Chapter 17: Anti-Ribosomal Antibxs
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- Describe the bacterial ribosome?
- 70S particle with a 50S and 30S subunit
- List the important anti-ribosomal antibiotics?
- Chloramphenicol, clindamycin, linezolid, erythromycin, tetracycline, and aminoglycosides.
- Which anti-ribosomal antibxs cannot be absorbed orally?
- Aminoglycosides
- List two drugs that can kill Bacteroides fragilis?
- Chloramphenicol and clindamycin
- Chloramphenicol kills which bacteria?
- Most clinically important bacteria - gram (+), gram (-), and anaerobes. (Like pouring chlorine on the organisms)
- What's the problem with using chloramphenicol?
- Rare but severe side effects - aplastic anemia, Gray Baby Syndrome.
- Where is chloramphenicol use clinically indicated?
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1. Bacterial meningitis with unknown organisms and patient penicillin/cephalosporin allergies.
2. Young children and pregnant women with Rocky Mountain spotted fever who cannot be treated with tetracycline. - Why do surgeons use clindamycin and aminoglycoside combos for penetrating wound infections of the abdomen?
- Clindamycin covers the anaerobes, while aminoglycosides cover the aerobic gram (-)s.
- What is the important adverse effect that clindamycin can cause?
- Pseudomembranous colitis, due to wiping out the natural flora of the GI tract, which can cause an opportunistic C. dificile infection.
- Which drug is a last resort for VRE?
- Linezolid
- What are erythromycin's clinical uses?
- Gram positives, Mycoplasma, and the gram (-) Legionella and Chlamydia (atypicals). Drug of choice for community-acquired pneumonia that does not require hospitalization.
- What drug is used as an alternative to doxycycline for the treatment of chlamydial non-gonococcal urethritis?
- Azithromycin
- What are the clinical uses of doxycycline/tetracycline?
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Think: Tet offensive.
1. Venereal diseases caused by chlamydia trachomatis.
2. Walking pneumonia caused by Mycoplasma
3. Animal and tick-borne diseases caused by Brucella and Rickettsia - What are the adverse effects of doxycycline?
- GI irritation, phototoxic dermatitis, renal/hepatic toxicity, depressed bone growth and brown teeth of babies and children.
- Why are aminoglycosides combined with penicillin?
- Penicillin breaks down the cell wall to allow aminoglycosides to diffuse into the cell.
- What are the clinical uses of aminoglycosides?
- Aerobic gram (-) enteric organisms, including Pseudomonas.
- What is the most commonly used of all the aminoglycosides?
- Gentamycin
- What are the side effects of aminoglycosides?
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Think: "a mean guy."
1. Eighth cranial nerve toxicity
2. Renal toxicity
3. Neuromuscular blockade