Pharmacology

• Erythromycin base (E-Mycin) is available in tablets, capsules, topical, and ophthalmic ointment.
• Erythromycin stearate (Erythrocin) is available in tablets.
• Erythromycin ethylsuccinate (EES) is available in tablets.
• Erythromycin lactobionate is available in IV form.
• Give tablets on an empty stomach 1 hr before or 2 hr after a meal for best absorption; give with 8 oz of water.
• If gastrointestinal symptoms occur, give with food.
• Give enteric-coated forms of erythromycin with or without meals.
• For IV form, follow dilution and rate recommendations to prevent thrombophlebitis.

• Available in oral, ophthalmic drops and ointment, and IV forms.
• For IV form, infuse slowly over at least 60 min; follow recommendations for dilution.
• Incompatible with multiple other drugs in IV solution or IV tubing

• Available in oral capsules and tablets, an oral liquid suspension, topical cream and ointment, and IV forms.
• Wear gloves, and instruct patients to wear gloves (or finger cots) when applying topical forms to prevent transferring virus.

IV

• Infuse at recommended rate and dilution.
• Hydrate the patient during and for 2 hr following IV infusion.

• Available in IM and IV forms.
• Administer IM injections into large muscle, and rotate sites.
• For IV, give as a slow bolus or infusion; follow recommendations for dilution and rate.

• Available for IV infusion; treatment may be given daily or on alternate days for up to 8 weeks.
• Infuse IV form at recommended dilution and rate; monitor IV site carefully for thrombophlebitis.
• If prescribed, administer a test dose to determine how the patient tolerates the drug.
• There is a lipid-based form available for IV use with fewer adverse effects, but it is more expensive.
• The patient may "swish and swallow" oral suspension for oral candida (thrush) infections; instruct the patient to swish well in mouth before swallowing.

• Available as capsules, in two fixed-dose combinations of capsules or tablets with isoniazid (INH), and IV form.
• Give with other tuberculosis drugs to prevent resistance.
• Give oral dose 1 hr before or 2 hr after meals.
• Give IV infusion in recommended dilution and rate.

• Give orally on an empty stomach 1 hr before or 2 hr after meals; give with nondairy food if patient is unable to tolerate.
• Do not give right before bedtime.
• Topical form treats acne vulgaris.
• IM and IV tetracycline are given only if oral form cannot be tolerated.
• Shake solution well before measuring.
• Ensure that outdated drug is not administered (causes a type of kidney dysfunction).

• Only available for IM or IV use.
• IM and IV forms are not interchangeable.
• Follow recommendations for rate and dilution when infusing IV doses.

• Available as tablets, capsules, sustained-release capsules, topical cream, vaginal gel, and IV infusion.
• IV powdered form is reconstituted and diluted as recommended for slow IV infusion.
• Sustained-release form must be swallowed whole and not crushed or chewed.
• Regular tablets may be crushed if patient cannot swallow them.
• Give oral dose 1 hr before or 2 hr after a meal for best absorption.

• Available as capsules, tablets, or oral suspension.
• Be careful to differentiate between cephalosporin prescriptions; generic names can be similar.

• Patient should not crush or chew extended-release form.
• Patient should chew chewable forms before swallowing.
• For an infant or young child, place drops directly on tongue or mix with a small amount of juice or formula; ensure that child takes full dose.
• Give at the beginning of meals to decrease gastrointestinal symptoms and increase absorption.
• Give amoxicillin with probenecid, if prescribed, to increase therapeutic activity of amoxicillin.

• Available in oral tablets.
• Give 500 mg tablets once weekly beginning 1 to 2 weeks before travel and continuing four weeks after leaving a region with malaria.
• Give 1 g of the drug orally for acute attacks. Give a smaller dose 6, 24, and 48 hr later.
• Dose for a child is based on weight.
• Give at least 4 hr before or after antacids or laxatives for adequate absorption.
• Give with food to prevent gastrointestinal effects.

• Available in oral capsules (Macrodantin and Macrobid) and liquid suspension (Furadantin).
• Instruct patient to swallow capsules whole.
• Dilute liquid suspension, and instruct patient to rinse mouth after taking.

• Available as a fixed-dose combination in tablets, liquid solution, and IV form.
• Give oral dose with 8 oz of water.
• Administer intermittent IV infusion slowly (over 60 to 90 min) and with recommended dilution.
• Instruct patient to drink at least 2,500 to 3,000 mL water a day during treatment.

• Available as tablets and oral syrup.
• Give tablets in combination with rifampin (Rifadin).
• Give oral drug on an empty stomach (1 hr before a meal).
• Give IM dose in large muscle mass; rotate sites.
• If IM form contains crystals, warm it to room temperature before using.
• Give with one or more other drugs for active tuberculosis (TB) to prevent resistance.
• Give by itself daily for latent TB (six- to nine-month treatment).

• Available in tablets, a topical preparation, and as a shampoo for fungal infections of the scalp.
• Oral form requires acid medium for absorption; give with water, coffee, tea, or juice.
• Give solution of 4 mL of 0.2 N hydrochloric acid to a patient who has achlorhydria (lack of hydrochloric acid in the stomach). Instruct patient to sip through a straw to prevent damage to tooth enamel; follow with 8 oz of water.

• Give orally for colitis.
• Give IV for all other infections.
• Administer slowly through IV, and follow recommendations for dilution.
• Infuse separately if possible (incompatible in solution with many other IV drugs).

Ophthalmic drops

• Gently press the inner canthus for 1 to 2 min after instilling drops to prevent systemic absorption.
• Instruct the patient to keep eyes shut for 1 to 2 min to maximize local absorption.

Topical cream

• Don't apply to large skin areas.
• There is a risk for toxicity with systemic absorption.

IM

Inject deeply into a large muscle.

IV

Give as an intermittent infusion, using recommendations for rate and dilution.

Intrathecal

• Use a preservative-free form
• Discard unused portions.