Antibacterial (Macrolide Antibiotic)
Counseling for Pharmacokinetics:
Counsel the patient that how your medication will show its effects when you will take. Erythromycin is absorbed from the small intestine, the drug gets partially destroyed by the gastric juice so it must be administered in an enteric coated form. It is mainly concentrated in the bile.
- Bioavailability Depends on the ester type between 30% – 65%
- Protein binding 90%
- Metabolism Liver (under 5% excreted unchanged)
- Half-life 1.5 hours
- Excretion bile
Erythromycin is a bacteriostatic drug and prescribed to treat respiratory tract infections, chlamydial infections, diphtheria, and acne vulgaris.
Counseling for Side Effects:
It is the duty of the pharmacist to counsel the patient regarding different side effects of the medication. The most common side effects of Erythromycin are nausea, vomiting, loss of appetite, diarrhea, and abdominal pain. Liver damage also may occur with erythromycin in some patients so patients having liver abnormality should use with great caution of recommended by doctor. If these side effects occur then consult your doctor/pharmacist immediately.
Counseling for Dosage:
Erythromycin is available in different dosage forms and used to manage various infections. So a dose of Erythromycin depends upon age of patient, dosage form and type of infection. The pharmacist should verify the dose of Erythromycin against above mentioned parameters by consulting with standard books. The normal dose of Erythromycin (as mentioned in the British National Formulary) is given as below:
For Oral Route:
- By mouth, adult and child over 8 years, 250–500 mg every 6 hours or 0.5–1 g every 12 hours; up to 4 g daily in severe infections
- Neonate 12.5 mg/kg every 6 hours
- Child 1 month–2 years 125 mg every 6 hours, 2–8 years 250 mg every 6 hours, doses doubled for severe infections
- For the treatment of early syphilis, 500 mg 4 times daily for 14 days
- For uncomplicated genital chlamydia, non-gonococcal urethritis, 500 mg twice daily for 14 days
For IV Infusion:
- By intravenous infusion, adult and child severe infections, 50 mg/kg daily by continuous infusion or in divided doses every 6 hours; mild infections (oral treatment not possible), 25 mg/kg daily;
- Neonate 30–45 mg/kg daily in 3 divided doses
Counseling for Contraindications:
Counseling for Pregnancy:
Erythromycin is placed in the pregnancy category B so counsel the patient that you can use this medication during pregnancy under supervision of your doctor and pharmacist.
Counseling for Drug Interactions:
Advise the patient that do not use Erythromycin With Theophyllines, Androgens, antithyroid agents, Chloroquine, Estrogens, Digoxin, Gold salts, Hydroxychloroquine as there is an interaction between them.
- Advise patient to consider medication with a full glass of water 1 hour before or 2 hours after meals. If extreme GI distress occurs, drug might be taken with food or milk.
- Inform patient that following ophthalmic administration, temporary blurring of vision or stinging may occur. Advise patient to inform the physician if redness, irritation or pain persists or worsens. Instruct patient to make use of medication 1 hour before driving.
- Instruct patient to notify physician if nausea, vomiting, diarrhea, abdominal pain, jaundice, dark urine, pale stools, unusual fatigue or signs of superinfection occur.
- Instruct patient to adhere to the complete span of therapy.
- When used topically for treatments for acne vulgaris, caution patient to never use OTC peeling, abrasive agents or abrasive sponges because cumulative irritant effect may occur.
- When a drug is employed topically, advise the patient in order to avoid exposure to sunlight also to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
- Erythroped A
- Tatro DS, Borgsdorf LR. A to z drug facts. Facts & Comparisons, 2003.
- Committee JF, Britain RPSoG. British National Formulary (BNF) 64. Pharmaceutical Press, 2012.
- Knoben JE, Anderson PO, Watanabe AS. Handbook of clinical drug data. Drug Intelligence Publications Hamilton, IL, 1988.
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