Drugs
• Blood, Pus and Tissue Fluids do not interfere with the antibacterial action of B-Lactam Antibiotics.
• The penicillin are widely distributed in the body fluids, passing into joints; into pleural and pericardial cavities; into bile, saliva and milk; and across the placenta.
° Being lipid-soluble, they do not cross the blood-brain barrier unless the meninges are inflammed.
• Cross-Infections with Cephalosporins.
• Metabolism : Liver
° Elimination : Renal
• t1⁄2 : 61.3 minutes.
• Pregnancy : A/B
°Exclusively breastfed infant would receive a maximum of about 0.1 mg/kg/day with a maternal dose of 500 mg 3 times a day (about 0.25% to 0.5% of a typical infant dose).
✓✓✓ Amoxicillin :
Food does not interfere with absorption.
Indications(Uses), Dosage & Frequency : 250, 500, 875, 1000 mg : 3-15 days, BID/TID.
-> Oral, I.V., I.M.
-> Children (including neonates) : 25-50 mg/kg/day.
Patients with a glomerular filtration rate of 10 to 30 mL/min should receive 500 mg or 250 mg every 12 hours, depending on the severity of the infection.
Patients with a glomerular filtration rate less than 10 mL/min should receive 500 mg or 250 mg every 24 hours, depending on severity of the infection.
Hemodialysis patients should receive 500 mg or 250 mg every 24 hours, depending on severity of the infection. They should receive an additional dose both during and at the end of dialysis.
• Dental Infection & Dental Abscess.
• Bacterial Endocarditis Prophylaxis.
• Acute Bacterial Sinusitis. (Amoxicillin + Clavulinic Acid)
• Bacterial Meningitis. (Benzylpenicillin : high dose I.V.)
• Bone & Joint infections. (Flucloxacillin)
• Skin & Soft tissue infections. (Benzylpenicillin, Flucloxacillin)
°Animal Bites. (Amoxclave)
• Pharyngitis. (Phenoxylmethypenicillin)
• Otitis Media{Ear Infections}. (Amoxicillin)
• UTI infections. (Amoxicillin)
• ENT infections. (Amoxicillin)
• Lower Respiratory Tract Infections. (Amoxicillin)
• Stomach Ulcers [H. pylori]. (1 gram AMOXIL, 500 mg clarithromycin, and 30 mg lansoprazole, all given twice daily (every 12 hours) for 14 days.)
• Bronchitis. (Amoxicillin)
• Bacterial rhinosinusitis. (Amoxicillin)
• Tonsillitis. (Amoxicillin)
• Pneumonia. (Amoxicillin)
• Gonorrhoea. (Amoxicillin + Probenecid)
• Syphilis. (Procaine Benzylpenicillin)
• Serious Infections casued by Pseudomonas aeruginosa. (Ticarcillin + Piperacillin).
Contraindications :
• Penicillin / Cephalosporin Allergy. (rash, swelling of the throat, face, tongue, eyes and lips).
• Renal Disease.
• Hemodialysis.
• Mononucleosis.
• Clostridioides difficile-associated diarrhea (CDAD) (Colitis).
• Diabetes.
Adverse Effects :
• Hypersensitivity Reactions.
• Diarrhoea.
• Skin Rashes.
• Fever.
• Nausea.
• Vomiting.
• Delayed type of Serum Sickness. {immune response that's similar to an allergic reaction}
• SupraInfection.
• Acute Anaphylactic Shock.
Drug Interactions :
• Birth-Control Pills : ⬇️
• Probenecid [used in treating gout and hyperuricemia.] : 🔼
• Oral Anticoagulants / Warfarin : ⬆️ (Abnormal prolongation of prothrombin time)
• Allopurinol : Increase chance of rash.
✓✓✓ Amoxicillin + Clavulinic Acid :
∆ Nitroimidazole : Disrupts energy metabolism of anaerobes.
Destroys Parasite DNA.
(Tinidazole, Secnidazole, Ornidazole, Satraidazole)
√√√ Metronidazole : Anti-Bacterial + Anti-Protozoal
• Anaerobic Infections (Does not affect aerobic bacteria.)
• Metabolism : Liver (Oxidation & Glucuronide Conjugation)
° Excretion : Urine.
• t1⁄2 : 8 hrs.
• Reaches High concentration in body fluids, including CSF.
• Pregnancy : Not to be Used.
• Lactation :
Indications(Uses), Dosage & Frequency : 200-400 mg TDS (15-30mg/kg/day)
• Orodental Infections.
• Acute Necrotozing Ulcerative Gingivitis.[ANUG] (Drug of Choice : Metronidazole +Amoxicillin/ Erythromycin/ Tetracycline)
• Periodontitis.
• Pericoronitis.
• Acute Apical Infections.
• Endodontic Infections.
• Endocarditis.
• Pseudomembranous (Entero)colitis.
-> Protozoal Infections (Choice of Drug against) :-
• Amoebiasis (Acute Dynestry{intestinal infection that causes severe diarrhea with blood}, Chronic Intestinal Amoebiasis, Liver Abscess).
• intestinal giardiasis.
• Trichomonas Vaginitis.
• Nonspecific Bacterial Vaginitis.
-> 15mg/kg over 1 hour I.V. (and) combined with gentamycin (or) 2nd/3rd generation Cephalosporin.
• Colorectal/ Pelvic Surgery.
• Appendicectomy.
• Brain Abscess.
• Gut and Biliary Tract Surgery : Metronidazole + Cefuroxime/ Gentamycin.
-> Triple Drug Therapy (Metronidazole + Amoxicillin/ Clarithromycin (and) a proton pump inhibitor) : For H. Pylori (Peptic Ulcer/ Nonulcer Dyspepsia)
Contraindications :
• Neurological Disorders.
• Blood Dyscrasias.
• 1st trimester of Pregnancy.
• Chronic Alcoholism.
Adverse Effects :
• Anorexia.
• Nausea.
• Bitter/Metallic Taste.
• Abdominal Cramps.
• Looseness of Stool.
• Inhibit cell-mediated immunity.
• Thromboflebitis - If I.V. is not diluted.
• Headache.
• Glossitis.
• Dryness of Mouth.
• Dizziness.
• Mutagenesis.
•Radiosensitization.
• Peripheral Neuropathy.
• Seizures.
• Leucopenia. (⬇️ WBC)
• Signs in Allergic Reactions :
• Utricaria / Hives. (skin rash)
• Flushing.
• Heat.
• Itching.
• Erruptions.
Drug Interactions :
• Alcohol : Disulfiram-like intolerance/ Reaction. (leading to nausea, vomiting, flushing, dizziness, throbbing headache, chest and abdominal discomfort, and general hangover-like symptoms among others.)
• Enzyme Inducers (Phenobarbitone, Rifampin) : 🔽
• Cimetidine(treatment of heartburn and peptic ulcers) : 🔼
• Warfarin : ⬆️
• Lithium : ⬆️ (Decreases Renal Elimination & Precipitates it's toxicity.)
Indications(Uses), Dosage & Frequency :
Contraindications :
Adverse Effects :
Drug Interactions :