dicloxacillin (Dynapen, Pathocil)
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Introduction
Tradenames: Dynapen, Pathocil. 2nd generation penicillin.
Indications
- treatment of non-life-threatening bacterial infections
- treatment of penicillinase-producing Staphylococci
- empiric treatment for fever of unknown oritin
Contraindications
- Streptococcus
- less active than other penicillins against Streptococci
Dosage
Tabs: (Capsule) 125, 250, 500 mg.
Elixir: 62.5 mg/5 mL (80, 100, 200 mL).
Pharmacokinetics
- oral bioavailability 50-70%, decreased when taken with food
- elimination 1/2life is 1 hour with normal or moderately impaired renal function
- docloxacillin & its metabolites are eliminated in the urine
- dosage adjustment not necessary with renal insufficiency
- well distributed to most body tissues
- minimal CSF penetration
elimination via kidney
1/2life = 1 hour
Adverse effects
- most common (1-10%)
- uncommon (< 1%)
- fever, rash, nausea/vomiting, eosinophilia, neutropenia, leukopenia, thrombocytopenia, serum sickness-like reaction, elevation in serum transaminases
Drug interactions
- codaministration with warfarin decreases PT & INR[6]
- probenecid increases serum concentrations & prolongs the 1/2life of dicloxacillin
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) of antibiotics with warfarin
Mechanism of action
- inhibition of bacterial cell wall synthesis
- active against penicillinase-resistant organisms
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Deprecated Reference
- ↑ 6.0 6.1 Pottegard A, Henriksen DP, Madsen KG et al Change in International Normalized Ratio Among Patients Treated With Dicloxacillin and Vitamin K Antagonists. JAMA. 2015;314(3):296-297. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26197191 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2397825