FA chloramphenicol; clindamycin Flashcards
Chloramphenicol. what groups is that?
amphenicols
Chloramphenicol mechanims?
bind 50S subunit → blockage of peptidyltransferase → inhibition of bacterial protein synthesis (bacteriostatic effect)
Chloramphenicol static or cidal?
static
Chloramphenicol cns peneteration?
good
Chloramphenicol route of elimination?
Renal elimination after hepatic metabolism
Chloramphenicol. two groups of indications?
Meningitis caused by H. influenzae, N. meningitidis, and/or S. pneumoniae
Rickettsia infections (e.g., Rocky Mountain spotted fever caused by Rickettsia rickettsii)
Chloramphenicol. What m/os of meningitis?
Meningitis caused by H. influenzae, N. meningitidis, and/or S. pneumoniae
Chloramphenicol. in what countries used?
Most commonly used in resource-limited countries due to low drug costs
Chloramphenicol. Adverse? mainly 3
Dose-dependent bone marrow suppression: APLASTIC anemia, leukopenia, and/or thrombocytopenia
Dose independent: anemia
Gray baby syndrome: Occurs in mainly in premature infants because of develomental lack of UDP-glucuronyltransferase. Symptoms: cyanosis, vomiting, flaccidity, hypothermia, shock
Chloramphenicol. Contraindications?
Infancy
Pregnancy
Cautious use in patients with renal and/or hepatic dysfunction
Chloramphenicol. resistance?
drug inactivation via plasmid-encoded acetyltransferase.
clindamycin. Belong to what group?
lincosamides
Clindamycin. mechanism?
binds to 50S subunit → blockage of peptide translocation (transpeptidation) → inhibition of peptide chain elongation →inhibition of bacterial protein synthesis (bacteriostatic effect)
Clindamycin. static or cidal?
static
Clindamycin. cns?
poor
Clindamycin. elimination?
both renal and biliary
Clindamycin. indications?
ANAEROBES, such as Clostridium perfringens, Bacteroides spp. (clindamycin is less effective against Bacteroides than other anaerobic species): Aspiration pneumonia; Lung abscesses; Oral infections
Group A streptococcus: especially invasive infections
Partially effective against gram-positive aerobes: Can be used in MRSA infections; Not effective against Enterococci
Babesia (together with quinine)
Clindamycin. special considerations?
cross-resistance with macrolides
Clindamycin. used to treat what infections in accordance to diaphragm?
Anaerobic infections ABOVE diaphragm (whereas metronidazole for below diaphragm)
Clindamycin. adverse?
GI upset (e.g., diarrhea)
Pseudomembranous colitis
Fever
Teratogenicity
Clindamycin. Contraindications: cautious use in pregnant patients during the 1st trimester and in breastfeeding patients.
.
What a/b most commonly associated with pseudomembranous colitis?
Clindamycin, along with fluoroquinolones and 3rd and 4th generation cephalosporins, is one of the antibiotics most frequently associated with pseudomembranous colitis.
