Antimicrobials II: Actions against the Intracellular Activity

Vocabulary flashcards covering key drug classes, mechanisms of action, indications, and side effects from the Antimicrobials II lecture.

Aminoglycosides

Potent antibiotics working well on gram (-) bacteria that inhibit bacterial ribosomes, used since 1944 for complicated infections, and requiring therapeutic drug monitoring due to nephrotoxicity ($5-25\%$) and permanent ototoxicity ($3-14\%$).

gentamycin

An aminoglycoside antibiotic that can cause neuromuscular blockade leading to profound respiratory distress in myasthenia gravis, central nervous system side effects, and cochlear damage.

clindamycin

A lincosamide antibiotic that binds to ribosomes to inhibit protein synthesis, requires monitoring with neuromuscular blockade medications, and can cause deadly pseudomembranous colitis.

Macrolides

A large group of generally bacteriostatic antibiotics (such as erythromycin and azithromycin) that inhibit protein synthesis by binding to ribosomes and are known as 'YUCK drugs' due to their intense GI side effect profile.

erythromycin

A macrolide antibiotic with hypomotility benefits for diabetic gastroparesis that does not cross the BBB and should not be taken orally on an empty stomach due to severe GI upset.

azithromycin (Z-pack)

A macrolide that differs structurally from erythromycin, offering very good tissue penetration, long duration of action, less GI upset, and decreased absorption when taken with food.

Tetracyclines

Broad-spectrum bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes, contraindicated in pregnant and nursing women and children younger than 8 due to tooth enamel hypoplasia and discoloration of permanent teeth.

tetracycline

A bacteriostatic tetracycline drug absorbed at 75%-77% when fasting, not available parenterally, which concentrates in bone, liver, tumor, spleen, and teeth.

doxycycline

A tetracycline antibiotic used to treat chlamydial and mycoplasmal infections, as prophylaxis for STIs, and for acne and other non-dangerous skin infections.

minocycline

A tetracycline used for Neisseria meningitides and decreasing symptoms of rheumatoid arthritis, available in an extended release (ER) formula called Solodyn for acne.

Fluoroquinolones

Potent, broad-spectrum antibiotics with very good oral absorption that destroy bacteria by interfering with bacterial enzymes DNA gyrase and topoisomerase.

ciprofloxacin

A fluoroquinolone used to treat UTIs, respiratory infections, and anthrax (Bacillus anthracis) that concentrates in neutrophils and carries an adverse effect of often irreversible joint disease (arthropathy).

levofloxacin (Levaquin)

The most widely used quinolone featuring once-daily dosing and 100% oral bioavailability, with side effects including QT interval prolongation, kidney failure, photosensitivity, and CNS disorders predisposing to seizures.

sulfamethoxale + trimethoprim

The combination sulfonamide used clinically that acts as a bacteriostatic agent by preventing the synthesis of folic acid needed for DNA synthesis.

metronidazole (Flagyl)

An antiprotozoal and antibacterial drug with anaerobic activity only that inhibits DNA synthesis, used for Crohn's disease and antibiotic-associated diarrhea, and must not be taken with alcohol.