macrolides Flashcards

1
Q

dose of clarithromcyin in CAP

A

500mg BD for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

dose of clarithromcyin in HAP

A

500mg BD for 5 days then review

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

dose of clarithromycin in acute exacerbation of COPD

A

500mg BD for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

caution for all macrolides (IV and oral)

A
  • electrolyte disturbances - predisposition to QT interval prolongation
  • may aggravate MG
  • predisposition to QT interval prolongation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

common SE

A
  • appetite decreased
  • d,n,v
  • GI discomfort
  • dizzy
  • headache
  • hearing impairment
  • insomnia
  • nausea
  • skin reactions
  • vision disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

clarithromcyin is a inhibitor or inducer? what does this mean

A

inhibitor
this means it increases the exposure of drugs that are normally metabolised by CYP enzymes, which can lead to toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

azithromycin interactions with warfarin, acenocoumarol, pheninidone

A

increases risk of bleeding events
monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

azithromycin interaction with colchicine

A

predicted to increase exposure to colchicine
avoid or adjust colchicine dose to half

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

azithromycin interaction with chloroquine

A

Azith might increase risk of serious CV adverse effects when given with this, MHRA advised caution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

azithromycin interaction with DOACs

A

predicted to increase exposure to DOACs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

azithromycin interaction with digoxin

A

increases conc of digoxin, monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

azithromycin interactions with theophylline

A

predicted to increase exposure
adjust dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

a script comes in for a prescription for azithromycin. the pt also regularly takes a statin. what do you do

A

no interaction so just dispense as normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

a script comes in for clarithromcyin. the pt also regularly takes a statin. what do you do

A

tell pt to stop statin while taking abx as there is increased risk of rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

macrolides and colchicine interaction

A

macrolides increase the exposure to colchicine
avoid or adjust colchicine dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

a script comes in for clarithromcyin for a pt with type one diabetes. what do you do

A

clarithromcyin reported to cause hypo when given with insulin
monitor BG

17
Q

use of clarithromcyin in pregnancy

A

avoid unless potential benefit outweighs risk esp in 1st trimester

18
Q

important safety info with erythromycin - MHRA (cardiac risks)

A
  • QT interval prolongation
  • do not give in pt with Hx QT interval prolongation or ventricular arrhythmias (including TDP), or in pt with electrolyte disturbances
19
Q

MHRA important safety info with rivaroxban and erythromycin

A

increased risk of bleeding
caution

20
Q

should erythromycin be prescribed to a pt taking rivaroxaban

A

can be but with caution as increased risk of bleeding

21
Q

erythromycin MHRA advice - infantile hypertrophic pyloric stenosis associated with use of erythromycin in infants

A
  • this is then there is abnormal thickening of the pyloric muscles in the stomach leading to gastric outlet obstruction
  • 2-3 fold increase in risk after exposure to erythromycin during infancy
  • risk highest in first 14 days after birth
  • seek medical attention if vomiting or irritability with feeding occurs in infants during treatment
  • benefit-risk balance of precribing in infants
22
Q

which abx holds a 2-3 fold increase in the risk of infantile hypertrophic pyloric stenosis after exposure of the abx during infancy? - azithromycin, clarithromcyin, erythromycin, doxycycline, co-amoxiclav

A

erythromycin

23
Q

erythromcyin is an enzyme…. and what does this mean

A

inhibtior
this means it leads to increased levels of drugs that are normally metabolised by CYP enzymes, which can lead to toxicity

24
Q

what is in common with the following drugs amiodarone, sotalol, domperidone, fluconazole and amisulpride
and what do you need to consider if prescribing macrolides to these pt

A

they prolong QT interval, as do erythromycin and clarithromcyin
- this increases risk of TDP

25
which statin is not associated with CYP interactions?
rosuvastatin
26
a pt who is on carbamazepine has been given clarithromcyin for an infection. what do you do
clarithromcyin can increase carb levels, causing toxicity (nav, ataxia, drowsiness) monitor carb levels within 3-5 days of starting abx and adjust dose
27
clarithromcyin and RI
if EGFR is below 30 do not use MR preps
28
azithromycin dose for uncomplicated gonorrhoea
2g for one dose
29
azithromcyin dose for uncomplicated genital chlamydia, uncomplicated non-gonococcal urethritis
take 1g once daily for 1 day then 500mg once daily for 2 days
30
erythromycin GR tabs labelling requirements (apart from space doses evenly, keep taking until course finished) - 2
do not take indigestion remedies 2 h before or after swallow whole, do not chew or crush
31
azithromycin labelling requirements (apart from space dose evenly, keep taking until course finished) - 1 (+1 for capsules)
do not take indigestion remedies 2h before or after CAPSULES : take on empty stomach - 1 hour before or 2 hours after food
32
which form of azithromycin needs to be taken on empty stomach (1h before or 2h after food)
azith capsules only
33
With form of clarithromycin needs to be taken with or after food
clarithromycin MR
34
broad or narrow spectrum?
broad
35
bacteriostatic or bactericidal?
bacteriostatic - prevents bacterial growth
36
MOA
inhibit the growth of bacteria by binding to the 50S ribosomal subunit of bacterial cells and preventing protein synthesis bacteriostatic