Beta Lactam Antibiotics-BDS-Feb'24 PDF

BETA LACTAM ANTIBIOTICS PENICILLINS  CLASSIFICATION I. PENICILLIN – G (BENZYL PENICILLIN, CRYSTALLINE PENICLLIN) IM,IV,ORAL REPOSITORY FORMS PROCAINE PENICILLIN – G BENZATHINE PENICLLIN -G II. ACID RESISTANT PENICILLINS PHENOXY METHYL PENICILLIN - PENICILLIN V III. PENICILLINAS...

BETA LACTAM ANTIBIOTICS PENICILLINS  CLASSIFICATION I. PENICILLIN – G (BENZYL PENICILLIN, CRYSTALLINE PENICLLIN) IM,IV,ORAL REPOSITORY FORMS PROCAINE PENICILLIN – G BENZATHINE PENICLLIN -G II. ACID RESISTANT PENICILLINS PHENOXY METHYL PENICILLIN - PENICILLIN V III. PENICILLINASE RESISTANT PENICILLINS CLOXACILLIN DICLOXACILLIN METHICILLIN IV. EXTENDED SPECTRUM PENICILLINS AMINOPENICILLINS AMOXICILLIN AMPICILLIN BACAMPICILLIN ANTIPSEUDOMONAL PENICILLINS PIPERACILLIN MEZLOCILLIN  PENICILLIN-G - USES Streptococcal infections – otitis media, pharyngitis, rheumatic fever, scarlet fever. Pneumococcal infections Meningococcal infections Gonnorrhea Syphilis Tetanus Gas gangrene Actinomycosis Rheumatic fever – prophylaxis  AMOXICILLIN -DENTAL USES PULPITIS PERIAPICAL PERIODONTITIS PERIODONTITIS PERICORONITIS DENTAL CARIES PERI APICAL ABSCESS POST SURGICAL INFECTIONS  AMOXICILLIN -DENTAL USES GINGIVITIS ACUTE NECROTISING ULCERATIVE GINGIVITIS  AMOXICILLIN – OTHER USES RESPIRATORY TRACT INFECTIONS URINARY TRACT INFECTIONS CHOLECYSTITIS ENTERIC FEVER/ TYPHOID GONORRHOEA SYPHILIS MENINGITIS  AMOXICILLIN – OTHER USES PEPTIC ULCER DISEASE – FOR H.pylori ERADICATION PROPHYLAXIS – SUBACUTE BACTERIAL ENDOCARDITIS SEPTICAEMIAS BACILLARY DYSENTRY ADR OF PENICILLINS  SUPRAINFECTION Jarisch-Herxheimer reaction – syphillis-sudden destruction of spirochetes and release of lytic products – severe fevere, myalgia, shivering, exacerbation of syphilitic lesion and vascular collapse CEPHALOSPORINS CLASSIFICATION  FIRST GENERATION ORAL PARENTER AL CEPHALEXIN CEPHALOTHIN CEFADROXIL CEFAZOLIN CEPHRADINE CEPHAPIRIN  SECOND GENERATION ORAL PARENTER AL CEFACLOR CEFOXITIN CEFUROXIME AXETIL CEFOTETAN LORACARBEF CEFUROXIME CEFPROZIL  THIRD GENERATION ORAL PARENTE RAL CEFTIBUTEN CEFOTAXIME CEFETAMET CEFTIZOXIME CEFPODOXIM E PROXETIL CEFTRIAXONE CEFIXIME CEFOPERAZONE CEFDINIR CEFTAZIDIME  FOURTH GENERATION PARENTERAL CEFEPIME CEFPIROME CEFACLIDINE  FIFTH GENERATION PARENTERAL CEFTAROLINE FOSAMIL CEFTOBIPROLE MEDOCARIL CEFTOLOZANE  MECHANISM OF ACTION BACTERICIDAL INHIBITS BACTERIAL CELL WALL SYNTHESIS.  MECHANISM OF RESISTANCE BETALACTAMASES IMPERMEABILITY TO PBPs EFFLUX PUMP THERAPEUTIC & PROPHYLACTIC USES DENTAL USE FIRST GENERATION DRUGS ARE WIDELY USED  Cephalexin – Alternate to Amoxicillin Cefadroxil, Cefuroxime axetil, Cefaclor– commonly used in dental infections THERAPEUTIC & PROPHYLACTIC USES CHOICE DRUGS FOR SERIOUS INFECTIONS DUE TO Klebsiella, Enterobacter, Proteus, Serratia, Haemophilus THERAPEUTIC & PROPHYLACTIC USES TYPHOID Ceftriaxone, Cefotaxime, Cefoperazone MENINGITIS Due to N.meningitidis, Haemophilus, Pneumococci Ceftriaxone, Cefotaxime, Ceftizoxime THERAPEUTIC & PROPHYLACTIC USES MENINIGITIS Due to Pseudomonas Ceftazidime, Cefoperazone + Aminoglycosides PNEUMONIA Pneumococci, H.influenzae Cefotaxime, Ceftriaxone THERAPEUTIC & PROPHYLACTIC USES ANAEROBES B.Fragilis Cefoxitin, Cefotetan, Cefotaxime SURGICAL PROPHYLAXIS Cefazolin – Single dose THERAPEUTIC & PROPHYLACTIC USES Streptococcal & Staphylococcal infections GONORRHOEA Ceftriaxone- single dose Cefixime THERAPEUTIC & PROPHYLACTIC USES Streptococcal & Staphylococcal infections GONORRHOEA Ceftriaxone- single dose Cefixime THERAPEUTIC & PROPHYLACTIC USES BILIARY TRACT INFECTIONS Cefoxitin, Cefotaxime, Cefuroxime, Cefazolin BONE & JOINT INFECTIONS 3rd generation Cephalosporins THERAPEUTIC & PROPHYLACTIC USES LEPTOSPIROSIS Ceftriaxone, Cefotaxime – i.v LYME DISEASES Cefuroxime THERAPEUTIC & PROPHYLACTIC USES PANCREATITIS 3rd generation Cephalosporins PELVIC INFLAMMATORY DISEASES THERAPEUTIC & PROPHYLACTIC USES CHANCROID GRANULOMA INGUINALE SYPHILIS THERAPEUTIC & PROPHYLACTIC USES SKIN INFECTIONS ENT INFECTIONS EYE INFECTIONS  ADVERSE DRUG REACTONS HYPERSENSITIVITY NEPHROTOXICITY Cephalothin  ADVERSE DRUG REACTONS DIARHOEA DISULFIRAM LIKE REACTION Cefoperazone, Cefotetan, Cefomandole  ADVERSE DRUG REACTONS POSITIVE COOMBS TEST BLEEDING Cefoperazone, Cefotetan  ADVERSE DRUG REACTONS SUPRAINFECTION PAIN, THROMBOPHLEBITIS  CARBAPENEMS IMIPENEM MEROPENEM FAROPENEM DORIPENEM  IMIPENEM SPECTRUM Gram positive cocci, Enterobacteriaceae, Ps.aeruginosa, Listeria, Bacteroides fragilis,Cl.difficile  Rapidly hydrolysed by the enzyme dehdropetidase I present in the brush border of renal tubular cells. Combined with Cilastatin which is reversible dehydropeptidase – I inhibitor  USES SERIOUS HOSPITAL – ACQUIRED RESPIRATORY,URINARY,ABDOMINAL,PELVIC, SKIN AND SOFT TISSUE INFECTIONS INCLUDING THOSE IN NEUTROPENIC,CANCER AND AIDS PATIENTS. FOR Ps. aeruginosa infections, it should be combined with gentamicin.  BETA LACTAMASE INHIBITORS CLAVULANIC ACID SULBACTAM TAZOBACTAM  COMBINATIONS CLAVULANIC ACID + AMOXICILLIN – AUGMENTIN SULBACTAM + AMPICILLIN SULBACTAM + CEFOPEROZONE + CEFOTAXIME + CEFODROXIL TAZOBACTAM + PIPERACILLIN TAZOBACTAM + CEFTRIAXONE