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Beamoxy

DESCRIPTION

Beamoxy Capsule 250 (A size 2, Maroon/Yellow, marked 'UPHA/BEAMOXY 250' capsule)

Beamoxy Capsule 500 (A size 0, Maroon/Yellow, marked 'UPHA/BEAMOXY 500' capsule)

Beamoxy Tablet 250 (A capsule shape, scored, marked 'USP 250', yellow tablet)

Beamoxy Tablet 500 (A capsule shape, scored, marked 'UP/500', yellow tablet)
Beamoxy Granules 125/Beamoxy Granules 250 (An almost white powder when reconstituted forms a yellow, fruity flavoured, homogeneous suspension)

INDICATIONS
Amoxycillin is an aminopenicillin, which has activity against penicillin-sensitive gram-positive bacteria, as well as Escherichia coli, Proteus mirabilis, Salmonella sp., Shigella sp., and Haemophilus influenzae. However, many Enterobacteriacaea, H. Influenzae, Salmonella and Shigella species are resistant to this penicillin because of beta-lactamase production by these organisms. Amoxycillin can he administered orally for the treatment of the following caused by susceptible bacterial organisms:
• Bronchitis
• Biliary Tract Infections
• Uncomplicated Endocervical and Urethral Gonorrhoea (caused by susceptible strains of Neisseria gonorrhoea)
• Acute Otitis Media
• Mouth Infections
• Pharyngitis
• Pneumonia
• Sinusitis
• Urinary Tract Infections
• Gastro-enteritis (including E. Coli enteritis and Salmonella enteritis)
• Lyme Disease (early stages monotherapy and later stages in combination with prohenecid)
• Typhoid Fever

Amoxycillin is a possible alternative to erythromycin, for chlamydial infections in pregnant women.

Amoxycillin is also indicated as prophylaxis for spleen disorders (pneumococcal infection) and bacterial endocarditis and adjunct for Helicobacter pylori-associated peptic ulcer.

MECHANISMS OF ACTION
Amoxycillin is bactericidal and acts by inhibiting bacterial cell wall synthesis. Its action is dependent on its ability to reach and bind penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. PBPs are enzymes responsible for the assembling and reshaping of the bacterial cell wall during growth and division. PBPs inactivation by amoxycillin results in the weakening and lysis of the bacterial cell wall.

PHARMACOLOGY
Amoxycillin is fairly well absorbed from the GIT It is more rapidly and more completely absorbed than ampicillin orally. Amoxycillin is acid-stable. Peak plasma concentrations of about 5 microgram per ml have been observed 1-2 hours after a dose of 250mg, with detectable amounts present for up to 8 hours. Doubling the dose can double the concentration. Total amount absorbed is not significantly affected by food. About 20% is plasma protein bound. The plasma half-life is about 1-1.5 hours and this increases in renal failure, neonates and the elderly. Amoxycillin is widely distributed at varying concentrations in body tissues and fluids, including peritoneal fluid, blister fluid, pleural fluid, middle ear fluid, intestinal mucosa, bone, gallbladder, urine(high concentrations), lung, female reproductive tissue and bile. It crosses the placenta and small amounts are excreted in breast milk. Little amoxycillin passes into the CSF unless the meninges are inflamed. Amoxycillin is metabolised to a limited extent to penicilloic acid which is excreted in the urine. About 60% of an oral dose is excreted unchanged in the urine in 6 hours by glomerular filtration and tubular secretion; urinary concentrations above 300 microgram per ml have been reported after a dose of 250mg. High concentrations have been reported in bile; some may he excreted in the faeces.

DOSAGE
The usual adult dose is 250 - 500mg every 8 hours. The adult prescribing limit is up to 4.5g a day.

Adults:

Children:

OVERDOSAGE
There is no specific antidote, treatment of amoxycillin overdose should be symptomatic and supportive. Amoxycillin may be removed from circulation by haemodialysis. Serious hypersensitivity reactions have been reported in patients on penicillin therapy. Serious anaphylactic reactions require immediate emergency treatment with parenteral epinephrine, oxygen, intravenous corticosteroids or air management (including inTubation).

For Clostridium difficile colitis, mild cases may respond to discontinuation of the medication alone. Moderate to severe cases may require fluid, electrolyte, and protein replacement. In cases not responding to the above measures, oral doses of the following may be used:

If diarrhoea occurs, administration of antiperistaltic antidiarrhoeals (e.g. opioids, diphenoxylate and atropine combination, loperamide, paregoric) is not recommended since they may delay the removal of toxins from the colon, thereby prolonging and/ or worsening the condition.

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