Erythromycin is first line for what 1?
1. Diphtheria ( Corynebacterium diphtheriae)
There are 2 method bacteria use to develope resistance to macrolides. Know which one goes with which gram stain?
Gram pos--> altered target site (50S) gram neg--> inactivation by esterase
T/F, if an organism is resistant to one macrolide, it's resistant to all of them?
Clarithromyacin is first line for ____ in combo with ethambutol? What ar 2 other things it is first line for?
MAI complex Chlamydia pneumoniae and corynebacterium diphtheria
Azithromycin has increased activity against what 2 gram - then other macrolides?
1. H. influenzae 2. Moraxella catarrhalis
What is the MOA of macrolides? They are ______
inhibit protein synthesis by binding to the 50S ribosome; bacteriostatic
What is characteristic of macrolides and ketolides?
macrocylic lactone ring
Clarithromycin: 1. how does it act in gastric aicd? 2. food? 3. excreted? 4. should the dose be decreased in a pt wth kidney failure?
1. increased stability 2. enhanced absoprtion 3. both the kidney and liver 4. YES
Describe azithromycin's 1/2 life?
It is VERYYYY long. So only 1 tab is needed to cure
What is the most widely used macrolide?
SE of Telithromycin? CI in who?
Liver failure; those under 18, with liver disease, and with prolonged QT intervals
Azithromycin is first line for what 4?
1. Legionella 2. Chlamydia pneumo 3. Corynebacterium diphtheriae 4. Haemophilus ducreyi
Azithromycin: 1. food? 2. excreted?
1. decreases absorption 2. in the bile
Telithromycin is indicated for what? Which drig-resistant organism is it also indicated for?
treat of community acquired PNA; MDRSP (multi-drug resistant strep. pneumo)
Clarithromycin is also better for what 4 intracellular pathogens?
1. Chlamydia 2. legionella 3. mycobacterium avium intracellulare complex 4. ureaplasma
Clarithryomycin is similar to erythromycin, but better against ______
respiratory ( H. FLu)
Azithromycin is the DOC for what?
Erythromycin is alternative treatment for what 5 gram pos? ** for pts that are betalactam allergy
1. streptococcus pyogenes 2. Listeria monocytogenes (sepsis in newborns) 3. Bacillus anthracis (malignant pustule and PNA) 4. clostridium perfringens (gas gangrene and food poisoning) 5. clostridium tentani (tetanus)
Erythromycin: 1. Is inactivated by _______ and is excreted in the ______ 2. good to use if the pt is allergic to _____. 3. Does food enhance or decrease the absorption? 4. SE's?
1. Inactivated by gastric pH; Bile 2. PCN 3. decreases 4. GI upset, Ototoxicity, MI
What is the MOA of Telithromycin?
Bactericidal and inhibits protein synthesis of 50S. It binds to 2 seperate domains
Which 2 macrolides are okay in RF pts?
1. erythromycin 2. Azithromycin
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