The document discusses various sulfonamide drugs, including their classifications, mechanisms of action, pharmacokinetics, uses, and side effects. It also covers fluoroquinolone antibiotics and beta-lactam antibiotics such as penicillins and cephalosporins. Sulfonamides, fluoroquinolones, and different classes of beta-lactam antibiotics are used to treat a variety of bacterial infections based on their absorption, distribution, metabolism, excretion properties and spectrums of activity.

3. SULFONAMIDES OR SULFA DRUGS
GROUP OF MEDICINES USED IN TREATING BACTERIAL INFECTIONS

4. Short acting
(4-8 hrs)
• sulfadiazine
Intermediate acitng
(8-12 hrs)
• Sulfamethoxazole
Long acting (7 days)
• sulfadoxine
• sulfamethopyrazine
Special purpose
sulfonamides
• sulfacetamide
• Sulfadiazine
• Sulfasalazine

5. SULFONAMIDES ARE BACTERIOSTATIC
AGAINST GRAM POSITIVE AND GRAM
NEGATIVE BACTERIA

7. ABSORPTION: Rapidly absorbed orally
EXCRETION: Through Urine
PLASMA PROTEIN BINDING: 50%
USES: meningitis (it have a good
penetrability in brain and CSF)
DOSE: 500mg

8. ABSORPTION: slowly absorbed orally
EXCRETION: Through Urine
PLASMA PROTEIN BINDING: 50%
PLASMA HALF LIFE: 10hours in adults
USES: Malaria
DOSE: 500mg

9. ABSORPTION: ultra long acting absorbed
orally
EXCRETION: Through Urine
PLASMA PROTEIN BINDING: high
PLASMA HALF LIFE: 5-9days in adults
USES: Malaria
DOSE: 500mg

10. ABSORPTION: highly soluble, topical use
EXCRETION: -----
PLASMA PROTEIN BINDING:-----
PLASMA HALF LIFE: ----
USES: Ocular infection
DOSE: 10%, 20%, 30% eye drops, 6% eye oint

11. Hepatitis
Hypersensitive reactions
Bone marrow depression
Acute renal failure
Cyanosis
Nausea and Vomitting
Headache
Mental depression

13. Fixed drug combination of sulfonamides
(sulfomethoxazole) and trimethoprim is
Cotrimoxazole

14. Trimethoprim is a diaminopyrimidine
related to the antimalarial drug
pyrimethamine
It is a selective dihydrofolate
reductase inhibitor

15. ABSORPTION: Well absorbed orally and
distributed through out the tissues
EXCRETION: Urine
PLASMA HALF LIFE: 24 hrs
USES: Brain Meningitis (high concentration at
CSF)
DOSE: 200 mg, 500 mg

18. Nalidixic acid
1960’s
Urinary and GI
infections only
Low potency, restrcited
spectrum, high
frequency to bacterial
resistance
Fluoroquinolones
1980’s
Flourination at Position
6 and piperazine at
position 7 changes
made fluoroquinolones
High potency, expanded
spectrum, slow
development of
resistance, better tissue
penetration, and
tolerability

19. Classification of
fluoroquinolones
First
generation
(one fluoro
substitutions)
Second
generation
(two fluoro
substitutions)

22. ABSORPTION:rapidly absorbed orally, food
delays
DISTRIBUTION: good tissue penetration
EXCRETION: Urine
USES: UTI, Gonorrhoea, Bacterial
gastroenteritis, typhoid
DOSE: 250 mg, 500 mg

23. ADVERSE EFFECTS:
CNS: Dizziness, Headache, restlessness,
anxiety, insomnia etc.
GASTROINTESTINAL: Nausea and vomitting,
Diarrhoea
SKIN/HYPERSENSITIVITY: rash, urticaria,
swelling of lips, cutaneaous reactions
INTERACTIONS
• Plasma concentration of theophylline,
warfarin, caffiene is increased dur to
ciprofloxacin
• NSAIDS: seizures are reported
• Antacids, iron salts will reduce the absorption
rate of FQ’s

24. ABSORPTION: oral bioavailability is high,
higher plasma conc,
DISTRIBUTION: good tissue penetration
EXCRETION: unchanged in Urine (dose
reduced in renal failure )
USES: cervicitis, urethritis, pneumonia caused
by chlamydia trachomatis, TB,
DOSE: 100, 200, 400mg tab, 200mg/100ml inj

25. It is a active levo isomer of ofloxacin of first
generation
ABSORPTION: 100% oral bioavailability and
IV dose also, higher potency
DISTRIBUTION: good tissue penetration
EXCRETION: Urine unchanged
USES: sinusitis, prostatitis, UTI
DOSE: 500 mg, 750mg/ 100ml inj

26. It is a tissue amaebicidic category, it lies under the both
intestinal and extraintestinal amaebiasis
Examples:
• Metronidazole
• Tinidazole
• Secnidazole
• Ornidazole
• Satranidazole

27. It is a synthetic antiprotozoal and anti
bacterial agent
It belongs to the nitroimidazole class of drugs
MECHANISM OF ACTION:
Metronidazole acts by inhibiting nucleic acid synthesis by
disrupting the DNA of microbial cells
This function only occurs when metrondazole is partially
reduced and because this reduction usually happens only in
anaerobic cells, it has relatively little effect upon human
cells or aerobic cells

29. PHARMCOKINETICS
ABSORPTION: Bioavailability is 80% absorbed from GI tract
PLASMA PROTEIN BINDING: < 20%
PLASMA HALF LIFE: 1-2 HRS
DISTRIBUTION: Well distributed, similar pattern for IV
METABOLISM: lliver enzymes inhibited
EXCRETION: unchanged in Urine (77% and faeces 14%)
USES: Anaerobe infections, H pylori, Bacterial vaginosis,
amebiasis,giardiasis
DOSE: 250mg and 500 mg (also in the form of gels creams
capsules suspensions etc)

30. SIDE EFFECTS
Epigastric disorder
Seizures
Metallic taste
Darkening of urine
Peripheral neuropathy
Pancreatitis
Hepatitis
Fever
Reversible neutropenia

31. DRUG INTERACTION
ALCOHOL: nausea vomitting abdominal
cramps
ANTICOAGULANTS (WARFARIN): Prolonged PT
CIMETIDINE: Prolong half life and decreased
clearance of metronidazole
PHENYTOIN and
PHENOBARBITONE:
decreased serum conc and
increased metabolism of
metronidazole

32. Long plasma half life,
slower in metabolism
Higher cure rates in amoebiasis
Lower side effects
USES:
Tricho,
giardiasis,
Anaerobic infection
H pylori

33. Longest plasma half life i.e., 17-29 hrs
2 grams of single dose but for hepatic amoebiasis 1.5 gram
twice X5 days
Long plasma half life, similar to TInidazole
Better tolerability
No disulfiram raaction
No acetamide metabolite (weak carcinogen)

36. It contains Beta lactam ring in thier molecular structure so
called beta lactam antibiotics
Nitrogen is attached to the beta carbon relative to the
carbonyl ring and hence the name is called

37. CLASSIFICATION
 Penicillins
 Cephalosporins
 Other Beta lactam drugs:
• Cephamycins
•Carbapenems
•Oxacephalosporins
•Beta lactamase inhibitors
•Monolactams

39. CLASSIFICATION:
NATURAL: Penicillin G
SEMISYNTHETIc:
Acid Resistant: Penicillin V
Penicillinase-resistant: methicillin, cloxacillin
Aminopenicillin: Ampicillin, Amoxicillin, Bacampicillin
Antipseudomonal penicillin:
Carboxypenicillin: cerbenicillin, ticarcillin
Ureidopenicillins: piperacillin, mezlocillin
Beta lactumase inhibitors: clavulanic acid, sulbactam,
tazobactam

40. It is Penicillin G
Narrow spectrum antibiotic
Primarily is it for gram positive cocci, bacilli and few gram
negative
Absorption: good but food delays hence given after 2 hrs of
food
Cant cross BBB
Plasma half life is 30 min
Uses: meningococci
Enterococcci
Actinomyces

41. Effective against: gram positive+ less effective against
gram negative bacteria
• Narrow spectrum
•Should be given orally
USES:
Tonsillitis
Anthrax
Rheumatic fever
Streptococcal skin infections

42. Effective against gram positive + gram negative bacteria
It is broad spectrum and can be given orally and
parenterally
USES:
Ear infection
Sinusitis
UTI
Meningitis

43. Effective against gram postitive and negative
It has a broad spectrum
Orally and paranterally administrated
USES:
Skin infection
Sinusitis
UTI
Streptococcal pharyngitis
SIDE EFFECTS:
Rash, Vomitting and Nausea, edema, stomatitis, Diarrhea

45. Septicaemia
Pneumonia
Meningitis
Billiary tract infection
UTI
Sinusitis

46. Administered: orally but mostly prefered is IV and IM
Distribution: well distributed in the tissues
Only few like cefotaxime, cefuroxime, ceftriaxome will cross
the BBB,
Elimination: thorugh urine few like ceftraixome is eliminated
through bile

47. Hypersensitivity reactions
Diarrhea