Lecture 63 - Macrolides/Clindamycin/Tetracyclines/Aminoglycosides

Question 1

Azythromycin is the drug of choice for ______ infection during pregnancy, for atypical pneumonia caused by _________ pneumoniae, and for Gram - rods. Bacteria can become resistant to Macrolides if they _____ a nucleic acid in the 50S subunit of their Ribosome that the Macrolide would normally bind to. They can also be inactivated by Esterases.

Macrolides are well absorbed _____ (route of administration.)

Answer 1

Chlamydia

Mycobacterium pneumoniae

Methylate

Orally

Question 2

Erythromycin can have significant drug-drug interactions bc it inhibits _____. Azithromycin does NOT, but dosing over 1g of Azithromycin can cause drug-limiting ______.

Answer 2

CYP450

Diarrhea

Question 3

Clindamycin acts in basically the same way as Macrolides. How is that? Keep in mind Clindamycin is used to treat _______ bacteria (aerobic or anaerobic?), so it’s good to treat bone or skin infections. Also keep in mind it can cross the ______, so be aware of pregnancy. One of the main complications of treating with Clindamycin is resultant superinfection with ___ ______.

Answer 3

Bacteristatic by inhibiting translation by binding the 50S subunit.

Anaerobic

Placenta

C. diff

Question 4

Tetracyclines, like Macrolides, inhibit protein synthesis by binding to bacterial Ribosomes. Keep in mind tetracyclines bind the ____S subunit. _______ is the tetracycline used to treat Chlamydia in non-pregnant women and is given as a prohpylaxis for _____ disease if within 72 of tick bite. Tetracyclines are effective against BOTH Gram + and Gram _, so braod spectrum.

Answer 4

30S

Doxycycline

Lyme disease

Question 5

Tetracyclines are _______ bioavailable, but are chelated into non-absorbable forms by metal ions in ______ products. Tetracyclines can also bind to tissues undergoing calcification, so they are contraindicated in children under ___ years old.

Answer 5

Orally

Dairy products

8 years old

Question 6

Aminoglycosides are typically used to treat Gram _____ infections and can only treat Aerobes bc they enter across the bacterial cell membrane via a transport system that requires _____. These are often co-dosed with ___-_____ for life-threatening infections/to broaden the spectrum of treatment. Aminoglycosides must be given ______ and keep in mind they can cross the _____. They act by blocking protein synth, binding to the ____S subuint of the bacterial ribosome. Adverse events include ____toxicity and Fetal _____ toxicity.

Answer 6

Gram -

02

Beta-lactams

IV

Placenta

30S

Ototoxicity

Fetal Auditory toxicity