Cephalosporins

Produced semisynthetically by chemical attachment of side chains to 7-aminocephalosporanic acid. Same mode of action , same resistance mech. 
But tend to be more resistant than penicillins to certain beta –lactamases .

GENERATION BASED ON :
-- BACTERIAL SUSCEPTIBILITY PATTERNS
-- RESISTANCE TO BETA –LACTAMASES
--NOT EFFECTIVE AGAINST -MRSA , L. MONOCYTOGENES , C. DIFFICLE , ENTEROCOCCI

First Generation 

Parentral

- CEPHALOTHIN
- CEFAZOLIN

Oral

- CEPHALEXIN
- CEPHRADINE
- CEFADROXIL

Second Generation

Parentral

CEFUROXIME
CEFOXITIN

Oral

CEFACLOR
CEFUROXIME AXETIL

Third Generation

Parentral

CEFOTAXIME 
CEFTIZOXIME
CEFTRIAXONE 
CEFTAZIDIME
CEFOPERAZONE

Oral 

CEFIXIME 
CEFPODOXIME
CEFDINIR 
CEFTIBUTEN

Fourth Generation

Parentral

CEFEPIME
CEFPIROME

Carbamazepine (Tegretol): most common; for generalized tonic-clonic and all partial seizures; especially active in temporal lobe epilepsies

Mechanism: ↓ reactivation of Na channels (↑ refractory period, blocks high frequency cell firing, ↓ seizure spread)

Side effects: induces hepatic microsomal enzymes (can enhance metabolism of other drugs)

Procaine penicillin Procaine penicillin is a combination of benzylpenicillin with the local anaesthetic agent procaine. This combination is aimed at reducing the pain and discomfort associated with a large intramuscular injection of penicillin.

Indications

respiratory tract infections where compliance with oral treatment is unlikely ,syphilis, cellulitis

Azithromycin

Azithromycin is the first macrolide antibiotic belonging to the azalide group. Azithromycin is derived from erythromycin by adding a nitrogen atom into the lactone ring of erythromycin A, thus making lactone ring 15-membered.

Azithromycin has similar antimicrobial spectrum as erythromycin, but is more effective against certain gram-negative bacteria, particularly Hemophilus influenzae.

azithromycin is acid-stable and can therefore be taken orally without being protected from gastric acids.

Main elimination route is through excretion in to the biliary fluid, and some can also be eliminated through urinary excretion

Balanced Anesthesia
A barbiturate, narcotic analgesic agent, neuromuscular blocking agent, nitrous oxide and one of the more potent inhalation anesthetic.

Classification

I) Esters

 1. Formed from an aromatic acid and an amino alcohol.

 2. Examples of ester type local anesthetics:

 Procaine

Chloroprocaine

Tetracaine

Cocaine

Benzocaine- topical applications only

2) Amides

 1. Formed from an aromatic amine and an amino acid.

 2. Examples of amide type local anesthetics:

Articaine

Mepivacaine

Bupivacaine

Prilocaine

Etidocaine

Ropivacaine

Lidocaine