920 Part 452—Macrolide Antibiotic Drugs
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"Macrolides"? Classify Each Drug in This Chapter As a Macrolide Or Azalide, and As an Antibiotic Or Semi-Synthetic Derivative
STUDY GUIDE THE MACROLIDE/AZALIDE ANTIMICROBIAL AGENTS 1. Why are these antibiotics derivatives called "macrolides"? Classify each drug in this chapter as a macrolide or azalide, and as an antibiotic or semi-synthetic derivative. 2. What are the key structural differences between erythromycin, clarithromycin, azithromycin and dirithromycin? 3. Generally how does spiramycin and josamycin differ in structure from the commercial macrolides/azalides (2 reasons)? 4. What are the “ketolides and how do they differ in structure from the commercial macrolides? 5. What is the biosynthetic source of erythromycin? What is the lactone moiety of erythromycin called? What sugar moieties are present and what are their properties? 6. What hydrolysis product forms from erythromycin in aqueous acid or base? What is the significance of this reaction? Can it occur with other macrolides? 7. When does the “intramolecular cyclization” reaction occur with erythromycin? What is it's significance (two reasons) and how does it occur? Which functional groups are important for this reaction? 8. What salt forms of erythromycin are available? Which are water soluble? Which are water-insoluble? How is each salt form formulated and used (oral or parenteral)? 9. What ester and ester salt derivatives of erythromycin are available? What is the estolate? How is each salt form formulated and used (oral or parenteral)? What are the advantages of these esters dosage forms? 10. How does clarithromycin differ in structure from erythromycin? Why was this macrolide developed (the role of the 6-methoxy)? 11. How does azithromycin differ in structure from erythromycin? Why was this macrolide developed? 12. How does dirithromycin differ in structure from erythromycin? Why was this macrolide developed? What is the active form of this prodrug? 13. -
35 Cyproterone Acetate and Ethinyl Estradiol Tablets 2 Mg/0
PRODUCT MONOGRAPH INCLUDING PATIENT MEDICATION INFORMATION PrCYESTRA®-35 cyproterone acetate and ethinyl estradiol tablets 2 mg/0.035 mg THERAPEUTIC CLASSIFICATION Acne Therapy Paladin Labs Inc. Date of Preparation: 100 Alexis Nihon Blvd, Suite 600 January 17, 2019 St-Laurent, Quebec H4M 2P2 Version: 6.0 Control # 223341 _____________________________________________________________________________________________ CYESTRA-35 Product Monograph Page 1 of 48 Table of Contents PART I: HEALTH PROFESSIONAL INFORMATION ....................................................................... 3 SUMMARY PRODUCT INFORMATION ............................................................................................. 3 INDICATION AND CLINICAL USE ..................................................................................................... 3 CONTRAINDICATIONS ........................................................................................................................ 3 WARNINGS AND PRECAUTIONS ....................................................................................................... 4 ADVERSE REACTIONS ....................................................................................................................... 13 DRUG INTERACTIONS ....................................................................................................................... 16 DOSAGE AND ADMINISTRATION ................................................................................................ 20 OVERDOSAGE .................................................................................................................................... -
Erythromycin Versus Tetracycline for Treatment of Mediterranean Spotted Fever
Arch Dis Child: first published as 10.1136/adc.61.10.1027 on 1 October 1986. Downloaded from Archives of Disease in Childhood, 1986, 61, 1027-1029 Erythromycin versus tetracycline for treatment of Mediterranean spotted fever T MUNOZ-ESPIN, P LOPEZ-PARtS, E ESPEJO-ARENAS, B FONT-CREUS, I MARTINEZ- VILA, J TRAVERIA-CASANOVA, F SEGURA-PORTA, AND F BELLA-CUETO Hospital de Sant Llatzer, Terrassa, Clinica Infantil del Nen Jesus, Sabadell, and Hospital Mare de Deu de la Salut, Sabadell, Barcelona, Spain SUMMARY Eighty one children aged between 1 and 13 years participated in a randomised comparative trial of tetracycline hydrochloride and erythromycin stearate for treatment of Mediterranean spotted fever. Both therapeutic regimens proved effective, but in patients treated with tetracycline both clinical symptoms and fever disappeared significantly more quickly. Likewise, when those patients who began treatment within the first 72 hours of illness are considered the febrile period had a significantly shorter duration in the group treated with tetracycline. One patient was switched to tetracycline because there was no improvement of clinical manifestations, with persistence of fever, myalgias, and prostration, after receiving eight days of treatment with erythromycin. These results suggest that tetracyclines are superior to erythromycin in the treatment of Mediterranean spotted fever. copyright. Mediterranean spotted fever is an acute infectious were not included in the trial; neither were those disease caused by Rickettsia conorii. During the -
MIRENA Data Sheet Vx3.0, CCDS 25 1
NEW ZEALAND DATA SHEET 1. PRODUCT NAME MIRENA 52 mg intrauterine contraceptive device (release rate: 20 microgram/24 hours) 2. QUALITATIVE AND QUANTITATIVE COMPOSITION MIRENA is an intrauterine system (IUS) containing 52 mg levonorgestrel. For details of release rates, see Section 5.2. For the full list of excipients, see Section 6.1. 3. PHARMACEUTICAL FORM MIRENA consists of a white or almost white drug core covered with an opaque membrane, which is mounted on the vertical stem of a T-body. The vertical stem of the levonorgestrel intrauterine system is loaded in the insertion tube at the tip of the inserter. Inserter components are an insertion tube, plunger, flange, body and slider. The white T-body has a loop at one end of the vertical stem and two horizontal arms at the other end. Brown coloured removal threads are attached to the loop. The T-body of MIRENA contains barium sulfate, which makes it visible in X-ray examination. The IUS and inserter are essentially free from visible impurities. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Contraception Treatment of idiopathic menorrhagia provided there is no underlying pathology. Prevention of endometrial hyperplasia during estrogen replacement therapy MIRENA Data Sheet Vx3.0, CCDS 25 1 4.2 Dose and method of administration MIRENA is inserted into the uterine cavity. One administration is effective for five years. The in vivo dissolution rate is approximately 20 microgram/24 hours initially and is reduced to approximately 18 microgram/24 hours after 1 year and to 10 microgram/24 hours after five years. The mean dissolution rate of levonorgestrel is about 15 microgram /24 hours over the time up to five years. -
Supplementary Materials
Supplementary Materials Table S1. The significant drug pairs in potential DDIs examined by the two databases. Micromedex Drugs.com List of drugs paired PK-PD Mechanism details 1. Amiodarone— PD Additive QT-interval prolongation Dronedarone 2. Amiodarone— PK CYP3A inhibition by Ketoconazole Ketoconazole 3. Ciprofloxacin— PD Additive QT-interval prolongation Dronedarone 4. Cyclosporine— PK CYP3A inhibition by Cyclosporine Dronedarone 5. Dronedarone— PK CYP3A inhibition by Erythromycin Erythromycin 6. Dronedarone— PD Additive QT-interval prolongation Flecainide 7. Dronedarone— PK CYP3A4 inhibition by Itraconazole Itraconazole 8. Dronedarone— PK Contraindication Major CYP3A inhibition by Ketoconazole Ketoconazole 9. Dronedarone— PD Additive QT-interval prolongation Procainamide PD 10. Dronedarone—Sotalol Additive QT-interval prolongation 11. Felodipine— PK CYP3A inhibition by Itraconazole Itraconazole 12. Felodipine— PK CYP3A inhibition by Ketoconazole Ketoconazole 13. Itraconazole— PK CYP3A inhibition by Itraconazole Nisoldipine 14. Ketoconazole— PK CYP3A inhibition by Ketoconazole Nisoldipine 15. Praziquantel— PK CYP induction by Rifampin Rifampin PD 1. Amikacin—Furosemide Additive or synergistic toxicity 2. Aminophylline— Decreased clearance of PK Ciprofloxacin Theophylline by Ciprofloxacin 3. Aminophylline— PK Decreased hepatic metabolism Mexiletine 4. Amiodarone— PD Additive effects on QT interval Ciprofloxacin 5. Amiodarone—Digoxin PK P-glycoprotein inhibition by Amiodarone 6. Amiodarone— PD, PK Major Major Additive effects on QT Erythromycin prolongation, CYP3A inhibition by Erythromycin 7. Amiodarone— PD, PK Flecainide Antiarrhythmic inhibition by Amiodarone, CYP2D inhibition by Amiodarone 8. Amiodarone— PK CYP3A inhibition by Itraconazole Itraconazole 9. Amiodarone— PD Antiarrhythmic inhibition by Procainamide Amiodarone 10. Amiodarone— PK CYP induction by Rifampin Rifampin PD Additive effects on refractory 11. Amiodarone—Sotalol potential 12. Amiodarone— PK CYP3A inhibition by Verapamil Verapamil 13. -
Diagnosis and Treatment of Tinea Versicolor Ronald Savin, MD New Haven, Connecticut
■ CLINICAL REVIEW Diagnosis and Treatment of Tinea Versicolor Ronald Savin, MD New Haven, Connecticut Tinea versicolor (pityriasis versicolor) is a common imidazole, has been used for years both orally and top superficial fungal infection of the stratum corneum. ically with great success, although it has not been Caused by the fungus Malassezia furfur, this chronical approved by the Food and Drug Administration for the ly recurring disease is most prevalent in the tropics but indication of tinea versicolor. Newer derivatives, such is also common in temperate climates. Treatments are as fluconazole and itraconazole, have recently been available and cure rates are high, although recurrences introduced. Side effects associated with these triazoles are common. Traditional topical agents such as seleni tend to be minor and low in incidence. Except for keto um sulfide are effective, but recurrence following treat conazole, oral antifungals carry a low risk of hepato- ment with these agents is likely and often rapid. toxicity. Currently, therapeutic interest is focused on synthetic Key Words: Tinea versicolor; pityriasis versicolor; anti “-azole” antifungal drugs, which interfere with the sterol fungal agents. metabolism of the infectious agent. Ketoconazole, an (J Fam Pract 1996; 43:127-132) ormal skin flora includes two morpho than formerly thought. In one study, children under logically discrete lipophilic yeasts: a age 14 represented nearly 5% of confirmed cases spherical form, Pityrosporum orbicu- of the disease.3 In many of these cases, the face lare, and an ovoid form, Pityrosporum was involved, a rare manifestation of the disease in ovale. Whether these are separate enti adults.1 The condition is most prevalent in tropical tiesN or different morphologic forms in the cell and semitropical areas, where up to 40% of some cycle of the same organism remains unclear.: In the populations are affected. -
Erythromycin* Class
Erythromycin* Class: Macrolide Overview Erythromycin, a naturally occurring macrolide, is derived from Streptomyces erythrus. This macrolide is a member of the 14-membered lactone ring group. Erythromycin is predominantly erythromycin A, but B, C, D and E forms may be included in preparations. These forms are differentiated by characteristic chemical substitutions on structural carbon atoms and on sugars. Although macrolides are generally bacteriostatic, erythromycin can be bactericidal at high concentrations. Eighty percent of erythromycin is metabolically inactivated, therefore very little is excreted in active form. Erythromycin can be administered orally and intravenously. Intravenous use is associated with phlebitis. Toxicities are rare for most macrolides and hypersensitivity with rash, fever and eosinophilia is rarely observed, except with the estolate salt. Erythromycin is well absorbed when given orally. Erythromycin, however, exhibits poor bioavailability, due to its basic nature and destruction by gastric acids. Oral formulations are provided with acid-resistant coatings to facilitate bioavailability; however these coatings can delay therapeutic blood levels. Additional modifications produced better tolerated and more conveniently dosed newer macrolides, such as azithromycin and clarithromycin. Erythromycin can induce transient hearing loss and, most commonly, gastrointestinal effects evidenced by cramps, nausea, vomiting and diarrhea. The gastrointestinal effects are caused by stimulation of the gastric hormone, motilin, which -
WSAVA List of Essential Medicines for Cats and Dogs
The World Small Animal Veterinary Association (WSAVA) List of Essential Medicines for Cats and Dogs Version 1; January 20th, 2020 Members of the WSAVA Therapeutic Guidelines Group (TGG) Steagall PV, Pelligand L, Page SW, Bourgeois M, Weese S, Manigot G, Dublin D, Ferreira JP, Guardabassi L © 2020 WSAVA All Rights Reserved Contents Background ................................................................................................................................... 2 Definition ...................................................................................................................................... 2 Using the List of Essential Medicines ............................................................................................ 2 Criteria for selection of essential medicines ................................................................................. 3 Anaesthetic, analgesic, sedative and emergency drugs ............................................................... 4 Antimicrobial drugs ....................................................................................................................... 7 Antibacterial and antiprotozoal drugs ....................................................................................... 7 Systemic administration ........................................................................................................ 7 Topical administration ........................................................................................................... 9 Antifungal drugs ..................................................................................................................... -
Pharmacology/Therapeutics II Block III Lectures 2013-14
Pharmacology/Therapeutics II Block III Lectures 2013‐14 66. Hypothalamic/pituitary Hormones ‐ Rana 67. Estrogens and Progesterone I ‐ Rana 68. Estrogens and Progesterone II ‐ Rana 69. Androgens ‐ Rana 70. Thyroid/Anti‐Thyroid Drugs – Patel 71. Calcium Metabolism – Patel 72. Adrenocorticosterioids and Antagonists – Clipstone 73. Diabetes Drugs I – Clipstone 74. Diabetes Drugs II ‐ Clipstone Pharmacology & Therapeutics Neuroendocrine Pharmacology: Hypothalamic and Pituitary Hormones, March 20, 2014 Lecture Ajay Rana, Ph.D. Neuroendocrine Pharmacology: Hypothalamic and Pituitary Hormones Date: Thursday, March 20, 2014-8:30 AM Reading Assignment: Katzung, Chapter 37 Key Concepts and Learning Objectives To review the physiology of neuroendocrine regulation To discuss the use neuroendocrine agents for the treatment of representative neuroendocrine disorders: growth hormone deficiency/excess, infertility, hyperprolactinemia Drugs discussed Growth Hormone Deficiency: . Recombinant hGH . Synthetic GHRH, Recombinant IGF-1 Growth Hormone Excess: . Somatostatin analogue . GH receptor antagonist . Dopamine receptor agonist Infertility and other endocrine related disorders: . Human menopausal and recombinant gonadotropins . GnRH agonists as activators . GnRH agonists as inhibitors . GnRH receptor antagonists Hyperprolactinemia: . Dopamine receptor agonists 1 Pharmacology & Therapeutics Neuroendocrine Pharmacology: Hypothalamic and Pituitary Hormones, March 20, 2014 Lecture Ajay Rana, Ph.D. 1. Overview of Neuroendocrine Systems The neuroendocrine -
Spironolactone
Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families Spironolactone This information sheet should be read in conjunction with any information provided by the manufacturer. This information sheet explains what spironolactone is, how it is given and some of the possible side effects. Each person reacts differently to medicines, so your child will not necessarily suffer every side effect mentioned. If you have any questions or concerns, please ask your doctor, nurse or pharmacist or telephone one of the contact numbers on this information sheet. What is spironolactone? The liquid preparation comes in 5mg/ml, 10mg/5ml, 25mg/5ml, 50mg/5ml and 100mg/5ml Spironolactone belongs to a group of medicines strengths. You should use the oral syringe called diuretics. It is commonly used alongside provided to draw up the correct amount of another medicine called furosemide to reduce liquid and squirt it in the inside of your child’s fluid overload, so reducing the amount of work cheek. Please note that some of these strengths the heart has to do to pump blood around the may not be available locally so you should body. It works by making the kidneys produce always tell the pharmacist the strength of your more urine (wee), so your child may have to child’s usual medicine. go to the toilet more often. It also prevents potassium being lost in the urine. It is commonly Your doctor, nurse or pharmacist will have prescribed for children with heart or kidney explained to you how to obtain the correct problems causing excess fluid in the body. -
2021 Formulary List of Covered Prescription Drugs
2021 Formulary List of covered prescription drugs This drug list applies to all Individual HMO products and the following Small Group HMO products: Sharp Platinum 90 Performance HMO, Sharp Platinum 90 Performance HMO AI-AN, Sharp Platinum 90 Premier HMO, Sharp Platinum 90 Premier HMO AI-AN, Sharp Gold 80 Performance HMO, Sharp Gold 80 Performance HMO AI-AN, Sharp Gold 80 Premier HMO, Sharp Gold 80 Premier HMO AI-AN, Sharp Silver 70 Performance HMO, Sharp Silver 70 Performance HMO AI-AN, Sharp Silver 70 Premier HMO, Sharp Silver 70 Premier HMO AI-AN, Sharp Silver 73 Performance HMO, Sharp Silver 73 Premier HMO, Sharp Silver 87 Performance HMO, Sharp Silver 87 Premier HMO, Sharp Silver 94 Performance HMO, Sharp Silver 94 Premier HMO, Sharp Bronze 60 Performance HMO, Sharp Bronze 60 Performance HMO AI-AN, Sharp Bronze 60 Premier HDHP HMO, Sharp Bronze 60 Premier HDHP HMO AI-AN, Sharp Minimum Coverage Performance HMO, Sharp $0 Cost Share Performance HMO AI-AN, Sharp $0 Cost Share Premier HMO AI-AN, Sharp Silver 70 Off Exchange Performance HMO, Sharp Silver 70 Off Exchange Premier HMO, Sharp Performance Platinum 90 HMO 0/15 + Child Dental, Sharp Premier Platinum 90 HMO 0/20 + Child Dental, Sharp Performance Gold 80 HMO 350 /25 + Child Dental, Sharp Premier Gold 80 HMO 250/35 + Child Dental, Sharp Performance Silver 70 HMO 2250/50 + Child Dental, Sharp Premier Silver 70 HMO 2250/55 + Child Dental, Sharp Premier Silver 70 HDHP HMO 2500/20% + Child Dental, Sharp Performance Bronze 60 HMO 6300/65 + Child Dental, Sharp Premier Bronze 60 HDHP HMO -
Erythromycin
Erythromycin Antibiotic Class: Macrolide Antimicrobial Activity: Gram-positive bacteria, mycoplasma pneumoniae, chlamydia trachomatis, chlamydia pneumoniae, chlamydia psittaci, ureaplasma urealyticum, legionella pneumophila, campylobacter jejuni, bordatella pertussis Mechanism of Action: Macrolides are inhibitors of protein synthesis. They impair the elongation cycle of the peptidyl chain by specifically binding to the 50 S subunit of the ribosome. Specificity towards prokaryotes relies upon the absence of 50S ribosomes in eukaryotes. Pharmacodynamics: Macrolides are considered time-dependent antibiotics, which means that their efficacy will be related to the time interval during which their concentration at the infected site remains above the MIC of the offending organism. Pharmacokinetics: (500mg P.O. dose) Cmax: 3mg/L; Half-life: 2 hours; Volume of distribution: 0.64L/kg; Bioavailability: 25-60%; Table 3 Adverse Effects: Gastrointestinal: abdominal pain, nausea, vomiting, diarrhea Cardiovascular System: prolongation of QT interval, ventricular fibrillation Hepatic: hepatotoxicity Otic: auditory and vestibular dysfunction Hematologic: eosinophilia Dermatologic: skin rashes, pain at injection site, thrombophlebitis Dosage: Capsule: 250mg Topical gel: 2% Granules for oral suspension: 200mg/5ml Injection, powder for reconstitution: 500mg, 1g Ophthalmic ointment: 2% Topical ointment: 2% Powder for oral suspension: 200mg/5ml, 400mg/5ml, 100mg/2.5ml Topical solution: 1.5%, 2% Oral suspension: 125mg/5ml, 250mg/5ml, 200mg/5ml, 400mg/5ml Swab: