Probenecid Piperacillin

Cefotetin, ceftriaxone, ceftizoxime, tobnetm, etodolac, chlorpropamide, carboplatin, cisplatin, ibuprofen, oxaliplatin, piperacillin, probenecid, quinine, quinidine... 

Piperacillin-Tazobactam (Zesyn) [Anribioric/Extended Spectrum Penicillin, Beta Lactamase Inhibitor] Uses Infxns of skin, bone, resp urinary tract, abd, sepsis Action PCN plus 3-lactamase inhibitor bactericidal i cell wall synth Dose Adults. 3.375-4.5 g IV q6h i in renal insuff Caution [B, M] Contra PCN or 3-lactam sensitivity Disp Powder for inj frozen, premix inj 3.25, 3.375, 4.5 g SE D, HA, insomnia, GI upset, serum sickness-like Rxn, pseudomembranous colitis Interactions T Effects W/ probenecid T effects OF anticoagulants, MTX i effects W/ macrolides, tetracyclines i effects OF OCPs EMS T Effects of anticoagulants monitor for signs of electrolyte disturbances and hypovolemia d/t D such as X- K+ may cause allergic Rxn in pts sensitive to PCN OD May cause N/V/D, resp difficulty, and Szs symptomatic and supportive... 

Clinically important, potentially hazardous interactions with acitretin, aldesleukin, aminoglycosides, amiodarone, amoxicillin, ampicillin, aspirin, bacampicillin, bismuth, carbenicillin, chloroquine, cisplatin, cloxacillin, co-trimoxazole, dapsone, demeclocycline, dexamethasone, diclofenac, dicloxacillin, etodolac, etoricoxib, etretinate, fenoprofen, flurbiprofen, folic acid antagonists, haloperidol, hydrocortisone, ibuprofen, indomethacin, influenza vaccines, ketoprofen, ketorolac, lithium, magnesium trisalicylate, meclofenamate, mefenamic acid, methicillin, mezlocillin, minocycline, nabumetone, nafcillin, naproxen, NSAIDs, omeprazole, oxacillin, oxaprozin, oxytetracycline, paromomycin, penicillin G, penicillin V, penicillins, phenylbutazone, piperacillin, piroxicam, polypeptide antibiotics, prednisolone, prednisone, probenecid, procarbazine, rofecoxib, salicylates, salsalate, sapropterin, sulfadiazine, sulfamethoxazole, sulfapyridine, sulfasalazine, sulfisoxazole, sulindac, tazobactum, tenoxicam, tetracycline, ticarcillin, tolmetin, trimethoprim, vaccines... 

In 10 healthy subjects probenecid 1 g given 1 hour before a single infusion of piperacillin 3 g/tazobactam 375 mg caused a decrease of about 25% in the clearance of both components. The half-life of tazobactam was increased by 72%. A study in 8 healthy subjects found that oral probenecid 1 g, given one hour before an intramuscular injection of piperacillin 1 g, increased both the peak plasma level and terminal half-life of piperacillin by 30% and the AUC by 60%. The apparent volume of distribution of piperacillin was reduced by 20% and renal clearance was reduced by 40%. ... 

Comparing the area under the curve for intramuscular administration and intravenous administration indicated that the bioavailability of the intramuscularly administered piperacillin was 70-80%. Urinary recovery after 24 hr was 60%. Oral administration of probenecid (1 g) 1 hr prior to the intramuscular injection of 1 g of piperacillin resulted in enhanced mean peak serum concentrations, an increased area under the curve, and a lengthened half-life. The volume of distribution, as well as the clearance rate, was also decreased. This is further evidence that a significant component of the urinary excretion is due to tubular secretion. Animal pharmacology has indicated varying degrees of elimination of piperacillin in the bile. 

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