Antibiotics That Inhibit Protein Synthesis

Sep 28, 2024

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Lecture Notes: Systemic Anti-Infectives - Antibiotics Inhibiting Protein Synthesis

Overview

  • Focus on antibiotics that inhibit protein synthesis.
  • Relevant for treating bacterial infections.

Macrolides

  • Examples: Azithromycin, Erythromycin.
  • Purpose: Treat various bacterial infections (not effective against MRSA).
  • Mechanism: Inhibit protein synthesis - bacteriostatic.
  • Side Effects:
    • GI upset (notable with erythromycin).
    • Dysrhythmias.
    • Ototoxicity and rash.
  • Administration:
    • Take on an empty stomach with a full glass of water.
    • Tip for recall: "Throw the mice" to recall respiratory infections.

Lincosamides

  • Example: Clindamycin.
  • Purpose: Treat serious bacterial infections.
  • Mechanism: Inhibits protein synthesis; bactericidal or bacteriostatic, depending on concentration.
  • Side Effects:
    • GI upset and diarrhea.
    • Risk of superinfection (e.g., Clostridium difficile).
  • Warnings:
    • Black box warning for CDAD.
    • Monitor bowel movements for signs of C. diff.

Aminoglycosides

  • Example: Gentamicin.
  • Purpose: Treat very serious bacterial infections.
  • Mechanism: Inhibit protein synthesis - bactericidal.
  • Side Effects:
    • Ototoxicity, nephrotoxicity.
    • Vertigo and ataxia.
  • Warnings:
    • Black box warning for ototoxicity.
    • Monitor for tinnitus or hearing loss.
    • Monitor kidney function.
  • Administration:
    • Intramuscular (IM) or Intravenous (IV).
    • Narrow therapeutic range - monitor peak and trough levels.
  • Tip for recall: Gentamicin is "not gentle" due to toxicities.

Tetracyclines

  • Examples: Tetracycline, Doxycycline.
  • Purpose: Wide range of infections - acne, Lyme disease, STDs, Rocky Mountain spotted fever.
  • Mechanism: Prevent protein synthesis - bacteriostatic.
  • Side Effects:
    • GI upset.
    • Tooth discoloration (children and fetuses).
    • Hepatotoxicity and photosensitivity.
    • Possible superinfection (e.g., C. diff).
  • Patient Teaching:
    • Avoid giving to children <8 years or pregnant women.
    • Use sunscreen due to photosensitivity.
    • Take on an empty stomach with water.
    • Avoid dairy, calcium, and iron-rich foods, and antacids - decrease absorption.
    • Decrease effectiveness of oral contraceptives.
  • Tip for recall: Tetracycline like "Tetris," blocks resemble teeth; treats many small things, causes tooth discoloration.

Conclusion

  • Be aware of side effects and patient tips for each antibiotic.
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