抗生素 （英文PPT）.ppt

ANTIBIOTICS Presented by Dr.Pavan kumar.G P.G.STUDENT Unwanted effects Precautions Contraindications Patient’s point if view Patient FIRST GENERATION Cinoxacin Oxolinic acid Nalidixic acid SECOND GENERATION Lomefloxacin Ciprofloxcin Norfloxacin Ofloxacin Levofloxacin FLOUROQUINOLONES 3RD GENERATION Gatifloxacin Sparfloxacin Grepafloxacin Pazufloxacin 4th GENERATION Clinafloxacin Gemfloxacin Mofifloxacin Trovafloxacin 1st generation Cefazolin Cephalexin Cefadroxil Cephradine Cephalothin* 2nd generation Cefuroxime Cefaclor Cefoxitin* 3rd generation Cefotaxime Cefoperaxone Ceftriaxone Ceftazidime Cefixime Cefdinir 4th generation Cefepime Cefpirome PHARMACOKINETICS Not absorbed can be given orally for intestinal candidiasis. Widely distributed with poor CSF penetration. Metabolized in liver with t1/2 of 15days excreted by urine bile. USES Gold standard of antifungal therapy. Used topically for oral, vaginal cutaneous candidiasis otomycosis Most effective for systemic mycoses. Reserve drug for resistant cases of kala azar. ADVERSE EFFECTS Acute reactions like chills, fever, aches,nausea, dyspnoea,etc. Thrombophlebitis of injected vein can occur. Nephrotoxicity is the most important long term effect. INTERACTIONS Flucytosine has supra-additive action with AMB. Rifampin minocycline potentiate AMB. Aminoglycosides, vancomycin, cyclosporine enhance the renal impairment caused by AMB. GRISEOFULVIN Heterocyclic Benzofuran from P.griseofulvam. Active against most most Dermatophytes but not candida. Interferes with mitosis causing multinucleated stunted fungal hyphae. Irregular absorption improved by taking it with fats. Gets deposited in keratin forming cells of skin,hair nails Ineffective topically. Induces warfarin metabolism reduces efficacy of OCP. Phenobarbitone reduces oral absorption induces metabolism of the drug. ANTIVIRAL DRUGS Therapy has to be started in the incubation period,i.e, has to be prophylactic.