Macrolides/Ketolides Flashcards

1
Q

Are macrolides given in an outpatient or inpatient setting for their broad coverage of respiratory pathogens?

A

Outpatient setting

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

How can macrolides combat resistance to develop a better coverage against S. pneumoniae?

A

Combine with a ketolide (telithromycin)

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

What is unfortunate about using telithromycin (ketolide) with macrolides?

A

Consist of more hepatotoxicity than macrolides

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

Which is the class patriarch of macrolides?

A

Erythromycin

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

Which macrolide has little use except as a GI stimulant, due to toxicity, drug interactions, and limited spectrum?

A

Erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the MOA of the macrolides?

A

Binds to the 50s ribosomal subunit and blockade of bacterial protein synthesis leads to bacteriostatic effects

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

What is the mechanism of resistance of the macrolides?

A

Alteration of macrolide target site (50s ribosomal subunit) by two things

  • bacterial enzymes OR
  • drug efflux by an active pump
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Macrolides and ketolides have a good spectrum over which bacteria?

A
  • Atypicals
  • H. influenzae
  • M. catarrhalis
  • H. pylori
  • Mycobacterium avium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What adverse events could occur with the use of macrolides and ketolides?

A
  • GI effects
  • Hepatotoxicity (rare)
  • QT prolongation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which macrolide or ketolide worsens GI effects?

A

Erythromycin since it’s a prokinetic agent for pts with impaired GI motility

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

Which macrolide or ketolide increases hepatotoxicity?

A

Telithromycin; could lead to transplant or death

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

Who should use macrolides and ketolides with caution to minimize the risk of QT prolongation?

A
  • Preexisting heart conditions
  • Pts on antiarrhythmics
  • Taking interacting drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Macrolides and ketolides inhibit what enzyme causing major drug interactions?

A
  • CYP450
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which macrolide or ketolide does not inhibit CYP450 enzymes?

A

Azithromycin

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

Which macrolide or ketolide has a prolonged half-life being adequate for most short course use of most infections?

A

Azithromycin

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

When is it appropriate to screen patients for beta-lactam allergies when given a macrolide and ketolide?

A

When clarithromycin and lansoprazole are being added to Prevpac containing amoxicillin for the use of H. pylori or peptic ulcer disease.

17
Q

What are the main utilizations for macrolides and ketolides?

A
  • Respiratory tract infections
  • Chlamydia
  • Atypical mycobacterial infections
  • Traveler’s diarrhea
18
Q

Which macrolide or ketolide is more appropriate for traveler’s diarrhea?

A

Azithromycin

19
Q

What indication is clarithromycin a key component of?

A

H. pylori-induced GI ulcer disease

20
Q

(T/F) - Encourage the use of macrolide and ketolides for viral infections and colds

A

FALSE - do not encourage

21
Q

(T/F) - Overprescribing leads to resistance of macrolides and ketolides

A

TRUE

22
Q

What are the names of the drugs under the macrolide class?

A
  • Clarithromycin
  • Erythromycin
  • Azithromycin