of Protein Synthesis

QuestionAnswer
What are three drugs used as bacteriostatic inhibitors of protein synthesis? Tetracyclines, erythromycin, linezolids
True or false: tetracycline is a broad spectrum antibiotic True
Describe the mechanism of action for tetracycline Inhibits protein synthesis by binding to 30S ribosome which inhibits mRNA/tRNA activity
How do bacteria form resistance against tetracycline/ Resistance results from reduced drug accumulation, increased drug inactivation, and decreased access to ribosomes
Tetracycline is mostly commonly used as a ___ agent for resistant infections second line
Tetracycline is used as first line treatment in... Rickettsial disease, chlamydia, cholera, mycoplasma pneumoniae, lyme disease, anthrax, h. plyori
True or false: tetracyclines can be used to treat acne or PUD True
What is chelation and why is this significant to tetracycline administration? Chelation refers to binding of metals that are positively charged (Ca2+, Mg, Fe). Tetracycline chelates with these metals so don't administer with supplements, milk products, Mg-laxatives, and most antacids otherwise drug not adequately absorbed by body
List the adverse effects of tetracycline Affects developing teeth; can suppress long-bone growth in premature infants. Photosensitivity, hepatotoxicity/renal toxicity, decreased oral contraceptive efficacy and breakthrough bleeding. Superinfection caused by c. diffcile colitis.
Tetracycline is a category ___ drug D. Don't give during pregnancy, breastfeeding, or kids under 8 years
The prototype of macrolides is known as Erythromycin
What is the mechanism of action of erythromycin? Inhibits bacterial protein synthesis by binding to 50S ribosome
True or false: due to ribosome binding, there is cross-reactivity between erythromycin and tetracycline False. Tetracycline binds to 30S ribosome, erythromycin to 50S. Since these are in different parts of ribosomes, drugs do not have cross-reactivity
How is resistance to erythromycin formed? Develops from increased drug efflux and modification of bacterial ribosome
True or false: erythromycin generally has few side effects True. Mostly GI (pain, naseua/vomiting, diarrhea)
Erythromycin is contraindicated with CYP3A4 inhibitors and _____ due to _______ Antidysrhythmics; cardiotoxicity
True or false: erythromycin is a narrow spectrum antimicrobial False. Broad-spectrum.
True or false: macrolides are effective against most G+ and some G- cells True
True or false: linezolid acts on the 30S ribosome unlike other antimicrobials False. Linezolid acts on 50S ribosome in a way unique to other antimicrobials.
Linezolid's mechanism of action has what nursing implication? (hint: related to binding) Linezolid is unlikely to have cross-resistance with other agents, thus is used to treat pathogens other drugs cannot such vancomycin-resistant/methicillin-resistant pathogens.
Why is linezolid's use so limited? To slow development of resistance. Drug reserved to treat vancomycin-resistant enterococci (VRE) and methicillin-resistant staph aureus (MRSA)
What is the prototype for aminoglycosides? Gentamicin
What is the mechanism of action for gentamicin? Severely disrupts bacterial protein synthesis by misreading the code.
True or false: gentamicin used to treat serious infections caused by anaerobic G- bacilli False. Treats aerobic G- bacilli
True or false: gentamicin only given IV True
How does resistance to gentamicin develop? Bacterial protein gentamicin is supposed to inhibit develops resistance
What are the adverse effects of gentamicin? Significant injury to inner ear/kidney. Monitor for tinnitus/headache. Hypersensitivity reactions, neuromuscular blockade (respiratory depression)
What DDIs should be noted with gentamicin? Inactivated if placed in IV bag with penicillin
Why must gentamicin be given parenterally? Otherwise not absorbed by body
Created by: choel
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