Macrolides

Question 1

ADVERSE EFFECTS OF MACROLIDES

Answer 1

GI Toxicity- epigastric distress (cla,azi<ery)
Cardiac Toxicity-QT prolongation with VT
Hepatotoxicity-Cholestatic hepatitis
Fever, eosinophilia, and skin eruptions
TInnitus

hep tox- 10-20 days after rx , stops after cessation of rx
tinnitus with high doses
skin eruptions and irritations - stops with drug cessation

Question 2

OFFLABEL USE OF ERYTHROMYCIN

Answer 2

Prokinetic agent in the ICU and in patients with diabetic gastroparesis- stimulates motilin receptors

Question 3

Increased risk of sudden cardiac death is associated with which macrolide?

Answer 3

azithromycin

beware of antiarrhythmic and other drugs causing long QTc

Question 4

drug interactions of erythromycin

Answer 4

CYP3A4 INHIBITOR
POTENTIATES - CET VWD
CYCLOSPORINE STEROIDS,CARBAMEZAPINE
WARFARIN DIGOXIN VALPROATE TRIAZOLAM ERGOT

Question 5

CYP3A4 inhibitors (e.g., itraconazole) increase peak serum concentrations of?

Answer 5

clarithromycin