Pharmacopeia

CWP-0092

ERYTHROMYCIN

Anti-infectives · Anti-infectives · Level 3 Gastrointestinal · Gastrointestinal · Level 3

Core pharmacology

Legacy Cicm Level

Level 3

Introduction

Macrolide antibiotic

Absorption

10-60% absorption
Undergoes first pass metabolism

Distribution

Poor CSF penetration but good lung penetration

Protein binding

85% PB

Volume of distribution

Vd 0.3-1.2L/kg

Metabolism

Hepatic demethylation

Excretion

Renally excreted (15% unchanged)

Half-life

T1/2= 1.5 hours

Class Group

ANTIBIOTIC:
MACROLIDE

Presentation

Topical, oral, IV

Antimicrobial Spectrum

1. Gram positives
2. Anaerobes
Obligate intracellular organisms (legionella, mycoplasma)

Anti-infectives · Anti-infectives

Mechanism of action

Inhibits 50s subunit to prevent protein synthesis
Bacteriocidal/static

Adverse Effects Toxicity

1. Must be avoided in porphyria
2. Nausea, vomiting, diarrhea
3. Hypersensitivity
4. QT prolongation and increased risk of torsade’s
5. Inhibits CYP3A4 (increased warfarin, carbamazepine, ciclosporin, valproate, tacrolimus, digoxin)
Inhibits p-glycoprotein

Gastrointestinal · Gastrointestinal

Mechanism of action

Binds motilin receptors in the stomach and duodenum leading to increased LOS tone, increased GIT motility and coordination

Adverse Effects Toxicity

1. Porphyria
2. QTc prolongation
3. Antibiotic resistance
4. Inhibits CYP3A4 (increased warfarin, carbamazepine, ciclosporin, valproate, tacrolimus, digoxin)
5. Inhibits p-glycoprotein