16 . December , 2017 - Saturday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Ampicillin

Big Image Pronouncation: (am-pih-SILL-in)
Class: Aminopenicillin

Trade Names:
Principen
- Capsules 250 mg (as trihydrate)
- Capsules 500 mg (as trihydrate)
- Powder for oral suspension 125 mg/5 mL (as trihydrate) when reconstituted
- Powder for oral suspension 250 mg/5 mL (as trihydrate) when reconstituted

Trade Names:
Ampicillin Sodium
- Powder for injection 250 mg
- Powder for injection 500 mg
- Powder for injection 1 g
- Powder for injection 2 g

APO-Ampi (Canada)
Novo Ampicillin (Canada)
Nu-Ampi (Canada)

Mechanism of Action

Pharmacology

Inhibits bacterial cell wall mucopeptide synthesis.

Pharmacokinetics

Absorption

Well absorbed from GI tract. C max is approximately 3 mcg/mL (500 mg capsules) and 3.4 mcg/mL (500 mg oral suspension). Food affects absorption; take on empty stomach.

Distribution

Diffuses readily into most body tissues and fluids; penetrates into the CSF and brain only when meninges are inflamed. Approximately 20% protein bound; excreted in breast milk.

Elimination

Excreted largely unchanged in the urine.

Special Populations

Renal Function Impairment

T 1/2 may be prolonged. Dosing interval adjustments may be necessary.

Indications and Usage

Treatment of respiratory, GI, and GU tract and soft tissue infections, bacterial meningitis and enterococcal endocarditis, septicemia and gonococcal infections caused by susceptible microorganisms.

Unlabeled Uses

Prophylaxis in Cesarean section in certain high risk patients.

Contraindications

Hypersensitivity to penicillins, cephalosporins or imipenem. Oral form not used to treat severe pneumonia, empyema, bacteremia, pericarditis, meningitis, and purulent or septic arthritis during acute stage.

Dosage and Administration

Enterococcal Endocarditis
Adults

IV 12 g/day either continuously or in equally divided doses every 4 h plus mg/kg IM or IV gentamicin every 8 h for 4 to 6 wk.

Respiratory Tract and Soft Tissue Infections
Adults and children (at least 40 kg)

IV/IM 250 to 500 mg every 6 h.

Children (less than 40 kg)

IV/IM 25 to 50 mg/kg/day in equally divided doses every 6 to 8 h.

Adults and children (more than 20 kg)

PO 250 mg every 6 h.

Children (20 kg or less)

PO 50 mg/kg/day in equally divided dose every 6 to 8 h.

Bacterial Meningitis
Adults and children

Initial treatment is usually IV followed by IM 150 to 200 mg/kg/day in equally divided doses every 3 to 4 h.

Septicemia
Adults and children

IV 150 to 200 mg/kg/day for at least 3 days followed by IM every 3 to 4 h.

GI and GU Infections (Other Than N. gonorrhea )
Adults and children (more than 20 kg)

PO 500 mg every 6 h; use larger doses for severe or chronic infections, if needed.

Children (20 kg or less)

PO 100 mg/kg/day in equally divided doses every 6 h.

GI and GU infections ( N. gonorrhea )
Adults

PO 3.5 g administered simultaneously with 1 g probenecid.

Adults and children (at least 40 kg)

IV/IM 500 mg every 6 h.

Children (less than 40 kg)

IV/IM 50 mg/kg/day in equally divided doses every 6 to 8 h.

Urethritis caused by N. gonorrhea
Adult males

IV/IM Two 500 mg doses at an interval of 8 to 12 h. Dose may be repeated if necessary. In complicated gonorrheal urethritis, intensive therapy is recommended.

Drug Interactions

Allopurinol

Increases potential for ampicillin-induced skin rash.

Atenolol

Antihypertensive and antianginal effects may be impaired.

Contraceptives, oral

May reduce efficacy of oral contraceptives.

Tetracyclines

May impair bactericidal effects of ampicillin.

Incompatibility

Do not mix with aminoglycosides (eg, gentamicin).

Laboratory Test Interactions

May cause false-positive urine glucose test results with Benedict solution, Fehling solution, or Clinitest tablets (enzyme-based tests, eg, Clinistix , Tes-tape , are recommended); false-positive direct Coombs test result in certain patient groups; false-positive protein reactions with sulfosalicylic acid and boiling test, acetic acid test, biuret reaction and nitric acid test (the bromphenol blue test, Multistix , is recommended).

Adverse Reactions

Cardiovascular

Thrombophlebitis at injection site.

CNS

Dizziness; fatigue; insomnia; reversible hyperactivity; neurotoxicity (eg, lethargy, neuromuscular irritability, hallucinations, convulsions, seizures).

Dermatologic

Urticaria; maculopapular to exfoliative dermatitis; vesicular eruptions; erythema multiforme; skin rashes.

EENT

Itchy eyes; laryngospasm; laryngeal edema.

GI

Diarrhea; pseudomembranous colitis.

Genitourinary

Interstitial nephritis (eg, oliguria, proteinuria, hematuria, hyaline casts, pyuria); nephropathy; increased BUN and creatinine; vaginitis.

Hematologic

Decreased Hgb, Hct, RBC, WBC, neutrophils, lymphocytes, platelets; increased lymphocytes, monocytes, basophils, eosinophils, and platelets.

Metabolic

Elevated serum alkaline phosphatase, glutamic oxaloacetic transaminase, ALT, AST, and LDH; reduced serum albumin and total proteins.

Miscellaneous

Pain at injection site; hyperthermia.

Precautions

Pregnancy

Category B .

Lactation

Excreted in breast milk.

Hypersensitivity

Reactions range from mild to life threatening. Use cautiously in cephalosporin-sensitive patients because of possible cross-allergenicity.

Renal Function

Use cautiously with altered dosing interval.

Superinfection

May result in overgrowth of nonsusceptible bacterial or fungal organisms.

Overdosage

Symptoms

Hyperexcitability, convulsive seizures.

Patient Information

  • Instruct patient to time the doses evenly over a 24-h period.
  • Inform patient that medication works best on an empty stomach, but may be taken with food if there is GI upset.
  • Tell patient to increase fluid intake to 2,000 to 3,000 mL/day, unless contraindicated.
  • Advise patient to refrigerate oral liquid preparations, and to discard unrefrigerated preparations that are more than 7 days old.
  • Inform patient to notify health care provider immediately if rash develops or if having difficulty breathing.
  • Warn diabetic patient that product may cause false-positive glucose urine test results, and identify alternative tests.
  • If therapy is changed because of allergic reaction, explain the significance of penicillin allergy and inform of potential sensitivity to cephalosporins.

Recent Drug Updates at DrugIndexOnline:





Advicor Advicor
Generic Name: lovastatin and niacin (LOE va stah tin and NYE a sin) Brand Names: Advicor What is Advicor (lovastatin and niacin)? Lovastatin blocks the production of cholesterol (a type of fat) in the body. Niacin, also known as nicotinic acid, is vitamin B3. It occurs naturally in plan more...

Canasa Suppositories Canasa Suppositories
Generic Name: Mesalamine Suppositories (me-SAL-a-meen) Brand Name: CanasaCanasa Suppositories is used for:Treating various forms of mild to moderate inflammation of the colon. Canasa Suppositories is a 5-aminosalicylic acid (5-ASA). It works by preventing the production of substances that cause more...

Hydralazine Tablets Hydralazine Tablets
Generic Name: Hydralazine Tablets (hye-DRAL-a-zeen) Brand Name: Generic only. No brands available.Hydralazine is used for:Treating high blood pressure. It may be used alone or in combination with other medicines. It may also be used for other conditions as determined by your doctor. Hydralazine i more...

Liquiprin Children's Elixir Liquiprin Children's Elixir
Some commonly used brand names are: In the U.S.— Aceta Elixir 1 Aceta Tablets 1 Acetaminophen Uniserts 1 Actamin 1 Actamin Extra 1 Actamin Super 2 Aminofen 1 Aminofen Max 1 Apacet Capsules 1 Apacet Elixir 1 Apacet Extra Strength Caplets 1 Apacet Extra Strength Tablets 1 Apacet, Infants' 1 more...

Methylin ER Methylin ER
Generic Name: methylphenidate (meth il FEN i date) Brand Names: Concerta, Metadate CD, Metadate ER, Methylin, Methylin ER, Ritalin, Ritalin LA, Ritalin-SR What is Methylin ER (methylphenidate)? Methylphenidate is a central nervous system stimulant. It affects chemicals in the brain and more...

Pediatex HC Liquid Pediatex HC Liquid
Generic Name: Chlorpheniramine/Hydrocodone/Pseudoephedrine Liquid and Syrup (klor-fen-EER-a-meen/hye-droe-KOE-done/sue-do-eh-FED-rin) Brand Name: Examples include Histinex PV and Pediatex HCPediatex HC Liquid is used for:Relieving symptoms of sinus congestion, runny nose, sneezing, and cough du more...

Pilocarpine Pilocarpine
Some commonly used brand names are: In the U.S.— Salagen In Canada— Salagen † Not commercially available in Canada. Category Cholinergic Description Pilocarpine (pye-loe-KAR-peen) tablets are used to treat dryness of the mouth and throat caused by a decrease in the more...

Propiomazine Propiomazine
Some commonly used brand names are: In the U.S.— Largon † Not commercially available in Canada. Category Sedative-hypnotic Description Propiomazine (proe-pee-OH-ma-zeen) is used to produce sleepiness or drowsiness and to relieve anxiety before or during surgery or certain more...