:

*1

*2

*3

*4

*5

655

*6

*7

755

*8

*9

8525

*11

855

*11

8575

*12

*
* 2

11
11

*3

13

*4

11

*5

17

= 8+) 2(
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bacterial infection


5

Types of antibiotics:
**Cell wall inhibitor

Penicillin
1-penicillin:
Ab
)(ampiflox

A-ampicillin+dicloxacillin

, ,
)2-amoxicillin: (Amoxil, E-mox, Ibiamox
, , ,
, gastroenteritis ,pneumonia,
:
251 155
511 255
1111 3
1 8
2:6 255 125 8 251 12

6 1: 5 251 8 251 12

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 1:6 5 251 6 511 12

6:12 5 411 8 1 12
N.B

)3-amoxicillin +clavulinic acid: (augmentin, curam, hibiotic, megamox

URTIs ,otitis media ,pharyngitis

2:5
11:5
11

( 111 12)
(228 12)
( 312 12)
( 1 12)

)4-amoxicillin +flucloxacillin: (flummox, floxamo

combination
attack B-lactam ring
ring
attack
(Flummox)
unasyn
* 511
)5- Ampicillin +sulbactam: (Unasyn, unictam, Sulbin
sulbactam and clavulinic acid penicillin b-
lactamase
13:(12*375 158 1)
35: (12*751 1.6 2)
4 6 3

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penicillin sulfur atom
Penicillin platelet aggregation
sulbactam and clavulinic acid
Long acting penicillin
()retarpen,pencitard ,depo-pen
ampicillin 500:1000 8
Penicillin act as cell wall synthesis inhibitor so called bactericidal

Cephalosporin A.b
* : , ,
,
*
generations

*First generation:
Ex: (Cefalaxine, cephradine, cefadroxil) "ceporex, velosef,
"duricef
penicillin G

*Second generation:
* activity
*
Ex: cefaclor (ceclor) , cefprozil (cefzil) , cefuroxime
* syrup and tab

*Third generation:
Ex: cefoperazone (cefazone) , cefotaxime (cefotax) ,ceftriaxone
)(trixone
against gram ve M.O
meningitis

BBB


* third generation
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* The first choice drug for meningitis.

* Very effective against penicillinase enzyme.

*Fourth generation:
Ex: cefipime
restricted in
hospital
A.B
resistance
* Lippincott oral
* cephalosporin

N.B ceftriaxone,
cefoperazone 5
generation
*First generation:
a. Cephradine: velosef
7 14 7
*1:5 years
500 mg in 2cm *12 hrs
5 ml *12 hrs.
2 12 1gm in 4 ml *12 hrs.
7.5 ml *12 hrs.

*5:12 years

1gm in 4 ml *24 hrs.

10 ml *12 hrs.
b. Cephalexin: ceporex
*12:18 years

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5ml *125mg *12hrs

5ml*250mg*8hrs
5ml*250mg*6hrs
251 7.5 ml*250mg*8hrs

*1 month: 1year
*1year: 2 year
*2 years: 6years
*6 years: 12 years
8

c. Cephadroxil :duricef
*1day: 1month
2.5 ml*125mg*12hrs
*2month: 1year
5ml *125mg*12hrs
*1 year: 5years
5ml*250*12hrs
*5years:12 years
5ml *500mg*12hrs
*Second generation:
d. Cefaclor: ceclor
*2months:1 year
2.5ml*125mg *8hrs
*1year: 5years
5ml*125mg *8hrs
*6years:12years
5ml*250mg*8hrs
*Third generation:
e. Cefotaxime :cefotax ,claforan
7
* 251 5 1 12
* 5 251 2 1 12
* 6 7 511 3 1 12
* 8 511 3 155 12
* 6 12 1 4 2 12
* 12 1 3 2 12
f. Ceftriaxone : oframax
24
* 0.25 159 155 158 1 355
1 24 0.5gm *1.8ml
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*1day:6months
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*6months:2years

1gm *3ml 24 155

*2years :6years

1gm*3.5ml 24 2

:
) cefixime,cefdinir(
C.f.s ) cefotaxime(
Ceftazidine is fourth generation and active against
pseudomonas
Adverse effects of cephalosporin: ( allergic
reaction,disulfiram like action,bleeding)
toxicity cephalosporin
Nephrotoxicity increased with diuretic and aminoglycoside
and NSAIDs.
vancomycine ,bacterocin ( cell wall inhibitors *
which used in topical skin infection ,cycloserin which used in T.B)
Vancomycin
Effective against +ve cocci like: (E.coli, MRSA ,colistridim difficile.
, , dental pt *:
MRSA ,colstridim ,

)vancolon and vancomix(

*Inhibitor of protein synthesis*

bacteriostatic

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 two subunits
80 subunits ()50s,30s
mamaline protein )60s,40s(100s

)*Act on 30s (aminoglycoside and tetracycline
bactericidal
lippincot
)*act on 50s (chloramphenicol ,macrolides,clindamycin
A. Tetracycline:
*
* amoebic dysentary
stool analysis cyste

* appropriat secretion of ADH
ADH
* )sexual transmitid disease (gonorrhea ,syphilis
*topical eye &skin infection

:tetracycline

1-teeth discoloration and bone abnormalitis and deposited in newly

formed teeth &bone
Teeth: permanet yellow bone discoloration
Bone : deformity &inhibition of growth

i.
ii.

8 12

iii.

2- vit B&K deficiency by intestinal flora

bacterial flora K&B
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inactive form to active form normal
flora broad spectrum normal flora
3- hepatotoxicity
4-phototoxicity
5-nephrotoxicity
6-fanconi syndrome
7- low to moderate lipid soluble
Tetracycline and oxytetracycline (
)(Ca ,Mg, Fe ,Al
8-high lipid soluble
Doxycycline ()Ca,AL,Mg,Fe
* : tetracycline protein
synthesis
50s 30s mRNA
tRNA amino acid
mRNA tetracycline
B. Chloramphenicol:

*bacterial meningitis
*typhoid fever
*topical eye /ear infection

*highly toxic
*bacteriostatic

* bone marrow depression
5hemolytic anemia

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* gray baby syndrome

fully maturation glucoronic acid
chloramphenicol conjugation

*
5ocuphenicol-D dp
* 5

C. Aminoglycoside:
* nephrotoxicity

5 5
* aminoglycoside
creatinin
creatinin chance
:

:

neomycin
5
Hepatic coma
brain
hepatic coma neomycin
5
:aminoglycoside
* ototoxicity
:
Neomycin

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,amikacin
,tobramycin
,gentamycin
, streptomycin
5

D. Macrolids:
* 50s irreversibile
translation step of protein synthesis
5bacteriostatic
*Ex: azithromycin, calrithromycin,erythromycin.
|* :

,UTRI 5

*erythromycin
5
erythromycin
*clarithromycin
5intracular pathogen such as chlamydia
staph&strept
*azithromycin
erythromycin
azithromycin
urethritis 5 chlamydia trach
* 5 epigastric pain
* ototoxicity high
5dose
*
erythromycin 5accumalation in liver
* :
erythromycin and clarithromycin are enzyme inhibitor
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()warfarin,theophylline,cyclosporin,cabamazipine

metabolism of digoxin
intestinal flora which make inactivation of digoxin
lanoxin
accumalation

flora inactivation enterohepatic circulation
3
enzyme inhibitor 5
*azithromycine doesn't inhibit cytochrome p450 systeme so
it is safe for hepatic and cardiac pateint.
* 3 11
5
* macrolids
()spiramycin,clindamycin
-clindamycin is effective against staph of anaeorobic bacteria
so it is good for dental pateint.(dalacin-C).
-spiramycin is effective against toxoplasmosis and dental
procedure .
class

**DNA inhibitors

1-quinolone :
*they are the drug of choice for UTRIs.

5urine

)Ciprofloxacin : (cipro, ciproby ,ciprofar
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Effective against pseudomonas,UTI,LRTI.

5
)Levofloxacin : (levoxin , tavanic, tavacin
Using for GIT, LRTI,and against g+ve bacteria .

ii.

5 5
)Norfloxacin: (noracin ,epinor

iii.

*
5
*
( )norfloxacin +tinidazole
conaze tinifloxacin
(5)ciprofloxacin +tinidazole
)Ofloxacin: (ofloxin, tarvid

iv.

*
5
* effective against atypical bacteria e.g chlamydia
5
)Lomefloxacin: (lomex ,lomeflox

v.

5 11
* 18 51
* they cause premature closure epiphysis and bone erosions
*
*
5

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