Macrolids Flashcards
1
Q
What are examples of macrolids?
A
- Erythromycin
* Clarithromycin
2
Q
What is the method of action of macrolids?
A
- Binds to the 50S ribosomal sub-unit
- Inhibits protein synthesis
- Gram +ve bacteria
- Gram -ve bacteria
- Mycoplasma
- Penicillin resistant atypical organisms
3
Q
What are the indications for macrolids?
A
- URTI – tonsillitis, peritonsillar abscess, pharyngitis, laryngitis, sinusitis
- LRTI – bronchitis, pneumonia, Legionnaire’s disease
- Ear infections – otitis media/externa, mastoiditis
- Oral infections – gingivitis, Vincent’s angina
- Blepharitis
- GI: cholecystitis, H. pylori
- Prophylaxis for pre and post ops, burns, rheumatic fever
4
Q
What are the contraindications for macrolids?
A
- Macrolid hypersensitivity
- Severe renal impairment
- Severe hepatic impairment
5
Q
What are the side effects of macrolids?
A
- Nausea/vomiting
- Abdominal pain
- Diarrhoea
- Thrombophlebitis – IV
- Allergy
- Antibiotic associated colitis
- Cholestatic jaundice
- Prolonged QT interval → arrhythmias
- Ototoxicity – in ↑ doses
6
Q
What are the interactions with macrolids?
A
- Inhibits P450 enzyme
- Domperidone
- Pimozide/amisulpride (psychosis) – already prolongs QT interval
- Amiodarone – already prolongs QT interval
- Quinine – already prolongs QT interval
- Quinolone – already prolongs QT interval
- SSRIs – already prolongs QT interval
- Simvastatin - ↑ plasma concentrations = myopathy
- Colchicine
- Warfarin - ↑ risk of bleeding
7
Q
Which organs eliminate macrolids?
A
• Liver and kidney
