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28 Cards in this Set
- Front
- Back
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TQ: mechanism of action of macrolides
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inhibit bacterial protein synthesis through binding to the 50s ribsomal rna
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Macrolides are bacteriostatic or bacteriocidal?
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bacteriostatic
(but bacteriocidal at elevated concentrations) |
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what do all drugs that end in -mycin have in common? what are the exceptions?
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all are protein synthesis inhibitors except vancomycin, phosphomycin and daptomycin
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What drug is 1st line for Corynebacterium diphtheriae?
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erythromycin
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What drug is backup for actinomyces israelii?
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Erythromycin
- first line is PCN G |
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what drug is 1st line for chancroid due to Haemophilus ducreyi?
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erythromycin
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What microorganisms do errythromycin mostly treat?
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similar as PCN G
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Which drug is more effective against H. influenzae, erythromycin or clarithromycin?
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clarithroymycin
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Clarithromycin is first line against?
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Corynebacterium diphtheriae
Chlamydia pneumoniae MAI Complex all C's |
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TQ: do macrolides work on strep pneumonia?
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NO
-macrolides are resistant to strep pneumonia |
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waht is the most widely prescribed macrolide?
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azithromycin
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What works better on strep and staph; azithromycin or erythromycin?
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erythromycin
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Which macrolide works best against RTIs caused by H. flu and Moraxella catarrhalis (otitis, sinisitis, and pneumonia)?
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Azithromycin
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What 2 drugs are the 1st line for Chlamydia pneumonia and Corynebacterium diphtheriae?
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Azithromycin and clarithromycin
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What are DOC/1st line for azithromycin?
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legionella pneumophila, chlamydia pneumoniae, chlamydia trachomatis, corynebacterium diptheriae
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Does cross-resistance exist b/w macrolides?
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yes
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TQ:
1. which macrolides does food decrease their absorption? 2. food enhances their absorption? |
1. erythromycin and azithromycin
2. clarithromycin |
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TQ: Do macrolides cross blood/brain barrier (get into CSF)?
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no. so cannot use for meningitis
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Where do all macrolides accumulate (in addition to other places)?
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Macrophages
erythromycin: also the liver and the other "also's" are not highlighted |
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Which macrolides are safe for those w/ renal insufficiencies?
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erythromycin and azithromycin (excreted in bile)
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TQ: which macrolide undergoes rapid first pass oxidation to active metabolite?
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clarithromycin
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TQ: Which macrolides are contraindicated in people exhibiting hepatic damage?
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erythromycin and azithromycin
since they concentrate in the liver azithromycin also undergoes hepatic metabolism but not by P450 enzyme so no drug interactions. |
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Which drugs should be controlled with a person using warfarin ?
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erythromycin and clarithromycin
(may inactivate hepatic microsomal enzymes) azithromycin also undergoes hepatic metabolism but not by P450 enzyme so no drug interactions. |
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Why use telithromycin over macrolides?
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telithromycin (KETEK) binds to 2 and 5 domain of 50s subunit, while macrolides only bind to 5 domain... so it can treat strep pneumonia
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What is telithromycin only used to treat? why?
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community-acquired pneumonia
because it has high risk of hepatic side effects |
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TQ: What drug can treat MDRSP, that are resistant to PCNs and Macrolides?
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telithromycin
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What microorganisms can Telithromycin treat
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strep, staph, MDRSP, and INTRACELLULAR (Legionella pneumophila, mycoplasma pneumoniae, chlamydia pneumoniae)
Look at last page of macrolide packet for a list of all |
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Who is telithromycin contraindicated in?
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- those w/ hepatic disease (it can cause cholestatic jaundice, hepatic failure)
- Not highlighted: under 18 y.o, pts w/ prolonged QT intervals, pt with myasthenia gravis |
