Exam 2 - Macrolide Spectrum/Clinical Use Flashcards
GP coverage for macrolides
PSSP
MSSA
GN coverage for macrolides
wimpy GN
NOT Enterbacteriaceae
Misc coverage for macrolides
Legionella Pneumophila
Mycobacterium Avium Complex (AC for MAC)
clinical uses for macrolides
respiratory tract infections
STIs
Mycobacterium avium (MAC)
what is the main RTI that macrolides cover
community acquired pneumonia
especially atypical coverage
what can you combine macrolides with for serious community acquired pneumonia
B-lactam like ceftriaxone
what is the main STI that macrolides cover and how to treat
nongonococcal urethritis
cervicitis from chlamydia trachomatis
treat with 1g dose of azith
what are the macrolides
azithromycin, clarithromycin, clarithromycin
macrolide mechanism of action
reversibly binds to 50S ribosome and suppresses protein synthesis
what kind of killers are macrolides
bacteriostatic
what is the main resistance against macrolides
alteration of the binding site (erm)
creates high levels of resistance for macrolides and all 50S binders
where do macrolides distribute
distribute extensively except the CSF
half lives of macrolides
erythro and clarithro a few hours
azithro 68 hours
what macrolides should be renally adjusted
dose adjust clarithromycin with CrCl <30
what macrolides should be removed during dialysis
none
what are the adverse reactions to macrolides
GI (take w/ food)
vein irritation (dilute and give slow)
ototoxicity
QTc Prolongation
what are the drug interactions for clarithro and erythro
inhibitors of CYP450 3A4 and 2C9
will increase concentration
-theophylline
-carbamazepine
-valproate
-cyclosporine
-digoxin
-phenytoin
-warfarin
what DDIs does azithromycin have
not the same as the other macrolides, but it can cause hypoprothrombinemia in warfarin patients
