Pharmacology of Chemotherapy: Protein Synthesis Inhibitors
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Questions and Answers

What is the alternative to 3rd generation cephalosporin in treating bacterial meningitis?

  • Tetracycline
  • Chloramphenicol (correct)
  • Minocycline
  • Doxycycline
  • What is the effect of calcium on the absorption of tetracyclines?

  • Decreases absorption (correct)
  • Has no effect on absorption
  • Enhances elimination
  • Increases absorption
  • What is the primary route of elimination of doxycycline?

  • Fecal excretion
  • Hepatic metabolism
  • Renal excretion
  • Biliary excretion (correct)
  • Why are tetracyclines contraindicated in children under 8 years old?

    <p>Risk of deposition in the bone and teeth</p> Signup and view all the answers

    What is the effect of taking tetracyclines with milk products?

    <p>Decreases absorption</p> Signup and view all the answers

    Which of the following is NOT a contraindication for tetracyclines?

    <p>Adults over 60 years old</p> Signup and view all the answers

    What is the primary mechanism of adverse effect of chloramphenicol in patients with low levels of G6PD?

    <p>Hemolytic anemia</p> Signup and view all the answers

    What is the primary route of elimination of chloramphenicol from the body?

    <p>Hepatic conjugation with glucuronide</p> Signup and view all the answers

    What is the advantage of using doxycycline in specific infections?

    <p>It has a long half-life</p> Signup and view all the answers

    Why is the use of chloramphenicol limited?

    <p>It can cause aplastic anemia</p> Signup and view all the answers

    What is the primary reason why clindamycin and broad-spectrum antimicrobials may induce pseudomembraneous colitis?

    <p>They disrupt the gut flora</p> Signup and view all the answers

    Which of the following antibiotics is a protein synthesis inhibitor?

    <p>All of the above</p> Signup and view all the answers

    What is the primary characteristic of chloramphenicol absorption?

    <p>Complete oral absorption</p> Signup and view all the answers

    What is the primary distribution characteristic of chloramphenicol?

    <p>Widespread tissue distribution</p> Signup and view all the answers

    What is the primary organ responsible for the elimination of macrolides?

    <p>Liver</p> Signup and view all the answers

    Which of the following macrolides is not an inhibitor of the liver microsomal enzyme system?

    <p>Azithromycin</p> Signup and view all the answers

    What is the main reason for contraindicating macrolides in patients with hepatic dysfunction?

    <p>Risk of hepatotoxicity</p> Signup and view all the answers

    Which of the following is a characteristic of azithromycin's pharmacokinetics?

    <p>Long half-life</p> Signup and view all the answers

    What is the main adverse effect of clindamycin?

    <p>Pseudomembranous colitis</p> Signup and view all the answers

    What is the main indication for the use of clindamycin?

    <p>Anaerobic infections</p> Signup and view all the answers

    Study Notes

    Protein Synthesis Inhibitors

    Chloramphenicol

    • Adverse effects: gastrointestinal disturbance, diarrhea, hemolytic anemia, aplastic anemia, and gray baby syndrome
    • Risk of drug interactions: inhibits liver microsomal enzymes (LME)
    • Pharmacokinetics: lipophilic, completely absorbed orally, widely distributed, and eliminated through liver conjugation with glucuronide and renal tubule secretion
    • Uses: restricted due to toxicity, but used for bacterial meningitis, anaerobic brain abscess, typhoid fever, and eye infections

    Tetracyclines

    • Broad spectrum antibiotics effective against Mycoplasma pneumonia, Chlamydia, Rickettsia, and Gram +ve and -ve bacteria
    • Examples: doxycycline, minocycline
    • Pharmacokinetics: incompletely absorbed orally, decreased by Ca2+, iron, antacids, and dairy products, and eliminated through metabolism, glucuronidation, and renal excretion
    • Adverse effects: gastric discomfort, GIT disturbance, diarrhea, deposition in bone and primary dentition, hepatotoxicity, and phototoxicity
    • Contraindications: renally impaired patients, pregnant or breastfeeding women, and children under 8 years old

    Macrolides

    • Effective against atypical pneumonia, Mycoplasma pneumonia, and Chlamydia
    • Examples: erythromycin, clarithromycin, and azithromycin
    • Pharmacokinetics: absorption decreased by food, concentrated in the liver, and eliminated through liver metabolism
    • Adverse effects: epigastric pain, hepatotoxicity, and ototoxicity
    • Contraindications: patients with hepatic dysfunction, and those with drug interactions due to LME inhibition

    Clindamycin

    • Used for anaerobic bacteria, bone infections, and beta-lactamase producing organisms
    • Adverse effects: pseudomembranous colitis caused by overgrowth of C. difficile, treated with oral metronidazole or vancomycin

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    Description

    This quiz covers the pharmacology of chemotherapy, focusing on protein synthesis inhibitors, hepatotoxic antimicrobials, and pediatric considerations.

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