Clindamycin

Question 1

MOA

Answer 1

Inhibits protein synthesis by binding to the bacterial 50S ribosome (binds to same site as erythromycin)

Question 2

Clinical use

Answer 2

Aerobic gram + cocci Staphylococcus and Streptococcus genera
Anaerobic Gram - bacilli Bacteroides and fusobacterium

Can be used systemically to treat bone infections with staphylococcus aureus or topically to treate severe acne

Treatment of lung abscesses and anaerobic lung and pleural space infections

Can be used with Pyrimethamine and leucovorin to treate aids

Question 3

Dosage forms

Answer 3

ORAL : capsules and oral susprensions

Parental : IV injection

Topical : foams or solutions

Question 4

Metabolism

Answer 4

Metabolized by Cytochrome P450 in the liver to sulfoxide and N-demethylated derivative which are both inactive

Question 5

Pharmacokinetics

Answer 5

90% of administered dose is absorbed from the GI tract

penetrated the CNS in high enough concentrations to be useful in the treatment of cerebral toxoplasmosis

Accumulation can occur in patients with hepatic failure

Question 6

Adverse effects

Answer 6

Pseudomembranous colitis, diarrhea, N/V, cramps, and rash

topical application can cause contact dermatitis

Question 7

Pseudomembranous colitis
what is it and how can we treat it

Answer 7

Can be lethal and can happen in 2-10% of patients treated with clindamycin
caused by overgrowth of clostridium difficile which is resistant to clindamycin and produces toxins that causes diarrhea or colitis and toxic megacolon

treatment is metronidazole