Term
| Describe the structure of macrolide antibiotics |
|
Definition
| 14 or 15 member lactone ring |
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Term
| Erythromycin is a ___ with activity against ___ |
|
Definition
a (14 member) macrolide
against S. aureus, Strep., Atypical pneumonias: Mycoplasma, Chalmydia, Legionella, URIs, STDs |
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Term
Clarithromycin is a ___ with activity against ___
It's better than Erythromycin in treating ___ (3) |
|
Definition
a macrolide
same as erythromycin + better for chlamydia, MSSA, strep
also against H. influenza and other stuff |
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Term
Azithromycin is a ___
+
Is less effective than erythromycin at treating ___ and ___
+
Is better at treating ___ |
|
Definition
Less effective at S. aureus and Strep.
Better at H. influenza |
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Term
| Describe the MOA of Macrolides |
|
Definition
| Inhibit protein synthesis by binding to the 23S ribosomal subunit of bacteria (inhibits tRNA translocation) |
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Term
- Name the resistance gene for bacteria that allows them to modify their 23S rRNA and avoid macrolides
- Name 2 pathogens that may have this gene |
|
Definition
23S rRNA modification (is called MLSB phenotype)
Resistance gene is called "erm"
Staph. and Strep. may have it |
|
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Term
Name 3 pathogens that may have a gene to pump out macrolide and are thereby resistant.
What is the name of this gene? |
|
Definition
S. pyogenes, S. pneumoniae, Group C strep
"mef" gene, M phenotype |
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Term
Erythromycin
- how excreted
- where it concentrates |
|
Definition
excreted in bile
concentrates in neutrophils and macrophages |
|
|
Term
Clarithromycin
- % bioavailability
- how excreted
- where it concentrates |
|
Definition
50%
excreted in bile OR by kidneys
concentrates in neutrophils (more than erythromycin) |
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Term
| Which macrolide DOESN"T interact with P-450? |
|
Definition
|
|
Term
| Compare Azithromycin to the other macrolides in terms of dispersion and elimination. |
|
Definition
Higher tissue penetration
huge concentration in phagocytes
hepatic elimination
no drug interactions |
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Term
| 3 possible adverse effects of erythromycin |
|
Definition
GI upset, diarrhea
QT prolongation (when in IV form)
Pyloric stenosis |
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Term
| 8 pathogens that are major indications for macrolide treament |
|
Definition
Mycoplasma pneumonia
Legionellosis
Diphtheria
Pertussis
Chlamydia, neonatal and STD
Campylobacter gastroenteritis
Mycobacterium avium complex
Helicobacter |
|
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Term
|
Definition
| A new type of macrolide that's more acid stable and works better (+ less resistance to it) |
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