Cleocin
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- What is the MOA of Clindamycin (Cleocin) ?
- BACTERIOSTATIC inhibitor of protein synthesis
- The uses of Cleocin are limited because of what major side effect ?
- AAPMC - antibiotic associated psuedomembranous colitis
- What is the spectrum of Cleocin ?
-
Active against most anaerobic gram negative and gram positive.
-Gram negative AEROBES are resistant
Bacteroides, fusobacterium, clostridium - What is Cleocin generally used for ?
-
Used to be used as an alternative to penicillin but not so much anymore due to the colitis
-used today primarily for anaerobic infections OUTSIDE the CNS
-is the DOC for abdominal and pelvic infections caused by B. fragilis
-diabetic foot ulcers, necrotizing fascitis
acne
-bacterial vaginosis
-alternative therapy for AIDS patients to treat pnuemocystic carnii
-MRSA - Discuss the distribution of Cleocin in the tissues ...
- widely distributed to bone and body tissues; poor perfusion to CNS
- Dose dosage need to be reduce for renal or hepatic dysfunction ?
- NO....but the drug *can* accumulate to toxic levels in combined renal/hepatic dysfunction. Reduce the dose or use another drug if this is the case.
- What are the signs and symptoms of AAPMC ?
- profuse, watery diarrhea (10-20 stools per day); abdominal pain, fever, leukocytosis. Stools may contain mucus or blood.
- When do symptoms of AAPMC usually begin ?
- within the first week of therapy OR up to 4-6 weeks after completion
- What should you do and what should you prescribe for the patient who has signs and symptoms of AAPMC ?
-
1. STOP Cleocin
2. Give oral Vancomycin or Metronidazole
3. Vigorous fluid replacement therapy
4. Do not use drugs that slow motility like opiods and anticholinergics ! - IV administration should be on or off the pump ?
- Should be ON the pump and given slowly.
- Pediatric concerns ?
- OK for kids > 1 month
- What pregnancy category is it ?
- B
- If you prescribe Cleocin in vaginal cream form, what else should you tell your patients ?
- The cream *may* weaken the diaphragm and condoms, so backup birth control is a good idea.
- How does Cleocin work ?
- BACTERIOSTATIC ! inhibits protein wall synthesis
- What is the name of the form of Cleocin that is given in cream form for vaginosis ?
- Clindesse