anti-ribosomal antimicrobials

MOA of anti-ribosomal drugs

inhibit bacterial ribosome to inhibit protein synthesis

MOR of anti-ribosomal drugs

ribosomal binding site alterations and efflux pumps

are anti-ribosomal drugs static or cidal

static

2 tetracyclines and their delivery route

Doxycycline (oral or IV)

minocycline (oral or topical)

minocycline treatment indications (2)

oral - MRSA

topical - acne

Doxycycline treatment indications (5)

- tick borne diseases (ricketts, Lyme, errlychia)

- chlamydia

- CAP

- URTI

ADRs of doxycycline (3)

photosensitivity, nausea, kids under 8 due to staining

excretion of doxy

split between liver and kidney

3 drug interactions of tetra

- can increase INR (don't use with warfarin)

- don't combine with isotretinoin

- cations (ex. milk) can decrease absorption

macrolides should only be used for...

true B lactam allergy, legionella/mycoplasma

least and most potent macrolides

axithro, clarithro

most commonly still used macrolide

azithromycin

4 main things covered by macrolides

chlamydia, legionella, mycoplasma, B. pertusis

3 main uses for azithro

CAP, pertusis, NGU

Chest, Cough, chlamydia

what should azithro NOT be used for generally

URTIs

2 ADRs of macrolides

1 - cardiac ryhtym disturbance (sus!)

2 - dysgeusia (metallic tase)

excretion of macrolides

liver, which means you should NOT use for any renal diseases

drug interactions of macrolides (3!)

1 - raises INR (don't combine with warfarin)

2 - don't use with other QT prolonging drugs! torsades risk

3 - inhibitor of CYP3A4 = drug interactions

what is clarithromycin used for specifically

H pylori

what form of clindamycin is used mostly

topical

what is coverage of clindamycin

most anaerobes

S. aureus, S. pyogenes, viridians strep (in pt with PCN allergies)

coverage of clinda

above the diaphragm! (mouth, head, neck)

pharyngitis

anaerobic infections + SSTIs

excretion of clinda

liver