Category: Infectious Disease and Oncology Medications

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Clarithromycin Pharmacology

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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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Rifaximin Pharmacology

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On this episode, I discuss rifaximin pharmacology.

Rifaximin is most commonly used in hepatic encephalopathy and C. difficile infection.

Rifaximin systemic absorption is minimal so that is why it is primarily only used for GI conditions.

Drug interactions with rifaximin are fairly minimal compared to its cousin rifampin which has tons of drug interactions.

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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Palivizumab Pharmacology

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On this episode, I discuss palivizumab pharmacology and how it is used in pediatric patients.

Palivizumab is a monoclonal antibody that is used to prevent RSV infections in pediatric patients.

Palivizumab is an IM injection that is dosed by weight. Learn more on this podcast episode.

RSV can be devastating in pediatric patients under the age of two. Palivizumab can be used in select populations to help prevent the infection.

Injection and skin reactions are possible with the use of palivizumab.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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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Fluconazole Pharmacology

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On this episode of the RLP podcast, I discuss fluconazole pharmacology.

Fluconazole prevents fungi from producing essential components for their cell membrane and thus inhibits their growth.

Drug interactions are common with fluconazole. Fluconazole inhibits CYP3A4, 2C9, and 2C19 to varying degrees.

I discuss an interaction between fluconazole and phenytoin in this podcast episode.

Hepatitis has rarely been reported with the use of azole antifungals like fluconazole.

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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Valacyclovir Pharmacology

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Valacyclovir can be used for various viral infections such as herpes virus and varicella.

The primary clinical advantage of valacyclovir compared to acyclovir is that it is dosed less frequently.

Valacyclovir may have some mild CYP1A2 inhibitory effect. I discuss the clinical relevance of this on this episode.

GI upset can occur so I usually recommend to give it with food even though it may be given with or without food.

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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Abacavir Pharmacology

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Abacavir is a nucleoside reverse transcriptase inhibitor used in the management of HIV.

In patients who have the HLA-B*5701 allele, they are at much greater risk for hypersensitivity reactions.

Lactic acidosis and hepatomegaly are potential complications with the use of abacavir.

While abacavir is not known for a large number of drug interactions, I discuss a few that you have a chance to run into.

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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Fosfomycin Pharmacology

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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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Terbinafine Pharmacology

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Terbinafine can inhibit CYP2D6 which plays an important role in the metabolism of many drugs such as metoprolol, fluoxetine, and clozapine.

With terbinafine’s ability to inhibit CYP2D6, it can also increase the risk of treatment failure with drugs like tamoxifen.

When using anti-fungal drugs like terbinafine, remember that fungal infections can often require more time to treat.

Terbinafine has the potential to cause liver impairment. I discuss this further on the podcast.

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

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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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Erythromycin Pharmacology

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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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!