antibiotics for osteomyelitis and skin infections med chem Flashcards Preview

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Flashcards in antibiotics for osteomyelitis and skin infections med chem Deck (42)
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1

tetracycline drugs

tetracycline
monocycline
doxycycline
tigecycline

2

tetracycline MoA

interacts with 30S subunit of ribosome and sits in A site to prevent elongation (bacteriostatic)

3

tetracycline general pharmacophore

4 rings and dimethylamine pointing into the board

4

ways to inactivate tetracyclines

-make dimethylamine come out of the board
-dehydration of OH on north side
-breaking C ring through intramolecular reaction

5

avoid taking tetracyclines with what

multivitamins and milk because of chelation with ions

6

tetracyclines clinical use

-Gm+
-MRSA
-limited Gm-

7

tetracycline resistance

widespread in forms of
-efflux
-mutations in ribosome
-cell wall variation

8

side effects of tetracyclines

-light sensitivity
-severe kidney damage
-incorporation into bones and teeth

9

tigecycline unique structure feature

the claw on the tetracycline ring that prevents efflux based resistance

10

tigecycline clinical use

broad spectrum, typically saved for instances of resistance
*hits basically everything but pseudomonas*

11

clindamycin MoA

sits in 50S peptidyltransferase to inhibit the enzyme

12

clindamycin clinical use

-Gm+ (staph, strep)
-used w/ aminoglycosides for Gm-
-some anaerobes
-used if PCN allergy
-PO/IV

13

clindamycin side effects

-GI
-pseudomembranous colitis caused by C.difficile

14

linezolid MoA

prevents formation of 70S subunit complex by binding w/ 50S subunit

15

linezolid clinical use

-Gm+
-MRSA
-VRE
-IV/PO

16

linezolid resistance

still rare but can be seen as:
-point mutation of ribosome
-efflux pump in Gm-

17

linezolid side effects

-monoamine oxidase inhibitor, so avoid w/ tyramine foods and serotonergic drugs
-bone marrow suppression

18

linezolid monitoring

weekly blood counts

19

synercid

-IV only
-combo of dalfopristin and quinupristin
-30:70 ratio quinupristin:dalfopristin because dalfo binding first increases affinity for quinupristin

20

synercid MoA

binds to A and P sites to interfere with tRNA binding and misalignment of P site

21

mupirocin MoA

binds to Ile-tRNA synthetase to prevent incorporation of Ile into proteins

22

mupirocin clinical use

-used topically or nasally because it is hydrolyzed in vivo
-broad spectrum activity, good against staph and strep

23

mupirocin resistance

mutations in synthetase enzyme prevents binding

24

vancomycin MoA

"hugs" cross link area of peptidoglycan to prevent transpeptidase cross link AND prevents sugars from cross linking

25

vancomycin clinical use

-narrow spectrum Gm+
-used for C.diff and enterococci
-last resort for MRSA
-PO/IV

26

vancomycin resistance

D-Ala D-Ala becomes D-Ala D-Lactate to reduce hydrogen bonding

27

vancomycin resistant enterococci background

-2nd most common Gm+ in hospitals
-high moretality

28

treatments for VRE

synercid
linezolid
cubicin (daptomycin)

29

linezolid route

oral and IV

30

clindamycin route

oral