Gentamicin Pharmacology Podcast Episode 311

On this podcast episode, I discuss gentamicin pharmacology, adverse effects, monitoring, drug interactions and much more!

Drug monitoring is critical with gentamicin. Trough and peak concentrations can guide therapy and identify someone at risk of toxicity.

Nephrotoxicity is a major concern with gentamicin. There are numerous nephrotoxic agents that can increase this risk. I discuss them on the podcast.

Ototoxicity is another risk associated with gentamicin. Loop diuretics like furosemide can increase this risk. Learn more on this podcast episode.

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Levofloxacin Pharmacology Podcast Episode 309

On this podcast episode, I discuss levofloxacin pharmacology, adverse effects, boxed warnings, interactions, and much more.

Levofloxacin is well known to cause QTc prolongation and many drugs can increase this risk such as antiarrhythmics, citalopram, antipsychotics, and many more.

Binding interactions are important when discussing levofloxacin pharmacology. Calcium, iron, magnesium, and many other cations can block the absorption of this medication.

I discuss tendon rupture in relation to levofloxacin use and what factors may increase the risk of this rare adverse effect.

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Cefuroxime Pharmacology Podcast

On this episode, I discuss cefuroxime pharmacology, adverse effects, drug interaction, pharmacokinetics, and much more.

Cefuroxime is a 2nd generation cephalosporin that binds Penicillin-binding proteins and prevents bacterial cell wall synthesis.

Medications that create a higher pH in the stomach such as antacids can ultimately reduce the concentrations of cefuroxime.

Cefuroxime is primarily eliminated by the kidney. Dose adjustments are recommended for patients with a CrCL less than 30 mls/min.

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Cephalexin (Keflex) Pharmacology Podcast

On this podcast episode, I discuss cephalexin pharmacology, adverse effects, drug interactions, and much more!

Penicillin allergies and cross-reactivity are common questions with regard to the use of cephalexin and I discuss this briefly in the podcast episode.

Cephalexin is a first-generation cephalosporin with its primary sweet spot being gram-positive bacteria like Staph and Strep species.

Warfarin, probenecid, zinc, and a couple of others are potential medications that can interact with cephalexin. I discuss this further in this podcast episode.

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Ceftriaxone Pharmacology

On this episode, I discuss ceftriaxone pharmacology, adverse effect, coverage, and drug interactions. Ceftriaxone is currently a drug of choice for the STI Gonorrhea. Pyrls.com has an amazing chart on all the STIs and their drugs of choice that you can get for free when you sign up for a free account!

Ceftriaxone is a third-generation cephalosporin that is used for numerous indications such as pneumonia, meningitis, gonorrhea, and many more.

It is important to remember that ceftriaxone can cover many staph and strep species but it does NOT cover MRSA.

Ceftriaxone does have some risks, particularly in pediatric patients. I discuss elevated bilirubin and calcium binding risks in the podcast.

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Clarithromycin Pharmacology

On this episode, I discuss clarithromycin pharmacology, adverse effects, and drug interactions.

Clarithromycin is a macrolide antibiotic that can be used for many similar indications as azithromycin.

Clarithromycin has numerous drug interactions as it can inhibit CYP3A4. This limits its use in practice.

Clarithromycin can be used in the treatment of H. pylori in combination with other antibiotics and a PPI.

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Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

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Drug Interactions In Primary Care (Amazing Resource for Practicing Clinicians)

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Fosfomycin Pharmacology

Fosfomycin is an antibacterial agents that can be utilized in the management of uncomplicated UTIs.

Uniquely, fosfomycin comes as a packet that needs to be mixed with COOL water. I discuss this further on the podcast.

Typhoid and Cholera vaccine effectiveness may be reduced when used with fosfomycin.

When there is kidney or systemic infection involvement, it is recommended to avoid the use of fosfomycin.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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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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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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