-
Which are 30S inhibitors and 50S inhibitors?
- 30S:
- A-Aminoglycosides (streptomycin, gentamicin, tobramycin, amikacin) (bactericidal)
- T-Tetracyclines (bacteriostatic
- 50S:
- C-Chloramphenicol, Clindamycin (bacteriostatic)
- E-Erythromycin (bacteriostatic)
- L-Lincomycin (bacteriostatic)
- L-Linezoid (variable)
"Buy AT 30, CCELL (sell) at 50."
-
MOA of aminoglycosides and types
- Inhibits formation of initiation complex and cause misreading of mRNA.
- Required O2 for uptake, thus NOT effective against anaerobes.
Gentamicin, neomycin, amikacin, tobramycin, streptomycin, paromomycin (safe for preggers)
-
Clinical use of aminoglycosides
Severe GNRs infxs. Synergistic with beta-lactams. Neomycin for bowel surgery.
-
Toxicity of aminoglycosides
- Nephrotoxicity (esp when used with ceph)
- Ototoxcitiy (esp when used with LOOP diuretics)
- Teratogen
-
MOA of tetracyclines and i.e
- Binds to 30S and prevent attachment of aminoacyl-tRNA
- Limited CNS penetration
- Doxycycline is fecally eliminated and can be used in pts with renal failure
- AVOID dairy, antacids, or Fe-containing prep bc divalent cations inhibit its absorption in the gut.
Tetracycline (1st line for mycoplasma spp), doxycycline, demeclocycline, minocycline
-
Clinical use of tetracyclines
Vibrio cholerae, P. acne, chlamydia, ureaplasma, urealyticum, mycoplasma pneuomoniae, tularemia, H.pylori, borrelia burgdorferi, rickettsia
-
Toxicities of tetracyclines
GI stress, discoloration of teeth, blue-ish skin hues, inhibition of bone growth in children, photosensitivity.
C/I in preggers
-
MOAs of Macrolides and i.es
Inhibit protein synthesis by blocking translocation; bind to the 23S rRNA of the 50S ribosomal subunit.
- Erythromycin (1st line for legionella b/c legionella produces beta lactamases)
- Azithromycin
- Clarithromycin (1st line for mycoplasma) (Biaxin)
-
Clinical use of macrolides
- URIs, pneumonias, STDs
- GPCs (streptococcal infxn in pts allergic to pen.)
- Mycoplasma, Legionella, Chlamydia, Neisseria
-
Toxicity of macrolides
- GI discomfort (MCC of noncompliance)
- Acute cholestatic hepatitis
- Eosinophilia, skin rashes
- Increases serum concentration of theophyllines, oral anticoagulants
-
MOAs of chloramphenicol
Inhibits 50S peptidyltransferase activity. Inhibit peptide bond formation.
Bacteriostatic
-
Clinical use of chloramphenicol
Meningitis (H. influenzae, N. meningitidis, S. pneumo)
conservative use owing to toxicities
-
Toxicities of chloramphenicol
- Anemia (dose dependent)
- Aplastic anemia (dose independent)
- Gray baby syndrome (esp in premies infants bc they lack liver UDP-glucuronyl transferase)
-
MOA of Clindamycin
Block peptide bond formation at 50S ribosomal subunit
Brands--Cleocin, Clindesse
-
Clinical Use/Toxicities of Clindamycin
Tx anaerobic infxns (i.e bacteroides fragilis, clostridium perfringens)
Pseudomembranous colitis (C. difficile overgrowth), fever, diarrhea
|
|
