Macrolides

Question 1

Macrolide family Mechanism of Action

Answer 1

• Decrease protein synthesis

- Reversibly binds to 50S ribosomal subunit

Question 2

3 main drugs in the macrolide family

Answer 2

• Erythromycin
• Clarithromycin
• Azithromycin

Question 3

Which macrolide can be taken with food, and what is the complete name

Answer 3

Erythromycin estolate

Question 4

Caveat to using Erythromycin estolate

Answer 4

NO-pregnant patients

Question 5

Cell type that most of the macrolide concentration accumulates

Answer 5

Alveolar macrophages

*Azithromycin = highest concentration

Question 6

Azithromycin able to have a short, 5 day regimen…why

Answer 6

Elimination via bile = long half life

Question 7

Macrolide with major abdominal adverse effects

Answer 7

Erythromycin (stimulation of motilin receptor)

Question 8

Macrolide that can be used in to treat gastroporesis (commonly seen in diabetics)

Answer 8

Erythromycin (stimulation of motilin receptor)

Question 9

Macrolide that interferes with the cytochrome p450 enzyme system

Answer 9

Erythromycin, causes slowed metabolism of drugs such as theophylline, warfarin

Question 10

Macrolide: Spectrum of Activity

Answer 10

• Gram +
• Gram - (up to PIDDLY)
• Atypicals

Question 11

Major difference with Spectrum of Activity with the macrolides

Answer 11

Clarithromycin/Azithromycin cover gram - (PIDDLY), Erythromycin does NOT

Question 12

Main use of macrolides

Answer 12

• Penicillin allergy

- Atypical bacteria treatment