By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Pharmacology MentorPharmacology MentorPharmacology Mentor
  • Home
  • Bookmarks
  • Pages
    • Terms and conditions
    • Submit a Topic or Chapter
    • Ask for a topic
    • Copyright Statement
    • Privacy Policy
    • Contact
    • About
  • Quizzes
    • Quiz on Antihyperlipidemics
    • Quiz on Antihypertensives
    • Quiz on Antiarrhythmics
    • Quiz on Drugs for CCF
    • Practice Quizzes on Antidiabetic drugs
    • Practice Quizzes on Drugs used in GI Disorders
    • CVS Post lab Quiz
    • Quiz on Pharmacokinetics and Pharmacodynamics
    • Drugs acting on CNS – All CNS topics EXCEPT NSAIDs
    • Drugs acting on ANS
    • Antimicrobial Chemotherapy: Antiprotozoal and antihelminthic drugs
    • Antimicrobial Chemotherapy – Antimalarial Drugs
    • Antimicrobial Chemotherapy – Antiviral and antifungal drugs
    • OC Pills
    • Antimicrobial Chemotherapy – Antibacterials
  • Blog
  • Chapters
    • General
    • CVS
    • Antimicrobial
    • Neuropharmacology
    • ANS
    • PNS
    • GI
    • Endocrine
    • Hematology
    • miscellaneous
Search
  • Advertise
© 2024 Pharmacology Mentor. All Rights Reserved.
Reading: Pharmacology of Quinupristin-dalfopristin
Share
Sign In
Notification Show More
Font ResizerAa
Pharmacology MentorPharmacology Mentor
Font ResizerAa
Search
  • Home
  • Blog
  • Bookmarks
  • Terms and conditions
  • Submit a Topic or Chapter
  • Ask for a topic
  • Copyright Statement
  • Contact
  • Quizzes
    • Quiz on Antihyperlipidemics
    • Quiz on Antiarrhythmics
    • Quiz on Drugs for CCF
    • Quiz on Antihypertensives
    • Practice Quizzes on Antidiabetic drugs
    • Practice Quizzes on Drugs used in GI Disorders
    • Quiz on Pharmacokinetics and Pharmacodynamics
    • Drugs acting on CNS – All CNS topics EXCEPT NSAIDs
    • NSAIDs
    • CVS Post lab Quiz
    • Drugs acting on ANS
    • Antimicrobial Chemotherapy – Antimalarial Drugs
    • Antimicrobial Chemotherapy: Antiprotozoal and antihelminthic drugs
    • Antimicrobial Chemotherapy – Antiviral and antifungal drugs
    • OC Pills
    • Antimicrobial Chemotherapy – Antibacterials
  • About
Have an existing account? Sign In
Follow US
  • Advertise
© 2024 Pharmacology Mentor. All Rights Reserved.
Pharmacology Mentor > Blog > Pharmacology > Antimicrobial > Pharmacology of Quinupristin-dalfopristin
AntimicrobialPharmacology

Pharmacology of Quinupristin-dalfopristin

Last updated: 2025/01/26 at 3:15 PM
Pharmacology Mentor 1 View
Share
16 Min Read
Quinupristin-dalfopristin
#Quinupristin-dalfopristin
SHARE

Introduction

Quinupristin-dalfopristin is a parenteral antibiotic combination belonging to the streptogramin class. It arose as a potent therapeutic alternative for managing resistant Gram-positive bacterial infections, particularly those involving methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE). This drug combination, composed of two distinct streptogramin derivatives—quinupristin and dalfopristin—exerts synergistic bactericidal activity by targeting the bacterial 50S ribosomal subunit, impeding protein synthesis. Despite its clinical importance, quinupristin-dalfopristin is not typically used as a first-line agent, instead reserved for specific multidrug-resistant cases.

Contents
IntroductionHistorical Perspective and DevelopmentMechanism of ActionOverviewDetailed Binding SitesBacteriostatic vs. Bactericidal PotentialAntimicrobial SpectrumGram-Positive BacteriaGram-Negative Aerobes and AnaerobesAtypical PathogensPharmacokineticsFormulation and Route of AdministrationDistributionMetabolismExcretionHalf-LifeClinical IndicationsVancomycin-Resistant Enterococcus faecium (VREF) InfectionsComplicated Skin and Skin Structure InfectionsBacteremia Due to Multi-Resistant StaphylococciRespiratory Tract Infections (Off-Label)Use in Special PopulationsDosage and AdministrationStandard Adult DoseInfusion ConsiderationsDuration of TherapyAdjustments in Hepatic DysfunctionAdverse EffectsLocal Infusion-Related ReactionsMusculoskeletal Pain and ArthralgiasGastrointestinal DisturbancesHepatotoxicityRash and HypersensitivityHematological EffectsDrug InteractionsCytochrome P450 3A4 InhibitionOther AntibioticsWarfarin and Oral AnticoagulantsResistance MechanismsTarget ModificationEfflux Pumps and Drug InactivationClinical ImplicationClinical Efficacy and Comparative ConsiderationsComparisons with LinezolidComparisons with DaptomycinComparisons with Newer AgentsMonitoring and Patient ManagementLaboratory TestsHandling and PreparationPatient EducationDuration of TherapyFuture PerspectivesNovel Streptogramin DerivativesCombinatorial TherapiesAddressing Resistance in EnterococciPractical Tips for CliniciansConclusionReferences

This comprehensive review delves into the pharmacology of quinupristin-dalfopristin, referencing reputable textbooks such as Goodman & Gilman’s “The Pharmacological Basis of Therapeutics,” Katzung’s “Basic & Clinical Pharmacology,” and Rang & Dale’s “Pharmacology.” We will explore the historical development, mechanism of action, antimicrobial spectrum, pharmacokinetics, clinical indications, adverse effects, and overall therapeutic considerations for optimizing its use in modern medical practice.

Historical Perspective and Development

Streptogramins have a longstanding place in antibiotic development, stemming from natural products derived from certain species of Streptomyces and related actinomycetes. Quinupristin-dalfopristin specifically belongs to the “streptogramin B + streptogramin A” subclass. The synergy between these two distinct molecules—quinupristin (a streptogramin B derivative) and dalfopristin (a streptogramin A derivative)—demonstrates the intricate approach scientists have taken to overcome bacterial resistance.

Quinupristin-dalfopristin (often cited under the brand name Synercid) was approved for clinical use in the late 1990s–early 2000s, driven by the demand to combat vancomycin-resistant organisms and other problematic Gram-positive pathogens. Initially heralded for its bactericidal potential against VRE (particularly Enterococcus faecium strains) and many staphylococci, quinupristin-dalfopristin became part of the limited arsenal against multi-drug-resistant organisms. However, usage soon faced competition from newer agents such as linezolid, daptomycin, and newer generation tetracyclines.

Mechanism of Action

Overview

Streptogramins function by binding to the bacterial 50S ribosomal subunit, interfering with the elongation phase of protein synthesis. Specifically:

  1. Dalfopristin (streptogramin A component) binds first, inducing a conformational alteration in the ribosome that enhances affinity for the second component.
  2. Quinupristin (streptogramin B component) subsequently binds to an adjacent site, locking the complex and inhibiting polypeptide elongation.

This sequential binding provokes a potent, synergistic blockade of bacterial protein synthesis. In many Gram-positive cocci, including certain staphylococci, streptogramin synergy culminates in a bactericidal effect.

Detailed Binding Sites

  • Dalfopristin: Associates with the peptidyl transferase center of the 50S subunit, distorting the rRNA structure, which amplifies quinupristin’s site accessibility.
  • Quinupristin: Affixes near the exit tunnel of the growing polypeptide chain, further preventing elongation.

Bacteriostatic vs. Bactericidal Potential

Quinupristin-dalfopristin exhibits a bactericidal effect against many staphylococci and streptococci. However, its activity may be merely bacteriostatic against some enterococcal species, specifically Enterococcus faecium. Nevertheless, the combination remains essential for certain multi-resistant patterns, particularly where other advanced agents are unsuitable or have failed.

Antimicrobial Spectrum

Gram-Positive Bacteria

Quinupristin-dalfopristin is notably effective against:

  • Staphylococcus aureus, including methicillin-resistant (MRSA) strains.
  • Streptococcus pyogenes (Group A strep) and Streptococcus agalactiae (Group B strep).
  • Penicillin-resistant Streptococcus pneumoniae.
  • Enterococcus faecium (including many vancomycin-resistant strains, VRE).
  • Corynebacterium species and some non-diphtheria corynebacteria.

Of these, Enterococcus faecalis is generally less susceptible, a distinction clinically significant when addressing VRE infections.

Gram-Negative Aerobes and Anaerobes

Quinupristin-dalfopristin typically shows limited coverage of Gram-negative bacteria, aside from certain atypical pathogens. Some synergy may exist against select Gram-negative cocci, but overall, coverage is insufficient for typical Gram-negative infections. Similarly, activity against anaerobes is modest and not the primary rationale for prescribing this agent.

Atypical Pathogens

In certain references, synergy has been described against Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydophila pneumoniae, but the drug is not commonly employed for these atypical respiratory infections due to other more convenient alternatives (macrolides, fluoroquinolones, tetracyclines).

Pharmacokinetics

Formulation and Route of Administration

Quinupristin-dalfopristin is administered intravenously. No oral formulation is available due to poor bioavailability. The recommended infusion is typically in 5% Dextrose solution (D5W), as quinupristin-dalfopristin is incompatible with normal saline.

Distribution

  • Exhibits moderate protein binding.
  • Adequate tissue penetration to treat complicated soft tissue infections and in certain cases of bacteremia. Data on CNS penetration is limited, and it is not typically indicated for meningitis.

Metabolism

Both components undergo hepatic metabolism via the cytochrome P450 system (notably CYP3A4). The drug is extensively metabolized into active and inactive metabolites. This pathway also underlies potential drug interactions.

Excretion

  • Predominantly biliary excretion of metabolites.
  • Excretion in urine is modest.
  • Dose adjustments in renal impairment are not typically mandated, but hepatic dysfunction may require caution and potentially adjusted dosing intervals.

Half-Life

  • Quinupristin: ~0.8 hours
  • Dalfopristin: ~0.5 hour
    However, both form active metabolites with extended half-lives, contributing to overall pharmacodynamic effects. Repeated or continuous administration is necessary to maintain inhibitory concentrations.

Clinical Indications

Vancomycin-Resistant Enterococcus faecium (VREF) Infections

One of the hallmark uses for quinupristin-dalfopristin is in treating VRE faecium infections (e.g., complicated or bacteremic scenarios). Although bactericidal activity may be incomplete, synergy across combination therapy can sometimes yield clinical success in salvage cases. However, usage competes with linezolid, daptomycin, and tigecycline, which often have broader profiles or more favorable side-effect profiles.

Complicated Skin and Skin Structure Infections

The combination may be employed in complicated skin and soft tissue infections caused by S. aureus (including MRSA) or Streptococcus pyogenes. This is especially relevant when patients cannot tolerate or fail to respond to other MRSA-oriented therapies (e.g., vancomycin, linezolid).

Bacteremia Due to Multi-Resistant Staphylococci

Though less common in the modern era with the availability of newer agents, quinupristin-dalfopristin can be prescribed off-label for persistent MRSA or staphylococcal bloodstream infections unresponsive to standard therapies. In such contexts, synergy ensures reliable anti-staphylococcal coverage, albeit with close monitoring for side effects.

Respiratory Tract Infections (Off-Label)

For severe pneumonia caused by resistant Gram-positive organisms (e.g., MRSA, penicillin-resistant S. pneumoniae), quinupristin-dalfopristin might be considered if alternative options are inadequate or contraindicated. Nevertheless, linezolid or newer respiratory fluoroquinolones often overshadow it due to convenience and broader coverage.

Use in Special Populations

The medication’s use in pediatrics or obstetrics is not well-established, and caution is advised. There is minimal data regarding neonates, pregnant women, or immunocompromised patients with complicated infections. Where possible, specialists weigh risk-benefit scenarios for each patient.

Dosage and Administration

Standard Adult Dose

A typical regimen is 7.5 mg/kg intravenous every 8–12 hours, depending on infection severity. Infusion is administered over 1 hour. Some protocols vary dosing intervals based on clinical response and local guidelines.

Infusion Considerations

  • Must be mixed only with 5% Dextrose to avoid precipitation or inactivation.
  • Central venous catheters are often preferred to reduce the risk of phlebitis. If peripheral lines are used, diligent monitoring is essential due to venous irritation.

Duration of Therapy

Therapy duration hinges on infection site and severity, ranging from a few days for uncomplicated skin infections to multiple weeks for endovascular or deep-seated infections. Early transition to an oral alternative is not applicable here, since no oral formulation exists.

Adjustments in Hepatic Dysfunction

Due to hepatic metabolism, patients with significantly impaired liver function may require dosage modifications or extended dosing intervals. Monitoring of liver enzymes is essential to detect drug-induced hepatic stress.

Adverse Effects

Local Infusion-Related Reactions

Quinupristin-dalfopristin is notorious for venous irritation, phlebitis, and injection-site pain. This side effect profile frequently necessitates central line administration.

Musculoskeletal Pain and Arthralgias

A significant portion of patients may experience myalgias and arthralgias. These can be dose-limiting or prompt therapy discontinuation. The mechanism revolves around potential cytokine release or direct muscle fiber irritation, although not fully elucidated.

Gastrointestinal Disturbances

Nausea, vomiting, diarrhea, or loose stools are reported. Typically mild but can disrupt patient adherence.

Hepatotoxicity

Elevations in serum transaminases (ALT, AST) and bilirubin occur in some individuals. Rarely, severe cholestatic hepatitis or jaundice can develop, mandating vigilant monitoring in patients with baseline liver disease.

Rash and Hypersensitivity

While quinupristin-dalfopristin is not as strongly associated with severe allergic phenomena as other classes, mild rashes or pruritus may occur. Rare anaphylactic reactions have been documented.

Hematological Effects

Eosinophilia, mild leukopenia, or thrombocytopenia can manifest. Periodic complete blood counts (CBC) are recommended, particularly in prolonged courses or combination therapy with other myelosuppressive agents.

Drug Interactions

Cytochrome P450 3A4 Inhibition

A major concern is quinupristin-dalfopristin acting as an inhibitor of CYP3A4, increasing levels of co-administered drugs metabolized by this enzyme. Potential interactions include:

  • Immunosuppressants (e.g., cyclosporine, tacrolimus).
  • Statins (particularly simvastatin, atorvastatin), which can raise the risk of myopathy or rhabdomyolysis.
  • Benzodiazepines and certain antiarrhythmics.

Other Antibiotics

If combined with other antimicrobial agents, synergy or antagonism could result, though clinically relevant combinations are seldom used. Concomitant usage with other CYP-inhibiting drugs can amplify side effects.

Warfarin and Oral Anticoagulants

Patients on vitamin K antagonists (e.g., warfarin) or direct oral anticoagulants must be closely monitored. Elevated anticoagulant levels can precipitate bleeding complications when combined with quinupristin-dalfopristin.

Resistance Mechanisms

Target Modification

Bacteria may develop modifications in the 50S ribosomal subunit genes, preventing effective streptogramin binding. Methylation of 23S rRNA (erm genes) can confer cross-resistance to macrolides, lincosamides, and streptogramin B (the so-called MLS_B phenotype).

Efflux Pumps and Drug Inactivation

Certain staphylococcal or enterococcal efflux pumps can extrude the drug. In addition, enzymatic modification of streptogramins by bacterial inactivating enzymes can hamper efficacy.

Clinical Implication

Rising incidence of quinupristin-dalfopristin resistance among Enterococcus faecium strains underscores the need to preserve this drug for carefully selected scenarios. Laboratory susceptibility testing is essential prior to initiating therapy for serious infections.

Clinical Efficacy and Comparative Considerations

Comparisons with Linezolid

Both quinupristin-dalfopristin and linezolid address VRE (particularly E. faecium). However, linezolid’s oral availability and safety profile often favor its selection. Quinupristin-dalfopristin remains relevant when linezolid intolerance or resistance emerges, or in salvaging certain complicated infections.

Comparisons with Daptomycin

Daptomycin is another mainstay for complicated Gram-positive infections, such as MRSA bacteremia or VRE. It offers convenient once-daily dosing but cannot be used for pneumonia (inactivated by surfactant). Quinupristin-dalfopristin might be chosen in pneumonia or if daptomycin resistance is encountered.

Comparisons with Newer Agents

Oxazolidinones (tedizolid), lipoglycopeptides (telavancin, dalbavancin), and long-acting agents (oritavancin) have overshadowed the older streptogramin combination in many settings, especially for outpatient transitions or simpler dosing regimens. Yet, quinupristin-dalfopristin fosters synergy in complex hospital-based infections where standard therapies have failed.

Monitoring and Patient Management

Laboratory Tests

  • Liver function tests (LFTs): Baseline and periodic checks are advised given the hepatic metabolism and potential hepatotoxicity.
  • CBC counts: Evaluate for hematologic abnormalities if therapy is prolonged.
  • C-reactive protein (CRP)/Procalcitonin: Monitor infection resolution or sepsis.

Handling and Preparation

  • Reconstitution with Dextrose 5% only, using correct volumes to ensure complete dissolution.
  • Administer via a central line if possible to avoid phlebitis. If using a peripheral line, rotate sites frequently and monitor for infiltration or extravasation.

Patient Education

Remind patients about potential side effects (joint pain, infusion discomfort) and the necessity of completing the prescribed course. In cases of outpatient infusion therapy, thorough instructions on dwelling catheters or infusion devices should be provided.

Duration of Therapy

As with other antimicrobials, therapy extends until the infection is controlled—commonly guided by clinical improvement, imaging, or microbiological clearance. Infectious disease specialists should tailor durations, especially for complicated endovascular infections (e.g., endocarditis) or osteomyelitis.

Future Perspectives

Novel Streptogramin Derivatives

Research continues into next-generation streptogramins with improved water solubility, oral bioavailability, or decreased venous toxicity. Although overshadowed by novel classes, the principle of synergy between type A and type B streptogramins spurs investigative trials aiming for better therapeutic indices and broader usage.

Combinatorial Therapies

Combining quinupristin-dalfopristin with other advanced agents (e.g., a beta-lactam or rifampin) could theoretically enhance killing capacity or offset emergent resistance. Clinical data remain limited, but synergy has been observed in select in vitro models.

Addressing Resistance in Enterococci

As multi-resistant enterococcal strains proliferate, quinupristin-dalfopristin might reemerge in tandem with newer antibiotics, forming an integrated approach for salvage therapy. Monitoring local epidemiology and in vitro synergy is crucial for guiding such multi-drug regimens.

Practical Tips for Clinicians

  1. Reserve Quinupristin-Dalfopristin for multi-resistant Gram-positive infections or confirmed VREF scenarios—particularly E. faecium—when more commonly used agents fail or are contraindicated.
  2. Central Line Administration: Minimizes infusion-site reactions. If peripheral lines must be used, carefully watch for pain, swelling, or line complications.
  3. Monitor LFTs and watch for hepatic dysfunction, especially if the patient experiences right upper quadrant pain, persistent nausea, or new-onset jaundice.
  4. Assess for Drug Interactions with CYP3A4 substrates. Caution with immunosuppressants, statins, or other narrow-therapeutic index drugs metabolized by this pathway.
  5. Be Vigilant for Arthralgias: Myalgias or arthralgias are a frequent cause of discontinuation. Provide supportive therapy, dose adjustments, or consider an alternative agent if severe.
  6. Encourage Collaboration: Involve infectious disease specialists for complex, resistant organisms or when prolonged therapy is envisioned.

Conclusion

Quinupristin-dalfopristin represents a unique streptogramin combination that harnesses the synergistic bacteriostatic (and often bactericidal) actions of two distinct components targeting bacterial ribosomes. Particularly valued in the fight against Vancomycin-Resistant Enterococcus faecium (VREF) and resistant staphylococci, its usage has been overshadowed by newer antibiotic agents like linezolid, daptomycin, and advanced oxazolidinones. Nonetheless, quinupristin-dalfopristin remains a vital second- or third-line agent in the physician’s arsenal for “hard-to-treat” or salvage cases involving Gram-positive pathogens.

Clinicians must carefully weigh the benefits of broad Gram-positive coverage—including MRSA and some VRE—against the notable side effects (infusion pain, arthralgias, potential for hepatic injury) and the risk of drug interactions via CYP3A4 inhibition. Judicious use, guided by robust antimicrobial stewardship principles, can ensure that quinupristin-dalfopristin continues to serve as a pivotal option in the management of dangerous, drug-resistant infections.

References

  1. Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 13th Edition.
  2. Katzung BG, Basic & Clinical Pharmacology, 15th Edition.
  3. Rang HP, Dale MM, Rang & Dale’s Pharmacology, 8th Edition.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always seek the advice of a healthcare provider with any questions regarding a medical condition.

You Might Also Like

Pharmacology of Antiviral Drugs

Pharmacotherapy of Type 1 Diabetes Mellitus

Broad spectrum antibiotics – Tetracyclines and Chloramphenicol

Pharmacotherapy of erectile dysfunction

Pharmacotherapy of migraine

TAGGED: Pharmacology, Quinupristin-dalfopristin

Sign Up For Daily Newsletter

Be keep up! Get the latest breaking news delivered straight to your inbox.

By signing up, you agree to our Terms of Use and acknowledge the data practices in our Privacy Policy. You may unsubscribe at any time.
Share This Article
Facebook Twitter Copy Link Print
Previous Article Metronidazole Metronidazole: an antibiotic and antiprotozoal medication
Next Article Testosterone Pharmacology of Testosterone
Leave a review Leave a review

Leave a review Cancel reply

Your email address will not be published. Required fields are marked *

Please select a rating!

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Most Popular Posts

  1. Drug Nomenclature: Drug Naming system (Dr. Ambadasu Bharatha) (550)
  2. Routes of Drug Administration: A detailed overview (Pharmacology Mentor) (447)
  3. Routes of Drug Administration (Pharmacology Mentor) (426)
  4. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) – A Comprehensive Guide (Pharmacology Mentor) (394)
  5. First-Order vs. Zero-Order Kinetics: What You Need to Know (Pharmacology Mentor) (330)
  6. Pharmacology Definitions and Terminology (Pharmacology Mentor) (291)
  7. Enzyme inducers: How they are important in the clinical pharmacology? (Pharmacology Mentor) (282)
  8. Drug Potency and Efficacy (Pharmacology Mentor) (261)
  9. Unlock the Power of Mnemonics in Pharmacology (anonymous) (240)
  10. Factors Affecting Oral Drug Absorption and its Bioavailability (Pharmacology Mentor) (231)

Categories

  • ANS26
  • Antimicrobial35
  • Clinical Pharmacology4
  • CVS31
  • Endocrine21
  • Featured15
  • General47
  • GI15
  • Hematology13
  • miscellaneous28
  • Neuropharmacology38
  • Pharmacology261
  • PNS2
  • Reproductive System10
  • Respiratory System7

Tags

Adverse effects Antibiotics Antiplatelet Drugs Aspirin Benzodiazepines beta-blockers Bioavailability Bipolar disorder calcium channel blockers Carbamazepine Clinical trials contraindications Coronary artery disease Dosage DRC drug absorption Drug Administration Drug classification drug design Drug development Drug discovery Drug Dosage Drug efficacy Drug formulation Drug interactions Drug metabolism Drug regulation Drugs Drug safety Generic drugs Headache Hypertension mechanism of action Medication Myocardial infarction Neurotransmitters Norepinephrine Pharmacodynamics Pharmacokinetics Pharmacological actions Pharmacology Pharmacovigilance Side effects Therapeutic uses Treatment

Latest Articles

antiretroviral drugs
Pharmacology of Antiviral Drugs
Antimicrobial Pharmacology May 1, 2025
Featured image on Diabetes
Pharmacotherapy of Type 1 Diabetes Mellitus
Endocrine Pharmacology April 24, 2025
broad-spectrum antibiotics - tetracyclines
Broad spectrum antibiotics – Tetracyclines and Chloramphenicol
Antimicrobial Pharmacology March 28, 2025
Pharmacotherapy of erectile dysfunction
Pharmacotherapy of erectile dysfunction
miscellaneous Pharmacology January 28, 2025

Stay Connected

Facebook Like
//

Pharmacology Mentor is dedicated to serving as a useful resource for as many different types of users as possible, including students, researchers, healthcare professionals, and anyone interested in understanding pharmacology.

Quick Link

  • Terms and conditions
  • Copyright Statement
  • Privacy Policy
  • Ask for a topic
  • Submit a Topic or Chapter
  • Contact

Top Categories

  • Pharmacology
  • Antimicrobial
  • Neuropharmacology
  • Endocrine
  • Reproductive System
  • miscellaneous

Sign Up for Our Newsletter

Subscribe to our newsletter to get our newest articles instantly!

Pharmacology MentorPharmacology Mentor
Follow US
© 2024 Pharmacology Mentor. All Rights Reserved.
Pharmacology Mentor
Welcome Back!

Sign in to your account

Register Lost your password?