Macrolides

Question 1

Macrolides MOA

Answer 1

INHIBIT BACTERIAL PROTEIN SYNTHESIS BY BINDING TO 50S SUBUNIT RIBOSOME

Broad-spec + bacteriostatic

Question 2

Uses of macrolides

Answer 2

~ H. pylori, RTIs, Skin/soft-tissue infections
~ alternative to Pen-allergy

Question 3

Macrolides e.g.

Answer 3

~ Azithromycin ~ OD (before food/ indigestion remedies; 2h gap)
~ Clarithromycin BD (taste disturbances)
~ Erythromycin QDS/BD (before indigestion remedies; 2h gap)
~ Telithromycin (for B-lactam resistant infections)
~ Spiramycin (toxoplasmosis)

Question 4

Macrolides SEs

Answer 4

1. GI effects
   ~ N, V, D, discomfort
2. QT prolongation
   ~ risk factors; bradycardia, heart disease, hypOK, hypOMg
3. Hepatoxic
4. Ototoxic at high dose

TAKE WITH FOOD or AFTER food

Question 5

Macrolides interactions

Answer 5

Erythromycin/Clarithromycin = enzyme inhibitors

warfarin = increased risk of bleeding
statins = increased risk of mypoathy