Antibiotics types and how it works

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1. Presentation out line Antibiotic definition PHC Antibiotics Drugs scientific and Trade names Drugs dosage form Drugs uses Drugs side effects Drugs interactions

2. Antibiotic Antibiotics : are a group of medicines that are used to treat infections caused by (bacteria and parasites ). They do not work against infections that are caused by viruses - for example, the common cold or flu.

3. PHC Antibiotic Amoxicillin Amoxicillin + clavulanic acid Azithromycin Benzathine pen.1.2 i.u vial Cefuroxim Cephalexin Ciprofloxacin Doxycline Erythromycin 10. Fusidic acid 11. Gentamicin 12. Metronidazole 13. Tetracycline e\o 14. Trimethoprime + sulphameth. 15. Penicillin V.K ( derivative Potassium) 16. Rifampicine 17.( Ethambutol + Pyrazinamide + Isoniazid + refampicine ) TB

4. 1. Amoxicillin Trade name ( Amoxitide , Moxypen , Amoxicare ) Dosage Forms oral susp . 250mg/5mL 400mg/5mL capsule 250mg 500mg 875 mg Uses Ear, Nose, & Throat Infections Genitourinary Tract Infections 875 mg PO q12hr or (250-500mg) PO q8hr for 10-14 days before meal

5. Cont. …. S ide E ffect Anaphylaxis الحساسية المفرطة ( severe allergy ) Anemia , AST/ALT elevation , Diarrhea, Headache Nausea, Vomiting, Rash I nteraction   Doxycycline * doxycycline decreases effects of amoxicillin Mycophenolate *amoxicillin will decrease the level or effect of mycophenolate Tetracycline *tetracycline decreases effects of amoxicillin

6. 2. Amoxicillin/ calvulanic acid Trade name : Augmentine , Ogmin , clamoxin ) Dosage Forms oral suspension ( 400mg/57mg)/5mL tablet 500mg/125mg 875mg/125mg Uses Lower Respiratory Tract Infection Chronic Obstructive Pulmonary Disease Acute Bacterial Sinusitis , Skin Abscess , Diabetic Foot Dosages based on amoxicillin 875/125 mg PO q12hr or 500/125 mg PO q8hr for 7-10 days before meal

7. Cont . … Side Effects Nausea Vomiting Diarhea rash I nteraction BCG vaccine live amoxicillin decreases effects of bcg vaccine live by pharmacodynamic antagonism. Doxycycline ( doxycycline decreases effects of amoxicillin by pharmacodynamic antagonism Tetracycline ( tetracycline decreases effects of amoxicillin by pharmacodynamic antagonism. Mycophenolate ( amoxicillin will decrease the level or effect of mycophenolate .

8. 3. Azithromycin Trade name : ( Azicare , Azemex , Zitrocin ) Dosage Forms 200mg/5mL Cap 250mg 500mg Uses Acute Bacterial Exacerbations of Chronic Obstructive Pulmonary Disease Acute Otitis Media / Pharyngitis/Tonsillitis Genital Ulcer Disease / Acute Bacterial Sinusitis 500 mg PO qDay for 3 days 500 mg PO once, then 250 mg once daily for 4 days Before meal

9. Cont . … Side effect High single dose therapy Diarrhea Nausea Abdominal pain Interaction Digoxin ( azithromycin will increase the level or effect of digoxin

10. CONT. .. Amiodarone and azithromycin both increase QTc interval (The QT interval is the time from the start of the Q wave to the end of the T wave.) Enoxaparin ( azithromycin increases effects of enoxaparin by decreasing metabolism. Ondansetron ( azithromycin and ondansetron both increase QTc interval Warfarine ( azithromycin increases effects of warfarin by decreasing metabolism.

11. 4. Erythromycin Trade name ( Erythrotab , Erythroteva , Erythrolet ) Dosage Forms 200mg/5ml tablet 250mg 500mg Azythromycin and Erthromycin alternative of penicillin if there any Anaphylaxis (sever allergy) . Uses Streptococcal Pharyngitis, Tonsillitis 20 mg/kg/day PO divided q12hr 250-500 mg PO q6hr for 7 days before meal

12. Cont. .. Side effect Abdominal pain Anaphylaxis Confusion Diarrhea Dyspepsia Fever interaction Many drugs

13. 5. Cefuroxime Trade name ( Zinnat , Zinex , Zinaxim ) Dosage Forms tablet 250mg 500mg Uses Pharyngitis/Tonsillitis / Sinusitis Chronic Bronchitis Uncomplicated Urinary Tract Infections Uncomplicated Skin Infections 250-500 mg PO q12hr for 5-10 days after meal

14. Cont. .. Side effect Diarrhea Decreased hemoglobin or hematocrit Nausea or vomiting Vaginitis Diaper rash Increase in alkaline phosphatase Interaction Warfarin : (cefuroxime will increase the level or effect of warfarin Enoxaparin : (cefuroxime will increase the level or effect of enoxaparin BCG vaccine : ( cefuroxime decreases effects of bcg vaccine

15. Trade name .( Jeflex , Cephacare , Cefalex ) Dosage Forms oral suspension 250mg/5mL capsule 250mg 500mg Uses Genitourinary Tract Infections Bone Infections / Otitis Media Skin Infections / Respiratory Tract Infections 250 - 500mg PO q6hr before meal 6. Cephalexin

16. Cont . … Side Effect Abdominal pain / Anemia Angioedema / Confusion Diarrhea / Dizziness Dyspepsia سوء الهضم Fatigue Interaction BCG vaccine live Cephalexin decreases effects of bcg vaccine live. typhoid vaccine live Cephalexin decreases effects of typhoid vaccine live cholera vaccine Cephalexin , cholera vaccine. pharmacodynamic antagonism

17. 7. Ciprofloxacin Trade name ( Floxine , ciprocare , ciprox ) Dosage Forms tablet 250mg 500mg uses Acute Sinusitis / Skin Infections Bone & Joint Infections / Urinary Tract Infections Lower Respiratory Tract Infections 250 500 mg PO q12hr for 7-14 days after meal

18. Cont. .. Side Effect Abdominal pain Diarrhea Increased aminotransferase levels Vomiting Headache Increased serum creatinine Rash Restlessness

19. CONT. … Interaction (Clozapine , Clomipramine, Imipramine, theophylline , warfarin) Ciprofloxacin will increase the level or effect of clozapine , Clomipramine , Imipramine , theophylline, warfarin by affecting hepatic enzyme CYP1A2 metabolism. Iron sucrose / iron sucrose decreases levels of ciprofloxacin by inhibition of GI absorption. Ondansetron / ciprofloxacin and ondansetron both increase QTc interval

20. Trade name ( Doxal , Doxypharm , Doxicillin ) Dosage Forms capsule 100mg Uses Acute Bacteria Rhino sinusitis Respiratory Tract Infections Brucellosis 200 mg/day divided twice daily PO after meal Don’t take it with milk 8. Doxycycline

21. Cont. .. Side effect Anorexia فقدان الشهية Dental discoloration Diarrhea / Dysphagia Headache Hemolytic anemia / Hepatotoxicity Interaction Amoxicillin ¸ ampicillin Doxycycline decreases effects of amoxicillin , ampicillin by pharmacodynamic antagonism. Calcium acetate, doxycycline . Either decreases levels of the other by inhibition of GI absorption. Iron sucrose decreases levels of doxycycline by inhibition of GI absorption .

22. 9. Rifampicin Trade name ( rifampicin , rifadin ) Dosage Forms capsule 150mg 300mg Uses Tuberculosis Brucellosis 10 mg/kg/day PO or 10 mg/kg PO twice weekly ; not to exceed 600 mg/day Before meal

23. Cont. … Side effect Elevated liver function test (LFT) results Rash / Anorexia Nausea / Vomiting Diarrhea / Cramps تشنجات In teraction Rifampicin will decrease the level or effect of alprazolam , Amiodarone , Clopidogrel , Clozapine , Colchicine , Cyclosporine , Diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

24. Trade name ( Resprim , Sulprim , Sulfaprim ) Dosage Forms Oral suspension 200mg/5mL tablet 80mg/400mg 160mg/800mg Uses Chronic Bronchitis Meningitis, Bacterial Urinary Tract Infections Dosing Guidelines for Infections 1-2 DS tablets PO q12 after meal 10. Trimethoprim/ sulfamethoxazole

25. Cont . .. Side effect Anorexia / Nausea Vomiting /Vertigo Seizure / Hyperkalemia Rash Interaction Amiodarone and trimethoprim both increase QTc interval. bCG vaccine live Trimethoprim decreases effects of bcg vaccine live by pharmacodynamic antagonism. Sulfamethoxazole decreases effects of cyclosporine by unknown mechanism

26. Cont. … Sulfamethoxazole increases effects of enoxaparin by decreasing metabolism Leucovorin decreases effects of trimethoprim by pharmacodynamic antagonism. Trimethoprim, methotrexate. Either increases toxicity of the other by pharmacodynamic synergism.  

27. 11. Pyrazinamide It is an antibiotic and works by stopping the growth of bacteria Dosage Forms Tablet 500mg Dosage :- is based on your age, weight, medical condition, and response to treatment. Daily therapy :- 15-30 mg/kg PO qDay with isoniazid & rifampin . USES : Pyrazinamide is used with other medications to treat tuberculosis (TB ) for HIV Exposed/Infected . Side E ffects : Nausea , vomiting, loss of appetite .

28. Dosage Forms Tablet 100mg , 400mg 15 mg/kg PO qDay .Take this medication by mouth with or without food, usually once daily or as directed by your doctor. This medication may sometimes be taken twice weekly. USES :- Ethambutol is used with other medications to treat tuberculosis (TB) Side Effects: Headache, loss of appetite, upset stomach, or nausea/vomiting may occur 12 . Ethambutol

29. Dosage Forms Tablets 300mg Take this medication by mouth on an empty stomach (1 hour before or 2 hours after meals. >30 kg: 300 mg PO qDay x9 months USES: Isoniazid is used with other medications to treat active tuberculosis (TB) infections. S ide E ffects : Nausea/vomiting or stomach upset may occur. 13. Isoniazid

30. Gentamicin sk. cream/ointment Trade names: Garamin ( بيت جالا ( , gentatrim ( tr i ma), genticin ( (القدس Contra indications :- Hypersensitivity , Skin rash Side Effects : Itching, redness, swelling . 2 . Gentamicin eye / ear drop ( Gentacol (بيزيت , lacromycin ( Dr.fisher ) USES: to treat bacterial infections of the eye and the skin around the eyes . It is also used to prevent infection after eye injury or surgery. Side Effects : Eye stinging/burning/redness or temporary blurred vision may occur. 14. Gentamicin

31. 3. Gentamicin Inj .( (القدس , Zetamycine ( (بيرزيت Dosage Forms & Strengths injectable solution 80mg/mL Susceptible Infections : التعرض السريع للعدوى 3-5g/kg/day IV/IM divided q8hr Side Effects Nausea, vomiting stomach upset, or loss of appetite may occur.  Cont . ..

32. Trade Names: Flagyl (sanofi) , Entogyl (القدس) , Metrozole (بيرزيت) Dosage Forms Oral susp 125 mg Tablet :250mg , 500mg Dosage : 7.5 mg/kg q6hr 7-10 days (or 2-3 weeks if severe). Uses:- Metronidazole is used to treat bacterial infections of the vagina, stomach, skin, joints, and respiratory tract. 15. Metronidazole

33. Cont. .. Side Effects: numbness in your hands or feet; white patches or sores inside your mouth or on your lips; pain or burning when you urinate. Interactions May increase the risk of kidney  damage or hearing loss if taken with  gentamicin .

34. Trade Names : fucidine (LEO), fucilyne ( القدس ), Zydex ( بيت جالا ) Dosage:- Fusidic Acid you should use.Usually a small amount of cream is applied to the infected skin three or four times each day . Treatment is usually 1 to 2 weeks. Uses :- Treat of skin infections caused by bacteria that are sensitive to fusidic acid ( especially staphylococcus infections ) impetigo : قوباء , folliculitis: الجرب Side Effects :- - M ay be having an allergic reaction. - Your skin develops a severe rash. 16. Fucidic Acid cream:-

35. Trade Names : Oxacin (بيريت) , Jordacycline (بيت جالا) Dosage :- Eye ointment may be placed in the infected eye 2-4 times daily. Mild bacterial infections usually respond within 48 hours. For the treatment of trachoma , applied to each eye twice daily for 2 months or twice daily for the first 5 days of each month for 6 months. 17. Tetracycline E\O

36. Cont. … Uses : It works by interfering with the bacteria's cell wall and the production of the bacteria's proteins, which kills the bacteria. Side Effects: Increased tears , burning sensation and a foreign body sensation may occur .   Interaction :- It can decrease the effectiveness of Refampicin .

37. Trade Names :- Bepen V.K( (بيرزيت , Rafapen ( rafa ) Dosage Forms :- oral solution 250mg/5mL , Tablet 500mg 500 mg PO q12hr or 250 mg PO q6hr for 10 days Uses :-  is an antibiotic used to treat and prevent a wide variety of bacterial infection . Side Effects Upset stomach , nausea, vomiting, diarrhea, and mouth sores may occur. Interactions :- Decreases of B CG vaccine live by pharmacodynamic antagonism . 18. Penicillin V.K

38. 19. Benzathine penicillin inj.1,2 Trade name : Benzetacil ( Spain) Dosing Form , Usees : injectable suspension 1.2 million units/2mL Streptococcal Respiratory Infections : 1.2 million units IM x1 Rheumatic Fever Prophylaxis : 1.2 million units IM monthly following acute attack, OR 600,000 units IM q2Weeks. Side Effects Pain at the injection site, nausea, or vomiting may occur

39. Presented By Doaa`Tarifi & Sami Dawabsha