Macrolides on the NCLEX
Azithromycin and the macrolide class: QT prolongation, drug interactions, uses.
Macrolides include azithromycin (Z-pak), clarithromycin, erythromycin. NCLEX tests QT prolongation and the GI motility effect of erythromycin.
Common uses
CAP. Atypical pneumonia (Mycoplasma, Legionella, Chlamydophila). Pertussis. Chlamydia. H. pylori (clarithromycin component of triple therapy).
Side effects
QT prolongation, caution with other QT-prolonging drugs. GI upset, erythromycin worst (used therapeutically for gastroparesis). Hepatotoxicity (rare).
Drug interactions
Clarithromycin and erythromycin are strong CYP3A4 inhibitors, increase levels of statins (rhabdo risk), warfarin, many others. Azithromycin minimal interactions.
Frequently asked
Z-pak is just for everything?
Overused. Reasonable for atypical pneumonia, pertussis. Not first-line for strep throat (PCN better).
Pregnancy?
Azithromycin generally safe. Clarithromycin avoided.
Quick check
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