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Antibiotics course.1-Quinolones : lecture

Contents :-
Quinolones and fluoroquinolones.
Other quinolones.
Basic structure of the quinolones.
Mechanism of action.
Spectrum of fluroquinolones.
Quinolones dosage.
Main side effects.
Interactions with quinolones.
Contraindications.
Ciprofloxacin.
Norfloxacin.
Ofloxacin.
Lomefloxacin and enoxacin.
New fluoroquinolones.

Uses of fluoroquinolones.
Practical notes.
Rapid review.
Test yourself.
Resources.


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3:59 PM | Posted in , , , , | Read More »

Acyclovir (Zovirax) : drug card


Drug name
# Acyclovir.
Brand name
# Zovirax.
Class of drug
# Antiviral agent.
Indications
# Herpes simplex (HSV-1 and HSV-2) infections and immune-compromised host.
# Genital herpes infections.
# Herpes simplex encephalitis.
# Herpes zoster infections.
# Chickenpox infections.
Mechanism of action
# Nucleotide analog; inhibits viral replication by termination of viral DNA chain and inhibition and inactivation of viral DNA polymerase.
route / Dosage form
# Route : Oral, IV, Topical.
# Dosage form : Cap 200; Tab 400, 800 mg; Inj 500 mg, 1 g; Inj 50 mg/mL; Oint 5%; Susp 40 mg/mL
Dose
# Herpes simplex (HSV-1 and HSV-2) infections (immunocompromised host)
* Adults, children >12 years: IV 5 mg/kg (infuse at constant rate over 1 hour), q8h for 7 days.
* Children <12 years: IV 250 mg/m2 (infuse at constant rate for 1 hour), q8h.
# Genital herpes
* Adults, children >12 years: PO 200 mg q4h, five doses/day; 10 days for initial therapy. Dose for 5 days for intermittent recurrent disease. Administer up to 12 months for chronic disease (suppressive therapy).
* Children <12 years: IV 250 mg/m2, t.i.d. for 10 days.
# Herpes simplex encephalitis
* Adults, children >12 years: IV 10 mg/kg (infuse at constant rate over 1 hour), q8h for 10 days.
* Children, 6 months to 12 years: IV 500 mg/m2 (infuse at constant rate over 1 hour), q8h for 10 days.
# Herpes zoster
* Adults, children >12 years: PO 80 mg, q4h, five doses/day, 7–10 days.
* Children <12 years: PO 250–600 mg/m2, 4–5 times/day, 7–10 days.
# Chickenpox
* Adults, children >40 kg: PO 800 mg, q.i.d. 5 days.
* Children >2 years: PO 20 mg/kg q.i.d. (maximum 800 mg), 5 days.
Pregnancy / Lactation
# Pregnancy: Category C.
# Lactation: Appears in breast milk.
Adverse reactions
# Common: headache, phlebitis (IV only).
# Serious: seizures, renal failure, anaphylaxis, encephalopathy (confusion, hallucinations), coma, leukopenia, renal crystalline precipitant, elevated liver enzymes, Stevens–Johnson syndrome, urticaria.
Important interactions
# Drugs that increase effects/toxicity of acyclovir: MAO inhibitors, probenecid, ziduvine, CNS depressants.
# Drugs that decrease effects/toxicity of acyclovir: β blockers, guanethidine.
Contraindications / precautions
# Use with caution in patients with the following conditions: kidney disease, neurologic disease.
# Beware of renal dysfunction especially if patient is taking other nephrotoxic drugs.
# Women with genital herpes should have annual Pap smears.
# Rapid bolus administration may cause crystalline precipitation in renal tubules and renal insufficiency.
# Patients receiving acyclovir IV must remain well hydrated during treatment and for 24 hours after treatment.
# Cases of thrombotic thrombocytopenic purpura/hemolytic uremia syndrome have been reported with high-dose acyclovir in immunocompromised patients.

Other notes
# Kidney disease: dose should be adjusted according to creatinine clearance.
# Pediatric: Safety has not been established in children <2 years old.
Practical notes
# Drink 2–3 L of fluid per day. This is particularly important following IV infusion.
# Avoid sexual intercourse when lesions are present; otherwise use condoms.
# Avoid contact of the drug with or around the eyes.
# Resume treatment at first indication of recurrence of infection.
# Use a finger cot or latex glove when applying acyclovir ointment. The ointment might cause transient burning or stinging.
Trade names
# Egypt :- Zovirax, Acyclovir, Virustat, Novirus, Lovir, Cycloviral.
# KSA :- Zovirax, Virustat, Acyclovir, Acivir, Clovir, Custiviral, Deforax, Herpavir, Imavir, Lovrak, Medvirox, Noviral, Novirax, ,
# prepared by : Dr.Mohamed Abd Elrahman
# References:  - Handbook of clinical drug data, 10th edition. - Clinician'shandbook of prescription drugs . - Physicians' Drug Manual 2005 Edition . -Egyptian drug index . - Saudi drug index .
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10:33 AM | Posted in , , , , | Read More »

The shapes of virus : video

* What are the common shapes of viruses ?
* What is the inner structure of virus ?
* What are the parts of a phage ?





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    9:19 PM | Posted in , , | Read More »

    The dental abscess : video

    * What is the cause of dental abscess ?
    * Why does the abscess area swell ?
    * What are the treatments of dental abscess ?





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      9:44 PM | Posted in , , , , | Read More »

      The blood groups : video

      * What are the groups of red blood cells ?
      * What is the benefit from knowing the blood type ?
      * Why does type (O) is a universal donner ?





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        9:50 PM | Posted in , , , , | Read More »

        The function of B cells : video

        * What is the role of B cells ?
        * What is happened when antigen enter the body ?
        * What are the function of plasma cells ?





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          8:01 PM | Posted in , , | Read More »

          The function of T cells : video

          * What are the types of T cells ?
          * How does killer T cell recognize on infected cells ?
          * What is the function of helper T cell ?





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            7:46 PM | Posted in , , | Read More »

            Understanding of Vaccination : video

            * What is vaccination ?
            * How does the immune system react with vaccine ?
            * What is the meaning of memory cell  ?





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              7:22 PM | Posted in , , | Read More »

              Understanding of lymphatic system : video

              * What is the function of the lymph system ?
              * How does the lymph tissue return to the circulatory system ?
              * What are the contents of the lymph node ?









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                1:30 PM | Posted in , , , , | Read More »

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