Pharmacology Antibiotics: Hepatic Encephalopathy to Macrolides

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Across
  1. 4. Macrolides AE: GI irritation, (two word blank)
  2. 5. Oral Neomycin: Used as adjunct in treatment for (two word blank)
  3. 7. Macrolides Resistance, 3 main mechanisms (usually plasmid encoded): Modification of ribosomal binding site (by (two word blank) or by methylation)
  4. 10. Macrolides Clinical Applications: Used in empiric therapy of community-acquired pneumonia (outpatient & in (blankwithblank) for inpatients)
  5. 12. Lactulose Adverse Effects: (blank)
  6. 14. Macrolides AE: (two word blank) (erythromycin & azithromycin)
  7. 15. Macrolides AE: Severe reactions are rare (blankandblank)
  8. 16. Macrolides PK: Clarithromycin, azithromycin, telithromycin = improved oral absorption, longer t1/2, (two word blank) compared to erythromycin
  9. 18. Lactulose: Nonabsorbable (blank)
  10. 22. Macrolides : Bacteriostatic ((blank) at high conc.)
  11. 25. Alternative treatment options to neomycin for hepatic encephalopathy: Lactulose, Oral vancomycin, Oral metronidazole, (blank)
  12. 26. Macrolides Antibacterial Spectrum: Azithromycin, (blankandblank) have broader spectrum than erythromycin
  13. 29. Macrolides Antibacterial Spectrum: Spectrum is slightly wider than that of (blank)
  14. 31. Lactulose Other Effects: Prebiotic (suppression of (two word blank) organisms)
  15. 33. Macrolides Clinical Applications: Common substitute for patients with (two word blank)
  16. 34. Macrolides Resistance, 3 main mechanisms (usually plasmid encoded): Reduced membrane permeability or (two word blank)
Down
  1. 1. Macrolides Clinical Applications: DOC for (two word blank)
  2. 2. Lactulose Adverse Effects: Abdominal (blank)
  3. 3. Macrolides Contraindications: (blank) (due to macrolides inhibiting CYP P450)
  4. 6. Macrolides MOA: Binding site is identical or close to that for (blankandblank)
  5. 8. Lactulose Adverse Effects: (two word blank)
  6. 9. Macrolides Resistance: (Three word blank) between erythromycin, azithromycin, & clarithromycin
  7. 11. Macrolides Clinical Applications: Treatment of (three word blank) & soft-tissue infections (eg, Staph, H.influenzae, S.pneumoniae, enterococci)
  8. 13. Lactulose Other Effects: (two word blank) laxative
  9. 17. Macrolides Resistance, 3 main mechanisms (usually plasmid encoded): Production of (blank) that hydrolyze drugs (by enterobacteriaceae)
  10. 19. (Erythromycin, Clarithromycin, Azithromycin, Telithromycin): Mainly used to treat Gram-positive infections
  11. 20. Lactulose MOA: Degraded by intestinal bacteria to (two word blank)+ other organic acids, causes acidification of gut lumen, favors formation of NH4+ from NH3
  12. 21. Lactulose MOA: NH4+ is trapped in colon effectively reducing (two word blank) concentrations
  13. 23. Macrolides MOA: (blankblanktotheblank) rRNA of the 50S subunit blocking translocation
  14. 24. Macrolides Resistance: (Three word blank) with clindamycin & streptogramins
  15. 27. Macrolides Clinical Applications: Erythromycin = DOC for whooping cough (blank)
  16. 28. Macrolides PK: Erythromycin, clarithromycin & telithromycin = (three word blank) (NOT azithromycin)
  17. 30. Macrolides Antibacterial Spectrum: Most active against Gram-positive bacteria ((two word blank) against Gram-negatives)
  18. 32. Macrolides Contraindications: (blank) – fatal hepatotoxicity, exacerbations of myasthenia gravis, & visual disturbances to don’t use for minor illnesses