Sulphonamides Penicillins (Beta Lactam) Cephalosporins (Beta Lactam) Mac
Sulphamethoxazole + Trimethoprim = MoA: Bactericidal: prevents formation of a cell wall (lysis). Similar to penicillin in structure & moa 1st choice alternativ
Co-tri-moxazole 5-10% cause hypersensitivity with penicillins. to pencillin.
Characteristics of CTM: BLISS Gram + Gram +/- 1st Generation: more Gram + & H.Influenzae Original: Erythromy
Bactericidal Grp 1: Narrow Spectrum Grp 3: Broad-Spectrum Pens 2nd Generation: more Gram – & H.Influenzae
Large spectrum (against Gram + & -) -Benzyl-penicillin (IV) -Amoxicillin 3rd Generation: broad spectrum. Very good Newer:
Infections. -Phenoxymethyl-penicillin (PenV) -Ampicillin H.Influenzae cover Azithro-mycin
Synergistic action blocks biosynthesis -Procaine-benzyl-penicillin -Amoxicillin + clavulanic Acid* = 4th Generation: Gram + & -Broad Spectrum Clarithro-mycin
of folic acid produced by bacteria. Augmentin Telithro-mycin
Selectively Toxic *clavulanic acid is a B-lactamase
inhibitor which prevents resistance
Uses: PRUDES Grp 2: Anti-Staphylococcal Pens Grp 4: Antipseudomonal Cef-azolin Advantages of newe
Pneumonia (kids) Resistant to penicillinase (enzyme -Piperacillin Cef-uroxime • Longer half life, l
Prophylaxis against opportunistic made by staph). -Piperacillin + Tazobactim Cef-trioxone • Lower incidence
organisms in HIV+ pts. - Cloxacillin Cef- podoxine • Larger spectrum
Respiratory Tract Infx - Fluvoxacillin Cef-amandole
Urinary Tract Infx
Diarrhea ass. HIV
STI’s (some)
Adverse Effects: SULFA Adverse Effects: ABCD SSS Adverse Effects: CEF the GIANT Adverse Effects
Steven-Johnson Sx Anaphylaxis ,Abdominal Pain GI side effects GI upset
Skin Rash BlaCk Tongue Increased Glucose QT prolongation
Urine precipitate (crystalluria) Diarrhea Anaphylaxis Azithromycin: hepa
Leucopenia Skin Rash Nephrotoxicity
Folic Acid deficiency Stomach Upset Thrombocytopenia
Aplastic Anaemia Seizures
Contraindications: Safe in Pregnancy & Children! Contraindications: Contraindications:
Pregnancy Think: Penicillin is Pregnancy Safe! Pregnancy, Lactation Pregnancy
Hepatic failure Hepatic failure
Hypersensitivity
Other Sulphonamides Uses of Pencillins: Prestik Uses Uses
1. Sulphasalizine (ulcerative colitis) Pneumonia Respiratory Infections Endocarditis (caused by Strep) Alternatives to penicillins Broad-spectrum gra
2. Sulpha-cetamide (conjunctivitis) STI’s Tooth & Gum Infections Infections eg. Inner Ear Respiratory Tract Infections Leigonella, Mycopla
Gonorrhea Treponema.
Meningitis
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