Macrolides

Question 1

Erythromycin is first line for what 1?

Answer 1

1. Diphtheria ( Corynebacterium diphtheriae)

Question 2

There are 2 method bacteria use to develope resistance to macrolides. Know which one goes with which gram stain?

Answer 2

Gram pos–> altered target site (50S) gram neg–> inactivation by esterase

Question 3

T/F, if an organism is resistant to one macrolide, it’s resistant to all of them?

Answer 3

True

Question 4

Clarithromyacin is first line for ____ in combo with ethambutol? What ar 2 other things it is first line for?

Answer 4

MAI complex Chlamydia pneumoniae and corynebacterium diphtheria

Question 5

Azithromycin has increased activity against what 2 gram - then other macrolides?

Answer 5

1. H. influenzae 2. Moraxella catarrhalis

Question 6

What is the MOA of macrolides? They are ______

Answer 6

inhibit protein synthesis by binding to the 50S ribosome; bacteriostatic

Question 7

What is characteristic of macrolides and ketolides?

Answer 7

macrocylic lactone ring

Question 8

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?

Answer 8

1. increased stability 2. enhanced absoprtion 3. both the kidney and liver 4. YES

Question 9

Describe azithromycin’s 1/2 life?

Answer 9

It is VERYYYY long. So only 1 tab is needed to cure

Question 10

What is the most widely used macrolide?

Answer 10

Azithromycin

Question 11

SE of Telithromycin? CI in who?

Answer 11

Liver failure; those under 18, with liver disease, and with prolonged QT intervals

Question 12

Azithromycin is first line for what 4?

Answer 12

1. Legionella 2. Chlamydia pneumo 3. Corynebacterium diphtheriae 4. Haemophilus ducreyi

Question 13

Azithromycin: 1. food? 2. excreted?

Answer 13

1. decreases absorption 2. in the bile

Question 14

Telithromycin is indicated for what? Which drig-resistant organism is it also indicated for?

Answer 14

treat of community acquired PNA; MDRSP (multi-drug resistant strep. pneumo)

Question 15

Clarithromycin is also better for what 4 intracellular pathogens?

Answer 15

1. Chlamydia 2. legionella 3. mycobacterium avium intracellulare complex 4. ureaplasma

Question 16

Clarithryomycin is similar to erythromycin, but better against ______

Answer 16

respiratory ( H. FLu)

Question 17

Azithromycin is the DOC for what?

Answer 17

Chlamydia trachomatis

Question 18

Erythromycin is alternative treatment for what 5 gram pos? ** for pts that are betalactam allergy

Answer 18

1. 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)

Question 19

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?

Answer 19

1. Inactivated by gastric pH; Bile 2. PCN 3. decreases 4. GI upset, Ototoxicity, MI

Question 20

What is the MOA of Telithromycin?

Answer 20

Bactericidal and inhibits protein synthesis of 50S. It binds to 2 seperate domains

Question 21

Which 2 macrolides are okay in RF pts?

Answer 21

1. erythromycin 2. Azithromycin

Question 22

Look at page 9

Answer 22

:)