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Antimicrobial Agents (General considerations)

Antimicrobial Agents (General considerations). Prof. R. K. Dixit Pharmacology and Therapeutics K.G.M.U. Lucknow dixitkumarrakesh@gmail.com. Objectives…. Important drug interactions related to antimicrobials. Important Drug Interactions of Antimicrobials. Pharmaceutical.

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Antimicrobial Agents (General considerations)

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  1. Antimicrobial Agents (General considerations) Prof. R. K. Dixit Pharmacology and Therapeutics K.G.M.U. Lucknow dixitkumarrakesh@gmail.com

  2. Objectives…. • Important drug interactions related to antimicrobials

  3. Important Drug Interactions of Antimicrobials Pharmaceutical • During manufacture, packaging, Storage • During drug administration • During Mixing and injecting drug • Mixing in oral solutions • Mixing in solvent, • In bottle, • No drug in • Blood, • Plasma and • Electrolyte solutions Pharmacokinetic (ADME) • Chlelation /(Antacids, Milk)- Tetracyclines • Alteration of pH/ Ionization of drug- Penicillins • Alteration with Enterohepatic recirculation- (OCP) • Inducer (Barbiturates, Rifampicin, Griseofulvin, Carbamazepine) • Inhibitor (Cimetidine, Chlolramphenicol, Erythromycin, Quinolones) • Protein biding displacement of drug (Important with high protein binding drugs)- Sulphonamides Pharmacodynamic • Synergism/Addition/ • Antagonism • Combinations of more than one antimicrobial • Combination of antimicrobial with other agents

  4. Important Drug Interactions of Antimicrobials Pharmaceutical • During Manufacture, Packaging, Storage • During drug administration • During Mixing and injecting drug (If Coagulate Reject) • Mixing in oral solutions (Not advisable) • Mixing in solvent (According to instructions) • No drug in • Blood, • Plasma and • Electrolyte solutions

  5. Important Drug Interactions of Antimicrobials Pharmacodynamic • Synergism/Addition(Cidal + Cidal, Static + Static) • Antagonism (Cidal + Static) When more sensitive to Cidal • Combination of antimicrobial with other agents

  6. Important Drug Interactions of Antimicrobials Pharmacokinetic (ADME) • Chelation /(Antacids, Milk)- • Tetracyclines • Alteration of pH/ Ionization of drug- • Penicillin G (not absorbed orally) • Alteration with Enterohepatic recirculation- • OCP with antimicrobials • Inducers- • Rifampicin, Griseofulvin, • Inhibitors- • Chlolramphenicol, Erythromycin, Quinolones (Grape fruit (Furanocoumarins) • Protein biding displacement of drug- • Sulphonamides

  7. List of Important Interactions Related to Antimicrobials

  8. Ethyl Alcohol – (Alcohol dehydrogenase or Acetaldehyde synthetase) Acetaldehyde- (Acetaldehyde dehydrogenase) Acetic Acid- Kreb’s cycle- ATP + CO2+ H2O (Blocked by Disulfiram)- Accumulation of Acetaldehyde and precipitations of syndrome consisting of Headache, Vomiting, Flushing etc.

  9. Thanks

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