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Antimicrobials > Lincosamides > Flashcards

Lincosamides Flashcards

1
Q

What are the available lincosamides?

A
  1. Clindamycin

2. Lincomycin

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2
Q

What is the MOA of lincosamides?

A

Bacteriostatic

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3
Q

What are the indications for lincosamides?

A
  1. Alternative to patients with allergy to penicillin or cephalosporins
  2. Toxoplasma encephalitis/abscess
  3. Bacterial vaginosis (clindamycin)
  4. Anaerobic Infections
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4
Q

What are the precautions to using a lincosamide?

A
  1. Serious allergic reaction to clindamycin or lincomycin - contraindicated
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5
Q

Are lincosamides safe in pregnancy and breastfeeding?

A

Safe to use in pregnancy and breastfeeding (may cause loose bowel actions in the baby)

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6
Q

What are the common adverse reactions to lincosamides?

A 
Diarrhoea
Nausea 
Vomiting
Abdominal pain or cramps 
Rash 
Itch 
Contact dermatitis (with topical use)
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7
Q

What are the infrequent adverse reactions to lincosamides?

A

Clostridium difficile-associated disease

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8
Q

What are the rare adverse effects for lincosamides?

A 
Anaphylaxis
Serious skin reations 
Blood dyscrasias
Jaundice
Hepatotoxicity (with high doses)

IV: Hypotension (rapid injection), cardiac arrest (rapid injection), thrombophlebitis

IM: pain, induration, sterile abcess

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9
Q

What microbes are lincosamides active against?

A
  1. Staphylococci
  2. Streptococci
  3. Most anaerobes
  4. Some protozoa
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10
Q

Which lincosamide is only available as n injection?

A

Lincomycin is only available as an injection

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11
Q

What are the monitoring requirements for lincosamides?

A

Monitor complete blood count, hepatic and renal function during prolonged treatment

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12
Q

Is there cross-resistance between lincosamides?

A

There is complete cross-resistance between clindamycin and lincomycin

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13
Q

Is there cross resistance between lincosmaides and other antimicrobials?

A

Often there is cross-resistance between lincosamides and macrolides for staphylococci and streptococci

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14
Q

Which lincosamide is preferred?

A

Clindamycin is generally preferred to lincomycin as it is more potent; some clinicians use higher than the recommended dose of lincomycin for serious infections and at these doses lincomycin has similar efficacy to clindamycin

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15
Q

What is the indications for clindamycin use?

A
  1. Alternative to patients with allergy to penicillin or cephalosporins
  2. Toxoplasma encephalitis/abscess
  3. Bacterial vaginosis (clindamycin)
  4. Anaerobic Infections
  5. Treatment of PCP, with primaquine (second line)
  6. Malaria (with quinine)
  7. Acne
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16
Q

What is the usual dose range for clindamycin?

A

Adult, oral, 150-450mg q6-8hrs

IV, 600-2700mg daily given in 2-4 doses, usually 450-900mg q8hr. Maximum IV 4.8g daily

17
Q

What is the treatment dose of clindamycin for dental infections?

A

Oral, 300-459mg q8hr for 5-7 days

18
Q

What is the treatment dose of clindamycin for PCP infection?

A

Give with primaquine for 21 days.

Oral, 450 mg every 6–8 hours or 600 mg every 8 hours.

IV, 600 mg every 6 hours or 900 mg every 8 hours.

19
Q

What is the treatment dose of clindamycin malaria infection?

A

Give with quinine.

Oral, 450 mg every 8 hours for 7 days.

20
Q

What is the treatment dose of clindamycin bacterial vaginosis infection?

A

Oral, 300 mg twice a day for 7 days.

21
Q

What is the prophylaxis dose of clindamycin for endocarditis prophylaxis (high risk)?

A

Oral, 600 mg 1–2 hours before dental procedure.

IV, 600 mg within 2 hours before dental procedure.

22
Q

What is the surgical prophylaxis dose of clindaymin?

A

IV, 600 mg within 2 hours before incision

23
Q

What are the counselling points for clindamycin?

A

Take with a full glass of water. Stop taking this medication and tell your doctor immediately if you develop diarrhoea.

Check with your doctor or pharmacist before taking any antidiarrhoeal medications.

24
Q

What are the available product strengths of clindamycin?

A

Capsules 150mg

25
Q

What are the precautions to lincomycin use?

A
  1. Serious allergic reaction to clindamycin or lincomycin - contraindicated
  2. Renal: Reduce dose if CrCL <10mL/min
  3. Hepatic: reduce dose in severe impairment
26
Q

What is the usual dose of lincomycin?

A

IV, 600 mg – 1 g every 8–12 hours (usually 600 mg every 8 hours). Maximum 8 g daily.

Antimicrobials (8 decks)

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