about Ampicillin class, uses, side effects contraindications
Ampicillin
Short Description
Ampicillin is a penicillin antibiotic that has been known since 1966 and has been used to treat a number of infections. In some cases, ampicillin can be used to treat gastrointestinal infections caused by?Salmonella?or Shigella bacteria?,?but these bacteria have acquired resistance to the drug over time.
It can also happen with any other type of penicillin antibiotic. Also, ampicillin may cause a severe allergic reaction that causes fever, swelling of the mouth and tongue, itching and shortness of breath.
Category
Chemical class: Semisynthetic aminopenicillin
Therapeutic class: Antibiotic
Pregnancy category: B
Indications
To treat GI infections and genitourinary infections (other than gonorrhea) caused by susceptible strains of Shigella, Salmonella typhi and other species, Escherichia coli, Proteus mirabilis, and enterococci , ORAL SUSPENSION,
IV
,
IM
Adults and children weighing 20 kg (44 lb) or more. 500 mg P.O. every 6 hr or 250 to 500 mg I.V. or I.M. every 6 hr. Children weighing less than 20 kg. 50 to 100 mg/kg daily in divided doses P.O. every 6 hr or 12.5 mg/kg I.V. or I.M. every 6 hr. To treat gonorrhea caused by susceptible strains of non–penicillinase-producing Neisseria gonorrhoeae , ORAL SUSPENSION Adults and children.3.5 g as a single dose with 1 g of probenecid.
IV:,
I.M.INJECTION Adults and children weighing 45 kg (99 lb) or more. 500 mg every 6 hr. Children weighing less than 40 kg (88 lb). 50 mg/kg daily in divided doses every 6 to 8 hr. To treat respiratory tract infections caused by susceptible strains of nonpenicillinase–producing Haemophilus influenzae, staphylococci, and streptococci, including Streptococcus pneumoniae , ORAL SUSPENSION,
IV:,
I.M.INJECTION Adults and children weighing 40 kg or more.250 to 500 mg I.V. or I.M. every 6 to 8 hr. Adults and children weighing 20 kg or more. 250 mg P.O. every 6 hr. Children weighing less than 40 kg. 25 to 50 mg/kg daily I.V. or I.M. in divided doses every 6 to 8 hr. Children weighing less than 20 kg. 50 mg/ kg daily P.O. in divided doses every 6 or 8 hr or 12.5 mg/kg I.V. or I.M. every 6 hr. To treat septicemia
IV:,
I.M.INJECTION
Adults.8 to 14 g I.V. daily in divided doses every 3 to 4 hr for at least 3 days; then I.M. Children.150 to 200 mg/kg daily I.V. in divided doses every 3 to 4 hr for at least 3 days; then I.M. To prevent bacterial endocarditis from dental, oral, or upper respiratory tract procedures
IV:,
I.M.INJECTION
Adults.2 g within 30 min of procedure Children. 50 mg/kg within 30 min of procedure To treat bacterial meningitis caused by susceptible strains of Neisseria meningitidis
IV:,
I.M.INJECTION
Adults.8 to 14 g daily or 150 to 200 mg/kg daily I.V. in equally divided doses every 3 to 4 hr for at least 3 days; then I.M. at same dosage and schedule. Children.100 to 200 mg/kg daily I.V. in equally divided doses every 3 to 4 hr for at least 3 days; then I.M. at same dosage and schedule. To treat listeriosis
IV:,
I.M.INJECTION Adults and children weighing 20 kg or more. 50 mg/kg every 6 hr. Children weighing less than 20 kg. 12.5 mg/kg every 6 hr. Route Onset Peak Duration I.V. Immediate Unknown Unknown
Mechanism of Action
Inhibits bacterial cell wall synthesis. The rigid, cross-linked cell wall is assembled in several steps. Ampicillin exerts its effects on susceptible bacteria in the final stage of the cross-linking process by binding with and inactivating penicillin-binding proteins (enzymes responsible for linking the cell wall strands). This action causes bacterial cell lysis and death.
Incompatibilities
Don’t mix ampicillin and any aminoglycoside in the same I.V. bag, bottle, or tubing; otherwise, both will be inactivated. If patient must receive both , administer them in separate sites at least 1 hour apart.
Contraindications
Hypersensitivity to any penicillin, infection caused by penicillinase-producing organism
Interactions
allopurinol: Increased risk of rash, particularly in hyperuricemic patient aminoglycosides: Possibly inactivated action of aminoglycoside and ampicillin when given together heparin, oral anticoagulants: Increased risk of bleeding oral contraceptives: Possibly reduced contraceptive effectiveness and breakthrough bleeding probenecid: Possibly increased serum ampicillin level and ampicillin toxicity tetracyclines: Possibly impaired action of ampicillin
Side Efect
CNS: Chills, fatigue, fever, headache, malaise
CV: Chest pain, edema, thrombophlebitis
EENT: Epistaxis, glossitis, laryngeal stridor, mucocutaneous candidiasis, stomatitis, throat tightness
GI: Abdominal distention, diarrhea, diarrhea related to Clostridium difficile, enterocolitis, flatulence, gastritis, nausea, pseudomembranous colitis, vomiting
GU: Dysuria, urine retention, vaginal candidiasis
HEME: Agranulocytosis, anemia, eosinophilia, leukopenia, thrombocytopenia, thrombocytopenic purpura
SKIN: Erythema multiforme; erythematous, mildly pruritic maculopapular rash or other types of rash; exfoliative dermatitis; pruritus; urticaria
Other: Anaphylaxis, facial edema, injection site pain
Cautions
Avoid giving ampicillin to patients with mon-nucleosis because of increased risk of rash. Expect to give ampicillin for 48 to 72 hours after patient becomes asymptomatic. For streptococcal infection, expect to give ampicillin for at least 10 days after cultures show streptococcal eradication to reduce risk of rheumatic fever or glomerulonephritis. To dilute ampicillin for I.M. use, add (depending on manufacturer) 1.2 ml of sterile water or bacteriostatic water for injection to each 125-mg vial, 1 ml of diluent to each 250-mg vial, 1.8 ml of diluent to each 500-mg vial, 3.5 ml of diluent to each 1-g vial, or 6.8 ml of diluent to each 2-g vial. To dilute ampicillin for intermittent infusion, add 5 ml of sterile water or bacteriostatic water for injection to each 125-, 250-, or 500-mg vial or 7.4 to 10 ml of diluent to each 1or 2-g vial. Infuse in suitable diluent at less than 30 mg/ml.
WARNING Infuse I.V. solution for 3 to 5 minutes for each 125 or 500 mg or 10 to 15 minutes for each 1 or 2 g. More rapid infusion may cause seizures. Monitor patient closely for anaphylaxis, which may be life-threatening. Patients at greatest risk are those with a history of multiple allergies, hypersensitivity to cephalosporins, or a history of asthma, hay fever, or urticaria.
WARNING In an anaphylactic reaction, stop drug, notify prescriber immediately, and provide immediate treatment with epinephrine, airway management, oxygen, and I.V. corticosteroids, as needed. Notify prescriber if patient has evidence of ampicillin 82 superinfection; expect to stop drug and provide appropriate treatment. If long-term or high-dose ampicillin therapy is required, closely monitor results of renal and liver function tests and CBCs. Monitor patient closely for diarrhea, which may be pseudomembranous colitis caused by Clostridium difficile. If diarrhea occurs, notify prescriber and expect to withhold ampicillin and administer fluids, electrolytes, protein, and an antibiotic effective against C. difficile. PATIENT SAFTY
Stress the importance of taking the full course of ampicillin exactly as prescribed. Tell patient to take dose with 8 oz of water 30 minutes before or 2 hours after meals. Instruct patient to shake suspension well before each use, keep bottle tightly closed between uses, and discard unused portion after 14 days if refrigerated or 7 days if stored at room temperature. Review signs of allergic reaction; if they occur, tell patient to hold next ampicillin dose and contact prescriber immediately. Urge patient to tell prescriber about diarrhea that’s severe or lasts longer than 3 days. Remind patient that watery or bloody stools may occur 2 or more months after antibiotic therapy and may be serious, requiring prompt treatment.
Trade Name & Company Name
effect of Ampicillin in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. Well absorbed orally except during labor, ampicillin is one of the most commonly used antibiotics during pregnancy. In addition to the noted indications, ampicillin was used without success in combination with tocolytic agents to delay or avoid preterm delivery. In comparison to nonpregnant women, Pregnancy
significantly increases the ampicillin elimination rate constant and total body clearance and decreases the serum t/2 and AUC. As a result, the dose during Pregnancy
should be increased and the interval decreased. Ampicillin clearance is reduced by pyelonephritis and rises with successful treatment. This suggests the dosing interval should be reduced from 6h to 4h after the first 24h of therapy. When combined with sulbactam, ampicillin significantly prolongs the latency interval between rupture and delivery. Ampicillin alone is less effective. Fetal Health
There is a wide body of clinical experience with ampicillin during pregnancy. There is no evidence of teratogenicity in either humans or rodents. Throughout pregnancy, fetal drug levels reach maternal equilibrium 1-3h after administration; thereafter, fetal drug levels exceed maternal values. AF levels are low during early pregnancy, but rise with advancing gestation and may exceed maternal values 6-8h after drug administration. Breastfeeding
Minimal amounts of ampicillin are excreted in breast milk. It is generally considered compatible with breastfeeding. Pregnancy
. Ampicillin-sulbactam is a reasonable selection for prophylaxis in women undergoing cesarean section. Ampicillin does not prolong the latency interval after PPROM unless paired with sulbactam. In comparison to nonpregnant women, Pregnancy
significantly increases the ampicillin elimination rate constant and total body clearance and decreases the serum t/2 and AUC. As a result, the dose during Pregnancy
should be increased and the interval decreased. Ampicillin clearance is reduced by pyelonephritis and rises with successful treatment. This suggests the dosing interval should be reduced from 6h to 4h after the first 24h of therapy. Fetal Health
Ampicillin-sulbactam reduces neonatal infectious morbidity after PPROM, but to no greater extent than erythromycin, which also prolongs the latency interval. There is no substantive evidence of teratogenicity. Rodent studies are reassuring, revealing no 50 evidence of teratogenicity or IUGR despite the use of doses higher than those used clinically. Breastfeeding
Minimal amounts of ampicillin-sulbactam are excreted in breast milk. It is generally considered compatible with breastfeeding.
the follwing drugs will increse Ampicillin by inhepiting cyp450
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the follwing drugs will decrease Ampicillin by inhancing cyp450
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trad drugs based on Ampicillin
| Gen name | Trade name | Catagory name |
| ampicillin / sulbactam | Unasyn | Beta-lactamase inhibitors |
| Ampicillin | AMPICILLIN 1GM POWDER FOR IV AND IM INJECTION | |
| Ampicillin | AMPICILLIN 500MG POWDER FOR IV AND IM INJECTION | |
| Ampicillin | AMPIPLUS 1.5GM POWDER FOR INGECTION | |
| Ampicillin | EPICOCILLIN VIAL 1G | |
| Ampicillin | EPICOCILLIN VIAL 500MG | |
| Ampicillin | PENBRITIN VIAL 250 MG | |
| Ampicillin | STANDACILLIN 1G VIAL WITH SOLVENT | |
| Ampicillin | STANDACILLIN 500MG INJ WITH SOLVENT | |
other drugs from same cataogory