Allman - Chlora, Macro, Clinda Flashcards Preview

POD Exam 2 > Allman - Chlora, Macro, Clinda > Flashcards

Flashcards in Allman - Chlora, Macro, Clinda Deck (19):
1

What are the 3 types of Macrolides?

Erythromycin
Clarithromycin
Azithromycin

2

Macrolid mechanism of action

Reversibly binds the 50S to decrease protein synthesis
-static

3

Erythromycin absorption

Base, Stearate, and Ethylsuccinate are more completely absorbed in the fasting state.

Estolate is NOT affected by food.

4

Macrolide Distribution

- tissues much longer than blood
- high concentration in alveoli

5

Excretion of Erythromycin and Clarithromycin

Heptatic
20-30% in urine unchanged

6

Excretion of Azithromycin

Biliary Excretion -- feces
Longest half life = 68 hours
Aids in allowing a mere 5 day regimen

7

Erythromycin Adverse Effects

GI: abdominal cramps -- stimulates gastric motility via motolin receptor in gut

Cholestatic hepatitis -- rare but higher incidence in pregnant women (avoid estolate!)

8

Erythromycin/ Clarithromycin Drug Interactions

Decreased metabolism of: warfarin (and others)

Due to interfering with cytochrome P-450 Enzymes

9

Macrolide Spectrum of activity

Gram +, Atypicals (ALL)
H.flu, M.cat (Clarithro, Azithro)

10

Macrolide Uses

CAP
PCN allergies
Mycoplasma Pneumonia
Chlamydia

11

Clindamycin Mechanism of Action

Binds 50S
Bioavailibility = 90% (food delays absorption but not extent)
GREAT tissue and bone penetration

12

Clindamycin Excretion

LIVER

13

Clindamycin Spectrum of Activity

Gram +
Anaerobic

NO GRAM - OR ATYPICAL

14

Clindamycin adverse effects

Clostridium Difficile (BIG CULPRIT!)

15

Chloramphenicol Mechanism of Action

Reversibly binds 50S / 70S

16

Chloramphenicol Facts

- must be hydrolyzed in the intestines for activation SO IV form has incomplete hydrolysis and only 70% the serum concentration as oral administration
- EXCELLENT CSF concentrations even without inflammation
- Excreted via LIVER
- Wide variations in metabolism and excretion in children (monitor closely)

17

Chloramphenicol spectrum of activity

Gram +
Gram -
Aerobic
Anaerobic

18

Chloramphenicol Adverse Reactions (2)

1. Idiosyncratic Aplastic Anemia: decrease in all blood cells
2. Gray Baby Syndrome: abdominal distention, vomiting, cyanosis; due to drug accumulation due to diminished excretion

19

Chloramphenicol Uses

Bacterial meningitis
Rickettsial Infections