Aminoglycosides, Macrolides, FQs

Question 1

What are the mechanisms of resistance for animoglycosides?

Answer 1

synthesis of animoglycoside-modifying enzymes -acetylation, phosphorylation, adenylation

Question 2

What aminoglycosides are used with gram positive aerobes?

Answer 2

gentamicin & always with a cell wall agent
-used in low doses

Question 3

What aminoglycosides are used with gram negative aerobes?

Answer 3

amikacin>plazomycin>tobramycin>gentamicin & with cell-wall agent
-high doses

Question 4

What are the target organisms of macrolides?

Answer 4

atypical bacteria
-legionella pneumophilia, mycobacterium avium complex

Question 5

can aminoglycosides or macrolides penetrate into the CSF?

Answer 5

no

Question 5

do macrolides need to be adjusted in the prescence of renal dysfunction?

Answer 5

yes- clarithromycin
no - eryhtromycin, azithromycin

Question 6

What adverse effects are of note for the macrolides?

Answer 6

QT prolongation, thrombophlebitis, infusion site irritation

Question 6

what drug interactions are of note for macrolides?

Answer 6

inhibitors of CYP450 and CYP2C9
-theophylline, carbamazepine, valproate, cyclosporine, digoxin, phenytoin, warfarin (clarithro and eryhtro only)
Azithro- only warfarin hypoprothromibinemia