Week 10: Lincosamides, Macrolides, Tetracyclines

Question 1

Lincosamides active against/MOA

Answer 1

Clindamycin

• Gram + organisms - bacteriostatic
• MRSA skin infections, strep pharyngitis, PID
• inhibits protein synthesis by binding to the 50S subunit of bacterial ribosome

Question 2

Clindamycin/Lincosamides ADRs

Answer 2

BBW: 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 clinic 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

• potent CYP450 inhibitor - combination with statins may increase risk of myopathy
• skin rash 9urticaria, bullous eruptions, eczema, SJS)
• GI distress (esp. E-mycin)

Question 6

Zyvox (Linozolid) MOA/ADR

Answer 6

• used for MRSA pneumonia, skin infections
  Narrow spectrum
• ADR: myelosuppression- suppresses the myelin sheath - resolves when drug is discontinued

Question 7

Tetracyclines MOA/indications

Answer 7

Tetracycline/Doxycycline

• inhibit protein synthesis by reversibly binding to the 30S subunit of the bacterial ribosome
• Doxy 1st line for RMSF and Lyme dz - CAP (2nd line)

Question 8

Tetracyclines cautions/CI/ADRs

Answer 8

• Preg Cat D
• avoid in children < 8 years old d/t teeth discoloring
  ADRs:
• nephrotoxic
• photosensitivity
• hepatotoxicity

Question 9

Tetracyclines patient teaching

Answer 9

Take with a full glass of water - do not take with milk or milk products (binds to calcium)
Use backup method of contraception