Metronidazole Pharmacology

Metronidazole (Flagyl) is an antibiotic that is used for various infections.

Metronidazole can certainly cause GI upset like most antibiotics, but uniquely may also cause a metallic taste.

Metronidazole is also rarely associated with CNS changes and can induce the potential for peripheral neuropathy.

Patients should avoid alcohol with the use of metronidazole and this is on account for the possibility of a disulfiram reaction. I discuss some of the symptoms of this reaction in the podcast.

Metronidazole can substantially raise the concentrations of warfarin. INR monitor and a reduction in dose of warfarin may be necessary.

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Erythromycin Pharmacology

Erythromycin uniquely has some potential benefit in the setting of gastroparesis. Azithromycin you will likely not see used for this indication.

Erythromycin binds the 50s subunit and ultimately prevents protein synthesis which is necessary for bacteria to grow and replicate.

QTc prolongation is a risk with all macrolide antibiotics (erythromycin included).

By inhibiting CYP3A4, erythromycin can be responsible for numerous drug interactions.

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Rifampin Pharmacology

Rifampin is classified as an antibiotic and an antituberculosis agent. It primarily works by inhibiting bacterial RNA polymerase.

While not extremely common, rifampin is well known to cause hepatic dysfunction.

You should remind patients who are taking rifampin that it can alter the color of tears, sweat, saliva and urine. It can change these fluids to a reddish/brown color.

Rifampin is very well known for causing drug interactions. It is an enzyme inducer that can reduce the concentrations of numerous medications such as warfarin, apixaban, cyclosporin, levothyroxine, and oral contraceptives to name a few.

Rifampin can be used to help prevent meningococcal infection. Learn more on rifampin by listening to this podcast!

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Azithromycin Pharmacology

Azithromycin Pharmacology

On this episode, I cover azithromycin pharmacology. This drug primarily acts by inhibiting protein synthesis. It binds to the 50s ribosomal subunit.

GI adverse effects like nausea and diarrhea are going to be the most common with azithromycin.

Azithromycin has been associated with prolonging the QT interval. Drugs like amiodarone, ondansetron, citalopram, antipsychotics, and quinolone antibiotics can also prolong the QT interval.

One major advantage that azithromycin has over other antibiotics is that it has a long half life which allows for once daily dosing.

Azithromycin has numerous uses like pneumonia, MAC, alternative for ear infections in patients with a beta-lactam allergy, certain STD’s, and also is rarely used in long term COPD exacerbation prevention.

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Linezolid Pharmacology

linezolid pharmacology

Linezolid is an antibiotic used for bacterial infection. It primarily works by inhibiting bacterial protein synthesis.

Linezolid is primarily bacteriostatic against most bacteria which means that it inhibits the growth and doesn’t necessarily kill the bacteria itself.

Caution must be used with linezolid and serotonergic drugs as there is a risk for serotonin syndrome. Clinical risk/benefit analysis needs to be done.

Linezolid overall has good coverage for VRE and MRSA. It is an option for MRSA pneumonia where daptomycin is not.

Linezolid has both an oral and an IV option which allows for good continuity of inpatient and outpatient use.

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Nitrofurantoin Pharmacology

On this episode I breakdown nitrofurantoin pharmacology. Nitrofurantoin is an antibiotic that is used in the treatment of UTI’s.

Nitrofurantoin has activity by creating reactive metabolites that can disrupt protein synthesis and ultimately kills the bacteria causing the infection.

It is important to remember with nitrofurantoin, that in the setting of systemic infection and/or kidney involvement, the drug may not be very effective.

Nitrofurantoin can potentially reduce the effectiveness of certain vaccines. Be sure to look this up prior to administration.

Nitrofurantoin can cause pulmonary symptoms as well as neuropathy. This is very important to monitor for.

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Quinolone Antibiotic Pharmacology

Quinolones are a class of antibiotics that can be used for various infections. I discuss the pharmacology, adverse effects, drug interactions and other items on this podcast episode.

On this episode, I talk about the warnings associated with quinolones.

Quinolone use has subsided over time, not due to the fact that they are ineffective, but to rising concerns and warnings about adverse effects.

Quinolones can interact with quite a few medications.  I’ve seen a case of amiodarone and levofloxacin contributing to QTc prolongation which I discuss on this episode.

It is critical to remember the binding interactions associated with quinolones as these can potentially lead to treatment failure.

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Tetracyclines Pharmacology Episode 038

On this episode, I discuss how the tetracyclines impact bacterial protein synthesis.

I also remind you of several medications that fall in the tetracycline class.  Doxycycline is by far the medication I see used the most.

You’ll also learn about common side effects like GI upset and photosensitivity.

I cover why this class of medication is typically avoided in pediatrics and pregnancy.

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Sulfamethoxazole and Trimethoprim RLP Episode 026

On this episode, I discuss sulfamethoxazole and trimethoprim. We cover mechanism of action, adverse effects, and some really important, clinically relevant drug interactions.  Hope you enjoy the show and be sure to take advantage of our FREE 31 page PDF document on the highly testable pearls of the Top 200 Drugs.  A great resource for any nursing, pharmacy, or midlevel, or med student!