h pylori eradication

Question 1

name some macrolides

Answer 1

clarithromycin, erythromycin, azithromycin

Question 2

macrolides MOA

Answer 2

• Treat resp, skin and soft tissue infections when pen CI
• severe pneumonia with penicillin to cover atypicals
• eradicate h pylori

Question 3

macrolides - spectrum of activity

Answer 3

• broad spectrum +ve and -ve gram

- clairthro and axithro = synthetic; increased activity against gram -ve e.g. Hib

Question 4

macrolides MOA

Answer 4

• Inhibit bacterial protein synthesis. bind to 50S of ribosome and block transolation.
• bacteriostatic

Question 5

SE Macrolides

Answer 5

• most often with erythromycin
• irritant - n + v, abdo pain and diarrhoea and thrombophlebitis in IV
• allergy, c diff, cholestatic jaundice, prolonged QTi and ototoxic

Question 6

CI macrolides

Answer 6

• hypersensitvity

Question 7

when to reduce dose of macorlides

Answer 7

• severe hepatic impairment and severe renal impairment as macrolide elimination in from liver and kidneys

Question 8

erythro and clarithro inhibit which enzyme and what are the implications of this

Answer 8

cyp450 = increased palsma conc and risk of SE with drugs normally metabolised by these e.g. warfarin, statins,

Question 9

plasma half life erythromycin

Answer 9

• 2hrs.

Question 10

typical dose of erythromycin

Answer 10

250-500mg 6hrly

Question 11

does erythro or clarithro have a longer half life

Answer 11

clarithro so prescribed 12hrly

Question 12

why shoudl you dilute IV macrolides

Answer 12

• risk of thrombophlebitis. 500mg in 250ml saline over min 60mins

Question 13

name some broad spec penicillins

Answer 13

amoxicillin, co-amoxi

Question 14

indications of broad spec penicillins

Answer 14

• amoxicillin =infection
• H pylori eradication
• co amoxi - severe, resistant, hospital acquired infection

Question 15

what can co - amoxi do to the liver

Answer 15

• acute liver injury - cholestatic haundice or hepatitis. = self limiting