Macrolides Flashcards
Erythromycin is first line for what 1?
- Diphtheria ( Corynebacterium diphtheriae)
There are 2 method bacteria use to develope resistance to macrolides. Know which one goes with which gram stain?
Gram pos–> altered target site (50S) gram neg–> inactivation by esterase
T/F, if an organism is resistant to one macrolide, it’s resistant to all of them?
True
Clarithromyacin is first line for ____ in combo with ethambutol? What ar 2 other things it is first line for?
MAI complex Chlamydia pneumoniae and corynebacterium diphtheria
Azithromycin has increased activity against what 2 gram - then other macrolides?
- H. influenzae 2. Moraxella catarrhalis
What is the MOA of macrolides? They are ______
inhibit protein synthesis by binding to the 50S ribosome; bacteriostatic
What is characteristic of macrolides and ketolides?
macrocylic lactone ring
Clarithromycin: 1. how does it act in gastric aicd? 2. food? 3. excreted? 4. should the dose be decreased in a pt wth kidney failure?
- increased stability 2. enhanced absoprtion 3. both the kidney and liver 4. YES
Describe azithromycin’s 1/2 life?
It is VERYYYY long. So only 1 tab is needed to cure
What is the most widely used macrolide?
Azithromycin
SE of Telithromycin? CI in who?
Liver failure; those under 18, with liver disease, and with prolonged QT intervals
Azithromycin is first line for what 4?
- Legionella 2. Chlamydia pneumo 3. Corynebacterium diphtheriae 4. Haemophilus ducreyi
Azithromycin: 1. food? 2. excreted?
- decreases absorption 2. in the bile
Telithromycin is indicated for what? Which drig-resistant organism is it also indicated for?
treat of community acquired PNA; MDRSP (multi-drug resistant strep. pneumo)
Clarithromycin is also better for what 4 intracellular pathogens?
- Chlamydia 2. legionella 3. mycobacterium avium intracellulare complex 4. ureaplasma
Clarithryomycin is similar to erythromycin, but better against ______
respiratory ( H. FLu)
Azithromycin is the DOC for what?
Chlamydia trachomatis
Erythromycin is alternative treatment for what 5 gram pos? ** for pts that are betalactam allergy
- streptococcus pyogenes 2. Listeria monocytogenes (sepsis in newborns) 3. Bacillus anthracis (malignant pustule and PNA) 4. clostridium perfringens (gas gangrene and food poisoning) 5. clostridium tentani (tetanus)
Erythromycin: 1. Is inactivated by _______ and is excreted in the ______ 2. good to use if the pt is allergic to _____. 3. Does food enhance or decrease the absorption? 4. SE’s?
- Inactivated by gastric pH; Bile 2. PCN 3. decreases 4. GI upset, Ototoxicity, MI
What is the MOA of Telithromycin?
Bactericidal and inhibits protein synthesis of 50S. It binds to 2 seperate domains
Which 2 macrolides are okay in RF pts?
- erythromycin 2. Azithromycin
Look at page 9
:)
