DRUG COMPENDIUM

1. Amoxicillin

Generic name: Penicillin

Brand name: Amoxil/Amoxil Forte, Britamox, Harbimox, Himox Suspension/Himox Drops, Littmox, Medvox, Moks,
Pediamox, Rhea Amoxicillin, RiteMED Amoxicillin
Drug Classification: Belongs to the class of penicillins
General Chemistry:

Mechanism of Action:

Pharmacokinetics:
Absorption: Rapidly and well absorbed from the gastrointestinal tract. Bioavailability: Approx 70% (oral).
Bioavailability: : Approx 70% (oral). Time to peak plasma concentration: 1-2 hours (oral).
Onset of action: 30 mins
Duration: 1-2 hours (oral).
Distribution: Readily distributed in gall bladder, abdominal tissue, lungs, liver, prostate, middle ear effusions, maxillary
sinus secretions, skin, fat, bone, muscle tissues, peritoneal and synovial fluids, bile, pus; poor penetration into the brain
and CSF (except when meninges are inflamed). Crosses the placenta and enters breast milk (small amounts). Volume of
distribution: Approx 0.3-0.4 L/kg. Plasma protein binding: Approx 20%.
Metabolism: Metabolised via hydrolysis (small amount) to inactive penicilloic acid.
Excretion: Via urine (60% as unchanged drug).
Half-life: Approx. 1 hour
Indication Dosage
Oral Adult:3 g, repeated once after 8 hours
Dental abscesses
Oral Adult:3 g as a single dose in combination with probenecid
Uncomplicated gonorrhoea
Oral Adult: In acute streptococcal cases: 500 mg 8 hourly or 750-
Pharyngitis, Tonsillitis 1,000 mg 12 hourly. For severe infections: 750-1,000 mg 8
hourly for 10 days.
Child: <40 kg: 40-90 mg/kg daily in divided doses
Oral Adult:. 250-500 mg 8 hourly or 500-1,000 mg 12 hourly. For
Acute bacterial sinusitis, Acute otitis media, Cystitis, severe infections: 750-1,000 mg 8 hourly
Ear, nose and/or throat infections, Genitourinary Child: >3 months <40 kg: 20-90 mg/kg daily in divided doses
infections, Pyelonephritis, Skin and soft tissue infections

Oral Adult: 500-2,000 mg 8 hourly

Paratyphoid fever, Typhoid fever Child: <40 kg: 100 mg/kg daily in 3 divided doses
Oral Adult: 2 g as single dose 30-60 minutes prior to procedure
Prophylaxis of endocarditis Child: <40 kg: 50 mg/kg as single dose 30-60 minutes prior
to procedure
Oral Adult: 3 g, repeated once after 10-12 hours
Uncomplicated acute urinary tract infections
Oral Adult: 500-1,000 mg 8 hourly.
Community-acquired pneumonia Child: >3 months <40 kg: 20-90 mg/kg daily in divided doses
Oral Adult: In combination with PPI (e.g. omeprazole,
Eradication of H. pylori associated with peptic ulcer lansoprazole) and another antibiotic (e.g. clarithromycin,
disease metronidazole): 750-1,000 mg bid for 7-14 days depending
on therapy regimen
Oral Acute exacerbations of chronic bronchitis, Adult: 250-500 mg 8 hourly or 750-1,000 mg 12 hourly. For
Asymptomatic bacteriuria in pregnancy severe infections: 750-1,000 mg 8 hourly
Oral Adult: In early stages: 500-1,000 mg 8 hourly for 14 days
Lyme disease (range: 10-21 days). Max: 4,000 mg daily in divided doses. In
late stages (systemic involvement): 500-2,000 mg 8 hourly
for 10-30 days. Max: 6,000 mg daily in divided doses.
Child: <40 kg: In early stages: 25-50 mg/kg daily in 3 divided
doses for 10-21 days. In late stages (systemic involvement):
100 mg/kg daily in 3 divided doses for 10-30 days.
Parenteral Adult: In combination with another antibiotic if needed: 1-2
Bacterial meningitis g 4-6 hourly via slow IV inj over 3-4 minutes or IV infusion
over 20-60 minutes. Doses may be also be given via IM inj if
IV route is impossible or less appropriate for the patient.
Max: 12 g daily (IV); 4 g daily (IM); 1 g (single IM dose).
Parenteral Adult: Treatment in combination with another antibiotic if
Endocarditis needed: 1-2 g 4-6 hourly via slow IV inj over 3-4 minutes or
IV infusion over 20-60 minutes. Doses may be also be given
via IM inj if IV route is impossible or less appropriate for the
patient. Max: 12 g daily (IV); 4 g daily (IM); 1 g (single IM
dose). Prophylaxis in patients at highest risk of infective
endocarditis: 2 g as single IV dose 30-60 minutes prior to
procedure. Consideration must be given to local treatment
guidelines.
Child: Treatment: ≥40 kg: Same as adult dose. Prophylaxis in
 patients at highest risk of infective endocarditis: <40 kg: 50
mg/kg as single IV dose 30-60 minutes prior to procedure
Parenteral Adult: Individualise dosing based on expected susceptible
Acute exacerbations of chronic bronchitis, Community- pathogens, severity and site of infection, age, weight and
acquired pneumonia, Cystitis, Ear, nose and/or throat renal function of the patient. 500 mg 8 hourly via slow IV or
infections, Pyelonephritis, Skin and soft tissue infections IM inj. Severe infections: May increase to 1,000 mg 6 hourly
via slow IV inj over 3-4 minutes or by IV infusion over 20-60
minutes.
Oral GFR <10 mL/min and/or patients on peritoneal dialysis:
Renal Impairment Adults and children ≥40 kg: Max: 500 mg daily; Children <40
kg: 15 mg/kg daily (max: 500 mg daily). GFR 10-30 mL/min:
Adults and children ≥40 kg: Max: 500 mg bid; Children <40
kg: 15 mg/kg bid (max: 500 mg bid). In patients receiving
haemodialysis: Adults and children ≥40 kg: 500 mg 24
hourly, and give an additional 500 mg dose prior to and
after dialysis; Children <40 kg: 15 mg/kg once daily (max:
500 mg daily), and give an additional 15 mg/kg dose prior to
and after dialysis.
Parenteral GFR <10 mL/min and patients on peritoneal dialysis: Adults
Renal Impairment and children ≥40 kg: 1,000 mg as IV loading dose then 500
mg daily via IV, or 500 mg daily as single IM dose; Children
<40 kg: 25 mg/kg daily as single IV dose, or 15 mg/kg daily
as single IM dose. GFR 10-30 mL/min: Adults and children
≥40 kg: 1,000 mg as IV loading dose followed by 500-1,000
mg bid via IV, or 500 mg 12 hourly via IM; Children <40 kg:
25 mg/kg bid via IV, or 15 mg/kg 12 hourly via IM. In
patients receiving haemodialysis: Adults and children ≥40
kg: 1,000 mg at the end of dialysis then 500 mg 24 hourly
via IV, or 500 mg during and at the end of dialysis then 24
hourly via IM; Children <40 kg: 25 mg/kg as IV loading dose,
followed by 25 mg/kg daily, and additional 12.5 mg/kg dose
at the end of dialysis via IV; alternatively, 15 mg/kg during
and at the end of dialysis, then 15 mg/kg 24 hourly via IM.

Adverse reaction:
Significant: Convulsion (high doses), Jarisch-Herxheimer reaction (in treatment of Lyme disease). Rarely, crystalluria
(high parenteral doses); prolonged prothrombin time.
Blood and lymphatic system disorders: Rarely, thrombocytopenia, leucopenia.
Gastrointestinal disorders: Nausea, diarrhoea, vomiting; tooth discolouration (brown, yellow, grey) particularly in
children.
Investigations: Elevated liver enzymes, changes in blood counts (prolonged therapy).
Nervous system disorders: Headache, dizziness, agitation.
Psychiatric disorders: Reversible hyperactivity, anxiety, insomnia, confusion, behavioural changes.
Reproductive system and breast disorders: Vulvovaginal infection.
Skin and subcutaneous tissue disorders: Rash, urticaria, pruritus.
Contraindications: Hypersensitivity or history of severe allergic reactions (e.g. anaphylaxis, Stevens-Johnson syndrome)
to amoxicillin or other β-lactams (e.g. penicillins, cephalosporins, carbapenems, monobactams). Infectious
mononucleosis (suspected or confirmed).
Special precautions: Patient with reduced urine output, history of seizures, treated epilepsy or meningeal disorders;
lymphatic leukaemia. Atopic individuals. Renal and hepatic impairment. Children. Pregnancy and lactation.
 2. Tetracylines

Generic name:Tetracycline
Brand name: Metrocycline, Moncycline, RiteMED Tetracycline, Traxetrine
Drug Classification: Belongs to the class of tetracyclines. Used in the systemic treatment of infections.
General Chemistry:

Mechanism of Action:

Pharmacokinetics:
Absorption:
Bioavailability: Approx 60-80%.
Onset of action:
Duration: Approx 1-4 hours
Distribution: Widely distributed in body tissues and fluids e.g. ascitic, synovial and pleural fluids. Crosses the placenta
and enters breast milk. Plasma protein binding: 55-64%.
Metabolism:
Excretion: Via urine (up to 55% as unchanged drug) and faeces.
Half-life: 8 hours (range: 6-12 hours).

Indication Dosage
Ophthalmic Adult: As 1% ointment: Apply thinly unto conjunctival sac
Bacterial conjunctivitis, Trachoma bid. Treatment duration: 7 days (bacterial conjunctivitis); 6
weeks (trachoma
Ophthalmic Child: As 1% ointment: 1 single application into each eye
Prophylaxis of neonatal conjunctivitis immediately after birth.
Oral Adult: 250-500 mg 6 hourly. Dosage and treatment
Susceptible infections duration vary depending on the type of infection.
Child: ≥8 years 25-50 mg/kg daily, in divided doses 6
hourly.
Oral Adult: 250-500 mg daily as a single or in divided doses for
Acne vulgaris, Rosacea at least 3 months.
Oral Adult: 500 mg 4 times daily for 3 weeks in combination
Brucellosis with streptomycin.
Oral Adult: 500 mg 4 times daily for 7 days.
Nongonococcal urethritis, Uncomplicated genital infections
due to Chlamydia trachomatis, Uncomplicated gonorrhoea
Oral Adult: 500 mg 4 times daily. Treatment duration: 15 days
Syphilis for early syphilis (<1 year’s duration) or 30 days for syphilis
of >1 year (except neurosyphilis).
Oral Adult: 500 mg 4 times daily for 10 days.
Epididymo-orchitis
Topical/Cutaneous Adult: As 3% ointment: Apply a small amount to affected
Minor skin infections area 1-3 times daily.
Adverse reaction:
Significant: Photosensitivity, intracranial hypertension, increased BUN. Enamel hypoplasia or permanent tooth
discolouration in children, tissue hyperpigmentation in children <8 years.
Blood and lymphatic system disorders: Rarely, agranulocytosis, aplastic or haemolytic anaemia, eosinophilia,
neutropenia, thrombocytopenia.
Gastrointestinal disorders: Oesophagitis, oesephageal ulceration, epigastric distress, glossitis, gastrointestinal irritations,
dysphagia, nausea, vomiting, diarrhoea, abdominal discomfort, pancreatitis.
Hepatobiliary disorders: Rarely, transient increases in LFT, hepatitis, hepatic failure, jaundice.
Metabolism and nutrition disorders: Anorexia.
Skin and subcutaneous tissue disorders: Erythematous or maculopapular rash, pruritus, bullous dermatoses, skin
discolouration.
Contraindications: Hypersensitivity to tetracyclines. Children <8 years. Severe renal impairment. Pregnancy and
lactation. Concurrent use of methoxyflurane, retinoids or vitamin A
Special precautions: Patient with myasthenia gravis, SLE. Children. Hepatic and mild to moderate renal impairment.