FA chloramphenicol; clindamycin

Question 1

Chloramphenicol. what groups is that?

Answer 1

amphenicols

Question 2

Chloramphenicol mechanims?

Answer 2

bind 50S subunit → blockage of peptidyltransferase → inhibition of bacterial protein synthesis (bacteriostatic effect)

Question 3

Chloramphenicol static or cidal?

Answer 3

static

Question 4

Chloramphenicol cns peneteration?

Answer 4

good

Question 5

Chloramphenicol route of elimination?

Answer 5

Renal elimination after hepatic metabolism

Question 6

Chloramphenicol. two groups of indications?

Answer 6

Meningitis caused by H. influenzae, N. meningitidis, and/or S. pneumoniae

Rickettsia infections (e.g., Rocky Mountain spotted fever caused by Rickettsia rickettsii)

Question 7

Chloramphenicol. What m/os of meningitis?

Answer 7

Meningitis caused by H. influenzae, N. meningitidis, and/or S. pneumoniae

Question 8

Chloramphenicol. in what countries used?

Answer 8

Most commonly used in resource-limited countries due to low drug costs

Question 9

Chloramphenicol. Adverse? mainly 3

Answer 9

Dose-dependent bone marrow suppression: APLASTIC anemia, leukopenia, and/or thrombocytopenia

Dose independent: anemia

Gray baby syndrome: Occurs in mainly in premature infants because of develomental lack of UDP-glucuronyltransferase. Symptoms: cyanosis, vomiting, flaccidity, hypothermia, shock

Question 10

Chloramphenicol. Contraindications?

Answer 10

Infancy
Pregnancy
Cautious use in patients with renal and/or hepatic dysfunction

Question 11

Chloramphenicol. resistance?

Answer 11

drug inactivation via plasmid-encoded acetyltransferase.

Question 12

clindamycin. Belong to what group?

Answer 12

lincosamides

Question 13

Clindamycin. mechanism?

Answer 13

binds to 50S subunit → blockage of peptide translocation (transpeptidation) → inhibition of peptide chain elongation →inhibition of bacterial protein synthesis (bacteriostatic effect)

Question 14

Clindamycin. static or cidal?

Answer 14

static

Question 15

Clindamycin. cns?

Answer 15

poor

Question 16

Clindamycin. elimination?

Answer 16

both renal and biliary

Question 17

Clindamycin. indications?

Answer 17

ANAEROBES, such as Clostridium perfringens, Bacteroides spp. (clindamycin is less effective against Bacteroides than other anaerobic species): Aspiration pneumonia; Lung abscesses; Oral infections

Group A streptococcus: especially invasive infections

Partially effective against gram-positive aerobes: Can be used in MRSA infections; Not effective against Enterococci

Babesia (together with quinine)

Question 18

Clindamycin. special considerations?

Answer 18

cross-resistance with macrolides

Question 19

Clindamycin. used to treat what infections in accordance to diaphragm?

Answer 19

Anaerobic infections ABOVE diaphragm (whereas metronidazole for below diaphragm)

Question 20

Clindamycin. adverse?

Answer 20

GI upset (e.g., diarrhea)
Pseudomembranous colitis
Fever
Teratogenicity

Question 21

Clindamycin. Contraindications: cautious use in pregnant patients during the 1st trimester and in breastfeeding patients.

Answer 21

.

Question 22

What a/b most commonly associated with pseudomembranous colitis?

Answer 22

Clindamycin, along with fluoroquinolones and 3rd and 4th generation cephalosporins, is one of the antibiotics most frequently associated with pseudomembranous colitis.