Which drug doesn’t cover G-
Erythromycin
most G- resistant to it
Macrolides inhibit which ribosome?
Inhibit 50S ribosome and inhibit protein synthesis
DOC for erythromycin
Clamydia
Clarithromycin DOC
Legionella
What is azithromycin (z pack) DOC for?
ask prof
which drug goes through biliary excretion (fecal elimination)?
Macrolides: erythromycin, clarithromycin, azithromycin
reversible non-selective inhibitor of MAO
Linezolid (Zyvox)
reserved for MDR strains, overuse can increase resistance of MDRS
Linezolid (Zyvox)
no cross-resistance
Zyvox (Linezolid)
primarily aerobic G+
Narrow
linezolid (zyvox)
binds to 23S ribosomal RNA of 50 S subunit
linezolid (zyvox)
metabolized by CYP3A4 (P450) in liver
thelithromycin
ketolides are
thelithromycin
clindamycin
Dalfopristin
quinupristin (IV)
Broad spectrum, static
against respriratory erythro and pen resistant pneumococci
thelithromycin
SE of diarrhea and hepatotoxic
thelithromycin
admin route for thelithromycin
oral
wide G+ cocci, anaerobic G- and G+
DOC for osteomylitis
clindamycin
bc high [ ] in bones
which drug causes psudomembranous colitis
clindamycin
overgrowth of C. Diff - DOC is metronidazole
clindomycin is DOC for
osteomylitis
is clindomycin cidal or static?
both, depends on [ ]
which drug crosses placenta and should be avoided during nursing?
clindamycin
if suspect toxic shock while using vanco - which drug should you switch to ?
clindamycin
low in CSF but used for toxoplasma encephilitis (not meningitis)
clindamycin
which 2 drugs are members of streptogramins
Dalfopristin and quinupristin (IV)
which 2 drugs are cidal together (IV) and static apart? (synergy)
Dalfopristin and quinupristin (IV)
SE of dalfopristin and quinupristin
hepatotoxic inhibits P450 (cyp3A4)
which drug inhibits early phase of protein synthesis by blocking ribosome 50?
Dalfopristin
which inhibits late phase of protein synthesis by blocking ribosome 50?
quinupristin
treats vanco resistant Enterococcus faecium,
penicillinase resistant s. pneumoniae (strep pn?)
MDR streptococci
MRSA and MSSA
s. epidermis
Dalfopristin and quinupristin (IV)
pen resistant strep pneumoniae is also tx’d by fluoroquinolone: moxi and gemifloxacin
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ask prof: is erythromycin DOC for clamydia or Azythro and tetracycline?
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spectrum of erythromycin
mostly G+
similar to Pen G
which drugs are macrolides
erythromycin (oral, IV)
clarithromycin oral
azithromycin (z pack) oral, IV
MOA of erythromycin and clarithro/azithro
revesibly bind to 50S ribosomal subunit
SE of IV erythromycin
ototoxicity
SE of erythromycin
lots of GI, diarrhea
hepatic (liver) changes (juandice, abnormal liver)
potent inhibitor of CYP3A4 -> lots of drug interactions
erythromycin:
inhibits hepatic metabolism of other drugs that need CYP3A4 -> increases other drug’s serum [ ] leading to toxicity
which of 3 macrolides has most GI and least GI side effects
most - erythromycin
least - clarithromycin
which has prolonged QT and arrythmias due to drug interactions:
erythromycin
(azithro has the least heart SE among 3)
(Cipro (quinolone) also increases QT interval)