Cephalosporins drug interactions

Monitor for adverse effects (see 13.19 Cephalosporin and Drug-Drug Interactions) and to call the healthcare provider immediately if any are present. 

Brown GR. Cephalosporin-probenecid drug interactions. Clin Pharmacokinet 1993 24 289-300. 

The work outlined above, and the interpretation of the chemical findings, indicates that as far as any resultant determinants are concerned, aminolysis results in structures in which only the R1 side chain, the attached amide, and remnants of the p-lactam ring remain from the original cephalosporin molecule. The resultant penaldate- and any penamaldate-like structures finked to carrier protein therefore represent hapten-carrier complexes that may interact with side chain (Rl)-specific IgE antibodies in allergic responses to therapeutic dosage of cephalosporin drugs. 

Discuss uses, general drug action, adverse reactions, contraindications, precautions, and interactions associated with the cephalosporins. 

Drugs that may interact include cephalosporins, nitroglycerin, penicillins, and salicylates. 

Probenecid has been reported to inhibit renal elimination of many drugs acyclovir (325,326), allopurinol (327), bumetanide (328), cephalosporins (329-334), cidofovir (335), ciprofloxacin (336), famotidine (337), fexofenadine (338), furosemide (339), and oseltamivir (Ro 64-0802) (340). Recent studies have elucidated that probenecid is a potent inhibitor of renal organic anion transporters (OAT1 and OAT3) with the Ki values lower than the unbound plasma concentration of probenecid, indicating the interaction with probenecid includes inhibition of the basolateral uptake process mediated by OAT1 and/or OAT3. 

Incompatibilities of metoclopramide depend on drug concentration, pH, and temperature. It is incompatible with cephalosporins, chloramphenicol, sodium bicarbonate, doxorubicin, cisplatin, and cyclophosphamide. Caution should be exercised with simultaneous administration of metoclopramide with lithium, sym-pathomimetics, antidepressants, bromocriptine, and carbamazepine. Omperazole interacts with tolbutamide, clarithromycin, and phenytoin. Coadministration of rantidine and cisapride increases the plasma concentration of rantidine. Abuse of senna laxative has been reported and may cause hepatitis.176-178... 

Carrier-mediated transport involves interaction of the drug with a specific transporter or carrier, in which drug is transferred across the cell membrane or entire cell and then released from the basal surface of the enterocyte into the circulation. The process is saturable and utilized by small hydrophilic molecules. Drugs that are shown to be transported by this mechanism include p-lactam antibiotics, cephalosporins, and ACE inhibitors. 

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