Week 10: Lincosamides, Macrolides, Tetracyclines

Question 1

Lincosamides active against/MOA

Answer 1

Clindamycin

• Gram + organisms - bacterioSTATIC
• MRSA skin infections, strep pharyngitis, Pelvic Inflammatory Disease

MOA: inhibits protein synthesis by binding to the 50S subunit of bacterial ribosome

Question 2

Clindamycin/Lincosamides ADRs

Answer 2

black box warning: colitis, C. diff

• diarrhea - NO IMMODIUM
• agranulocytosis
• dizziness

Question 3

Clindamycin pt education

Answer 3

• take w/ full glass of water
• sit or stand for 30 minutes after dose
• call doc if diarrhea occurs

Question 4

Macrolides MOA/indications

Answer 4

Azithromycin, Erythromycin, Clarithromycin
- Gram + and gram - organisms 
- bacteriostatic
- inhibits RNA-dependent protein synthesis by binding to the 50S subunit 
**Think respiratory for this class**
1st line CAP
1st line pertussis
1st line chlamydia

Question 5

Macrolides ADRs

Answer 5

• GI distress (esp erythromycin oral)

- n/v/d, abd pain, liver abnormalities

Question 6

Tetracyclines MOA/indications

Answer 6

Tetracycline/Doxycycline

• inhibit protein synthesis by reversibly binding to the 30S subunit of the bacterial ribosome
• Doxy 1st line for Rocky Mountain Spotted Fever and Lyme dz
• CAP (2nd line)
• MRSA (3rd line)

Question 7

Tetracyclines cautions/CI/ADRs

Answer 7

• NO PREG!
• avoid in children < 8 years old d/t teeth discoloring
  ADRs:
• nephrotoxic
• photosensitivity
• hepatotoxicity

Question 8

Tetracyclines patient teaching

Answer 8

Take with a full glass of water
- NO milk products (binds to calcium affecting absoprtion)
Use backup method of contraception
-wear sunscreen, protective clothing

Question 9

Macrolides caution and contraindications

Answer 9

• QT elongation (get EKG prior, cardiac hx)
• avoid in pts at risk for torsades de pointes
• caution in renal and hepatic impairment
• ok in pregnancy (except clarithromycin)