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MCPH 4
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Antimicrobial Agents
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ANTIMICROBIAL ACTIONS OF DRUGS PART 4
level: ANTIMICROBIAL ACTIONS OF DRUGS PART 4
Questions and Answers List
level questions: ANTIMICROBIAL ACTIONS OF DRUGS PART 4
Question
Answer
Inhibitors of Protein Synthesis Binds to 50s ribosomes
1 CHLORAMPHENICOL 2 MACROLIDES 3 LINCOSAMIDES 4 STREPTOGRAMINS 5 Oxazolidinones 6. Pleuromutilins
Used in meningococcal infections, H influenza infections and cephalosporin allergic patients as well as anaerobic infections Broad spectrum but potentially toxic
CHLORAMPHENICOL
CHLORAMPHENICOL is __ spectrum. It is no longer widely used because it is potentially __
broad, toxic
Serious adverse effects of Chloramphenicol
1 Suppression of bone marrow activity 2 Aplastic anemia 3 Gray baby syndrome
Dose-related; Manifest only at a certain dose of chloramphenicol
Suppression of bone marrow activity - Suppress the formation of blood cells and immune cells
Non-dose related Condition that occur when the body is not producing enough new blood cells
Aplastic anemia
Because of circulatory collapse that occur in premature or newborn infants It is associated with excessively high levels of chloramphenicol It can happen if a pregnant person takes chloramphenicol
Gray baby syndrome
Have presence of macrocyclic lactone ring which is a ketone group, this is glycosidically linked amino sugar Because of its nucleus, it prevents the translocation movement of ribosome along mRNA
MACROLIDES
Types of Macrolides
1 Erythromycin 2 Clarithromycin 3 Azithromycin 4 Telithromycin
Enable to penetrate cell walls of most gram negative bacteria The spectrum of activity is similar to Penicillin G. Drug of choice for penicillin G allergic patients.
Erythromycin
Erythromycin have poor GI absorption that is why it is made into what dosage form?
Enteric coated dosage form
Also used for Legionellosis, mycoplasma pneumonia, campylobacter, Chlamydial infections, Diphtheria, and Pertussis
Erythromycin
Broader antimicrobial spectrum It can penetrate the tissues better
Clarithromycin & Azithromycin
Clarithromycin is usually used together with __, __ for H pylori eradication
Omeprazole, Lansoprazole
Drug of choice for Non gonococcal urethritis (NGU) such as from chlamydia Also used for Lower respiratory tract infection, Pharyngitis, Legionnaires, Pelvic Inflammatory Disease
Azithromycin
Ketolides Not used anymore because it causes hepatoxicity
Telithromycin
What are the Adverse Effects of Macrolides
1 Epigastric distress, 2 Cholestatic jaundice
Pain that is localized to the region of the upper abdomen immediately below the ribs Often, those who experience this type of pain feel it during or right after eating
Epigastric distress
Caused by the Estolate form of erythromycin Unable to transport bilirubin because of hepatic bile capillary
Cholestatic jaundice
Resembles sulfonamides in antibacterial spectrum, biochemical form and mechanism of action
LINCOSAMIDES
Their use is for abdominal and female genitourinary tract infection caused by bacillus fragilis, and pseudomonas
LINCOSAMIDES
Example of lincosamides
Clindamycin
Adverse effects of clindamycin
Pseudomembranous colitis and rash
Pseudomembranous colitis is treated by
Clindamycin
1 ___ Block an early step in protein synthesis 2 ___ Blocks the later step in protein synthesis
1 Quinupristin, 2 dalfopristin
Alternative for treating vancomycin resistant gram positive bacteria
Quinupristin / dalfopristin (Synercid)
Totally synthetic antibiotic which makes resistance slower to develop No usefulness against gram __ but very active against certain __ which are not sensitive to synercid
Oxazolidinones, negatives, enterococci
Oxazolidinones example
Linezolid
Useful primarily against penicillin resistant gram positive bacteria or MRSA
Linezolid
Derivatives and oxazolidinones represent the two classes of antibiotics developed since 2000s
Pleuromutilins
The first antibiotics of Pleuromutilins approved for human use
Retapamulin