macrolides_classification and_morphine.pptx

Macrolides classification and also morphine indications and use

1. MACROLIDES AND MORPHINE Complete drug profile

2. Group members Bisma A nsar 12 Rutaba A shfaq 78 Ayesha Khalil 33 Arooba Safdar 47 Nawal Shakoor 75

3. : They are a class of drugs used to manage and treat various bacterial infections. Azithro , E rythro and C larithro are commomnly used to treat infections like pneumonia , sinusitis , pharyngitis and tonsilitis . CLASSIFICATION : Erythromycin Clarithromycin Azithromycin Roxithromycin Spiramycin Telithromycin (a semi-synthetic derivative of erythromycin , is a ketolide ) Macrolides

4. AZITHROMYCIN : Indications / Uses : Used to treat certain bacterial infections, including bronchitis , pneumonia , STD , and infections of ear ,nose, throat ,lungs , sinusitis ,skin throat and reproductive organs . Doses : Usual Adult Dose for Sinusitis 500 mg orally once a day for 3 days Usual Adult Dose for Pneumonia IV : 500 mg IV once a day for at least 2 days Oral: After IV therapy, 500 mg orally once a day to complete a 7- to 10-day course . Usual Adult Dose for Tonsillitis/Pharyngitis 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day for 2 to 5 days .

5. Azithro (cont.) Side effects : Feeling sick (nausea ) Stick to simple meals and do not eat rich or spicy food . Diarrhoea Loosing your A petite Headache Feeling dizzy or tired Changes to your sense of taste .

6. INTERACTIONS & CONTRAINDICATIONS INTERACTIONs Drugs that may interact with azithromycin include: digoxin, a heart medication. colchicine, a gout medication. phenytoin, a seizure medication. antacids that contain magnesium or aluminum . CONTRAINDICATIONS:  In patients with heart disease, azithromycin can speed up the heart so that it beats very fast, up to 200 times per minute. I n patients with a history of severe hypersensitivity (e.g., anaphylaxis or SJS) Diarrhoea from an infection with Clostridium difficile bacteria.

7. BRANDS

8. ERYTHROMYCIN It was first discovered in 1952 . It contains two deoxy sugars attached with macrocyclic lactone ring . Chemical formula : C 37 H 67 NO 13 Mechanism of action :

9. INDICATIONS AND SIDE EFFECTS : Interactions / Uses : Usually preferred as alternative to the patients having penicillin hypersensitivity Pharyngitis / tonsilitis Diphtheria Pneumonia Acne Syphillis Chlamydia Whooping cough Side effects : Nausea ,vomiting ,diarrhoea ,abdominal cramps . Toxicity resulting in hearing loss . GIT disturbances Rashes

10. DOSE OF ERYTHROMYCIN

11. INTERACTIONS & CONTRAINDICATIONS INTERACTIONS : Statins Cyclosporins Digoxin (QT prolongation) Benzodiazepines CONTRAINDICATIONS : Contraindicated in Hypersensitivity Used with cautions in case of liver and kidney diseases . Muscle weakening condition called myasthenia gravis .

12. BRANDS

13. CLARITHROMYCIN Indications Acute otitis media Pharyngitis / Tonsilitis Respiratory tract infections like Maxillary sinusitis , pertusis,community acquired pneumonia . Uncomplicated skin infections Encephalitis Early lyme disease .

14. DOSE & INTERACTIONS Dose ADULTS: 1 . Oral suspension 125 mg /5 ml 250 mg /5 ml 2 . Tablet 250 mg ,500mg EXTENDED RELEASE 500mg CHILDRENS / PEDIATRICS Use and dose must be determined by the doctor according to the body weight . Usually oral suspension or tablet 7.5mg /kg of weight every 12 hours for 10 days Interactions Benzodiazepines Abatacept Acetaminophen Cisapride Ergotamine Warfarin

15. Warnings & Contraindications Warnings /precautions : Serious skin reactions can occur . Pain in the upper stomach , nausea and yellow eyes , these could be the symptoms of serious liver problems . Don’t drive because medicine may cause dizziness . Avoid grape fruit juice or grape fruit containing food as it may increase the side effects of clarithromycin . Contraindications : Diarrhoea from an infection . Prolonged QT interval on ECG Chronic kidney disease . Inflammation of liver . Coronary artery disease Myasthenia gravis Pregnancy .

16. SIDE EFFECTS GI Effects mostly : Abnormal taste , nausea ,vomiting ,diarrhoea , abdominal pain Rash (children ) Headache Dyspepsia Anxiety Dizziness Dyspnea Longer time for blood to clot Severe allergic reactions Liver dysfunction Inflammation of liver QT prolongation

17. BRANDS

18. MORPHINE

19. Introduction Morphine belongs to the group of medicines called narcotic analgesics (pain medicines ) It is strong opiate that is found naturally in opium , a dark brown resin in poppies ( papaver somniferum It is mainly used as a pain medication .

20. Indications / Uses : Used for the relief of moderate to severe acute and chronic pain . ANALGESIA in severe pain and when sleep is desired DIARRHOEA as it decreases GIT motility and increases tone of anal sphincter . COUGH as it suppresses cough reflex Treatment of acute pulmonary edema morphine relief dyspnea caused by pulmonary edema due to LV failure . ANASTHESIA morphine is used as pre anesthetic medications , for systemic and spinal anesthesia and for post operative analgesia .

21. SIDE EFFECTS /ADVERSE EFFECTS Respiratory depression Sedation Nausea and vomiting Constipation Miosis Dizziness

22. INTERACTIONS INTERACTIONS : MAO inhibitors Sedative hypnotics TCAs Antipsychotic agents OTHERS : Morphine will not be effective in people taking naltrexone . It increases the sedative effect of alcohol. It antagonize the effect of diuretics . PRECAUTIONS /WARNINGS : Use it with caution in cirrhotic patients Morphine metabolites are renally excreted thus use it with caution in renal failure . Patients with renal failure may develop encephalopathy and myoclonus due to the accumulation of morphine metabolites.

23. Contraindications Head injury Increased intracranial tension Epilepsy ,liver disease Pregnancy and labor Extremities of age Respiratory diseases like asthma and COPD . Allergy to morphine .

24. DOSE AND BRANDS DOSAGE FORM AND STRENGTH Tablet /capsules 15mg ,30mg,60mg,100mg,200mg Injections 10mg/ml ,15mg/ml Oral solutions 10mg/5ml Suppository 10mg, 20 mg Granules /Powders 10mg ,20mg ,50 mg ,100mg ,200mg Brands